Occurrence of anticancer drugs in the aquatic environment: a systematic review (original) (raw)
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A Human Health Risk Assessment of Pharmaceuticals in the Aquatic Environment
Human and Ecological Risk Assessment, 2002
Analyses were conducted on four pharmaceutical compounds, representing different therapeutic classes, to evaluate the presence and potential adverse human health effects of trace levels of these substances in aqueous environmental media. Acetylsalicylic acid, clofibrate, cyclophosphamide, and indomethacin have been detected in aqueous environmental media including sewage treatment plant effluent, surface water, drinking water, and groundwater. An extensive literature search and chemical-specific risk assessments were performed to assess the potential human health significance of each compound's individual presence in environmental media. Safe water quality limits were estimated for each pharmaceutical by following the USEPA Methodology for Deriving Ambient Water Quality Criteria for the Protection of Human Health and were compared to the concentrations found in the environment. The calculation of the provisional ambient water quality criteria involved estimation of human exposure to contaminated water, including intake via bioaccumulation in fish, and calculation of cancer risk and non-cancer hazard indices. Parameters detailing the toxicological and pharmacological nature, exposure assessment, and environmental fate and transport of each pharmaceutical were also considered. The overall conclusion was that based on available data, no appreciable risk to humans exists, as the detected concentrations of each of these pharmaceutical compounds found in aqueous media were far below the derived safe limits.
Occurrence of pharmaceuticals in surface waters
2021
The present work illustrates the development of an analytical method, based on offline solid phase extraction (SPE) followed by liquid chromatography-electron spray ionisation-single quadrupole mass spectrometry (LC-ESI-MS) for the simultaneous determination of pharmaceuticals belonging to various therapeutic classes (analgesics/anti-inflammatories, lipid regulators, antibiotics, antiepileptics, antipsychotics, psychomotor stimulants, glucocorticoid steroids, disinfectants, beta-blockers, H2 receptor antagonists and oestrogens) in surface waters. The method developed was applied for the analysis of pharmaceutical residues in surface waters from different sampling points along the aquatic systems of Lake Pamvotis and the River Kalamas, close to the city of Ioannina (Epirus, Greece), while the monitoring programme was carried out during the four seasons of the year. According to the results obtained, the majority of the compounds were detected in discrepant concentrations. The concentrations for all the compounds ranged from levels below quantification limit to 3506 ng/L, with caffeine and salicylic acid being the ubiquitous compounds. The results of the monitoring contributed substantially to the knowledge on the occurrence of pharmaceuticals in Greece and more specifically in surface waters of the region of Epirus. Regarding the environmental risk due to the presence of target compounds in surface waters, this was estimated calculating risk quotients (RQs) for different aquatic organisms (algae, daphnids and fish). The results denoted a possible threat for the aquatic environment, rendering in this way the RQ method as a helpful tool for a first approach. Extensive study is needed for triclosan, salicylic acid, sulfamethoxazole and erythromycin in order to better correlate their occurrence and potential toxic effects in aquatic life and humans.
Molecules, 2020
Potential risks associated with releases of human pharmaceuticals into the environment have become an increasingly important issue in environmental health. This concern has been driven by the widespread detection of pharmaceuticals in all aquatic compartments. Therefore, 22 pharmaceuticals, 6 metabolites and transformation products, belonging to 7 therapeutic groups, were selected to perform a review on their toxicity and environmental risk assessment (ERA) in different aquatic compartments, important issues to tackle the water framework directive (WFD). The toxicity data collected reported, with the exception of anxiolytics, at least one toxicity value for concentrations below 1 µg L −1. The results obtained for the ERA revealed risk quotients (RQs) higher than 1 in all the aquatic bodies and for the three trophic levels, algae, invertebrates and fish, posing ecotoxicological pressure in all of these compartments. The therapeutic groups with higher RQs were hormones, antiepileptics, anti-inflammatories and antibiotics. Unsurprisingly, RQs values were highest in wastewaters, however, less contaminated water bodies such as groundwaters still presented maximum values up to 91,150 regarding 17α-ethinylestradiol in fish. Overall, these results present an important input for setting prioritizing measures and sustainable strategies, minimizing their impact in the aquatic environment.
Determination of Anticancer Drugs in the Aquatic Environment by SPE-LC-MS/MS-A Lebanese Case Study
Water, 2023
Compared to other countries in the Middle East and North Africa region, Lebanon is considered the richest in water resources. However, due to inadequate water management, Lebanese water resources are under stress. Previous studies in Lebanon were mainly focused on heavy metals and microbiological analysis. Following the increase in cancer rates in Lebanon, the occurrence of six anticancer drugs estimated to be the most administered in Lebanon was assessed in samples collected from wastewater treatment plants (WWTPs), sewage outfalls, and surface water. Two SPE–LC–MS/MS methods were developed and validated for the detection of the selected anticancer drugs with LOD values ranging between 0.1 and 0.9 ng/L and LOQ values ranging between 0.3 and 2.8 ng/L. Three anticancer drugs were detected using this technique, 5-fluorouracil, methotrexate, and cyclophosphamide, with an overall concentration range of 1 to 305 ng/L. The detection of these drugs in WWTP effluents, sewage outfalls, and rivers confirmed the weaknesses prevailing in the management of wastewater and the treatment technologies adopted by the few operational WWTPs in Lebanon.
Antineoplastic Agents: Environmental Prevalence and Adverse Outcomes in Aquatic Organisms
Antineoplastic Agents: Environmental Prevalence and Adverse Outcomes in Aquatic Organisms, 2020
Cancer is the second leading cause of death worldwide, with 9.6 million cancer-related deaths in 2018. Cancer incidence has increased over time, and so has the prescription rate of chemotherapeutic drugs. These pharmaceuticals, known as antineoplastic agents, enter the aquatic environment via human excretion and wastewater. The objectives of the present critical review were to investigate the risk of antineoplastics to aquatic species and to summarize the current state of knowledge regarding their levels in the environment, because many antineoplastics are not adequately removed during wastewater treatment. We conducted 2 separate literature reviews to synthesize data on the global environmental prevalence and toxicity of antineoplastics. The antineoplastics most frequently detected in the environment included cyclophosphamide, ifosfamide, tamoxifen, methotrexate, and 5-fluorouracil; all were detectable in multiple water sources, including effluent and surface waters. These antineoplastics span 3 different mechanistic classes, with cyclophosphamide and ifosfamide classified as alkylating agents, tamoxifen as a hormonal agent, and methotrexate and 5-fluorouracil as antimetabolites. Studies that characterize the risk of antineoplastics released into aquatic environments are scarce. We summarize the biological impacts of the most environmentally prevalent antineoplastics on aquatic organisms and propose an adverse outcome pathway for cyclophosphamide and ifosfamide, 2 widely prescribed drugs with a similar immunotoxic mode of action. Acute and chronic ecotoxicity studies using aquatic models are needed for risk characterization of antineoplastics. Environ Toxicol Chem 2020;00:1-19. © 2020 SETAC
Environmental risk assessment of anti-cancer drugs and their transformation products is a major concern worldwide due to two main factors: the consumption of chemotherapeutic agents is increasing throughout the years and conventional water treatment processes seem to be ineffective. The aim of the study is to investigate the consumption of anticancer drugs and assess their potential health hazard as contaminants of the Lebanese surface waters. Data on yearly consumption of 259 anti-neoplastic drugs over the years 2013 to 2018 were collected and the following parameters were calculated: yearly consumption of single active ingredients, yearly consumption of drug equivalents (for drugs belonging to the same pharmacologic class/ having the same active ingredient) and Predicted Environmental Concentrations (PECs). The classification of compounds into risk categories was based on exposure using PECs. The top five most commonly consumed drugs are Mycophenolate mofetil, Hydroxycarbamide, Ca...
Human health risk assessment from the presence of human pharmaceuticals in the aquatic environment
Regulatory Toxicology and Pharmacology, 2009
Analyses were conducted on four pharmaceutical compounds, representing different therapeutic classes, to evaluate the presence and potential adverse human health effects of trace levels of these substances in aqueous environmental media. Acetylsalicylic acid, clofibrate, cyclophosphamide, and indomethacin have been detected in aqueous environmental media including sewage treatment plant effluent, surface water, drinking water, and groundwater. An extensive literature search and chemical-specific risk assessments were performed to assess the potential human health significance of each compound's individual presence in environmental media. Safe water quality limits were estimated for each pharmaceutical by following the USEPA Methodology for Deriving Ambient Water Quality Criteria for the Protection of Human Health and were compared to the concentrations found in the environment. The calculation of the provisional ambient water quality criteria involved estimation of human exposure to contaminated water, including intake via bioaccumulation in fish, and calculation of cancer risk and non-cancer hazard indices. Parameters detailing the toxicological and pharmacological nature, exposure assessment, and environmental fate and transport of each pharmaceutical were also considered. The overall conclusion was that based on available data, no appreciable risk to humans exists, as the detected concentrations of each of these pharmaceutical compounds found in aqueous media were far below the derived safe limits.
Journal of Hydrology, 2008
This opinion paper assesses for the UK, whether the current use of cytotoxic drugs, one of the most toxic pharmaceuticals in common use, could pose a risk to aquatic organisms and to humans through water recycling. A water quality model was set up for one of these drugs, 5-fluorouracil, in the Aire and Calder catchment in Northern UK. The study predicts 5-50 ng/L concentrations for long stretches of this catchment under low flow conditions. Due to their mode of action, practically all eukaryotic organisms are vulnerable to damage, with teratogenicity being the greatest concern at such levels. However, it is unclear to what extent the predicted low concentrations would affect flora and fauna in receiving waters but there may be an additive effect of a mixture of cytotoxic drugs which should be taken into account. The exposure of the pregnant mother, or more specifically her foetus, to these drugs via drinking water should be minimised. Current drinking water purification technology gives grounds for optimism on removal of these compounds, but no appropriate data exist yet.
Prioritising anticancer drugs for environmental monitoring and risk assessment purposes
Science of The Total Environment, 2014
Anticancer drugs routinely used in chemotherapy enter wastewater through the excretion of the nonmetabolised drug following administration to patients. This study considers the consumption and subsequent behaviour and occurrence of these chemicals in aquatic systems, with the aim of prioritising a selection of these drugs which are likely to persist in the environment and hence be considered for environmental screening programmes. Accurate consumption data were compiled from a hospital survey in NW England and combined with urinary excretion rates derived from clinical studies. Physical-chemical property data were compiled along with likely chemical fate and persistence during and after wastewater treatment. A shortlist of 15 chemicals (from 65) was prioritised based on their consumption, persistency and likelihood of occurrence in surface waters and supported by observational studies where possible. The ecological impact of these 'prioritised' chemicals is uncertain as the measured concentrations in surface waters generally fall below standard toxicity thresholds. Nonetheless, this prioritised sub-list should prove useful for developing environmental screening programmes.
Selected Pharmaceuticals in Different Aquatic Compartments: Part I—Source, Fate and Occurrence
Molecules, 2020
Potential risks associated with releases of human pharmaceuticals into the environment have become an increasingly important issue in environmental health. This concern has been driven by the widespread detection of pharmaceuticals in all aquatic compartments. Therefore, 22 pharmaceuticals, 6 metabolites and transformation products, belonging to 7 therapeutic groups, were selected to perform a systematic review on their source, fate and occurrence in different aquatic compartments, important issues to tackle the Water Framework Directive (WFD). The results obtained evidence that concentrations of pharmaceuticals are present, in decreasing order, in wastewater influents (WWIs), wastewater effluents (WWEs) and surface waters, with values up to 14 mg L −1 for ibuprofen in WWIs. The therapeutic groups which presented higher detection frequencies and concentrations were anti-inflammatories, antiepileptics, antibiotics and lipid regulators. These results present a broad and specialized background, enabling a complete overview on the occurrence of pharmaceuticals in the aquatic compartments.