Multi-residue ultra-performance liquid chromatography coupled with tandem mass spectrometry method for comprehensive multi-class anthropogenic compounds of emerging concern analysis in a catchment-based exposure-driven study

A high-throughput analytical method for complex contaminant mixtures in biosolids

Biosolids are rich in organic matter and other nutrients that contribute to environmental and agricultural sustainability by improving soil textural and biological properties and enhancing plant growth when applied to agricultural crops. Land application of biosolids encourages resource recovery and circumvents drawbacks associated with landfilling or incineration. However, biosolids contain numerous chemicals at trace levels, and quantitative analysis of such mixtures in this complex matrix is crucial for understanding and managing application risks. There are currently few analytical methods available that are capable of extracting and quantifying a large range of the emerging contaminants found in biosolids. In this study, a simplified, rapid, and robust method of analysis was developed and validated for a high-priority organic contaminant mixture of 44 endocrine disrupting compounds known to occur in biosolids. Analytes consisted of chemicals from many classes with a wide range of physiochemical properties (e.g., log Kow values from -1.4 to 8.9). The biosolids extraction and cleanup protocol was validated for 42 of the targeted compounds. The UPLC-MS2 parameters were validated for all 44 organic contaminants targeted for study. From the two batches of biosolids tested using this analytical method, most of the targeted contaminants (86%) were detected with 100% frequency at concentrations ranging from 0.036 to 10,226 μg/kg dw. Performance results highlighted that internal standards alone could not negate biosolids matrix effects; thus, internal standards and the standard addition method were used for residue quantification. This was the first study to detect and quantify 6PPD-q in biosolids, and the first to quantify lidocaine and 11 other chemicals in biosolids using a single analytical method. This method may be expanded for analysis of additional chemicals in biosolids and comparable matrices.

Targeted multi-analyte UHPLC-MS/MS methodology for emerging contaminants in septic tank wastewater, sludge and receiving surface water

Septic tanks treat wastewater of individual houses and small communities (up to 2000 people in Scotland) in rural and semi-urban areas and are understudied sources of surface water contamination. A multi-analyte methodology with solid phase extraction (SPE), ultra-sonic extraction, and direct injection sample preparation methods was developed to analyse a comprehensive range of emerging contaminants (ECs) including prescription and over-the-counter pharmaceuticals and related metabolites, natural and synthetic hormones, and other human wastewater marker compounds in septic tank influent and effluent, river water, suspended solids, and septic tank sludge by ultra-high-performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). The number of quantifiable compounds in each matrix varied from 68 in septic tank wastewater to 59 in sludge illustrating its applicability across a range of matrices. Method quantification limits were 2.9 × 10-5-1.2 μg L-1 in septic tank influent, effluent and river water, with ≤0.01 μg L-1 achieved for 60% of ECs in all three water matrices, and 0.080-49 μg kg-1 in sludge. The developed method was applied to a septic tank (292 population equivalents) and the receiving river in the North-East of Scotland. Across all samples analysed, 43 of 68 ECs were detected in at least one matrix, demonstrating the method's sensitivity. The effluent concentrations suggest limited removal of ECs in septic tanks and a potential impact to river water quality for some ECs. However, further monitoring is required to better appreciate this. The developed methodology for a wide variety of ECs in a range of liquid and solid phases will allow, for the first time, a comprehensive assessment of ECs fate and removal in septic tanks, and their impact to surface water quality.

A new Wastewater-Based Epidemiology workflow to estimate community wide non-communicable disease prevalence using pharmaceutical proxy data

This manuscript introduces a new wastewater-based epidemiology workflow for estimation of non-communicable diseases (NCDs) prevalence by using wastewater-based epidemiology (WBE) and pharmaceuticals/their metabolites as proxies for NCDs prevalence. 83 targets were selected (54 parent pharmaceuticals and 29 metabolites). Three critical aspects were tested: (i) Solid-Phase Extraction - Ultra-Performance Liquid Chromatography and Tandem Mass Spectrometry (SPE-UHPLC-MS/MS) method performance, (ii) biomarker stability under variable storage conditions (during sampling and long-term storage) and (iii) accounting for human metabolism in WBE back-calculations. High stability of most analytes was observed under tested storage conditions. A few exceptions include diazepam, dihydroketoprofen and 5-hydroxy-lansoprazole. Analyte recoveries varied between 75% and 125% for most analytes. MDLs ranged from 0.2 ng L-1 to 5.6 ng L-1, while MQLs from 0.2 ng L-1 to 16.8 ng L-1. The overall average method accuracy and precision were: 99.5% and 4.0% respectively. A fully validated method was tested using community wastewater in the Southwest of England to estimate pharmaceutical usage, test metabolism correction factors established and compare results with prescription data. The new WBE method for NCD approximation allowed for the estimation of the daily usage/intake of 69 NCD targets with a standardized approach and a consistent reporting format.

An integrated One Health framework for holistic evaluation of risks from antifungal agents in a large-scale multi-city study

A new framework for retrospective mass spectral data mining for antifungal agents (AFs) and Wastewater-Based Epidemiology (WBE) was developed as part of One Health framework to tackle risks from AFs. A large scale, multi-city study was undertaken in South-West England. Key drivers of AFs in the catchment were identified with communal wastewater discharges being the main driver for human AFs (fluconazole, ketoconazole) and agricultural runoff being the main driver for pesticide AFs (prochloraz, prothioconazole and tebuconazole). Average WBE-estimated human used fluconazole and ketoconazole PNDIs (population normalised daily intake) exceeded 300 mg day-1 1000 inh-1 and 2000 mg day-1 1000 inh-1. This is much higher than PNDPs (population normalised daily prescriptions <40 mg day-1 1000 inh-1 and <80 mg day-1 1000 inh-1 for fluconazole and ketoconazole respectively). This was expected due to both prescription and over-the-counter usage, and both oral and topical applications. Pesticide AF, prothioconazole had PNDIs <40,000 mg day-1 1000 inh -1, which gave intake: 0.43, 0.26, 0.07 mg kg-1 in City A, B, and C, likely due to accounting for external/non-human sources. This is higher than the acceptable daily intake (ADI) of 0.01 mg kg-1bw day-1, which warrants further study. Intake per kg of body weight estimated using tebuconazole was 0.86, 1.39, 0.12, 0.13, and 2.7 mg kg-1 in City A-E respectively and is likely due to external/non-human sources. Intake calculated using its metabolite was 0.02 and 0.01 mg kg-1 in City B and C respectively, which aligned with ADI (0.03 mg kg-1bw day-1). The environmental risk assessment of AFs indicated low/medium risk from fluconazole, prochloraz, and tebuconazole, medium risk from epoxiconazole, prothioconazole's metabolite, and tebuconazole, and high risk for prothioconazole in river water. High risk was estimated from fluconazole, epoxiconazole, prothioconazole and its metabolite, tebuconazole, ketoconazole in wastewater samples, which is important during raw sewage discharge events via sewer overflows.

Absorption, translocation, and metabolism of atrazine, carbamazepine, and sulfamethoxazole by the macrophyte Orange King Humbert canna lily (Canna × generalis L.H. Bailey (pro sp.) [glauca × indica])

Canna × generalis L.H. Bailey (pro sp.) [glauca × indica] (common name: Orange King Humbert canna lily) has been reported as a promising plant species that can effectively remove contaminants of emerging concern (CECs), such as atrazine (ATZ), carbamazepine (CBZ), and sulfamethoxazole (SMX), from contaminated surface water. In the present study, absorption, translocation, and metabolism of such CECs in canna were examined using carbon-14-labeled ([¹⁴C]) analogues of each contaminant to understand the removal of each. Uptake/adsorption of the [¹⁴C]-CECs increased over time and was > 47.5% at the end of the 14-day study. The root-shoot translocation of [¹⁴C]-ATZ in canna was the greatest at 49.9-78.8%, followed by [¹⁴C]-CBZ (1.9-44.7%) and [¹⁴C]-SMX (3.3-6.0%). The cumulative transpiration of canna was correlated with absorption (R² > 0.95) and root-shoot translocation (R² > 0.97) magnitudes of [¹⁴C]-CECs in canna. Radiographic results revealed significant conversion of parent [¹⁴C]-CECs into other metabolites during the 14-day study. Metabolism of [¹⁴C]-ATZ and [¹⁴C]-CBZ occurred mainly in the shoots, whereas metabolism of [¹⁴C]-SMX occurred in the roots. Taken together, root-shoot redistribution and metabolism of CECs absorbed into canna can vary by transpiration volume as well as chemical properties.

Occurrence of contaminants of emerging concern in the Eerste River, South Africa: Towards the optimisation of an urban water profiling approach for public- and ecological health risk characterisation

The study evaluated the presence and fate of various contaminants of emerging concern (CECs) from a South African wastewater treatment works (WWTW) and surface waters located around an urban setting. A total of 45 CECs were quantified from nine sampling locations over an 11-month period. Daily loads (g/day) of the target analytes in the WWTW showed persistence of some CECs, along with population-normalised daily loads (mg/day/1000inh) of pharmaceuticals and drugs of abuse (DOA) that were estimated for the first time in the study area. Multiple chemical markers were recorded in river water located upstream of the WWTW discharge throughout the study period, suggesting a high degree of diffuse pollution from urban communities in the study area that are not connected to sewage networks or where sanitation services are limited. The potential of using defined surface water locations to perform community-wide substance use profiling for non-sewered communities was also explored. Environmental risk characterisation for the WWTW effluent and surface waters throughout the study period provided multiple risk quotients (RQ) for the target list of CECs spanning over various sentinel trophic levels. High risk profiles (RQ > 1.0) with a frequency of exceedance (FoE) larger than 75 % were recorded for several CECs in both WWTW effluent and surface water locations that suggest potential long-term ecological health risk impacts of pollution hotspot areas in the river catchment situated around the urban area. We present challenges in surface water quality within the study area that is relatable, or may even present more challenging, in other low- or middle-income country (LMICs) settings. The study also highlighted some challenges and limitations associated with the much-needed application of wastewater-based epidemiology (WBE) intervention in non-sewered communities that can inform on public health and communal substance use profiles of the entire urban setting.

Development of multi-residue gas chromatography coupled with mass spectrometry methodologies for the measurement of 15 chemically different disinfection by-products (DBPs) of emerging concern in drinking water from two different Portuguese water treatment plants

In water treatment plants (WTPs), chemical agents, such as chlorine and ozone, might react with organic matter and anthropogenic contaminants, forming a high diversity of disinfection by-products (DBPs). Due to the potential toxicological effects, the identification of unregulated DBPs (UR-DBPs) is critical to help water managers in the selection of effective water treatment processes, contributing to improving water safety plans. Given the limited validated analytical methods to detect UR-DBPs, here we developed new multi-residue gas chromatography coupled with mass spectrometry methodologies for the detection and quantification of 15 UR-DBPs, including aldehydes, haloketones (HKs), nitrosamines and alcohols, in drinking water matrices. Solid-phase extraction (SPE), for the nitrosamine group, and solid-phase micro extraction (SPME), for the remaining DBPs, were used as sample preparation methods. The developed methodologies allowed the quantification of target UR-DBPs at trace concentration levels (ng L^-1), with method quantification limits (MQLs) ranging from 14.4 ng L^-1 to 26.0 ng L^-1 (SPE-GC-MS) and 2.3 ng L^-1 and 1596 ng L^-1 (SPME-GC-MS). The methods were applied to different drinking water matrices, considering distinct delivery points of EPAL - Empresa Portuguesa das Águas Livres WTPs. Overall, the aldehyde group, represented by decanal, nonanal and 2-ethylheaxanal, showed the highest occurrence, followed by HKs and nitrosamines. The results of this study suggested that the formation of these UR-DBPs should be further monitored in WTPs.

Research needs for optimising wastewater-based epidemiology monitoring for public health protection

Wastewater-based epidemiology (WBE) is an unobtrusive method used to observe patterns in illicit drug use, poliovirus, and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The pandemic and need for surveillance measures have led to the rapid acceleration of WBE research and development globally. With the infrastructure available to monitor SARS-CoV-2 from wastewater in 58 countries globally, there is potential to expand targets and applications for public health protection, such as other viral pathogens, antimicrobial resistance (AMR), pharmaceutical consumption, or exposure to chemical pollutants. Some applications have been explored in academic research but are not used to inform public health decision-making. We reflect on the current knowledge of WBE for these applications and identify barriers and opportunities for expanding beyond SARS-CoV-2. This paper critically reviews the applications of WBE for public health and identifies the important research gaps for WBE to be a useful tool in public health. It considers possible uses for pathogenic viruses, AMR, and chemicals. It summarises the current evidence on the following: (1) the presence of markers in stool and urine; (2) environmental factors influencing persistence of markers in wastewater; (3) methods for sample collection and storage; (4) prospective methods for detection and quantification; (5) reducing uncertainties; and (6) further considerations for public health use.

Comparison of sorption models to predict analyte loss during sample filtration and evaluation of the impact of filtration on data quality

Although filtration has been a widely applied sample pretreatment step in environmental analytical chemistry, its impact on the quality of the data produced is often underappreciated in the scientific community. The objective of this literature review and modeling exercise was to examine nine existing sorption models with input parameters including hydrophobic interactions, pH, and structural features to predict the loss of analytes during wastewater filtration due to sorption to suspended solids and to assess the impact of filtration on data quality. Models' sorption estimates were further validated with a set of comprehensive metadata collected and analyzed from 20 peer-reviewed research papers that reported physical measurements of the suspended solids sorbed fraction of analytes obtained during wastewater filtration of contaminants of emerging concern (CECs). Data on the impact of filtration were obtained from the literature for 156 organic compounds reported both for the dissolved and particulate bound analyte mass. Approximately 40% of CECs (62/156) showed significant filtration loss (>20%) as a result of the removal of suspended solids during filtration. The loss of analyte mass due to filtration ranged from <1% for atenolol to >95% for acenaphthene. Collected literature data were then used to evaluate the utility of sorption modeling to predict analyte losses during sample pretreatment. Among nine sorption models, three were found to predict filtration loss of at least 70% of the CECs evaluated within a range of ±20% of the actually measured filtration loss of analytes, assuming a suspended solid concentration of 200 mg/L and a fraction of organic carbon in suspended solids of 0.43. Thus, sorption modeling can help reduce error when calculating mass loadings based on samples filtered before analysis. It is concluded that the estimates could be further improved by considering the following factors: ionic interactions, characteristics of the water-borne sorbents, and filtration media properties.

Understanding and managing uncertainty and variability for wastewater monitoring beyond the pandemic: Lessons learned from the United Kingdom national COVID-19 surveillance programmes

The COVID-19 pandemic has put unprecedented pressure on public health resources around the world. From adversity, opportunities have arisen to measure the state and dynamics of human disease at a scale not seen before. In the United Kingdom, the evidence that wastewater could be used to monitor the SARS-CoV-2 virus prompted the development of National wastewater surveillance programmes. The scale and pace of this work has proven to be unique in monitoring of virus dynamics at a national level, demonstrating the importance of wastewater-based epidemiology (WBE) for public health protection. Beyond COVID-19, it can provide additional value for monitoring and informing on a range of biological and chemical markers of human health. A discussion of measurement uncertainty associated with surveillance of wastewater, focusing on lessons-learned from the UK programmes monitoring COVID-19 is presented, showing that sources of uncertainty impacting measurement quality and interpretation of data for public health decision-making, are varied and complex. While some factors remain poorly understood, we present approaches taken by the UK programmes to manage and mitigate the more tractable sources of uncertainty. This work provides a platform to integrate uncertainty management into WBE activities as part of global One Health initiatives beyond the pandemic.

A comprehensive aquatic risk assessment of the beta-blocker propranolol, based on the results of over 600 research papers

A comprehensive aquatic environmental risk assessment (ERA) of the human pharmaceutical propranolol was conducted, based on all available scientific literature. Over 200 papers provided information on environmental concentrations (77 of which provided river concentrations) and 98 dealt with potential environmental effects. The median concentration of propranolol in rivers was 7.1 ng/L (range of median values of individual studies 0.07 to 89 ng/L), and the highest individual value was 590 ng/L. Sixty-eight EC50 values for 35 species were available. The lowest EC50 value was 0.084 mg/L. A species sensitivity distribution (SSD) provided an HC50 value of 6.64 mg/L and an HC5 value of 0.22 mg/L. Thus, there was a difference of nearly 6 orders of magnitude between the median river concentration and the HC50 value, and over 4 orders of magnitude between the median river concentration and the HC5 value. Even if an assessment factor of 100 was applied to the HC5 value, to provide considerable protection to all species, the safety margin is over 100-fold. However, nearly half of all papers reporting effects of propranolol did not provide an EC50 value. Some reported that very low concentrations of propranolol caused effects. The lowest concentration reported to cause an effect - in fact, a range of biochemical and physiological effects on mussels - was 0.3 ng/L. In none of these 'low concentration' papers was a sigmoidal concentration-response relationship obtained. Although inclusion of data from these papers in the ERA cause a change in the conclusion reached, we are sceptical of the repeatability of these 'low concentration' results. We conclude that concentrations of propranolol present currently in rivers throughout the world do not constitute a risk to aquatic organisms. We discuss the need to improve the quality of ecotoxicology research so that more robust ERAs acceptable to all stakeholders can be completed.

Spatiotemporal profiling of antibiotics and resistance genes in a river catchment: Human population as the main driver of antibiotic and antibiotic resistance gene presence in the environment

Studies to understand the role wastewater treatment plants (WWTPs) play in the dissemination of antibiotics (ABs), and in the emergence of antibiotic resistance (ABR), play an important role in tackling this global crisis. Here we describe the abundance and distribution of 16 ABs, and 4 corresponding antibiotic resistance genes (ARGs), sampled from the influent to five WWTPs within a single river catchment. We consider four classes of antibiotics: fluroquinolones, macrolides, sulfamethoxazole and chloramphenicol, as well the corresponding antibiotic resistance genes qnrS, ermB, sul1 and catA. All antibiotics, apart from four fluroquinolones (besifloxacin, lomefloxacin, ulifloxacin, prulifloxacin), were detected within all influent wastewater from the 5 cities (1 city = 1 WWTP), as were the corresponding antibiotic resistance genes (ARGs). Strong correlations were observed between the daily loads of ABs and ARGs versus the size of the population served by each WWTP, as well as between AB and ARG loads at a single site. The efficiency of ABs and ARGs removal by the WWTPs varied according to site (and treatment process utilized) and target, although strong correlations were maintained between the population size served by WWTPs and daily loads of discharged ABs and ARGs into the environment. We therefore conclude that population size is the main determinant of the magnitude of AB and ARG burden in the environment.

Diagnosing Down-the-Drain Disposal of Unused Pharmaceuticals at a River Catchment Level: Unrecognized Sources of Environmental Contamination That Require Nontechnological Solutions

Down-the-drain disposal of pharmaceuticals remains an overlooked and unrecognized source of environmental contamination that requires nontechnological "at-source" solutions. Monitoring of 31 pharmaceuticals over 7 days in five wastewater treatment plants (WWTPs) serving five cities in South-West UK revealed down-the-drain codisposal of six pharmaceuticals to three WWTPs (carbamazepine and propranolol in city A, sildenafil in city B, and diltiazem, capecitabine, and sertraline in city D), with a one-off record codisposal of estimated 253 pills = 40 g of carbamazepine and estimated 96 pills = 4 g of propranolol in city A accounting for their 10- and 3-fold respective increases in wastewater daily loads. Direct disposal of pharmaceuticals was found to affect the efficiency of wastewater treatment with much higher pharmaceutical removal (decrease in daily load) during "down-the-drain disposal" days. This is due to lack of conjugated glucuronide metabolites that are cleaved during "consumption-only" days, with the release of a parent pharmaceutical counterbalancing its removal. Higher removal of pharmaceuticals during down-the-drain disposal days reduced pharmaceutical loads reaching receiving environment, albeit with significant levels remaining. The estimated daily loads in receiving water downstream from a discharge point accounted for 13.8 ± 3.4 and 2.1 ± 0.2 g day^-1 of carbamazepine and propranolol, respectively, during consumption-only days and peaked at 20.9 g day^-1 (carbamazepine) and 4.6 g day^-1 (propranolol) during down-the-drain disposal days. Actions are needed to reduce down-the-drain disposal of pharmaceuticals. Our recent work indicated that down-the-drain disposal of pharmaceuticals doubled since the last study in 2005, which may be due to the lack of information and messaging that informs people to dispose of unused medicines at pharmacies. Media campaigns that inform the public of how to safely dispose of medicines are key to improving rates of return and reducing pharmaceutical waste in the environment. The environment is a key motivator for returning unused medicines to a pharmacy and so messaging should highlight environmental risks associated with improper disposal.

Magnetic Mesoporous Carbon/β-Cyclodextrin-Chitosan Nanocomposite for Extraction and Preconcentration of Multi-Class Emerging Contaminant Residues in Environmental Samples

This study reports the development of magnetic solid-phase extraction combined with high-performance liquid chromatography for the determination of ten trace amounts of emerging contaminants (fluoroquinolone antibiotics, parabens, anticonvulsants and β-blockers) in water systems. Magnetic mesoporous carbon/β-cyclodextrin-chitosan (MMPC/Cyc-Chit) was used as an adsorbent in dispersive magnetic solid-phase extraction (DMSPE). The magnetic solid-phase extraction method was optimized using central composite design. Under the optimum conditions, the limits of detection (LODs) ranged from 0.1 to 0.7 ng L-1, 0.5 to 1.1 ng L-1 and 0.2 to 0.8 ng L-1 for anticonvulsants and β-blockers, fluoroquinolone and parabens, respectively. Relatively good dynamic linear ranges were obtained for all the investigated analytes. The repeatability (n = 7) and reproducibility (n = 5) were less than 5%, while the enrichment factors ranged between 90 and 150. The feasibility of the method in real samples was assessed by analysis of river water, tap water and wastewater samples. The recoveries for the investigated analytes in the real samples ranged from 93.5 to 98.8%, with %RSDs under 4%.

Estimation of community-wide multi-chemical exposure via water-based chemical mining: Key research gaps drawn from a comprehensive multi-biomarker multi-city dataset

This paper explores the strong potential of chemical mining of wastewater for markers of community-wide intake of wide-ranging harmful chemicals belonging to several usage groups: industrial chemicals, personal care products, pesticides, illicit drugs, lifestyle chemicals and prescription pharmaceuticals as a proxy for multi-chemical community-wide exposure. An estimation of chemical intake in five contrasting town/cities based in the Avon River catchment in the South-West UK was undertaken. High-resolution spatiotemporal pharmaceutical prescription databases were used for system calibration, both in terms of biomarker selection and its correction factor, as well as for the overall system performance evaluation, both spatially and temporality. Only metabolism data accounting for phase two metabolism provided correct estimates of pharma intake. Using parent compounds as XCRs (xenobiotic compounds residue) was found to overestimate exposure due to an inclusion of directly disposed (unused) drugs. Spatiotemporal trends in XC intake were observed as a result of occupational exposure (higher bisphenol A (BPA) intake during weekday), and lifestyle choices (higher cocaine and pyrethroid pesticides intake during weekend). WBE is not intended to estimate individual exposure to chemicals. It can however provide estimates at a community level, and as a result, it has the potential to be developed into an early warning system, a powerful tool for large scale screening studies identifying communities at risk and in need of high resolution individual testing at a localised scale.

Micropollutant fluxes in urban environment - A catchment perspective

This study provided a holistic understanding of the sources, fate and behaviour of 142 compounds of emerging concern (CECs) throughout a river catchment impacted by 5 major urban areas. Of the incoming 169.3 kg d^-1 of CECs entering the WwTWs, 167.9 kg d^-1 were present in the liquid phase of influent and 1.4 kg d^-1 were present in the solid phase (solid particulate matter, SPM). Analysis of SPM was important to determine accurate loads of incoming antidepressants and antifungal compounds, which are primarily found in the solid phase. Furthermore, these classes and the plasticiser, bisphenol A (BPA) were the highest contributors to CEC load in digested solids. Population normalised loads showed little variation across the catchment at 154 ± 12 mg d^-1 inhabitant^-1 indicating that population size is the main driver of CECs in the studied catchment. Across the catchment 154.6 kg d^-1 were removed from the liquid phase during treatment processes. CECs discharged into surface waters from individual WwTWs contributed between 0.19 kg d^-1 at WwTW A to 7.3 kg d^-1 at WwTW E, which correlated strongly with the respective contributing populations. Spatial and temporal variations of individual CECs and their respective classes were found in WwTW influent (both solid (influent_SPM) and liquid phases (influent_AQ)) throughout the catchment, showing that different urban areas impact the catchment in different ways, with key variables being lifestyle, use of over-the-counter pharmaceuticals and industrial activity. Understanding of both spatial and temporal variation of CECs at the catchment level helped to identify possible instances of direct disposal, as in the case of carbamazepine. Analysis of surface waters throughout the catchment showed increasing mass loads of CECs from upstream of WwTW A to downstream at WwTW D, showing clear individual contributions from WwTWs. Many CECs were ubiquitous throughout the river water in the catchment. Daily loads ranged from 0.005 g d^-1 (ketamine, WwTW A) up to 1890.3 g d^-1 (metformin, WwTW C) for the 84/138 CECs that were detected downstream of the WwTWs. For metformin this represents the equivalent of ∼1,890 tablets (1,000 mg per tablet) dissolved in the river water downstream of WwTW C.

(Fluoro)quinolones and quinolone resistance genes in the aquatic environment: A river catchment perspective

This study provides an insight into the prevalence of (fluoro)quinolones (FQs) and their specific quinolone qnrS resistance gene in the Avon river catchment area receiving treated wastewater from 5 wastewater treatment plants (WWTPs), serving 1.5 million people and accounting for 75% of inhabitants living in the catchment area in the South West of England.. Ofloxacin, ciprofloxacin, nalidixic acid and norfloxacin were found to be ubiquitous with daily loads reaching a few hundred g/day in wastewater influent and tens of g/day in receiving waters. This was in contrast to other FQs analysed: flumequine, nadifloxacin, lomefloxacin, ulifloxacin, prulifloxacin, besifloxacin and moxifloxacin, which were hardly quantified. Enantiomeric profiling revealed that ofloxacin was enriched with the S-(-)-enantiomer, likely deriving from its prescription as the more potent enantiomerically pure levofloxacin, alongside racemic ofloxacin. While ofloxacin's enantiomeric fraction (EF) remained constant, high stereoselectivity was observed in the case of its metabolite ofloxacin-N-oxide. The removal efficiency of quinolones during wastewater treatment at 5 WWTPs utilising either trickling filters (TF) or activated sludge (AS), was compound and wastewater treatment process dependent, with AS providing better efficiency than TF. The qnrS resistance gene was ubiquitous in wastewater. Its removal was WWTP treatment process dependent with TF performing best and resulting in significant removal of the gene (from 28 to 75%). AS underperformed with only 9% removal in the case of activated sludge and actual increase in the gene copy number within sequencing batch reactors (SBRs). Interestingly, the data suggests that higher removal of antibiotics could be linked with high prevalence of the gene (SBR and WWTP E) and vice versa, low removal of antibiotic is correlated with lower prevalence of the gene in wastewater effluent (TF, WWTP B and D). This is especially prominent in the case of ofloxacin and could indicate that AS might be facilitating antimicrobial resistance (AMR) prevalence to higher extent than TF. Wastewater-based epidemiology (WBE) was also applied to monitor any potential misuse (e.g. direct disposal) of FQs in the catchment. In most cases higher use of antibiotics with respect to official statistics (i.e. ciprofloxacin, ofloxacin) was observed, which suggests that FQs management practice require further attention.