Cytotoxic effects of seven Tunisian hospital wastewaters on the proliferation of human breast cancer cell line MDA-231: correlation with their chemical characterization

Pharmaceuticals and personal care products in Tunisian hospital wastewater: occurrence and environmental risk

Despite concerns about the potential risk associated with the environmental occurrence of pharmaceuticals and personal care products (PPCPs), few studies address the emissions of hospitals to aquatic compartments. We examined within a 3-month sampling period the occurrence and environmental risk of PPCPs in seven Tunisian hospital wastewaters. From personal care products, UV filters, main metabolites, and benzotriazoles were quantified, with benzophenone 3 (oxybenzone, BP3) and benzotriazole (BZT) the most frequently found (71%) at median concentrations in the range 2.43 ± 0.87 ngL-1-64.05 ± 6.82 ngL-1 for BP3 and 51.67 ± 1.67 ngL-1-254 ± 9.9 ngL-1 for BZT. High concentrations were also found for 4-hydroxybenzophenone (4HB) (221 ± 6.22 ngL-1), one of the main metabolites of BP3. The antibiotics ofloxacin and trimethoprim, the anti-inflammatory acetaminophen, the antiepileptic carbamazepine, and the stimulant caffeine were present in all the wastewaters. The highest median concentration corresponded to acetaminophen, with 1240 ± 94 mgL-1 in Tunis Hospital, followed by ofloxacin with 78850 ± 39 μgL-1 in Sousse Hospital. For ecotoxicity assessment, acute toxicity was observed for Daphnia magna and Vibrio fischeri. The toxicity data were used in a hazard quotient (HQ) approach to evaluate the risk posed by the target PPCPs to aquatic organisms. The calculated HQs revealed that marbofloxacin (234 for V. fischeri), enrofloxacin (121 for D. magna), and BZT (82.2 for D. magna and 83.7 for V. fischeri) posed the highest risk, concluding that potential risk exists toward aquatic microorganisms. This study constitutes the first monitoring of UV filters in Tunisian hospital effluents and provides occurrence and toxicity data of PPCPs for reference in further surveys in the country.

Critical review of technologies for the on-site treatment of hospital wastewater: From conventional to combined advanced processes

This review aims to assess different technologies for the on-site treatment of hospital wastewater (HWW) to remove pharmaceutical compounds (PhCs) as sustances of emerging concern at a bench, pilot, and full scales from 2014 to 2020. Moreover, a rough characterisation of hospital effluents is presented. The main detected PhCs are antibiotics and psychiatric drugs, with concentrations up to 1.1 mg/L. On the one hand, regarding the presented technologies, membrane bioreactors (MBRs) are a good alternative for treating HWW with PhCs removal values higher than 80% in removing analgesics, anti-inflammatories, cardiovascular drugs, and some antibiotics. Moreover, this system has been scaled up to the pilot plant scale. However, some target compounds are still present in the treated effluent, such as psychiatric and contrast media drugs and recalcitrant antibiotics (erythromycin and sulfamethoxazole). On the other hand, ozonation effectively removes antibiotics found in the HWW (>93%), and some studies are carried out at the pilot plant scale. Even though, some families, such as the X-ray contrast media, are recalcitrant to ozone. Other advanced oxidation processes (AOPs), such as Fenton-like or UV treatments, seem very effective for removing pharmaceuticals, Antibiotic Resistance Bacteria (ARBs) and Antibiotic Resistance Genes (ARGs). However, they are not implanted at pilot plant or full scale as they usually consider extra reactants such as ozone, iron, or UV-light, making the scale-up of the processes a challenging task to treat high-loading wastewater. Thus, several examples of biological wastewater treatment methods combined with AOPs have been proposed as the better strategy to treat HWW with high removal of PhCs (generally over 98%) and ARGs/ARBs (below the detection limit) and lower spending on reactants. However, it still requires further development and optimisation of the integrated processes.

Residential proximity to industrial pollution and mammographic density

BACKGROUND

Mammographic density (MD), expressed as percentage of fibroglandular breast tissue, is an important risk factor for breast cancer. Our objective is to investigate the relationship between MD and residential proximity to pollutant industries in premenopausal Spanish women.

METHODS

A cross-sectional study was carried out in a sample of 1225 women extracted from the DDM-Madrid study. Multiple linear regression models were used to assess the association of MD percentage (and their 95% confidence intervals (95%CIs)) and proximity (between 1 km and 3 km) to industries included in the European Pollutant Release and Transfer Register.

RESULTS

Although no association was found between MD and distance to all industries as a whole, several industrial sectors showed significant association for some distances: "surface treatment of metals and plastic" (β = 4.98, 95%CI = (0.85; 9.12) at ≤1.5 km, and β = 3.00, 95%CI = (0.26; 5.73) at ≤2.5 km), "organic chemical industry" (β = 6.73, 95%CI = (0.50; 12.97) at ≤1.5 km), "pharmaceutical products" (β = 4.14, 95%CI = (0.58; 7.70) at ≤2 km; β = 3.55, 95%CI = (0.49; 6.60) at ≤2.5 km; and β = 3.11, 95%CI = (0.20; 6.01) at ≤3 km), and "urban waste-water treatment plants" (β = 8.06, 95%CI = (0.82; 15.30) at ≤1 km; β = 5.28; 95%CI = (0.49; 10.06) at ≤1.5 km; β = 4.30, 95%CI = (0.03; 8.57) at ≤2 km; β = 5.26, 95%CI = (1.83; 8.68) at ≤2.5 km; and β = 3.19, 95%CI = (0.46; 5.92) at ≤3 km). Moreover, significant increased MD was observed in women close to industries releasing specific pollutants: ammonia (β = 4.55, 95%CI = (0.26; 8.83) at ≤1.5 km; and β = 3.81, 95%CI = (0.49; 7.14) at ≤2 km), dichloromethane (β = 3.86, 95%CI = (0.00; 7.71) at ≤2 km), ethylbenzene (β = 8.96, 95%CI = (0.57; 17.35) at ≤3 km), and phenols (β = 2.60, 95%CI = (0.21; 5.00) at ≤2.5 km).

CONCLUSIONS

Our results suggest no statistically significant relationship between MD and proximity to industries as a whole, although we detected associations with various industrial sectors and some specific pollutants, which suggests that MD could have a mediating role in breast carcinogenesis.

DNA as a Next-Generation Biomonitoring Tool of Hospital Effluent Contamination

A DNA biosensor based on a modified gold electrode with a Au/cysteine/DNA matrix was developed for ultratrace determination of genotoxicity antibiotics. The modified Au/cysteine/DNA electrode was characterized by cyclic voltammetry and impedance spectroscopy methods. The interaction between immobilized DNA and genotoxicity antibiotics in hospital wastewater was investigated using differential pulse voltammetry (DPV) technology. Using this technique, ciprofloxacin and ofloxacin were detected in real time in the hospital wastewater (HW) of the Tunisian cities of Gabes, Tozeur, Sfax, and Gbeli. In addition, physicochemical parameters such as the chemical oxygen demand (COD), biological oxygen demand (BOD), and total organic carbon (TOC) of HW samples that may affect the nature of the samples were studied. Comet assay (single-cell gel electrophoresis) was performed to measure the capacity of xenobiotics to induce DNA damage. In our conditions, this test indicated that all tested wastewater was able to alter cell integrity and cause DNA molecular damage, and the most genotoxic effect was found in the wastewater of Gabes hospital. Results show that the concentrations of the two antibiotics reached 33 and 40 ng/mL in the hospital wastewater of Gabes and Tozeur, respectively. The DNA biosensor based on the modified gold electrode exhibited superb performance and offers a probable application for the detection of genotoxicity antibiotics in hospital wastewater. The level of genotoxicity is proportional to the concentration of antibiotics detected in hospital wastewater. We will explore the application of this model for continuous monitoring downstream of hospital discharge and wastewater treatment plants for effective control of the presence of genotoxic products.

In vivo toxicities of the hospital effluent in Mahdia Tunisia

Hospital effluent (HE) is one of the most important sources of pharmaceuticals released into the environment. This kind of pollution is a recognized problem for both human health and aquatic life. Consequently, in the present study, we assessed the effects of untreated hospital effluent on mice via biochemical and histopathological determinations. Female mice were given free access to water bottles containing untreated HE at different dilutions for 21 days. Then clinical biochemistry and histopathology evaluation were conducted. Serum biochemistry analysis showed the presence of significant increase in cholesterol, triglycerides, glycaemia and total bilirubin. However, phosphatase alkaline and urea activities have been significantly decreased compared to the control group. No significant variation was observed for the rest of the studied parameters (high-density lipoproteins; low-density lipoproteins and uric acid). Additionally, multiple alterations, including cellular necrosis, leucocyte infiltration and congestion, were observed in different tissues of mice exposed to the tested HE.

Monitoring hospital wastewaters for their probable genotoxicity

Hospitals' effluents contain a considerable amount of chemicals. Considering the significant volume of wastewater discharged by hospitals, the presence of these chemicals represents a real threat to the environment and human health. Thus, the aim of this study was to evaluate the in vivo and in vitro genotoxicities of three wastewater effluents collected from Tunisian hospitals. The liver of Swiss albino male mice, previously treated with different doses of the hospital wastewaters, was used as a model to detect DNA fragmentation. Our results showed all the hospital effluents caused significant qualitative and quantitative hazards in hepatic DNA. The wastewater collected from Sfax hospital exhibited the highest genotoxic effect, which may be explained by the presence in this effluent of some toxic micropolluants. There was a significant increase in genotoxicity, proportionally to the concentration of effluent. However, the vitotox assay did not show any significant genotoxicity on Salmonella typhimurium TA104 in the presence or absence of microsomal fraction S9. The ratio gentox/cytox was lower than the threshold 1.5. This study assessed the toxicological risk issued from Tunisian hospital wastewaters, which is potentially very harmful, and it has been pointed out that wastewater treatment requires special attention.

Occurrence of 40 pharmaceutically active compounds in hospital and urban wastewaters and their contribution to Mahdia coastal seawater contamination

In the present study, the occurrence of 40 pharmaceuticals belonging to several therapeutic groups was investigated for the first time in hospital effluent, wastewater treatment plant influent and effluent, and seawater in Mahdia, Tunisia. Forty-six samples were collected within a 6-month sampling period. Pharmaceuticals were analyzed using solid-phase extraction followed by ultra-performance liquid chromatography-triple quadrupole mass spectrometry. Thirty-three out of the forty target compounds were detected over a wide concentration of ranges, from nanograms per liter to micrograms per liter, depending on the type of sample. Maximum values were detected for caffeine at 902 μgL^-1 in hospital wastewater. This compound, as well as salicylic acid, sulfadiazine, and sulfamethizole, were detected in all samples. The average concentration of total pharmaceuticals in hospital wastewater (340 μgL^-1) was higher than those detected in influent and effluent wastewater and seawater (275.11 and 0.2 μgL^-1, respectively). Risk quotients (RQs) were also estimated to provide a preliminary environmental risk assessment and results revealed that sulfadiazine, sulfamethoxazole, and fluoxetine could pose medium/high risk to the tested aquatic organisms for maximum measured concentrations in wastewater (including hospital and WWTP samples). Although the measured environmental concentrations (MECs) detected in seawater samples might not pose a toxic effect to the aquatic organisms (except for salicylic acid, sulfamethoxazole and fluoxetine), further researches are needed due to the continuous release of wastewater in the environment and the limited efficiency of wastewater treatment processes.

Enhancement effects of process optimization technique while elucidating the degradation pathways of drugs present in pharmaceutical industry wastewater using Micrococcus yunnanensis

Pharmaceutical effluents released from industries are accountable to deteriorate the aquatic and soil environment through indirect toxic effects. Microbes are adequately been used to biodegrade pharmaceutical industry wastewater and present study was envisaged to determine biodegradation of pharmaceutical effluent by Micrococcus yunnanensis. The strain showed 42.82% COD (Chemical oxygen demand) reduction before optimization. After applying Taguchi's L8 array as an optimization technique, the biodegradation rate was enhanced by 82.95% at optimum conditions (dextrose- 0.15%, peptone 0.1%, inoculum size 4% (wv^-1), rpm 200, pH 8 at 25 °C) within 6 h. The confirmation of pharmaceuticals degradation was done by ¹H NMR (Nuclear magnetic resonance) studies followed by elucidation of transformation pathways of probable drugs in the effluent through Q-Tof-MS (Quadrupole Time of Flight- Mass Spectrometry). The cytotoxicity evaluation of treated and untreated wastewater was analyzed on Human Embryonic Kidney (HEK 293) cells using Alamar Blue assay, which showed significant variance.

Preliminary evaluation of plasticizer and BPA in Tunisian cosmetics and investigation of hazards on human skin cells

In this study, 18 plasticizer (phthalates, adipates, sebacates, and others) and BPA residues in some cosmetic samples collected from Tunisian market are evaluated by micro-matrix solid-phase dispersion combined with GC-MS. In parallel, the impact of these molecules and the cosmetics in the human epithelial cell lines is investigated. The cytotoxic activity of cosmetic extracts is evaluated in vitro against B16 and Hep-2 human skin cell lines using the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide assay. This study shows that the tested cosmetic products could constitute a hazard to the consumer health and wellness and that strict safety analysis on cosmetic products needs to be carried out before they are marketed.