Contribution of hospital effluents to the load of pharmaceuticals in urban wastewaters: identification of ecologically relevant pharmaceuticals

Occurrence and enantiomer profiles of β-blockers in wastewater and a receiving water body and adjacent soil in Tianjin, China

A total of 58 samples were collected from hospitals, municipal wastewater treatment plants (WWTPs), a receiving water body (Dagu Drainage Canal, DDC), and adjacent farmland in Tianjin City, China, in May and November 2013 and were analyzed for five common β-blockers (atenolol, sotalol, metoprolol, propranolol, and nadolol) to elucidate their source, occurrence and fate in a typical city in China. The profiles of the enantiomers of the β-blockers in some samples were examined. Sotalol, metoprolol and propranolol were frequently detected, atenolol was less frequently detected, and nadolol was mostly not detected. Generally, the concentrations in hospital wastewaters occurred from <LOQ to 10 μg/L, while concentrations in municipal WWTP water samples ranged from <LOQ to 5.2 μg/L. Hence, both hospitals and WWTPs acted as sources of β-blockers in the environment. Sotalol, metoprolol and propranolol were determined in soils adjacent to the DDC with concentrations up to hundreds of ng/kg in the topsoil and declining levels in the subsoil. Seasonal variation was observed with samples obtained in May showing higher concentrations, both in the canal and the adjacent soil, which could be ascribed to greater consumption of these drugs, lower temperature and less precipitation in the spring and the former winter. Enantiomeric fractions (EFs) of metoprolol and propranolol in soil samples showed a trend of enrichment of E1 (first-eluted) compared to E2 (second-eluted), while sotalol was almost racemic. In the DDC, no significant difference was found for the pair enantiomers of each β-blocker, while in hospital and WWTP wastewaters, E1 predominated.

Environmental risk assessment of metformin and its transformation product guanylurea. I. Environmental fate

Metformin (MET) is a pharmaceutical with very high use worldwide that is excreted in unchanged form, leading to concern about potential aquatic life impacts associated with MET, and its primary transformation product guanylurea (GUU). This study presents, in two companion papers, a risk assessment following internationally accepted guidelines of MET and GUU in surface water based on literature data, previously unpublished studies, and a new degradation test that resolves conflicting earlier results. Previous studies have shown that MET is removed during sewage treatment, primarily through transformation to GUU. In addition, measurements in WWTPs suggest that MET is not only transformed to GUU, but that GUU is further biodegraded. A prolonged inherent biodegradation test strongly suggests not only primary transformation of MET to GUU, but also subsequent full mineralization of GUU, with both degradation phases starting after a clear lag phase. MET may partition from surface water to sediment, where both transformation to GUU and in part mineralization is possible, depending on the presence of competent degrading microorganisms. In addition, MET may form non-extractable residues in sediments (12.8-73.5%). Both MET and GUU may be anaerobically degraded during sludge digestion, in soils or in sediments. Bioconcentration factor (BCF) values in crops and most plants are close to 1 suggesting low bioaccumulation potential, moreover, at least some plants can metabolize MET to GUU; however, in aquatic plants higher BCFs were found, up to 53. Similarly, neither MET nor GUU are expected to bioaccumulate in fish based on estimated values of BCFs ≤3.16.

Comparison of Prioritisation Schemes for Human Pharmaceuticals in the Aquatic Environment

Only a small proportion of pharmaceuticals available for commercial use have been monitored in the aquatic environment, and even less is known about the effects on organisms. With thousands of pharmaceuticals in use, it is not feasible to monitor or assess the effects of all of these compounds. Prioritisation schemes allow the ranking of pharmaceuticals based on their potential as environmental contaminants, allowing resources to be appropriately used on those which are most likely to enter the environment and cause greatest harm. Many different types of prioritisation schemes exist in the literature and those utilising predicted environmental concentrations (PECs), the fish plasma model (FPM), critical environmental concentrations (CECs) and acute ecotoxicological data were assessed in the current study using the 50 most prescribed drugs in the UK. PECs were found to be overestimates of mean measured environmental concentrations but mainly underestimations of maximum concentrations. Acute ecological data identified different compounds of concern to the other effects assessments although the FPM and CECs methods were more conservative. These schemes highlighted antidepressants, lipid regulators, antibiotics, antihypertensive compounds and ibuprofen as priority compounds for further study and regulation.

Effect of ciprofloxacin dosages on the performance of sponge membrane bioreactor treating hospital wastewater

This study aimed to evaluate treatment performance and membrane fouling of a lab-scale Sponge-MBR under the added ciprofloxacin (CIP) dosages (20; 50; 100 and 200 µg L^-1) treating hospital wastewater. The results showed that Sponge-MBR exhibited effective removal of COD (94-98%) during the operation period despite increment of CIP concentrations from 20 to 200 µg L^-1. The applied CIP dosage of 200 µg L^-1 caused an inhibition of microorganisms in sponges, i.e. significant reduction of the attached biomass and a decrease in the size of suspended flocs. Moreover, this led to deteriorating the denitrification rate to 3-12% compared to 35% at the other lower CIP dosages. Importantly, Sponge-MBR reinforced the stability of CIP removal at various added CIP dosages (permeate of below 13 µg L^-1). Additionally, the fouling rate at CIP dosage of 200 µg L^-1 was 30.6 times lower compared to the control condition (no added CIP dosage).

Toxicity of erythromycin to Oncorhynchus mykiss at different biochemical levels: detoxification metabolism, energetic balance, and neurological impairment

During the last decades, the presence of antibiotics in different aquatic compartments has raised increasing interest and concern, since these compounds are usually persistent and bioactive pseudo pollutants. Erythromycin (ERY) is a macrolide antibiotic, prescribed for human and veterinary medicines but also used in aquaculture and livestock production. Taking into account the recorded environmental levels of ERY, its toxicity to non-target organisms has become a still poorly studied issue, particularly in fish. In this sense, this study investigated the acute and chronic effects of realistic levels of ERY on Oncorhynchus mykiss (rainbow trout), namely, through the quantification of the activity of enzymes involved in different biochemical pathways, such as detoxification (phase I-7-ethoxyresorufin O-deethylase (EROD); phase II-glutathione S-transferases (GSTs), uridine-diphosphate-glucuronosyltransferases (UGTs)), neurotransmission (acetylcholinesterase (AChE)), and energy production (lactate dehydrogenase (LDH)). Both types of exposure caused significant increases in EROD activity in liver of O. mykiss; an increase in GST activity in gills after chronic exposure was also observed. UGT branchial activity was significantly depressed, following the long-term exposure. Thus, EROD, GST, and UGT enzymatic forms seem to be involved in the biotransformation of ERY. In terms of neurotransmission and preferential pathway of energy homeostasis, the exposed organisms appear not to have been affected, as there were no significant alterations in terms of AChE and LDH activities, respectively. The here-obtained data suggest that the observed alterations in terms of detoxification enzymes may have prevented the establishment of a set of toxic responses, namely, neurotoxic and metabolic disorders.

Antibiotics in hospital effluents: occurrence, contribution to urban wastewater, removal in a wastewater treatment plant, and environmental risk assessment

The study presented the occurrence of antibiotics in 16 different hospital effluents, the removal of antibiotics in urban wastewater treatment plant (WWTP), and the potential ecotoxicological risks of the effluent discharge on the aquatic ecosystem. The total concentration of antibiotics in hospital effluents was ranged from 21.2 ± 0.13 to 4886 ± 3.80 ng/L in summer and from 497 ± 3.66 to 322,735 ± 4.58 ng/L in winter. Azithromycin, clarithromycin, and ciprofloxacin were detected the highest concentrations among the investigated antibiotics. The total antibiotic load to the influent of the WWTP from hospitals was 3.46 g/day in summer and 303.2 g/day in winter. The total antibiotic contribution of hospitals to the influent of the WWTP was determined as 13% in summer and 28% in winter. The remaining 87% in summer and 72% in winter stems from the households. The total antibiotic removal by conventional physical and biological treatment processes was determined as 79% in summer, whereas it decreased to 36% in winter. When the environmental risk assessment was performed, azithromycin and clarithromycin in the effluent from the treatment plant in winter posed a high risk (RQ > 10) for the aquatic organisms (algae and fish) in the receiving environment. According to these results, the removal efficiency of antibiotics at the WWTP is inadequate and plant should be improved to remove antibiotics by advanced treatment processes.

Application of experimental design methodology to optimize antibiotics removal by walnut shell based activated carbon

Three-level Box-Behnken experimental design with three factors (pH, temperature and antibiotic initial concentration) combined with response surface methodology (RSM) was applied to study the removal of Metronidazole and Sulfamethoxazole by walnut shell based activated carbon. This methodology enabled to identify the effects of the different factors studied and their interactions in the response of each antibiotic. The relationship between the independent variable (sorption capacity) and the dependent variables (pH, temperature and antibiotic concentration) was adequately modelled by second-order polynomial equation. The pH factor exerted a significant but distinct influence on the removal efficiency of both antibiotics. The removal of Metronidazole is favoured by increasing pH values, with the maximum value obtained for pH 8 - upper limit of the study domain; while Sulfamethoxazole displays a maximum value around 5.5, with a decrease in the extent of adsorption as the pH increases. The best conditions, predicted by the model, for the removal of the antibiotic Sulfamethoxazole (106.9 mg/g) are obtained at a temperature of 30 °C, initial concentration of 40 mg/L and a pH value of 5.5. For the antibiotic Metronidazole, the highest removal value (127 mg/g) is expected to occur at the maximum levels attributed to each of the factors (pH = 8, C_in = 40 mg/L, T = 30 °C). The results of isotherm experiments (at 20 °C and pH 6) displayed a good agreement with the models predictions. The maximum sorption capacity, estimated by the Langmuir model, was 107.4 mg/g for Metronidazole and 93.5 mg/g for Sulfamethoxazole.

Effect of hydraulic retention time on electricity generation using a solid plain-graphite plate microbial fuel cell anoxic/oxic process for treating pharmaceutical sewage

Treatment efficiency and electricity generation were evaluated using a solid plain-graphite plate microbial fuel cell (MFC) anoxic/oxic (A/O) process that treated pharmaceutical sewage using different hydraulic retention times (HRT). Short HRTs increased the volumetric organic loading rate, thereby reducing the MFC performance due to rapid depletion of the substrate (carbon/nitrogen source). The COD removal efficiency decreased from 96.28% at a HRT of 8 h to 90.67% at a HRT of 5 h. The removal efficiency of total nitrogen was reduced from 74.16% at a HRT of 8 h to 53.42% at a HRT of 5 h. A shorter HRT decreased the efficiency in treatment of the pharmaceutical products (PPs), which included acetaminophen, ibuprofen and sulfamethoxazole in an aerobic reactor because these antibiotic compounds inhibited the microbial activity of the aerobic activated sludge in the MFC A/O system. The average power density and coulombic efficiency values were 162.74 mW m^-2 and 7.09% at a HRT of 8 h and 29.12 mW m^-2 and 2.23% at a HRT of 5 h, respectively. The dominant bacterial species including Hydrogenophaga spp., Rubrivivax spp. and Leptothrix spp., which seem to be involved in PP biodegradation; these were identified in the MFC A/O system under all HRT conditions for the first time using next generation sequencing. Bacterial nanowires were involved in accelerating the transfer of electrons and served as mediators in the SPGRP biofilm. In conclusion, a SPGRP MFC A/O system at a HRT of 8 h gave better removal of COD, T-N and PPs, as well as generated more electricity.

Identification and quantification of 19 pharmaceutical active compounds and metabolites in hospital wastewater in Cameroon using LC/QQQ and LC/Q-TOF

Human pharmaceutical residues are a serious environmental concern. They have been reported to have eco, geno, and human toxic effects, and thus their importance as micropollutants cannot be ignored. These have been studied extensively in Europe and North America. However, African countries are still lagging behind in research on these micropollutants. In this study, the wastewaters of the University Teaching Hospital of Yaoundé (UTHY) were screened for the presence of active pharmaceutical ingredients and their metabolites. The screening was carried out using two methods: high-performance liquid chromatography coupled to a triple quadrupole analyzer (LC/QQQ) and high-performance coupled to a mass spectrometer with a time of flight analyzer (LC/Q-TOF). A total of 19 active pharmaceutical ingredients and metabolites were identified and quantified. The compounds identified include paracetamol (211.93 μg/L), ibuprofen (141 μg/L), tramadol (76 μg/L), O-demethyltramadol (141 μg/L), erythromycinanhydrate (7 μg/L), ciprofloxacin (24 μg/L), clarinthromycine (0.088 μg/L), azitromycine (0.39 μg/L), sulfamethoxazole 0.16 μg/L), trimetoprime (0.27 μg/L), caffeine (5.8 μg/L), carnamaeepine (0.94 μg/L), atenolol (0.43 μg/L), propranolol (0.3 μg/L), cimetidine (34 μg/L), hydroxy omeprazole (5 μg/L), diphenhydramine (0.38 μg/L), metformine (154 μg/L), and sucralose (13.07 μg/L).

Biological removal of pharmaceuticals from hospital wastewater in a pilot-scale staged moving bed biofilm reactor (MBBR) utilising nitrifying and denitrifying processes

Hospital wastewater contains high concentrations of pharmaceuticals, which pose risks to receiving waters. In this study, a pilot plant consisting of six moving bed biofilm reactors (MBBRs) in series (with the intention to integrate Biological Oxygen Demand (BOD) removal, nitrification and denitrification as well as prepolishing Chemical Oxygen Demand (COD) for ozonation) was built to integrate pharmaceutical removal and intermittent feeding of the latter reactors aimed for micropollutant removal. Based on the experimental resultss, nitrifying MBBRs achieved higher removal as compared to denitrifying MBBRs except for azithromycin, clarithromycin, diatrizoic acid, propranolol and trimethoprim. In the batch experiments, nitrifying MBBRs showed the ability to remove most of the analysed pharmaceuticals, with degradation rate constants ranging from 5.0 × 10^-3 h^-1 to 2.6 h^-1. In general, the highest degradation rate constants were observed in the nitrifying MBBRs while the latter MBBRs showed lower degradation rate constant. However, when the degradation rate constants were normalised to the respective biomass, the intermittently fed reactors presented the highest specific activity. Out of the 22 compounds studied, 17 compounds were removed with more than 20%.

Assessment of Pharmaceuticals, Personal Care Products, and Hormones in Wastewater Treatment Plants Receiving Inflows from Health Facilities in North West Province, South Africa

The presence of 17 pharmaceutical and personal care products (PPCPs) belonging to various therapeutic categories was investigated in two hospital wastewater treatment plants (WWTPs) in North West Province, South Africa. The compounds were extracted from wastewater samples by solid-phase extraction and analysed by liquid chromatography-tandem mass spectrometry. The results showed that ofloxacin, chloramphenicol, and bezafibrate were generally below the limit of quantification (LOQ) in the analysed samples. Acetaminophen and ibuprofen were the dominant pharmaceuticals in the influent streams with corresponding concentrations ranging from 21 to 119 μg/L and 0.3 to 63 μg/L, respectively. Both WWTPs were shown to have the capability to remove some of the target PPCPs, including acetaminophen (76-98%), tetracycline (15-93%), ibuprofen (44-99%), and triclocarban (13-98%). The monitoring of the target PPCPs in both influent and effluent samples of the investigated WWTPs revealed that the discharge of inadequately treated effluents could be contributing to the possible increase in the concentrations of these contaminants in the receiving environmental compartments. Further studies must be focused on the broader characterisation of these matrices in order to assess the potential ecological impacts of this waste disposal practice.

Wastewater chemical contaminants: remediation by advanced oxidation processes

Approximately 70% of the terrestrial area is covered with water, but only a small water fraction is compatible with terrestrial life forms. Due to the increment in human consumption, the need for water resources is increasing, and it is estimated that more than 40% of the population worldwide will face water stress/scarcity within the next few decades. Water recycling and reuse may offer the opportunity to expand water resources. For that, the wastewater treatment paradigm should be changed and adequately treated wastewater should be seen as a valuable resource instead of a waste product. It is easily understandable that the exact composition and constituent concentration of wastewater vary according to its different sources (industrial, agricultural, urban usage of water). Consequently, a variety of known and emerging pollutants like heavy metals, antibiotics, pesticides, phthalates, polyaromatic hydrocarbons, halogenated compounds and endocrine disruptors have been found in natural water reservoirs, due to the limited effectiveness of conventional wastewater treatment. The conventional approach consists of a combination of physical, chemical and biological processes, aiming at the removal of large sediments such as heavier solids, scum and grease and of organic content in order to avoid the growth of microorganisms and eutrophication of the receiving water bodies. However, this approach is not sufficient to reduce the chemical pollutants and much less the emerging chemical pollutants. In this review, after some considerations concerning chemical pollutants and the problematic efficiency of their removal by conventional methods, an update is presented on the successes and challenges of novel approaches for wastewater remediation based on advanced oxidation processes. An insight into wastewater remediation involving the photodynamic approach mediated by tetrapyrrolic derivatives will be underlined.

Ecotoxicological effects of losartan on the brown mussel Perna perna and its occurrence in seawater from Santos Bay (Brazil)

The antihypertensive losartan (LOS) has been detected in wastewater and environmental matrices, however further studies focused on assessing the ecotoxicological effects on aquatic ecosystems are necessary. Considering the intensive use of this pharmaceutical and its discharges into coastal zones, our study aimed to determine the environmental concentrations of LOS in seawater, as well as to assess the biological effects of LOS on the marine bivalve Perna perna. For this purpose, fertilization rate and embryolarval development were evaluated through standardized assays. Phase I (ethoxyresorufin O‑deethylase EROD and dibenzylfluorescein dealkylase DBF) and II (glutathione S-transferase GST) enzymes, glutathione peroxidase (GPx), Cholinesterase (ChE), lipoperoxidation (LPO) and DNA damage were used to analyze sublethal responses in gills and digestive gland of adult individuals. Lysosomal membrane stability was also assessed in hemocytes. Our results showed the occurrence of LOS in 100% of the analyzed water samples located in Santos Bay, Sao Paulo, Brazil, in a range of 0.2 ng/L-8.7 ng/L. Effects on reproductive endpoints were observed after short-term exposure to concentrations up to 75 mg/L. Biomarker responses demonstrated the induction of CYP450 like activity and GST in mussel gills exposed to 300 and 3000 ng/L of LOS, respectively. GPx activity was also increased in concentration of exposure to 3000 ng/L of LOS. Cyto-genotoxic effects were found in gills and hemocytes exposed in concentrations up to 300 ng/L. These results highlighted the concern of introducing this class of contaminants into marine environments, and pointed out the need to include antihypertensive compounds in environmental monitoring programs.

Prospective environmental risk assessment of mixtures in wastewater treatment plant effluents - Theoretical considerations and experimental verification

The aquatic environment is continually exposed to a complex mixture of chemicals, whereby effluents of wastewater treatment plants (WWTPs) are one key source. The aim of the present study was to investigate whether environmental risk assessments (ERAs) addressing individual substances are sufficiently protective for such coincidental mixtures. Based on a literature review of chemicals reported to occur in municipal WWTP effluents and mode-of-action considerations, four different types of mixtures were composed containing human pharmaceuticals, pesticides, and chemicals regulated under REACH. The experimentally determined chronic aquatic toxicity of these mixtures towards primary producers and the invertebrate Daphnia magna could be adequately predicted by the concept of concentration addition, with up to 5-fold overestimation and less than 3-fold underestimation of mixture toxicity. Effluents of a municipal WWTP had no impact on the predictability of mixture toxicity and showed no adverse effects on the test organisms. Predictive ERAs for the individual mixture components based on here derived predicted no effect concentrations (PNECs) and median measured concentrations in WWTP effluents (MC_eff) indicated no unacceptable risk for any of the individual chemicals, while MC_eff/PNEC summation indicated a possible risk for multi-component mixtures. However, a refined mixture assessment based on the sum of toxic units at species level indicated no unacceptable risks, and allowed for a safety margin of more than factor 10, not taking into account any dilution of WWTP effluents by surface waters. Individual substances, namely climbazole, fenofibric acid and fluoxetine, were dominating the risks of the investigated mixtures, while added risk due to the mixture was found to be low with the risk quotient being increased by less than factor 2. Yet, uncertainty remains regarding chronic mixture toxicity in fish, which was not included in the present study. The number and identity of substances composing environmental mixtures such as WWTP effluents is typically unknown. Therefore, a mixture assessment factor is discussed as an option for a prospective ERA of mixtures of unknown composition.

Presence of pharmaceuticals in fish collected from urban rivers in the U.S. EPA 2008-2009 National Rivers and Streams Assessment

Fish are good indicators of aquatic environment pollution because of their capability to uptake pollutants contained in water. Therefore, accumulation of pharmaceutical compounds in freshwater and marine fish and other aquatic organisms has been studied extensively in the last decade. In this context, the present study investigates the occurrence of pharmaceutical compounds in wild fish from 25 polluted river sites in the USA, downstream from wastewater treatment plants (WWTPs). Sample sites constitute a subset of urban rivers investigated in the U.S. EPA's 2008-2009 National Rivers and Streams Assessment. Thirteen pharmaceuticals (out of the twenty compounds analyzed) were quantified in fish fillets at concentrations commonly below 10ngg^-1, in accordance with the findings from previous studies in the USA and Europe. The psychoactive drugs venlafaxine, carbamazepine and its metabolite 2-hydroxy carbamazepine were the most prevalent compounds (58%, 27% and 42%, respectively). This group of drugs is highly prescribed and rather resistant to degradation during conventional treatment in WWTPs as well as in natural aquatic environments. Salbutamol, a drug used to treat asthma, and the diuretic hydrochlorothiazide were also frequently detected (in >20% of the samples). Occurrence of six pharmaceutical families due to chronic exposure at environmental concentrations in water was detected in eight fish species.

Global review and analysis of erythromycin in the environment: Occurrence, bioaccumulation and antibiotic resistance hazards

Environmental observations of antibiotics and other pharmaceuticals have received attention as indicators of an urbanizing global water cycle. When connections between environment and development of antibiotic resistance (ABR) are considered, it is increasingly important to understand the life cycle of antibiotics. Here we examined the global occurrence of erythromycin (ERY) in: 1. wastewater effluent, inland waters, drinking water, groundwater, and estuarine and coastal systems; 2. sewage sludge, biosolids and sediments; and 3. tissues of aquatic organisms. We then performed probabilistic environmental hazard assessments to identify probabilities of exceeding the predicted no-effect concentration (PNEC) of 1.0 μg L^-1 for promoting ABR, based on previous modeling of minimum inhibitory concentrations and minimal selective concentrations of ERY, and measured levels from different geographic regions. Marked differences were observed among geographic regions and matrices. For example, more information was available for water matrices (312 publications) than solids (97 publications). ERY has primarily been studied in Asia, North America and Europe with the majority of studies performed in China, USA, Spain and the United Kingdom. In surface waters 72.4% of the Asian studies have been performed in China, while 85.4% of the observations from North America were from the USA; Spain represented 41.9% of the European surface water studies. Remarkably, results from PEHAs indicated that the likelihood of exceeding the ERY PNEC for ABR in effluents was markedly high in Asia (33.3%) followed by Europe (20%) and North America (17.8%). Unfortunately, ERY occurrence data is comparatively limited in coastal and marine systems across large geographic regions including Southwest Asia, Eastern Europe, Africa, and Central and South America. Future studies are needed to understand risks of ERY and other antibiotics to human health and the environment, particularly in developing regions where waste management systems and treatment infrastructure are being implemented slower than access to and consumption of pharmaceuticals is occurring.

Formation and occurrence of transformation products of metformin in wastewater and surface water

The aim of this work was to investigate the occurrence and fate of the antidiabetic metformin (MF) and its transformation products (TPs) in wastewater and surface water samples. New TPs of MF were approached by electrochemical degradation with a boron-doped-diamond electrode (at 1.5V for 10min). 2,4-Diamino-1,3,5-triazine (2,4-DAT), methylbiguanide (MBG), 2-amino-4-methylamino-1,3,5-triazine (2,4-AMT) and 4-amino-2-imino-1-methyl-1,2-dihydro-1,3,5-triazine (4,2,1-AIMT) were identified by hydrophilic interaction chromatography (HILIC) with quadrupole time-of-flight mass spectrometry (QTOF-MS) and accurate mass fragmentation. However, the well-known transformation product guanyl urea (GU) could not be formed electrochemically. In samples from wastewater treatment plants (WWTP), 2,4-AMT and 2,4-DAT showed an increasing trend from influents to effluents, which implies formation of the TPs during WWT. MBG is also formed by hydrolysis of MF and therefore didn't show this trend in WWTPs. Compared to GU, the concentrations of other TPs are generally three orders of magnitude lower. MBG and 2,4-DAT were also detected in surface water which was impacted by waste water, while 4,2,1-AIMT could not be detected in any sample. The concentrations of MF were in an expected range for influent (14 to 95μg/l), effluent (0.7 to 6.5μg/l), surface water (up to 234ng/l) and tap water (34ng/l). GU concentrations, however, were in one of the two investigated WWTP much higher in the influent (between 158μg/l and 2100μg/l) than in the effluent (between 26 and 810μg/l). This is a rather unexpected result which has not been reported yet. Obviously, GU has been already formed in parts of the sewer system from MF or from other biguanide compounds like antidiabetics or disinfection chemicals. Furthermore, lower concentrations of GU in the effluents than in the influents indicate degradation processes of guanyl urea in the waste water treatment.

Antibiotics in the aquatic environments: A review of lakes, China

The potential threat of antibiotics to the environment and human health has raised significant concerns in recent years. The consumption and production of antibiotics in China are the highest in the world due to its rapid economic development and huge population, possibly resulting in the high detection frequencies and concentrations of antibiotics in aquatic environments of China. As a water resource, lakes in China play an important role in sustainable economic and social development. Understanding the current state of antibiotics in lakes in China is important. Closed and semi-closed lakes provide an ideal medium for the accumulation of antibiotics and antibiotic resistance genes (ARGs). This review summarizes the current levels of antibiotic exposure in relevant environmental compartments in lakes. The ecological and health risks of antibiotics are also evaluated. This review concludes that 39 antibiotics have been detected in the aquatic environments of lakes in China. The levels of antibiotic contamination in lakes in China is relatively high on the global scale. Antibiotic contamination is higher in sediment than water and aquatic organisms. Quinolone antibiotics (QNs) pose the greatest risks. The contents of antibiotics in aquatic organisms are far lower than their maximum residual limits (MRLs), with the exception of the organisms in Honghu Lake. The lakes experience high levels of ARG contamination. A greater assessment of ARG presence and antibiotic exposure are urgent.

Understanding Electrochemically Activated Persulfate and Its Application to Ciprofloxacin Abatement

This study offers insight into the roles anodic and cathodic processes play in electrochemically activated persulfate (EAP) and screens EAP as a viable technique for ciprofloxacin degradation in wastewater. Sulfate radical formation at a boron-doped diamond (BDD) anode and persulfate activation at a graphite cathode were experimentally elucidated using different electrolytes and electrochemical setups. Rapid ciprofloxacin transformation occurred via pseudo-first-order mechanisms with respect to ciprofloxacin in persulfate electrolyte, reaching 84% removal in 120 min using EAP. Transformation pathways were compared to those in nitrate and sulfate electrolytes. Ciprofloxacin removal rates in the electrochemical system were 88% and 33% faster in persulfate than nitrate and sulfate electrolytes, respectively. Total organic carbon removal rates were 93% and 48% faster in persulfate than nitrate and sulfate, respectively. Use of sulfate electrolyte resulted in removal rates 6-7 times faster than those in nitrate solution. Accelerated removal in sulfate was attributed to anodic sulfate radical formation, while enhanced removal in persulfate was associated with cathodic persulfate activation and nonradical persulfate activation at the BDD anode. Quenching experiments indicated both sulfate radicals and hydroxyl radicals contributed to degradation. Comparisons between platinum and graphite cathodes showed similar cathodic persulfate activation and ciprofloxacin degradation.

The fate and risk assessment of psychiatric pharmaceuticals from psychiatric hospital effluent

Psychiatric pharmaceuticals are gaining public attention because of increasing reports of their occurrence in environment and their potential impact on ecosystems and human health. This work studied the occurrence and fate of 15 selected psychiatric pharmaceuticals from 3 psychiatric hospitals effluent in Shanghai and investigated the effect of hospitals effluent on surface water, groundwater, soil and plant. Amitriptyline (83.57ng) and lorazepam (22.26ng) showed the highest concentration and were found frequently in hospital effluent. Lorazepam (8.27ng), carbamazepine (83.80ng) and diazepam (79.33ng) showed higher values in surface water. The concentration of lorazepam (46.83ng) in groundwater was higher than other reports. Only six target compounds were detected in all three soil points in accordance with very low concentration. Alkaline pharmaceuticals were more easily adsorbed by soil. Carbamazepine (1.29ng) and lorazepam (2.95ngg^-1) were frequently determined in plant tissues. The correlation analyses (Spearman correlations > 0.5) showed the main source of psychiatric pharmaceuticals pollutants might be hospital effluents (from effluent to surface water; from surface water to groundwater). However, hospital effluents were not the only pollution sources from the perspective of the dilution factor analysis. Although the risk assessment indicated that the risk was low to aquatic organism, the continuous discharge of pollution might cause potential environment problem.

Ecotoxicity and antibiotic resistance of a mixture of hospital and urban sewage in a wastewater treatment plant

Hospital and urban effluents are a source of diverse pollutants such as organic compounds, heavy metals, detergents, disinfectants, pharmaceuticals, and microorganisms resistant to antibiotics. Usually, these two types of effluent are mixed in the sewage network, but a pilot site in France now allows studying them separately or mixed to understand more about their characteristics and the phenomena that occur following their mixing. In this study, their ecotoxicity (Daphnia magna mobility, Pseudokirchneriella subcapitata growth, Brachionus calyciflorus reproduction, and SOS Chromotest) and antibiotic resistance (integron quantification) were assessed during mixing and treatment steps. The main results of this study are (i) the ecotoxicity and antibiotic resistance potentials of hospital wastewater are higher than in urban wastewater and (ii) mixing two different effluents does not lead to global synergistic or antagonistic effects on ecotoxicity and antibiotic resistance potential. The global additivity effect observed in this case must be confirmed by other studies on hospital and urban effluents on other sites to improve knowledge relating to this source of pollution and its management.

Two-year survey of specific hospital wastewater treatment and its impact on pharmaceutical discharges

It is well known that pharmaceuticals are not completely removed by conventional activated sludge wastewater treatment plants. Hospital effluents are of major concern, as they present high concentrations of pharmaceutically active compounds. Despite this, these specific effluents are usually co-treated with domestic wastewaters. Separate treatment has been recommended. However, there is a lack of information concerning the efficiency of separate hospital wastewater treatment by activated sludge, especially on the removal of pharmaceuticals. In this context, this article presents the results of a 2-year monitoring of conventional parameters, surfactants, gadolinium, and 13 pharmaceuticals on the specific study site SIPIBEL. This site allows the characterization of urban and hospital wastewaters and their separate treatment using the same process. Flow proportional sampling, solid-phase extraction, and liquid chromatography coupled with tandem mass spectrometry were used in order to obtain accurate data and limits of quantification consistent with ultra-trace detection. Thanks to these consolidated data, an in-depth characterization of urban and hospital wastewaters was realized, as well as a comparison of treatment efficiency between both effluents. Higher concentrations of organic carbon, AOX, phosphates, gadolinium, paracetamol, ketoprofen, and antibiotics were observed in hospital wastewaters compared to urban wastewaters. Globally higher removals were observed in the hospital wastewater treatment plant, and some parameters were shown to be of high importance regarding removal efficiencies: hydraulic retention time, redox conditions, and ambient temperature. Eleven pharmaceuticals were still quantified at relevant concentrations in hospital and urban wastewaters after treatment (e.g., up to 1 μg/L for sulfamethoxazole). However, as the urban flow was about 37 times higher than the hospital flow, the hospital contribution appeared relatively low compared to domestic discharges. Thanks to the SIPIBEL site, data obtained from this 2-year program are useful to evaluate the relevance of separate hospital wastewater treatment.

Biotransformation and oxidative stress responses in rat hepatic cell-line (H4IIE) exposed to racemic ketoprofen (RS-KP) and its enantiomer, dexketoprofen (S(+)-KP)

Pharmaceuticals such as racemate ketoprofen (RS-KP) and its enantiomer, dexketoprofen (S(+)-KP) are highly detectable non-steroidal anti-inflammatory drugs (NSAIDs) in the aquatic environment and therefore are designated as one of the most emerging groups of pollutants that can affect environmental and human health. The potential impact of these pharmaceuticals was assessed for the first time in vitro using a rat hepatocellular carcinoma cell line (H4IIE). Cells were exposed to low and high concentrations of these drugs. Cytotoxicity was determined by MTT reduction assay; CYP1A1 transcriptional and enzymatic levels together with canonical oxidative stress responsive markers (GPx, GR, GST and CAT) were also investigated. Cells exposed to RS-KP and S(+)-KP did not show cytotoxicity effect at the concentrations tested. However, this study highlighted differences between RS-KP and S(+)-KP in most of the evaluated markers, showing compound-, concentration- and time-specific effect patterns which suggest a potential stereo-selective toxicity of these drugs.

Effects of low concentrations of ibuprofen on freshwater fish Rhamdia quelen

Ibuprofen is a pharmaceutical drug widely used by the global population and it has been found in aquatic ecosystems in several countries. This study evaluated the effects of ibuprofen in environmental concentrations (0, 0.1, 1 and 10 μg/L) on the freshwaterspecies Rhamdia quelen exposed for 14 days. In the posterior kidney, ibuprofen increased glutathione-S-transferase activity in all groups exposed. Furthermore, increased glutathione peroxidase activity and the levels of reduced glutathione in the group exposed to 10 μg/L. Ibuprofen decreased the carbonic anhydrase activity in the posterior kidney in all exposed groups, and increased the activity in the gills in group exposed to 0.1 μg/L. The levels of plasma magnesium increased in groups exposed to 0.1 and 1 μg/L. In the blood, ibuprofen decreased the white blood cell count in groups exposed to 0.1 e 1.0 μg/L. Therefore, these results indicated that ibuprofen caused nephrotoxicity and demonstrated immunosuppressive effect in Rhamdia quelen.

Environmentally relevant concentrations of glibenclamide induce oxidative stress in common carp (Cyprinus carpio)

The hypoglycemic pharmaceutical glibenclamide (GLB) is widely used around the world. This medication is released into the environment by municipal, hospital and industrial wastewater discharges. Although there are reports of its environmental occurrence in the scientific literature, toxicity studies on aquatic species of commercial interest such as the common carp Cyprinus carpio are scarce. The present study aimed to evaluate the oxidative stress induced on C. carpio by environmentally relevant concentrations of GLB. Biomarkers of oxidative damage such as hydroperoxide content, lipid peroxidation and protein carbonyl content were evaluated as well as the activity of the antioxidant enzymes superoxide dismutase and catalase. The concentration of GLB was determined in water as well as in gill, liver, muscle, brain and blood of carp at 12, 24, 48, 72 and 96 h. The findings obtained in the study prove that GLB induces increases in biomarkers of oxidative damage and antioxidant enzyme activity in the teleost C. carpio, that this response is not concentration dependent and that the organs evaluated bioconcentrate this hypoglycemic agent. These findings permit us to conclude that the presence of GLB in water bodies represents a risk for aquatic species.

[Newly Designed Water Treatment Systems for Hospital Effluent]

　Pharmaceuticals are indispensable to contemporary life. Recently, the emerging problem of pharmaceutical-based pollution of river environments, including drinking water sources and lakes, has begun to receive significant attention worldwide. Because pharmaceuticals are designed to perform specific physiological functions in targeted regions of the human body, there is increasing concern regarding their toxic effects, even at low concentrations, on aquatic ecosystems and human health, via residues in drinking water. Pharmaceuticals are consistently employed in hospitals to treat disease; and Japan, one of the most advanced countries in medical treatment, ranks second worldwide in the quantity of pharmaceuticals employed. Therefore, the development of technologies that minimize or lessen the related environmental risks for clinical effluent is an important task as well as that for sewage treatment plants (STPs). However, there has been limited research on clinical effluent, and much remains to be elucidated. In light of this, we are investigating the occurrence of pharmaceuticals, and the development of water treatment systems for clinical effluent. This review discusses the current research on clinical effluent and the development of advanced water treatment systems targeted at hospital effluent, and explores strategies for future environmental risk assessment and risk management.

Toxicological assessment of hospital wastewater in different treatment processes

This study surveyed the hospital wastewater characters focusing on antibiotic contamination in seven hospitals in Bangkok. It detected 19 antibiotics of which the high-frequent detection were quinolones such as ofloxacin + levofloxacin, norfloxacin, ciprofloxacin including sulfamethoxazole. Norfloxacin and ciprofloxacin appeared the highest concentrations of 12.11 and 9.60 μg/L, respectively. Most antibiotic concentrations in the wastewaters of the studied hospitals gave a good correlation (r ²  = 0.77-0.99) to the amount of usage. In this study, batch acute toxicity tests were performed to assess the toxicity of hospital wastewater on mixed liquor, freshwater algae (Chlorella vulgaris and Scenedesmus quadricauda), and microcrustacean (Moina macrocopa). The hospital wastewaters could inhibit the mixed liquor growth and gave similar toxic levels among test species: algae and microcrustacean (9.81-13.63 and 2.62-3.09 TU, respectively). The conventional activated sludge (CAS) and rotating biological contactor (RBC) could remove fluoroquinolones and tetracycline via biomass adsorption. After treatment, most of treatment could reduce the toxicity. Nevertheless, the effluent gave slight toxicity on some test species which might be caused from chlorination and a common toxicant (NH₃-N).

Pharmaceuticals released from senior residences: occurrence and risk evaluation

One of the main pursuits, yet most difficult, in monitoring studies is to identify the sources of environmental pollution. In this study, we have identified health-care facilities from south European countries as an important source of pharmaceuticals in the environment. We have estimated that compounds consumed in by the elderly and released from effluents of senior residences can reach river waters at a concentration higher than 0.01 μg/L, which is the European Medicines Agency (EMA) threshold for risk evaluation of pharmaceuticals in surface waters. This study has been based on five health institutions in Portugal, Spain, and France, with 52 to 130 beds. We have compiled the pharmaceuticals dispensed on a daily base and calculated the consumption rates. From 54.9 to 1801 g of pharmaceuticals are consumed daily, with laxatives, analgesics, antiepileptics, antibiotics, and antidiabetic agents being the main drug families administered. According to excretion rates, dilution in the sewerage system, and elimination in wastewater treatment plants, macrogol, metformin, paracetamol, acetylcysteine, amoxicillin, and gabapentin, among others, are expected to reach river waters. Finally, we discuss the risk management actions related to the discharge of pharmaceuticals from senior residences to surface waters.

Targeted eco-pharmacovigilance for ketoprofen in the environment: Need, strategy and challenge

Implementing "targeted" eco-pharmacovigilance(EPV) which focuses on individual or specific pharmaceuticals on a prioritised basis is a feasible, economical and customized approach to reduce the environmental concentrations and risks of pharmaceuticals. Non-steroidal anti-inflammatory drugs(NSAIDs) remaining in environment are a kind of priority hazard substances, due to a notable case that diclofenac residues caused the loss of more than 99% of vultures across the Indian sub-continent. Ketoprofen, as another widely used NSAID with comparable or even higher global consumption than diclofenac, in the environment has been shown to present a potential risk to non-target terrestrial and aquatic species. Based on the review of 85 articles reporting the analyses of ketoprofen residues in environment since 2010, we found that this NSAID frequently present in various environmental compartments around the world. Therefore, it is urgent to implement EPV targeting ketoprofen pollution. Here, we provide some recommendations for implementing the targeted EPV for ketoprofen, including: Closely monitoring ketoprofen in the natural environment; Reducing the residues of ketoprofen through source control; Encouraging urine source separation and treatment; Limiting the application of veterinary ketoprofen; Designing and constituting a framework system of targeted EPV. But some challenges, such as ambiguity in the accountability of the main bodies responsible for continued monitoring of ketoprofen residues, the lack of optimized urine source separation scenarios and procedure, the need for detailed design and application schemes of the framework system of targeted EPV, etc. should be addressed.

Occurrence of antimicrobial agents, drug-resistant bacteria, and genes in the sewage-impacted Vistula River (Poland)

Antimicrobial agents (antimicrobials) are a group of therapeutic and hygienic agents that either kill microorganisms or inhibit their growth. Their occurrence in surface water may reveal harmful effects on aquatic biota and challenge microbial populations. Recently, there is a growing concern over the contamination of surface water with both antimicrobial agents and multidrug-resistant bacteria. The aim of the study was the determination of the presence of selected antimicrobials at specific locations of the Vistula River (Poland), as well as in tap water samples originating from the Warsaw region. Analysis was performed using the liquid chromatography-electrospray ionization-tandem mass spectrometry method. In addition, the occurrence of drug-resistant bacteria and resistance genes was determined using standard procedures. This 2-year study is the first investigation of the simultaneous presence of antimicrobial agents, drug-resistant bacteria, and genes in Polish surface water. In Poland, relatively high concentrations of macrolides are observed in both surface and tap water. Simultaneous to the high macrolide levels in the environment, the presence of the erm B gene, coding the resistance to macrolides, lincosamides, and streptogramin, was detected in almost all sampling sites. Another ubiquitous gene was int1, an element of the 5'-conserved segment of class 1 integrons that encode site-specific integrase. Also, resistant isolates of Enterococcus faecium and Enterococcus faecalis and Gram-negative bacteria were recovered. Multidrug-resistant bacteria isolates of Gram-negative and Enterococcus were also detected. The results show that wastewater treatment plants (WWTP) are the main source of most antimicrobials, resistant bacteria, and genes in the aquatic environment, probably due to partial purification during wastewater treatment processes.

Synthetic hospital wastewater treatment by coupling submerged membrane bioreactor and electrochemical advanced oxidation process: Kinetic study and toxicity assessment

In this work, the combination of membrane bioreactor (MBR) and electro-oxidation (EO) process was studied for the treatment of a synthetic hospital wastewater fortified with four pharmaceutical pollutants namely carbamazepine (CBZ), ibuprofen (IBU), estradiol (E-E) at a concentration of 10 μg L^-1 venlafaxine (VEN) at 0.2 μg L^-1. Two treatment configurations were studied: EO process as pre-treatment and post-treatment. Wastewater treatment with MBR alone shows high removal percentages of IBU and E-E (∼90%). Unlikely for CBZ and VEN, a low elimination percentage (∼10%) was observed. The hydraulic and the solid retention times (HRT and SRT) were 18 h and 140 d respectively, while the biomass concentration in the MBR was 16.5 g L^-1. To enhance pharmaceuticals elimination, an EO pretreatment was conducted during 40 min at 2 A. This configuration allowed a 92% removal for VEN, which was far greater than both treatments alone, with lower than 30% and 50% for MBR and EO, respectively. The MBR-EO coupling (EO as post-treatment) allows high removal percentages (∼97%) of the four pharmaceutical pollutants after 40 min of treatment at a current intensity of 0.5 A with Nb/BDD as electrodes. This configuration appears to be very effective compared to the first configuration (EO-MBR) where EO process is used as a pre-treatment. Toxicity assessment showed that the treated effluent of this configuration is not toxic to Daphnia magna except at 100% v/v. The MBR-EO coupling appears to be a promising treatment for contaminated hospital effluents.

Bacterial community dynamics within an aerobic granular sludge reactor treating wastewater loaded with pharmaceuticals

Pharmaceuticals are micropollutants often present in wastewater treatment systems. In this study, the potential impact of such micropollutants on the bacterial population within aerobic granular sludge (AGS) bioreactor was investigated. The AGS bacterial community structure and composition were accessed combining DGGE fingerprinting and barcoded pyrosequencing analysis. Both revealed the existence of a dynamic bacterial community, independently of the pharmaceuticals presence. The AGS microbiome at both phylum and class levels varied over time and, after stopping pharmaceuticals feeding, the bacterial community did not return to its initial composition. Nevertheless, most of the assigned OTUs were present throughout the different operational phases. This core microbiome, represented by over 72% of the total sequences in each phase, probably played an important role in biological removal processes, avoiding their failure during the disturbance period. Quantitative-PCR revealed that pharmaceuticals load led to gradual changes on the abundance of ammonia-oxidizing bacteria (AOB), nitrite-oxidizing bacteria (NOB) and polyphosphate-accumulating organisms (PAO) but their persistence during that phase demonstrated the resilience of such bacterial groups. AGS microbiome changed over time but a core community was maintained, probably ensuring the accomplishment of the main biological removal processes.

Human pharmaceuticals in Portuguese rivers: The impact of water scarcity in the environmental risk

Pharmaceuticals occurrence and environmental risk assessment were assessed in Portuguese surface waters, evaluating the impact of wastewater treatment plants (WWTPs) and river flow rates. Twenty three pharmaceuticals from 6 therapeutic groups, including metabolites and 1 transformation product, were analysed in 72 samples collected from 20 different sites, upstream and downstream the selected WWTPs, in two different seasons. Analysis was performed by solid phase extraction followed by liquid chromatography coupled to tandem mass spectroscopy. Pharmaceuticals were detected in 27.8% of the samples. Selective serotonin reuptake inhibitors (SSRIs), anti-inflammatories and antibiotics presented the highest detection frequencies (27.8, 23.6 and 23.6%, respectively) and average concentrations (37.9, 36.1 and 33.5ngL^-1, respectively). When assessing the impact of WWTPs, an increase of 21.4% in the average concentrations was observed in the samples located downstream these facilities, when compared with the upstream samples. Increased detection frequencies and concentrations were observed at lower flow rates, both when comparing summer and winter campaigns and by evaluating the different rivers. Risk quotients (RQs) higher than one were found for two pharmaceuticals, concerning two trophic levels. However, since Iberian rivers are highly influenced by water scarcity, in drought periods, the flow rates in these rivers can decrease at least ten times from the lowest value observed in the sampling campaigns. In these conditions, RQs higher than 1 would be observed for 5 pharmaceuticals, additionally, all the detected pharmaceuticals (11) would present RQs higher than 0.1. These results emphasize that the river flow rate represents an important parameter influencing pharmaceuticals concentrations, highlighting the ecotoxicological pressure, especially due to water scarcity in drought periods. This should be a priority issue in the environmental policies for minimizing its impact in the aquatic environment.

A critical evaluation of different parameters for estimating pharmaceutical exposure seeking an improved environmental risk assessment

A critical evaluation of the European Medicines Agency (EMA) Guideline on Environmental Risk Assessment (ERA) was performed on 16 of Portugal's most consumed pharmaceuticals in wastewater effluents (WWEs), the main route for aquatic contamination. The predicted environmental concentrations (PECs) were formulated based on the Guideline, after incorporating several refinements. The best approach was selected by comparing the measured environmental concentrations (MECs) to the PECs in WWEs. Finally, risk was assessed by comparing PECs to predicted no-effect concentrations (PNECs). The results showed that the default value of the penetration factor (Fpen) used by the EMA (0.01) was surpassed and that national consumption and excretion data were the two most important parameters for PEC calculations. The risk quotient between PECs and PNECs was higher than 1 for 12 pharmaceuticals, indicating a risk to all three trophic levels of aquatic organisms (algae, daphnids and fish). To improve the current ERA framework, suggestions were made for incorporating consumption and excretion data, changing the default value of Fpen to 0.04 and adding a safety factor of 10. Moreover, this evaluation should be performed for pharmaceuticals already on the market, and future ERAs should incorporate a risk-benefit analysis, an important risk-management step.

Implementing ecopharmacovigilance (EPV) from a pharmacy perspective: A focus on non-steroidal anti-inflammatory drugs

Environmental experts have made great efforts to control pharmaceutical pollution. However, the control of emerged environmental problems caused by medicines should draw more attention of pharmacy and pharmacovigilance researchers. Ecopharmacovigilance (EPV) as a kind of pharmacovigilance for the environment is recognized worldwide as crucial to minimize the environmental risk of pharmaceutical pollutants. But continuing to treat the pollution of pharmaceuticals as a group of substances instead of targeting individual pharmaceuticals on a prioritized basis will lead to a significant waste of resources. Considering vulture population decline caused by non-steroidal anti-inflammatory drugs (NSAIDs) residues, we presented a global-scale analysis of 139 reports of NSAIDs occurrence across 29 countries, in order to provide a specific context for implementing EPV. We found a heavy regional bias toward research in Europe, Asia and America. The top 5 most frequently studied NSAIDs included ibuprofen, diclofenac, naproxen, acetaminophen and ketoprofen. The profile of NSAIDs was dominated by acetaminophen in wastewater influents and effluents. Ibuprofen was the most abundant NSAID in surface water. Only 9 NSAIDs were reported in groundwater samples. And majority of NSAIDs were detected in solid matrices at below 1μg/g except for ketoprofen, diclofenac and ibuprofen. From a pharmacy perspective, we get some implication and propose some management practice options for EPV implementation. These include: Further popularizing and applying the concept of EPV, together with developing relevant regulatory guidance, is necessary; More attention should be paid to how to implement EPV for the pollution control of older established drugs; Triggering "a dynamic watch-list mechanism" in conjunction with "source control"; Implementing targeted sewage treatment technologies and strengthening multidisciplinary collaboration; Pharmaceutical levels in aquatic organisms as biological indicators for monitoring pharmaceutical pollution within the water environment; Upgrading drinking water treatment plants with the aim of removing pharmaceutical residues; Paying more attention to EPV for pharmaceuticals in solid matrices.

Furosemide removal in constructed wetlands: Comparative efficiency of LECA and Cork granulates as support matrix

The removal efficiency of LECA and cork granulates as support matrix for pharmaceuticals active compounds in a constructed wetland system was investigated using the diuretic drug Furosemide. Kinetics studies were performed testing three different concentrations of Furosemide in an ultrapure water matrix, along seven days. LECA achieved higher removal values compared to cork granulates. However, cork granulates presented a higher removal in the first 24 h of contact time compared to the other adsorbent. The kinetic studies showed that LECA and cork granulates have different adsorption behaviours for Furosemide which is controlled by different adsorption mechanisms. Both materials showed good removal efficiencies and a combination of the two should be further explored in order to applied both materials as support matrix to cope with different furosemide concentrations.

Shadow prices of emerging pollutants in wastewater treatment plants: Quantification of environmental externalities

Conventional wastewater treatment plants (WWTPs) are designed to remove mainly the organic matter, nitrogen and phosphorus compounds and suspended solids from wastewater but are not capable of removing chemicals of human origin, such as pharmaceutical and personal care products (PPCPs). The presence of PPCPs in wastewater has environmental effects on the water bodies receiving the WWTP effluents and renders the effluent as unsuitable as a nonconventional water source. Considering PPCPs as non-desirable outputs, the shadow prices methodology has been implemented using the output distance function to measure the environmental benefits of removing five PPCPs (acetaminophen, ibuprofen, naproxen, carbamazepine and trimethoprim) from WWTP effluents discharged to three different ecosystems (wetland, river and sea). Acetaminophen and ibuprofen show the highest shadow prices of the sample for wetland areas. Their values are 128.2 and 11.0 €/mg respectively. These results represent a proxy in monetary terms of the environmental benefit achieved from avoiding the discharge of these PPCPs in wetlands. These results suggest which PPCPs are urgent to remove from wastewater and which ecosystems are most vulnerable to their presence. The findings of this study will be useful for the plant managers in order to make decisions about prioritization in the removal of different pollutants.

Psychoactive drugs: occurrence in aquatic environment, analytical methods, and ecotoxicity-a review

This review focused on seven psychoactive drugs being six benzodiazepines (alprazolam, bromazepam, clonazepam, diazepam, lorazepam, and oxazepam) and one antidepressant (citalopram) widely consumed by modern society and detected in different aqueous matrices (drinking water, surface water, groundwater, seawater, estuary water, influent and effluent of wastewater treatment plants). The review included 219 selected scientific papers from which 1642 data/entries were obtained, each entry corresponding to one target compound in one aqueous matrix. Concentrations of all investigated drugs in all aqueous matrices varied from 0.14 to 840,000 ng L^-1. Citalopram presented the highest concentrations in the aqueous matrices. Based on the Wilcoxon-Mann-Whitney test, differences between wastewater influents and effluents were not significant for most wastewater categories, suggesting that conventional wastewater treatment systems as such do not remove or remove partially these compounds. High-income countries showed much lower concentrations in surface water than the group formed by upper-middle-, lower-middle-, and low-income countries. Regarding analytical methods, solid-phase extraction (SPE) was by far the most used extraction method (83%) and performance liquid chromatography (HPLC) (73%) coupled to mass spectrometry (99%) the most common analytical method. Changes in behavior and in survival rates were the most common effects reported on bioindicators (aquatic species) due to the presence of these drugs in water. Concentrations of psychoactive drugs found in surface waters were most of the time within the range that caused measurable toxic effects in ecotoxicity assays.

Consumption-based approach for pharmaceutical compounds in a large hospital

Hospital wastewater contains a great variety of pharmaceutical compounds (PhCs), mainly due to excretion by patients. These PhCs, called emerging pollutants, are not fully eliminated in treatment plants, and are consequently detected in various environmental matrices, contributing to bacterial resistance and adverse environmental impacts on water resources. This study explores a consumption-based approach to predict the contribution of PhCs to a Brazilian hospital's wastewater. This approach identifies the consumption of major pharmaceutical classes in the studied hospital. Overall, this approach demonstrates a unique opportunity to screen PhCs used in hospitals and identify priority pollutants in hospital wastewater.

Removal of antibiotics in sponge membrane bioreactors treating hospital wastewater: Comparison between hollow fiber and flat sheet membrane systems

Hollow fiber (HF) and flat sheet (FS) Sponge MBRs were operated at 10-20 LMH flux treating hospital wastewater. Simultaneous nitrification denitrification (SND) occurred considerably with TN removal rate of 0.011-0.020mg TN mgVSS^-1d^-1. Furthermore, there was a remarkable removal of antibiotics in both Sponge MBRs, namely Norfloxacin (93-99% (FS); 62-86% (HF)), Ofloxacin (73-93% (FS); 68-93% (HF)), Ciprofloxacin (76-93% (FS); 54-70% (HF)), Tetracycline (approximately 100% for both FS and HF) and Trimethoprim (60-97% (FS); 47-93% (HF). Whereas there was a quite high removal efficiency of Erythromycin in Sponge MBRs, with 67-78% (FS) and 22-48% (HF). Moreover, a slightly higher removal of antibiotics in FS than in HF achieved, with the removal rate being of 0.67-32.40 and 0.44-30.42µgmgVSS^-1d^-1, respectively. In addition, a significant reduction of membrane fouling of 2-50 times was achieved in HF-Sponge MBR for the flux range.

Evaluation of the influence of surfactants in the bioaccumulation kinetics of sulfamethoxazole and oxazepam in benthic invertebrates

The potential ecotoxicological effects of mixtures of contaminants in the aquatic environment are generating a global concern. Benthic invertebrates, such as the crustacean Gammarus fossarum, are key in the functioning of aquatic ecosystems, and are frequently used as sentinel species of water quality status. The aim of this work was to study the effects of a mixture of the most frequently detected surfactants in the bioconcentration kinetics of two pharmaceuticals in G. fossarum, evaluating their potential enhancing or suppressing effects. Laboratory exposure experiments for both pharmaceuticals and surfactants (concentration ratio 1:25) were set up for two individual compounds, the anxiolytic oxazepam and the antibiotic sulfamethoxazole. Gammarid samples were processed using microQuEChERS (Quick, Easy, Cheap, Effective, Rugged, and Safe) extraction. Pharmaceuticals concentration in the organisms was followed-up by means of nanoliquid chromatography coupled to tandem mass spectrometry (nanoLC-MS/MS). Results indicated a similar mode of action of the surfactants in the bioconcentration kinetics of both drugs, decreasing the accumulation rate in the organism. Oxazepam showed a higher accumulation potential than sulfamethoxazole in all cases. Depuration experiments for oxazepam also demonstrated the high depurative capacity of gammarids, eliminating >50% of the concentration of oxazepam in <6h.

Environmental risk assessment of effluents as a whole emerging contaminant: Efficiency of alternative tertiary treatments for wastewater depuration

Emerging contaminants (ECs) and regulated compounds (RCs) from three different WWTP effluents were measured in the current study. The efficiency of two tertiary treatments, Photobiotreatment (PhtBio) and Multi-Barrier Treatment (MBT), for removing contaminants was determined. Results indicated different percentages of removal depending on the treatment and the origin of the effluent. Risk Quotients (RQs) were determined for different species of algae, Daphnia, and fish. RQ results revealed diverse risk values depending on the bioindicator species. Tonalide, galaxolide (fragrances), and ofloxacin (antibiotic) were the most persistent and harmful substances in tested effluents. "Negligible risk" category was reached since a wide diversity of ECs were removed by MBT with high removal percentages. Contrarily, PhtBio was effective only in the depuration of certain chemical compounds, and its efficiency depended on the composition of the raw effluent.

Combined use of VUV and UVC photoreactors for the treatment of hospital laundry wastewaters: Reduction of load parameters, detoxification and life cycle assessment of different configurations

The present research investigated the treatment of hospital laundry wastewaters by the combined use of photochemical VUV and UVC reactors. Seven different configurations were tested and the performances of each of them were evaluated based on the removal of the load parameters, detoxification and life cycle assessment (LCA). The characterization of studied wastewaters included analysis of the following parameters: COD, BOD₅, TKN, total P, pH, turbidity and conductivity. Acute ecotoxicity was evaluated using Daphnia magna. Ultraviolet-Visible (UV-Vis) spectroscopy was performed to determine the organic fraction and chromatography coupled to the mass spectrometer (GC-MS) was used for the qualitative characterization of priority pollutants. Characterization parameters showed the presence of drugs like lidocaine and dipyrone and a high organic load with a poor biodegradability. Wastewaters presented an extreme acute toxicity against D. magna (EC₅₀ 6.7%). The ozonation process (mainly generated by the VUV reactor) obtained the best results concerning the ratio between the consumed energy and the removed COD and the UVC process presented the lowest environmental impacts for the characterization and normalization parameters of the LCA. Normalization revealed that the highest environmental burdens were associated with human toxicity, ecotoxicity and eutrophication of surface waters as well as to the use of non-renewable resources. VUV/UVC/O₃ process presented the best results considering detoxification (EC₅₀ 100%).

Influence of Select Antibiotics on Vibrio fischeri and Desmodesmus subspicatus at μg L-1 Concentrations

The presence of pharmaceuticals in the aquatic environment is a contemporary reality and it is necessary to understand more about the effects of this presence on organisms. The purpose of this work was to assess the ecotoxicity of antibiotics metronidazole, nitrofurantoin, trimethoprim, and sulphamethoxazole (single and mixture) in Vibrio fischeri and Desmodesmus subspicatus at μg L^-1 concentrations. The evaluation of the toxic effect of the antibiotics on V. fischeri and D. subspicatus was based on fluorescence and bioluminescence tests, respectively, using nominal concentrations. When tested individually, the four antibiotics gave rise to a toxic effect on the evaluated organisms. Sulphamethoxazole caused a higher toxic effect on V. fischeri and D. subspicatus from 7.81 to 500 μg L^-1. Trimethoprim and sulphamethoxazole showed hormesis for the concentrations, which ranged from 7.81 to 62.5 μg L^-1. The mixture of antibiotics induced a toxic effect on the V. fischeri and D. subspicatus organisms (from 0.03 to 1 μg L^-1 concentrations) than when the antibiotics were evaluated individually. These results were significant since water quality problems are widespread all over the word, and emerging pollutants such as antibiotics have been detected in the aquatic environment in very low concentrations.

Occurrence and behaviour of pharmaceutical compounds in a Portuguese wastewater treatment plant: Removal efficiency through conventional treatment processes

Wastewater treatments can eliminate or remove a substantial amount of pharmaceutical active compounds (PhACs), but there may still be significant concentrations of them in effluents discharged into surface water bodies. Beirolas wastewater treatment plant (WWTP) is located in the Lisbon area and makes its effluent discharges into Tagus estuary (Portugal). The main objective of this study is to quantify a group of 32 PhACs in the different treatments used in this WWTP. Twelve sampling campaigns of wastewater belonging to the different treatments were made in 2013-2014 in order to study their removal efficiency. The wastewaters were analysed by solid phase extraction (SPE) and ultra-performance liquid chromatography coupled with tandem mass detection (UPLC-MS/MS). The anti-diabetics were the most frequently found in wastewater influent (WWI) and wastewater effluent (WWE) (208 and 1.7 μg/L, respectively), followed by analgesics/antipyretics (135 μg/L and < LOQ, respectively), psychostimulants (113 and 0.49 μg/L, respectively), non-steroidal anti-inflammatory drugs (33 and 2.6 μg/L, respectively), antibiotics (5.2 and 1.8 μg/L, respectively), antilipidemics (1.6 and 0.24 μg/L, respectively), anticonvulsants (1.5 and 0.63 μg/L, respectively) and beta blockers (1.3 and 0.51 μg/L, respectively). A snapshot of the ability of each treatment step to remove these target PhACs is provided, and it was found that global efficiency is strongly dependent on the efficiency of secondary treatment. Seasonal occurrence and removal efficiency was also monitored, and they did not show a significant seasonal trend.

Ionic liquids for the passive sampling of sulfonamides from water-applicability and selectivity study

Ionic liquids (ILs) are new-generation, non-volatile solvents which are designable, and their structure may be specifically adjusted to the current application needs. Therefore, it is possible to create and apply ILs which efficiently and selectively extract various analytes from different matrices. It has already been examined that ILs may be applied as receiving phases in passive sampling for the long-term water monitoring of PAHs and pharmaceuticals in water. In this paper, the concept of passive sampling with ILs (PASSIL applied as receiving phases) was continued and developed using phosphonium-, imidazolium-, and morpholinium-cation-based ILs. The target group of analytes was pharmaceuticals which represent one of the most common categories of water contaminants. Fourteen-day-long extractions using various ILs were performed in stirred conditions at a constant temperature (20 °C). The best extraction efficiency was achieved for trihexyl(tetradecyl)phosphonium dicyanamide ([P666-14][N(CN)₂]). For this preliminary calibration, the sampling rates were calculated for each sulfonamide. Once again, selectivity was observed in passive sampling using [P666-14][N(CN)₂]. Therefore, PASSIL is seen as a very promising method for pharmaceutical monitoring in water.