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Liu Y, Cai D, Li X, Wu Q, Ding P, Shen L, Yang J, Hu G, Wu J, Zhang L. Occurrence, fate, and risk assessment of antibiotics in typical pharmaceutical manufactories and receiving water bodies from different regions. PLoS One 2023; 18:e0270945. [PMID: 36662697 PMCID: PMC9858356 DOI: 10.1371/journal.pone.0270945] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/21/2022] [Indexed: 01/21/2023] Open
Abstract
This study aimed to investigate the presence and persistence of antibiotics in wastewater of four typical pharmaceutical manufactories in China and receiving water bodies and suggest the removal of antibiotics by the wastewater treatment process. It also evaluated the environmental impact of antibiotic residues through wastewater discharge into receiving water bodies. The results indicated that thirteen antibiotics were detected in wastewater samples with concentrations ranging from 57.03 to 726.79 ng/L. Fluoroquinolones and macrolides were the most abundant antibiotic classes found in wastewater samples, accounting for 42.5% and 38.7% of total antibiotic concentrations, respectively, followed by sulfonamides (16.4%) and tetracyclines (2.4%). Erythromycin-H2O, lincomycin, ofloxacin, and trimethoprim were the most frequently detected antibiotics; among these antibiotics, the concentration of ofloxacin was the highest in most wastewater samples. No significant difference was found in different treatment processes used to remove antibiotics in wastewater samples. More than 50% of antibiotics were not completely removed with a removal efficiency of less than 70%. The concentration of detected antibiotics in the receiving water bodies was an order of magnitude lower than that in the wastewater sample due to dilution. An environmental risk assessment showed that lincomycin and ofloxacin could pose a high risk at the concentrations detected in effluents and a medium risk in their receiving water bodies, highlighting a potential hazard to the health of the aquatic ecosystem. Overall, The investigation was aimed to determine and monitor the concentration of selected antibiotics in 4 typical PMFs and their receiving water bodies, and to study the removal of these substances in PMFs. This study will provide significant data and findings for future studies on antibiotics-related pollution control and management in water bodies.
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Affiliation(s)
- Yuanfei Liu
- School of Environment and Energy, South China University of Technology, Guangzhou, Guangdong, China
| | - Dan Cai
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, Guangdong, China
| | - Xin Li
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, Guangdong, China
| | - Qingyao Wu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, Guangdong, China
- School of Public Health and Emergency Management, South University of Science and Technology of China, Shenzhen, Guangdong, China
| | - Ping Ding
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, Guangdong, China
| | - Liangchen Shen
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, Guangdong, China
| | - Jian Yang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, Guangdong, China
| | - Guocheng Hu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, Guangdong, China
| | - Jinhua Wu
- School of Environment and Energy, South China University of Technology, Guangzhou, Guangdong, China
| | - Lijuan Zhang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, Guangdong, China
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Yuan J, Lu ZK, Xiong X, Jiang B. Lowering drug prices and enhancing pharmaceutical affordability: an analysis of the national volume-based procurement (NVBP) effect in China. BMJ Glob Health 2021; 6:bmjgh-2021-005519. [PMID: 34518200 PMCID: PMC8438819 DOI: 10.1136/bmjgh-2021-005519] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/20/2021] [Indexed: 11/04/2022] Open
Abstract
To cope with the increasing healthcare costs brought about by the universal health insurance programme, national volume-based procurement (NVBP) was implemented in China to reduce drug prices. However, the impact of NVBP remains unknown. We reported the effects of the NVBP pilot programme on medication affordability and discussed the challenges and recommendations for further reforms. A total of 25 molecules won the bidding in the NVBP pilot programme, and price cuts ranged from 25% to 96%. Medication affordability was measured as the number of days' wages needed to pay for a course of treatment, and the medication was identified as affordable if the cost of a treatment course was less than the average daily wage. After the NVBP, the proportion of affordable drugs increased from 33% to 67%, and the mean affordability improved from 8.2 days' wages to 2.8 days' wages. Specifically, for rural residents, the proportion of affordable drugs increased from 13% to 58%, and the mean affordability improved from 15.7 days' wages to 5.3 days' wages. For urban residents, the proportion of affordable drugs increased from 54% to 71%, and the mean affordability improved from 5.9 days' wages to 2.0 days' wages. Implementing the NVBP substantially improved medication affordability. In future reforms, a multifaceted approach addressing all issues in the health system is needed to enhance medicine access.
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Affiliation(s)
- Jing Yuan
- Department of Clinical Pharmacy and Pharmacy Administration, Fudan University School of Pharmacy, Shanghai, China
| | - Z Kevin Lu
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina, USA
| | - Xiaomo Xiong
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina, USA
| | - Bin Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, Peking University School of Pharmaceutical Sciences, Beijing, China
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