Occurrence and removal of pharmaceuticals in a municipal sewage treatment system in the south of Sweden

Effectiveness of three configurations of membrane bioreactors on the removal of priority and emergent organic compounds from wastewater: comparison with conventional wastewater treatments

In this work the effectiveness of membrane bioreactors as advanced treatment on the removal of emergent and priority organic compounds in wastewater treatment plants has been evaluated during a one-year monitoring study. The studied wastewater treatment plant operates with flat sheet and hollow fibre membranes in two parallel lines. Moreover, a reverse osmosis module connected in series after the hollow fibre membrane was evaluated for one month. Comparison of membrane bioreactor and conventional activated sludge treatment was also investigated, as well as the influence of the physicochemical properties of the compounds on the removal rates achieved. Sixteen pharmaceutical compounds belonging to seven therapeutic groups and eight priority organic pollutants, including linear alkylbenzene sulfonates, nonylphenol and its ethoxylates and phthalate, were monitored. The highest mean concentrations corresponded to priority organic pollutants (309 μg L(-1) of linear alkylbenzene sulfonate C(12)) followed by pharmaceutical compounds (24.5 μg L(-1) of ibuprofen). No significant difference of effectiveness was found among flat sheet and hollow fibre membranes. However, an improvement was obtained with the addition of a reverse osmosis module for most of the compounds. Biodegradation has been shown as the main route involved in the removal of organic compounds during both technologies.

An evaluation of free water surface wetlands as tertiary sewage water treatment of micro-pollutants

Increased attention is currently directed towards potential negative effects of pharmaceuticals and other micro-pollutants discharged into the aquatic environment via municipal sewage water. A number of additional treatment technologies, such as ozonation, have therefore been suggested as promising tools for improving the removal efficiency of pharmaceuticals in existing Sewage Treatment Plants (STPs). Constructed wetlands are also capable of removing a variety of micro-pollutants, including some pharmaceuticals, and could hence be a resource efficient complement to more advanced treatment technologies. The purpose of the present study was therefore to increase the knowledge base concerning the potential use of constructed wetlands as a treatment step to reduce emissions of organic micro-pollutants from municipal sewage effluents. Under cold winter conditions, incoming and outgoing waters from four Swedish free water surface wetlands, operated as final treatment steps of sewage effluent from municipal STPs, were sampled and analyzed for levels of a set of 92 pharmaceuticals and 22 inorganic components as well as assessed using subchronic ecotoxicity tests with a macro-alga and a crustacean. Sixty-five pharmaceuticals were detected in the range from 1 ng L(-1) to 7.6 μg L(-1) in incoming and outgoing waters from the four investigated wetlands. Although the sampling design used in the present study lacks the robustness of volume proportional to 24h composite samples, the average estimated removal rates ranged from 42% to 52%, which correlates to previous published values. The effects observed in the ecotoxicity tests with the macro-alga (EC(50)s in the range of 7.5-46%) and the crustacean (LOECs in the range of 11.25-90%) could not be assigned to either pharmaceutical residues or metals, but in general showed that these treatment facilities release water with a relatively low toxic potential, comparable to water that has been treated with advanced tertiary treatments. From the present study it can be concluded that constructed wetlands may provide a complementary sewage treatment option, especially where other treatment is lacking today. To fully remove micro-pollutants from sewage effluent, however, other more advanced treatment technologies are likely needed.

Removal of pharmaceuticals in biologically treated wastewater by chlorine dioxide or peracetic acid

Removal of six active pharmaceutical ingredients in wastewater was investigated using chlorine dioxide (ClO2) or peracetic acid (PAA) as chemical oxidants. Four non-steroidal anti-inflammatory drugs (ibuprofen, naproxen, diclofenac and mefenamic acid) and two lipid-regulating agents (gemfibrozil and clofibric acid, a metabolite of clofibrate) were used as target substances at 40 microg/L initial concentration. Three different wastewaters types originating from two wastewater treatment plants (WWTPs) were used. One wastewater was collected after extended nitrogen removal in activated sludge, one after treatment with high-loaded activated sludge without nitrification, and one from the final effluent from the same plant where nitrogen removal was made in trickling filters for nitrification and moving-bed biofilm reactors for denitrification following the high-loaded plant. Of the six investigated compounds, only clofibric acid and ibuprofen were not removed when treated with ClO2 up to 20 mg/L. With increasing PAA dose up to 50 mg/L, significant removal of most of the pharmaceuticals was observed except for the wastewater with the highest chemical oxygen demand (COD). This indicates that chemical oxidation with ClO2 could be used for tertiary treatment at WWTPs for active pharmaceutical ingredients, whereas PAA was not sufficiently efficient.

Suspended biofilm carrier and activated sludge removal of acidic pharmaceuticals

Removal of seven active pharmaceutical substances (ibuprofen, ketoprofen, naproxen, diclofenac, clofibric acid, mefenamic acid, and gemfibrozil) was assessed by batch experiments, with suspended biofilm carriers and activated sludge from several full-scale wastewater treatment plants. A distinct difference between nitrifying activated sludge and suspended biofilm carrier removal of several pharmaceuticals was demonstrated. Biofilm carriers from full-scale nitrifying wastewater treatment plants, demonstrated considerably higher removal rates per unit biomass (i.e. suspended solids for the sludges and attached solids for the carriers) of diclofenac, ketoprofen, gemfibrozil, clofibric acid and mefenamic acid compared to the sludges. Among the target pharmaceuticals, only ibuprofen and naproxen showed similar removal rates per unit biomass for the sludges and biofilm carriers. In contrast to the pharmaceutical removal, the nitrification capacity per unit biomass was lower for the carriers than the sludges, which suggests that neither the nitrite nor the ammonia oxidizing bacteria are primarily responsible for the observed differences in pharmaceutical removal. The low ability of ammonia oxidizing bacteria to degrade or transform the target pharmaceuticals was further demonstrated by the limited pharmaceutical removal in an experiment with continuous nitritation and biofilm carriers from a partial nitritation/anammox sludge liquor treatment process.

Effect studies of human pharmaceuticals on Fucus vesiculosus and Gammarus spp

In two experiments, the human pharmaceutical propranolol negatively affected the physiology of two test organisms, Fucus vesiculosus and Gammarus spp. from a Baltic Sea littoral community in a concentration of 1000 μg l⁻¹. Some effects were also observed for the lower, more ecologically relevant concentrations (10 μg l⁻¹ and 100 μg l⁻¹). The effects on F. vesiculosus not only increased with increasing concentration, but also with exposure time; while the effects on Gammarus spp. were more inconsistent over time. No clear effects of the pharmaceuticals diclofenac and ibuprofen were observed for any of the organisms. Physiological parameters measured were GP:R-ratio, chlorophyll fluorescence and release of coloured dissolved organic matter, respiration and ammonium excretion. Pharmaceutical substances are repeatedly detected in the Baltic Sea which is the recipient for STP effluents from more than 85 million people living in the catchment area, but the knowledge of their effects on non-target organisms is still very limited.

Influences of two antibiotic contaminants on the production, release and toxicity of microcystins

The influences of spiramycin and amoxicillin on the algal growth, production and release of target microcystins (MCs), MC-LR, MC-RR and MC-YR, in Microcystis aeruginosa were investigated through the seven-day exposure test. Spiramycin were more toxic to M. aeruginosa than amoxicillin according to their 50 percent effective concentrations (EC(50)) in algal growth, which were 1.15 and 8.03 μg/l, respectively. At environmentally relevant concentrations of 100 ng/l-1 μg/l, spiramycin reduced the total MC content per algal cell and inhibited the algal growth, while exposure to amoxicillin led to increases in the total MC content per algal cell and the percentage of extracellular MCs, without affecting the algal growth. Toxicity of MCs in combination with each antibiotic was assessed in the luminescent bacteria test using the toxic unit (TU) approach. The 50 percent effective concentrations for the mixtures (EC(50mix)) were 0.56 TU and 0.48 TU for MCs in combination with spiramycin and amoxicillin, respectively, indicating a synergistic interaction between MCs and each antibiotic (EC(50mix)<1TU). After seven-day exposure to 100 ng/l-1 μg/l of antibiotics, spiramycin-treated algal media and amoxicillin-treated algal media showed significantly lower (p<0.05) and higher (p<0.05) inhibition on the luminescence of Photobacterium phosphoreum, respectively, compared with the untreated algal medium. These results indicated that the toxicity of MCs were alleviated by spiramycin and enhanced by amoxicillin, and the latter effect would increase threats to the aquatic environment.

Occurrence of antibiotics in eight sewage treatment plants in Beijing, China

The occurrence, removal efficiency and seasonal variation of 22 antibiotics, including eight fluoroquinolones, nine sulfonamides and five macrolides, were investigated in eight sewage treatment plants (STPs) in Beijing, China. A total of 14 antibiotics were detected in wastewater samples, with the maximum concentration being 3.1 μg L(-1) in the influent samples and 1.2 μg L(-1) in the effluent samples. The most frequently detected antibiotics were ofloxacin, norfloxacin, sulfadiazine, sulfamethoxazole, erythromycin and roxithromycin; of these, the concentration of ofloxacin was the highest in most of the influent and effluent samples. Eighteen antibiotics were detected in the sludge samples, with concentrations ranging from 1.0×10(-1) to 2.1×10(4) μg kg(-1). The dominant antibiotics found in the sludge samples were the fluoroquinolones, with ofloxacin having the highest concentration in all the sludge samples. The antibiotics could not be removed completely by the STPs, and the mean removal efficiency ranged from -34 to 72%. Of all the antibiotics, the fluoroquinolones were removed comparatively more efficiently, probably due to their adsorption to sludge. Seasonal variation of the antibiotics in the sludge samples was also studied. The concentrations of antibiotics in winter were higher than in spring and autumn. Since the total levels of the fluoroquinolones detected in the influent samples were lower than the predicted no-effect concentration (PNEC) of 8.0 μg L(-1), the residues of these antibiotics would be unlikely to have adverse effects on microorganisms involved in sewage treatment processes.

Review of risk from potential emerging contaminants in UK groundwater

This paper provides a review of the types of emerging organic groundwater contaminants (EGCs) which are beginning to be found in the UK. EGCs are compounds being found in groundwater that were previously not detectable or known to be significant and can come from agricultural, urban and rural point sources. EGCs include nanomaterials, pesticides, pharmaceuticals, industrial compounds, personal care products, fragrances, water treatment by-products, flame retardants and surfactants, as well as caffeine and nicotine. Many are relatively small polar molecules which may not be effectively removed by drinking water treatment. Data from the UK Environment Agency's groundwater screening programme for organic pollutants found within the 30 most frequently detected compounds a number of EGCs such as pesticide metabolites, caffeine and DEET. Specific determinands frequently detected include pesticides metabolites, pharmaceuticals including carbamazepine and triclosan, nicotine, food additives and alkyl phosphates. This paper discusses the routes by which these compounds enter groundwater, their toxicity and potential risks to drinking water and the environment. It identifies challenges that need to be met to minimise risk to drinking water and ecosystems.

Removal of persistent pharmaceutical micropollutants from sewage by addition of PAC in a sequential membrane bioreactor

The performance of a membrane bioreactor operating in a sequential mode (SMBR) using an external flat-plate membrane was investigated. After 200 days of operation, a single addition of 1 g L(-1) Powdered Activated Carbon (PAC) was added directly into the mixed liquor in order to enhance the simultaneous removal of nutrients and pharmaceutical micropollutants from synthetic urban wastewater. Throughout the entire operation (288 days), Chemical Oxygen Demand (COD) removal efficiencies were up to 95%, ammonium nitrogen removal was maintained over 70-80%, whereas phosphorus removal achieved only high values (around 80%) after PAC addition. During the operation of the SMBR without PAC addition, micropollutants which exerted a more recalcitrant behaviour were carbamazepine, diazepam, diclofenac and trimethoprim, with no significant removal. On the other hand, moderate removals (42-64%) were observed for naproxen and erythromycin, whereas ibuprofen, roxithromycin and fluoxetine were removed in the range of 71-97%. The addition of PAC into the aeration tank was a successful tool to improve the removal of the more recalcitrant compounds up to 85%. The highest removal with PAC was observed for carbamazepine, trimethoprim as well as for roxithromycin, erythromycin and fluoxetine. The latter four compounds have amine groups and pKa in the range 6.7-10.1, thus the interaction between PAC and the positively charged amino groups might be the cause of their comparatively better results. Microbial ecology present in the biomass showed a higher abundance of Accumulibacter phosphatis as well as the ammonium oxidizing bacteria belonging to the genus Nitrosomonas after PAC addition.

Effects of pH and ionic strength on sulfamethoxazole and ciprofloxacin transport in saturated porous media

Many antibiotics regarded as emerging contaminants have been frequently detected in soils and groundwater; however, their transport behaviors in soils remain largely unknown. This study examined the transport of two antibiotics, sulfamethoxazole (SMZ) and ciprofloxacin (CIP), in saturated porous media. Laboratory columns packed with quartz sand was used to test the effects of solution pH and ionic strength (IS) on their retention and transport. The results showed that these two antibiotics behaved differently in the saturated sand columns. In general, SMZ manifested a much higher mobility than CIP for all experimental conditions tested. Almost all SMZ transported through the columns within one pore volume in deionized water (i.e., pH=5.6, IS=0), but no CIP was detected in the effluents under the same condition after extended column flushing. Perturbations in solution pH (5.6 and 9.5) and IS (0 and 0.1M) showed no effect on SMZ transport in the saturated columns. When pH increased to 9.5, however, ~93% of CIP was eluted from the sand columns. Increase of IS from 0 to 0.1M also slightly changed the distribution of adsorbed CIP within the sand column at pH 5.6, but still no CIP was detected in the effluents. A mathematical model based on advection-dispersion equation coupled with equilibrium and kinetic reactions successfully simulated the transport of the antibiotics in water-saturated porous media with R(2)=0.99.

Dynamics of steroid estrogen daily concentrations in hospital effluent and connected waste water treatment plant

Hospital effluent and connected waste water treatment plant (WWTP) influent and effluent were sampled daily to determine the levels and inter-day variations of three naturally occurring steroid estrogens: estrone, 17β-estradiol, estriol, and synthetic 17α-ethinylestradiol. After solid phase extraction, interferences were removed with a silica gel clean-up step and the samples analysed using gas chromatography with mass selective detection (GC-MSD). The determined inter-day concentrations in hospital effluent were between 8.6 to 31.3 ng L(-1) for estrone, <LOD (limit of detection) to 4.2 ng L(-1) for 17β-estradiol and 6.4 to 385.5 ng L(-1) for estriol. In the WWTP influent concentrations were 18.9 to 49.7 ng L(-1) for estrone, 2.4 to 12.7 ng L(-1), for 17β-estradiol and <LOQ (limit of quantitation) to 63.9 ng L(-1) for estriol. Reduced levels were found in the WWTP effluent: <7.1 ng L(-1) for estrone, <LOQ for 17β-estradiol and <5.2 ng L(-1) for estriol. 17α-ethinylestradiol was detected in only one influent sample. Calculated estradiol equivalents (EEQ) were 33.4, 22.4, 1.7 ng (EEQ) L(-1) in the hospital effluent, WWTP influent and WWTP effluent, respectively. Interestingly, the estrone: 17β-estradiol:estriol ratio in the hospital effluent (1:0.1:9.4) is comparable to that found in the urine of pregnant women (1:0.3:20) indicating the most likely source of steroid estrogens. In WWTP influent the ratio was similar to that found in the non-pregnant population. Our result recognise estriol as being one of the most important steroid estrogens, accounting for up to 92% of the total EEQ present in hospital samples and 37% and 46% in WWTP influent and effluent samples, respectively. The study reveals how concentrations of steroid estrogens vary on a daily basis and concludes that careful sampling strategies must be adopted when making a risk assessment. In addition, the low potency steroid estrogens that contribute towards overall estrogenicity of the sample, e.g. estriol, should be incorporated into environmental monitoring programs.

UV and VUV photolysis vs. UV/H2O2 and VUV/H2O2, treatment for removal of clofibric acid from aqueous solution

Clofibric acid (CA), a metabolite of lipid regulators, was investigated in ultra-pure water and sewage treatment plant (STP) effluent at 10 degrees C under UV, vacuum UV (VUV), UV/H2O2 and VUV/H2O2 processes. The influences of NO3-, HCO3- and humic acid (HA) on CA photolysis in all processes were examined. The results showed that all the experimental data well fitted the pseudo-first-order kinetic model, and the apparent rate constant (k(ap)) and half-life time (t(1/2)) were calculated accordingly. Direct photolysis of CA through UV irradiation was the main process, compared with the indirect oxidation of CA due to the slight generation of hydroxyl radicals dissociated from water molecules under UV irradiation below 200 nm monochromatic wavelength emission. In contrast, indirect oxidation was the main CA degradation mechanism in UV/H2O2 and VUV/H2O2, and VUV/H2O2 was the most effective process for CA degradation. The addition of 20 mg L(-1) HA could significantly inhibit CA degradation, whereas, except for UV irradiation, the inhibitive effects of NO3- and HCO3- (1.0 x 10(-3) and 0.1 mol L(-1), respectively) on CA degradation were observed in all processes, and their adverse effects were more significant in UV/H2O2 and VUV/H2O2 processes, particularly at the high NO3- and HCO3- concentrations. The degradation rate decreased 1.8-4.9-fold when these processes were applied to a real STP effluent owing to the presence of complex constituents. Of the four processes, VUV/H2O2 was the most effective, and the CA removal efficiency reached over 99% after 40 min in contrast to 80 min in both the UV/H2O2 and VUV processes and 240 min in the UV process.

Mass flows and removal of antibiotics in two municipal wastewater treatment plants

The mass flows and removal of 20 antibiotics of seven classes in two wastewater treatment plants (WWTPs) of Hong Kong were investigated in different seasons of a whole year, using bihourly 24h flow proportional composite samples. Antibiotics were detected at concentrations of 3.2-1718, 1.3-1176 and 1.1-233ngL(-1) in influents, secondary and disinfection effluents. Total daily discharges of all the detected antibiotics from effluents of Shatin and Stanley WWTPs were 470-710 and 3.0-5.2gd(-1), respectively. Ampicillin, cefalexin, sulfamethoxazole, sulfadiazine, sulfamethazine, chlortetracycline and vancomycin were effectively (52-100%) eliminated by activated sludge process while ampicillin and cefalexin were effectively (91-99%) eliminated by disinfection. Bihourly variation analysis showed that concentrations of the major antibiotics in influents varied more significantly in Stanley WWTP which served small communities.

Sorption and biodegradation of sulfonamide antibiotics by activated sludge: experimental assessment using batch data obtained under aerobic conditions

This study investigated the adsorption, desorption, and biodegradation characteristics of sulfonamide antibiotics in the presence of activated sludge with and without being subjected to NaN(3) biocide. Batch experiments were conducted and the relative contributions of adsorption and biodegradation to the observed removal of sulfonamide antibiotics were determined. Three sulfonamide antibiotics including sulfamethoxazole (SMX), sulfadimethoxine (SDM), and sulfamonomethoxine (SMM), which had been detected in the influent and the activated sludge of wastewater treatment plants (WWTP) in Taiwan, were selected for this study. Experimental results showed that the antibiotic compounds were removed via sorption and biodegradation by the activated sludge, though biodegradation was inhibited in the first 12 h possibly due to competitive inhibition of xenobiotic oxidation by readily biodegradable substances. The affinity of sulfonamides to sterilized sludge was in the order of SDM > SMM > SMX. The sulfonamides existed predominantly as anions at the study pH of 6.8, which resulted in a low level of adsorption to the activated sludge. The adsorption/desorption isotherms were of a linear form, as well described by the Freundlich isotherm with the n value approximating unity. The linear distribution coefficients (K(d)) were determined from batch equilibrium experiments with values of 28.6 ± 1.9, 55.7 ± 2.2, and 110.0 ± 4.6 mL/g for SMX, SMM, and SDM, respectively. SMX, SMM, and SDM desorb reversibly from the activated sludge leaving behind on the solids 0.9%, 1.6%, and 5.2% of the original sorption dose of 100 μg/L. The sorbed antibiotics can be introduced into the environment if no further treatments were employed to remove them from the biomass.

Insight to ternary complexes of co-adsorption of norfloxacin and Cu(II) onto montmorillonite at different pH using EXAFS

Co-adsorption of norfloxacin (Nor) and Cu(II) on montmorillonite at pH 4.5, 7.0 and 9.0 was studied by integrated batch adsorption experiments and extended X-ray absorption fine structure (EXAFS) spectroscopy. Under such pH conditions the dominant species of Nor are cation (Nor(+)), zwitterion (Nor(±)), and anion (Nor(-)), respectively. Results indicated that Nor sorption decreased with an increase of solution pH. The presence of Cu(II) slightly suppressed the Nor(+) sorption at pH 4.5, while increased Nor(±) and Nor(-)sorption on montmorillonite at pH 7.0 and 9.0, respectively. In contrast, Nor increased Cu(II) adsorption at pH 4.5, but had little effect on the adsorption of Cu(II) on montmorillonite at pH 7.0 and 9.0. Spectroscopic results showed that, at pH 4.5, Nor(+) was sorbed on montmorillonite by the formation of outer-sphere montmorillonite-Nor-Cu(II) ternary surface complex. At pH 7.0, montmorillonite-Nor-Cu(II) and montmorillonite-Cu(II)-Nor ternary surface complexes co-exist. At pH 9.0, montmorillonite-Cu(II)-Nor ternary surface complex was likely formed, which was different to Cu(II)(Nor)(2) precipitate of the solution.

Selected personal care products and endocrine disruptors in biosolids: an Australia-wide survey

Personal care products (PCPs) and endocrine disrupting compounds (EDCs) are groups of organic contaminants that have been detected in biosolids around the world. There is a shortage of data on these types on compounds in Australian biosolids, making it difficult to gain an understanding of their potential risks in the environment following land application. In this study, 14 biosolids samples were collected from 13 Australian wastewater treatment plants (WWTPs) to determine concentrations of eight compounds that are PCPs and/or EDCs: 4-t-octylphenol (4tOP), 4-nonylphenol (4NP), triclosan (TCS), bisphenol A (BPA), estrone (E1), 17β-estradiol (E2), estriol (E3) and 17α-ethinylestradiol (EE2). Concentration data were evaluated to determine if there were any differences between samples that had undergone anaerobic or aerobic treatment. The concentration data were also compared to other Australian and international data. Only 4tOP, 4NP, TCS, and BPA were detected in all samples and E1 was detected in four of the 14 samples. Their concentrations ranged from 0.05 to 3.08 mg/kg, 0.35 to 513 mg/kg, <0.01 to 11.2 mg/kg, <0.01 to 1.47 mg/kg and <45 to 370 μg/kg, respectively. The samples that were obtained from WWTPs that used predominantly anaerobic treatment showed significantly higher concentrations of the compounds than those obtained from WWTPs that used aerobic treatment. Overall, 4NP, TCS and BPA concentrations in Australian biosolids were lower than global averages (by 42%, 12% and 62%, respectively) and 4tOP concentrations were higher (by 25%), however, of these differences only that for BPA was statistically significant. The European Union limit value for NP in biosolids is 50 mg/kg, which 4 of the 14 samples in this study exceeded.

Effluent-dominated streams. Part 2: Presence and possible effects of pharmaceuticals and personal care products in Wascana Creek, Saskatchewan, Canada

Recent worldwide surveys have not only established incomplete removal of pharmaceuticals and personal care products (PPCPs) by sewage treatment plants, but also their presence in surface waters receiving treated sewage effluent. Those aquatic systems where sewage effluent dominates flow are thought to be at the highest risk for ecosystem level changes. The city of Regina, Saskatchewan, Canada (population 190,400) treats its sewage at a modern tertiary sewage treatment facility located on Wascana Creek. The Wascana Creek hydrograph is dominated by one major event: spring snow melt. Thereafter, creek flow declines considerably and in winter treated sewage effluent makes up almost 100% of stream flow. Four water surveys conducted on the creek from winter 2005 to spring 2007 indicated that PPCPs were always present, in nanogram and sometimes microgram per liter concentrations downstream of the sewage treatment plant. This mixture included antibiotics, analgesics, antiinflammatories, a lipid regulator, metabolites of caffeine, cocaine and nicotine, and an insect repellent. Not surprisingly, concentrations of some PPCPs were highest in winter. According to hazard quotient calculations and homologue presence, ibuprofen, naproxen, gemfibrozil, triclosan, erythromycin, trimethoprim, and sulfamethoxazole were present in Wascana Creek at concentrations that may present a risk to aquatic organisms. The continual exposure to a mixture of pharmaceuticals as well as concentrations of un-ionized ammonia that far exceed Canadian and American water quality guidelines suggests that Wascana Creek should be considered an ecosystem at risk. Although the Wascana Creek study is regional in nature, the results highlight the considerable risks posed to aquatic organisms in such effluent-dominated ecosystems.

Disposal practices for unused medications around the world

Pharmaceuticals have been detected throughout the environment where at least in some cases, they have been shown to have a detrimental effect. Many result from improper patient disposal of unused pharmaceuticals via environmentally-unfriendly routes, such as the sink, toilet or rubbish bin. This review surveys the current peer-reviewed literature on attitudes and practices to medicine disposal methods as reported by patients and the various medication disposal and destruction systems around the world. A literature search was carried out using the keywords 'medicines disposal', 'unused medicines', 'medicines wastage', and 'medication disposal' in the PubMed TM, ISI Web of Knowledge TM, Google Scholar TM, Medline TM, Scopus TM and International Pharmaceuticals Abstracts TM up to the end of May 2010. Twelve peer-reviewed articles with specified sample sizes were selected. The most popular methods for medication disposal were in the garbage, toilet or sink. Liquid medications were more likely to be rinsed down the sink, as opposed to solid tablets and capsules which were more likely deposited in the rubbish bin. Much confusion exists about the 'proper' way of medication disposal as many countries do not have standard medication disposal protocols. Furthermore, some pharmacies around the world refused to accept unused medications or discouraged the practice. Patients with knowledge about the impact of pharmaceuticals in the environment were more likely to return medications for proper disposal and destruction. It is concluded that it is of paramount importance that a formalized protocol for patient disposal and destruction of pharmaceuticals be implemented around the world.

Occurrence, partition and removal of pharmaceuticals in sewage water and sludge during wastewater treatment

During 8 sampling campaigns carried out over a period of two years, 72 samples, including influent and effluent wastewater, and sludge samples from three conventional wastewater treatment plants (WWTPs), were analyzed to assess the occurrence and fate of 43 pharmaceutical compounds. The selected pharmaceuticals belong to different therapeutic classes, i.e. non-steroidal anti-inflammatory drugs, lipid modifying agents (fibrates and statins), psychiatric drugs (benzodiazepine derivative drugs and antiepileptics), histamine H2-receptor antagonists, antibacterials for systemic use, beta blocking agents, beta-agonists, diuretics, angiotensin converting enzyme (ACE) inhibitors and anti-diabetics. The obtained results showed the presence of 32 target compounds in wastewater influent and 29 in effluent, in concentrations ranging from low ng/L to a few μg/L (e.g. NSAIDs). The analysis of sludge samples showed that 21 pharmaceuticals accumulated in sewage sludge from all three WWTPs in concentrations up to 100 ng/g. This indicates that even good removal rates obtained in aqueous phase (i.e. comparison of influent and effluent wastewater concentrations) do not imply degradation to the same extent. For this reason, the overall removal was estimated as a sum of all the losses of a parent compound produces by different mechanisms of chemical and physical transformation, biodegradation and sorption to solid matter. The target compounds showed very different removal rates and no logical pattern in behaviour even if they belong to the same therapeutic groups. What is clear is that the elimination of most of the substances is incomplete and improvements of the wastewater treatment and subsequent treatments of the produced sludge are required to prevent the introduction of these micro-pollutants in the environment.

Dissipation and leaching potential of selected pharmaceutically active compounds in soils amended with biosolids

Biosolids land application is an important pathway introducing pharmaceuticals into the environment. In this work, laboratory column and dissipation experiments were performed using soils of varying properties in order to study the fate and transport of pharmaceutical residues introduced by the land application of biosolids. For experimentation, five pharmaceutical compounds (carbamazepine, diphenhydramine, fluoxetine, diltiazem, and clindamycin) and two metabolites (carbamazepine-10,11-epoxide and norfluoxetine) commonly found in biosolids were selected. Leaching experiments indicate that the selected pharmaceuticals have low mobility in tested soils. However, small portions of the applied pharmaceuticals were recovered in the leachates, likely attributed to sorption to dissolved organic matter. Dissipation experiments show that carbamazepine, diphenhydramine, and fluoxetine were persistent in soils, whereas the dissipation of diltiazem and clindamycin was affected by redox conditions and soil properties.

Characterization of additional sewage treatment technologies: ecotoxicological effects and levels of selected pharmaceuticals, hormones and endocrine disruptors

In the present study, two conventional (with and without sand filter) and four additional (moving bed biofilm reactor, ozone, moving bed biofilm reactor combined with ozone and a membrane bio reactor) treatment technologies were operated in small-scale at Hammarby Sjöstad sewage treatment plant, Stockholm, Sweden. The effluents were tested with five short-term (≤ 7 days exposure) ecotoxicological tests, and analyzed for a number of target analytes, comprising pharmaceuticals, natural hormones and industrial chemicals. Overall, the tested effluents generated few adverse effects at lower concentrations (< 50% sewage effluent), and no major differences were observed between any of the treatments. The effluent treated with the moving bed biofilm reactor resulted in the lowest effects in the ecotoxicological tests. The most efficient treatment technology with regard to the pharmaceutical residues was the ozone treatment, which however caused negative effects in some of the ecotoxicological tests.

Sampling for pharmaceuticals and personal care products (PPCPs) and illicit drugs in wastewater systems: are your conclusions valid? A critical review

The analysis of 87 peer-reviewed journal articles reveals that sampling for pharmaceuticals and personal care products (PPCPs) and illicit drugs in sewers and sewage treatment plant influents is mostly carried out according to existing tradition or standard laboratory protocols. Less than 5% of all studies explicitly consider internationally acknowledged guidelines or methods for the experimental design of monitoring campaigns. In the absence of a proper analysis of the system under investigation, the importance of short-term pollutant variations was typically not addressed. Therefore, due to relatively long sampling intervals, potentially inadequate sampling modes, or insufficient documentation, it remains unclear for the majority of reviewed studies whether observed variations can be attributed to "real" variations or if they simply reflect sampling artifacts. Based on results from previous and current work, the present paper demonstrates that sampling errors can lead to overinterpretation of measured data and ultimately, wrong conclusions. Depending on catchment size, sewer type, sampling setup, substance of interest, and accuracy of analytical method, avoidable sampling artifacts can range from "not significant" to "100% or more" for different compounds even within the same study. However, in most situations sampling errors can be reduced greatly, and sampling biases can be eliminated completely, by choosing an appropriate sampling mode and frequency. This is crucial, because proper sampling will help to maximize the value of measured data for the experimental assessment of the fate of PPCPs as well as for the formulation and validation of mathematical models. The trend from reporting presence or absence of a compound in "clean" water samples toward the quantification of PPCPs in raw wastewater requires not only sophisticated analytical methods but also adapted sampling methods. With increasing accuracy of chemical analyses, inappropriate sampling increasingly represents the major source of inaccuracy. A condensed step-by-step Sampling Guide is proposed as a starting point for future studies.

Fate of antibiotics during municipal water recycling treatment processes

Municipal water recycling processes are potential human and environmental exposure routes for low concentrations of persistent antibiotics. While the implications of such exposure scenarios are unknown, concerns have been raised regarding the possibility that continuous discharge of antibiotics to the environment may facilitate the development or proliferation of resistant strains of bacteria. As potable and non-potable water recycling schemes are continuously developed, it is imperative to improve our understanding of the fate of antibiotics during conventional and advanced wastewater treatment processes leading to high-quality water reclamation. This review collates existing knowledge with the aim of providing new insight to the influence of a wide range of treatment processes to the ultimate fate of antibiotics during conventional and advanced wastewater treatment. Although conventional biological wastewater treatment processes are effective for the removal of some antibiotics, many have been reported to occur at 10-1000 ng L(-1) concentrations in secondary treated effluents. These include beta-lactams, sulfonamides, trimethoprim, macrolides, fluoroquinolones, and tetracyclines. Tertiary and advanced treatment processes may be required to fully manage environmental and human exposure to these contaminants in water recycling schemes. The effectiveness of a range of processes including tertiary media filtration, ozonation, chlorination, UV irradiation, activated carbon adsorption, and NF/RO filtration has been reviewed and, where possible, semi-quantitative estimations of antibiotics removals have been provided.

Occurrence and removal of PPCPs in municipal and hospital wastewaters in Greece

A monitoring study was carried out for the four seasons over 1-year monitoring period (March 2006-March 2007) to investigate the residues of 11 pharmaceuticals and personal care products (PPCPs) belonging to various therapeutic categories. The selected areas of the study were the municipal and hospital wastewater treatment plants (WWTPs) of Ioannina city, located in Western Greece. The most common pre-treatment technique for pharmaceuticals, solid-phase extraction (SPE), was used for the isolation and pre-concentration of the target analytes. The samples were screened using gas chromatography mass spectrometry (GC-MS). The results of the monitoring study, showed the occurrence of all target compounds in the wastewater samples. Concentrations in the municipal WWTP ranged between 0.3 and 164.4 microg/L in the influent and between 0.5 and 13.9 microg/L in the effluent. In the hospital WWTP concentrations ranged between 0.6 and 70.1 microg/L in the influent and between 0.5 and 14.6 microg/L in the effluent. Mean removal efficiencies ranged between 13% and 97% and between 9% and 87% for municipal and hospital WWTPs, respectively. Removal efficiencies were higher in the municipal WWTP than in the hospital WWTP.

Presence of pharmaceutically active compounds in Doñana Park (Spain) main watersheds

Among the emerging environmental contaminants, pharmaceutically active compounds have become a growing public concern because of their potential to cause undesirable ecological and human health effects. Doñana Park (South of Spain) includes a mosaic of unique ecosystems known around the world which is particularly affected by the quality of the incoming flowing water. This study reports the presence of a number of priority pharmaceuticals in wastewater and surface water samples from Doñana watersheds. In general, ibuprofen, naproxen, salicylic acid, propranolol, caffeine and gemfibrozil were the compounds most frequently found in all locations, in the range of ng/L to microg/L. Carbamazepine, with high potential risk to the environment, was also detected, although only in a few water samples. The main results are: (i) pharmaceuticals, as water pollutants, are continually discharged into Doñana water bodies and, owing to their biological activity, could lead to adverse effects in this outstanding aquatic ecosystem; (ii) wastewater treatments implemented in the area are insufficient to remove pharmaceuticals; and (iii) therefore, there is a requirement for better wastewater treatments in this natural area to reduce or avoid the presence of organic pollutants in general and pharmaceutical active compounds in particular. To the best of our knowledge, these data constitute the first measurements of pharmaceutical compounds in water not only from the protected area of Doñana Park but also from other Natural or National Parks in the world.

Norfloxacin sorption and its thermodynamics on surface-modified carbon nanotubes

Adsorption on carbon nanotubes (CNTs) may affect the environmental behavior of organic contaminants including antibiotics. In this study, sorption of norfloxacin (NOR) onto graphitized multiwall CNTs (G-CNTs), carboxylated multiwall CNTs (C-CNTs), hydroxylated multiwall CNTs (H-CNTs), and activated carbon (AC) was investigated. All sorption isotherms were highly nonlinear and were fitted well by Freundlich and Polanyi-Manes models. AC showed the highest NOR sorption capacity because of its highest surface area. H-CNTs had much higher NOR sorption than C-CNTs, and the pi-pi electron donor-acceptor (EDA) interactions could explain the distinction between the two types of CNTs. Comparison of sorption coefficients at different pHs indicates that hydrophobic and electrostatic interaction also played major roles in sorption of NOR on CNTs. Furthermore, high sorption capacity and hysteresis of NOR on CNTs were demonstrated in this study, which needs to be considered for predicting environmental risks of CNTs and NOR. The results from thermodynamic analysis show that sorption of NOR on AC and CNTs was thermodynamically favorable and generally endothermic. Sorption site energy analysis illustrates a distribution of sorption energy, consistent with nonlinear isotherms, which indicates the heterogeneous sites on CNTs for NOR adsorption.

Fate and removal of estrogens in municipal wastewater

Natural and synthetic estrogens are some of the most potent endocrine disrupting compounds found in municipal wastewater. Much research has been conducted on the source and fate of estrogens in wastewater treatment plants. Sorption and biodegradation are the primary removal mechanisms for estrogens in activated sludge systems, which are widely used biological treatment techniques for municipal wastewater treatment. However, when removal of estrogens in a wastewater treatment plant is incomplete, these compounds enter the environment through wastewater discharges or waste activated sludge at concentrations that can cause endocrine-reproductive system alterations in birds, reptiles and mammals. Therefore, studies have also focused on potential advanced treatment technologies with the aim of removing the compounds before discharging wastewater effluent or disposing waste sludge. This review discusses the physiological effects of these estrogens and the degree of problems estrogens pose as they enter the wastewater stream. Thereafter, this review also analyzes their fate in wastewater treatment systems and how they may reach drinking water sources. Furthermore, this review includes a discussion on various treatment technologies being investigated and future research trends for this pressing environmental issue.

Photodegradation of pharmaceuticals and personal care products during UV and UV/H2O2 treatments

Photodegradation characteristics of pharmaceuticals and personal care products (PPCPs) and the effectiveness of H(2)O(2) addition for PPCPs photodegradation during UV treatment were examined in this study. Average k (1st order rate constant) value for all the PPCPs investigated increased by a factor of 1.3 by H(2)O(2) addition during UV treatment using biologically treated water (TW) spiked with the 30 PPCPs. Therefore, the effectiveness of H(2)O(2) addition for PPCPs removal during UV treatment in real wastewater treatment process was expected. It could be also known that H(2)O(2) addition would improve photodegradation rates of PPCPs highly resistant for UV treatment such as DEET, ethenzamide and theophylline. UV dose required for 90% degradation of each PPCP was calculated from k values obtained in UV and UV/H(2)O(2) treatment experiments using TW spiked with 30 PPCPs. For UV treatment, UV dose required for degrading each PPCP by 90% of initial concentration ranged from 38 mJ cm(-2) to 5644 mJ cm(-2), indicating that most of PPCPs will not be removed sufficiently in UV disinfection process in wastewater treatment plant. For UV/H(2)O(2) treatment, all the PPCPs except seven PPCPs including cyclophosphamide and 2-QCA were degraded by more than 90% by UV irradiation for 30 min (UV dose: 691 mJ cm(-2)), indicating that H(2)O(2) addition during UV treatment will be highly effective for improving the degradation of PPCPs by UV, even though much higher UV dose is still necessary comparing to for UV disinfection.