Predicted environmental concentration and fate of the top 10 most dispensed Australian prescription pharmaceuticals

Pharmaceutical emissions on the example of the Baltic Sea catchment: comparing measurements with multi-tier predictive models

Currently, there is uncertainty about emissions of pharmaceuticals into larger closed ecosystems that are at risk such as the Baltic Sea. There is an increasing need for selecting the right strategies on advanced wastewater treatment. This study analysed 35 pharmaceuticals and iodinated X-ray contrast media in effluents from 82 Wastewater Treatment Plants (WWTPs) across Denmark, Estonia, Finland, Germany, Latvia, Lithuania, Poland and Sweden. Measured concentrations from Finland and Denmark were compared to predicted effluent concentrations using different levels of refinement. The concentrations predicted by the Total Residue Approach, as proposed by the European Medicines Agency, correlated with R2 of 0.18 and 0.031 to measured ones for Denmark and Finland, respectively and the predicted data were significantly higher than the measured ones. These correlations improved substantially to R2 of 0.72 and 0.74 after adjusting for estimated human excretion rates and further to R2 = 0.91 and 0.78 with the inclusion of removal rates in WWTPs. Temporal analysis of compound variations in a closely monitored WWTP showed minimal fluctuation over days and weeks for most compounds but revealed weekly shifts in iodinated X-ray contrast media due to emergency-only operations at X-ray clinics during weekends and an abrupt seasonal change for gabapentin. The findings underscore the limitations of current predictive models and findings (...) demonstrate how these methodologies can be refined by incorporating human pharmaceutical excretion/metabolization as well as removal in wastewater treatment plants to more accurately forecast pharmaceutical levels in aquatic environments.

Pollution levels and ecological risks of PPCPs in water and sediment samples of Danjiangkou Reservoir

The concentrations and distribution patterns of three typical pharmaceuticals and personal care products (PPCPs) in water and sediment samples obtained from Danjiangkou Reservoir during two seasonal sampling periods were studied to determine their impact on water quality. The temporal and spatial variations in concentrations measured were analyzed and related to ecological risks with data obtained during the mean-flow period (in June) and the dry period (in November). We found a high detection rate of ketoprofen (KTP) in water samples from Danjiangkou Reservoir; the concentrations ranged from not detected (ND) to 46.80 ng/L with the highest values measured in the Hanku tributary samples followed by the samples collected in the main body of Danjiangkou Reservoir. The KTP concentrations in the Danku tributary samples were the lowest measured in this study. In addition, the concentrations of KTP in the Shending River, Sihe River, Jianghe River, Guanshan River, and Jianhe River water samples were relatively high in the mean-flow period. The water sample detection rates and concentrations of triclosan (TCS) and triclocarban (TCC) were low in both the mean-flow period and the dry period. All three kinds of PPCPs were detected in the sediment samples with the concentrations of KTP, TCS, and TCC ranging from 0.76 to 7.89 μg/kg, 0.01 to 0.59 μg/kg, and 0.01 to 11.36 μg/kg, respectively. Overall, the concentrations of the three measured PPCPs in the water and sediment samples were all relatively low compared to results reported in the recent literature. The dry period concentrations of PPCPs in the water samples were lower than the concentrations measured in the mean-flow period. However, dry period concentrations were higher in the sediment samples compared to those in the mean-flow period samples. Our interpretation of the spatial and temporal patterns of PPCPs in Danjiangkou Reservoir suggests that these compounds were likely mainly derived from wastewater discharge in the upper reaches of the reservoir. The risk quotient (RQ) method was used for an ecological risk assessment of the detected PPCPs in this study. We found that TCS in water and sediment posed medium ecological risks to algae at different times of the year. In view of the extreme importance of water safety in Danjiangkou Reservoir, the ecological risks of PPCPs require additional attention.

Integrated biomarker response in signal crayfish Pacifastacus leniusculus exposed to diphenhydramine

Diphenhydramine (DPH) is a pharmaceutical with multiple modes of action, primarily designed as an antihistamine therapeutic drug. Among antihistamines, DPH is a significant contaminant in the environment, frequently detected in surface waters, sediments, and tissues of aquatic biota. In the present study, signal crayfish Pacifastacus leniusculus was used as a model organism because of their prominent ecological roles in freshwater ecosystems. The biochemical effects were investigated in crayfish exposed to the environmental (low: 2 μg L^-1), ten times elevated (medium: 20 μg L^-1), and the sublethal (high: 200 μg L^-1) nominal concentrations of DPH in water for 96 h. Lipid peroxidation, antioxidant enzyme activities, and acetylcholinesterase activity were assessed as toxicological biomarkers in crayfish hepatopancreas, gills, and muscles. Low and medium DPH exposure caused imbalances only in glutathione-like enzyme activities. Integrated biomarker response showed the absolute DPH toxicity effects on all tested tissues under high exposure. This study identified that high, short-term DPH exposure induced oxidative stress in crayfish on multiple tissue levels, with the most considerable extent in muscles.

Systems assessment of statins hazard: Integrating in silico prediction, developmental toxicity profile and transcriptomics in zebrafish

Statins are prescribed widely as lipid-lowering agents. However, statins are associated with an increased harmful risk on public health and the ecosystem. Little is known about statins' toxicity on biological development and the underlying molecular mechanisms. We exposed zebrafish embryos to a series of statins to evaluate their development toxicity. Statins-induced embryonic developmental defects in a concentration-dependent manner. 72 h LC₅₀ values for lovastatin, simvastatin, fluvastatin, atorvastatin, rosuvastatin, and pravastatin were 0.01 μM, 0.04 μM, 1.93 μM, 37.28 μM, 79.29 μM, and 2170 μM, respectively. Moreover, the expression of genes involved in heart contraction, calcium ion binding, transcription factors, nucleus, and G protein-coupled receptor signaling pathway was altered by statins. The early growth response gene (egr4) and transcription factor genes (fosab and fosb) were screened as potential toxicity targets due to their significant upregulation based on protein-protein interaction (PPI) and drug-gene interaction network analysis. Finally, the ecotoxicity profile of statins was predicted by in silico method, and statins were high or moderate risk to aquatic organisms. We provide a systems toxicology strategy to explore the toxicity of statins and illustrate the potential mechanisms of action.

Human health and ecological risk assessment of 98 pharmaceuticals and personal care products (PPCPs) detected in Indian surface and wastewaters

The release of pharmaceuticals and personal care products (PPCPs) in environmental waters has become an urgent issue due to their pseudo-persistent traits. The present study was undertaken to conduct a screening-level risk assessment of 98 PPCPs, detected in different water matrices (treated wastewater, surface water, and groundwater) of India, for evaluating ecological risk (risk to fish, daphnia, and algae), human health risk, and antimicrobial resistance (AMR) selection risk by following risk quotient (RQ) based methodology. In the present study, 47% of the detected PPCPs in Indian waters were found to exert a possible risk (RQ > 1) to either aquatic species and human health, or cause AMR selection risk. 17 out of 25 antibiotics detected in the environmental waters were found to pose a threat of AMR selection. 11 out of 49 pharmaceuticals were found to exert human health risk from ingesting contaminated surface water, whereas only 2 pharmaceuticals out of 25 were found to exert risk from the intake of groundwater. Very high RQs (>1000) for few pharmaceuticals were obtained, signifying a great potential of the detected PPCPs in causing severe health concern, aquatic toxicity, and AMR spread. Within India, special attention needs to be given to the pharmaceutical hubs, as the environmental waters in these regions were found to be severely contaminated with drug residues resulting in extremely high RQs. The present study will be helpful in prioritizing the detected PPCPs in the environmental waters of India, for which immediate attention and enforceable guidelines are required.

Combined toxicity of therapeutic pharmaceuticals to duckweed, Lemna minor

Pharmaceuticals, which are designed to be biologically active at low concentrations, are found in surface waters, meaning aquatic organisms can be exposed to complex mixtures of pharmaceuticals. In this study, the adverse effects of four pharmaceuticals, 17α-ethynylestradiol (synthetic estrogen), methotrexate (anticancer drug), diclofenac (nonsteroidal anti-inflammatory drug) and fluoxetine (antidepressant), and their binary mixtures at mg/L concentrations were assessed using the 7-day Lemna minor test, with both apical and biochemical markers evaluated. The studied biochemical markers included chlorophyll a, chlorophyll b, carotenoids and oxidative stress enzymes catalase, glutathione-S-transferase and glutathione reductase, with effects compared to solvent controls. The adverse effects on Lemna minor were dose-dependent for frond number, surface area, relative chlorophyll content and activity of glutathione S-transferase for both individual pharmaceuticals and binary mixtures. According to the individual toxicity values, all tested pharmaceuticals can be considered as toxic or harmful to aquatic organisms, with methotrexate considered highly toxic. The most sensitive endpoints for the binary mixtures were photosynthetic pigments and frond surface area, with effects observed in the low mg/L concentration range. The concentration addition model and toxic unit approach gave similar mixture toxicity predictions, with binary mixtures of methotrexate and fluoxetine or methotrexate and 17α-ethynylestradiol exhibiting synergistic effects. In contrast, mixtures of diclofenac with fluoxetine, 17α-ethynylestradiol or methotrexate mostly showed additive effects. While low concentrations of methotrexate are expected in surface water, chronic ecotoxicological data for invertebrates and fish are lacking, but this is required to better assess the environmental risk of methotrexate.

Knowledge gaps in ecotoxicology studies of marine environments in Pacific Island Countries and Territories - A systematic review

The Pacific Island Countries and Territories (PICTs) are heavily dependent on the marine resources for food security, employment, government revenue and economic development, hence the concern about the potential exposure of these resources to pollutants. The main goal of this review was to identify ecotoxicology studies published that were done in PICTs. Four major gaps were identified: i) a quantitative gap, with low number of studies published on the PICTs; ii) a geographic gap, where ecotoxicology studies have unevenly covered the different PICTs; iii) a temporal gap, as no biological effect monitoring study has so far been published for the PICTs; and, iv) a pollutants gap, as all of the PICTs studies focused mainly on environmental monitoring studying on average two types of pollutants (heavy metals and pesticides) per PICT only. We suggest, therefore, the potential risk to the marine environment to be estimated by assessing the fate of pollutants via chemical and biological effect monitoring.

Surface Enhanced Raman Spectroscopy in environmental analysis, monitoring and assessment

Environmental pollution is usually monitored via mass spectrometry-based approaches. Such techniques are extremely sensitive but have several disadvantages. The instruments themselves are expensive, require specialized training to use and usually cannot be taken into the field. Samples also usually require extensive pre-treatment prior to analysis which can affect the final result. The development of analytical methods that matched the sensitively of mass spectrometry but that could be deployed in the field and require minimal sample processing would be highly advantageous for environmental monitoring. One method that may meet these criteria is Surface Enhanced Raman Spectroscopy (SERS). This is a surface-sensitive technique that enhances Raman scattering by molecules adsorbed on rough nanostructure surfaces such as gold or silver nanoparticles. SERS gives selective spectral enhancement such that increases in sensitivity of 10¹⁰ to 10¹⁴ have been reported. While this means SERS is, theoretically at least, capable of single molecule detection such a signal enhancement is hard to achieve in practice. In this review the background of SERS is introduced for the environmental scientist and the recent literature on the detection of several classes of environmental pollutants using this technique is discussed. For heavy metals the lowest limit of detection reported was 0.45 μg/L for Mercury; for pharmaceuticals, 2.4 μg/L for propranolol; for endocrine disruptors, 0.35 μg/L for 17β-estradiol; for perfluorinated compounds, 500 μg/L for perfluorooctanoic acid and for inorganic pollutants, 37g/L for general pesticide markers. The signal enhancements achieved in each case show great promise for the detection of pollutants at environmentally relevant concentrations and, although it does not yet routinely match the sensitivity of mass spectrometry. Further work to develop SERS methods and apply them for the detection of contaminants could be of wide benefit for environmental science.

Sale-based estimation of pharmaceutical concentrations and associated environmental risk in the Japanese wastewater system

Information on sales and emission of selected pharmaceuticals were used to predict their concentrations in Japanese wastewater influent through a >300 of pharmaceuticals data sink. A combined wastewater-based epidemiology and environmental risk analysis follow was established. By comparing predicted environmental concentrations (PECs) of pharmaceuticals in wastewater influent against measured environmental concentrations (MECs) reported in previous studies, it was found that the model gave accurate results for 17 pharmaceuticals (0.5 < PEC/MEC < 2), and acceptable results for 32 out of 40 pharmaceuticals (0.1 < PEC/MEC < 10). Although the majority of pharmaceuticals considered in the model were antibiotics and analgesics, pranlukast, a receptor antagonist, was predicted to have the highest concentration in wastewater influent. With regard to the composition of wastewater effluent, the Estimation Program Interface (EPI) suite was used to predict pharmaceutical removal through activated sludge treatment. Although the performance of the EPI suite was variable in terms of accurate prediction of the removal of different pharmaceuticals, it could be an efficient tool in practice for predicting removal under extreme scenarios. By using the EPI suite with input data on PEC in the wastewater influent, the PEC values of pharmaceuticals in wastewater effluent were predicted. The concentrations of 26 pharmaceuticals were relatively high (>1 μg/L), and the PECs of 6 pharmaceuticals were extremely high (>10 μg/L) in wastewater effluent, which could be attributed to their high usage rates by consumers and poor removal rates in wastewater treatment plants (WWTPs). Furthermore, environmental risk assessment (ERA) was carried out by calculating the ratio of predicted no effect concentration (PNEC) to PEC of different pharmaceuticals, and it was found that 9 pharmaceuticals were likely to have high toxicity, and 54 pharmaceuticals were likely to have potential toxicity. It is recommended that this is further investigated in detail. The priority screening and environmental risk assessment results on pharmaceuticals can provide reliable basis for policy-making and environmental management.

Contaminants of Emerging Concern as novel groundwater tracers for delineating wastewater impacts in urban and peri-urban areas

Management and treatment of environmental impacts from wastewater treatment plants (WWTPs) is a major, worldwide, sustainability challenge. One issue associated with WWTP operation is the potential for groundwater contamination via leaking or infiltration of wastewater, particularly with inorganic nutrients (ammonia and nitrate) as well as persistent organic compounds. Despite the potential for such contamination to create environmental and health risks, conventional methods, such as the assessment of major ions, nutrients, bacteriological indicators and conventional tracers (such as stable and radiogenic isotopes) are often unable to provide accurate delineation of multiple potential sources of contamination. This is particularly important for WWTPs which often occur in urban, peri-urban or intensively farmed agricultural areas where multiple potential sources (such as livestock, fertilisers, wastewater irrigation, and domestic septic systems) may contribute similar contaminants. This review explores the applicability of promising novel groundwater tracers, such as Contaminants of Emerging Concern (CECs) and isotopic tracers, which can be used in conjunction with conventional tracers (i.e. 'co-tracers') to provide a more definitive assessment of contaminant sources, plume delineation and even (potentially) indicating the age of contamination (e.g., recent vs. legacy). The suitability of the novel groundwater tracers is evaluated according to four key criteria: (i). sufficient presence in raw wastewater and/or treated effluents; (ii) diagnostic of WWTP impacts as opposed to other potential off-site contamination sources; (iii) persistence in the subsurface environment; and (iv) amenable to rapid and sensitive analysis. Further analysis of various classes of CECs along with improved detection limits associated with improvements in analytical methodologies should allow for future application of promising groundwater tracers, providing WWTP operators and regulatory authorities a more definitive toolbox with which to assess groundwater contamination associated with site operations. These include: persistent pharmaceuticals and personal care products (carbamazepine, crotamiton, primidone, atenolol and sulfamethoxazole), artificial sweeteners (acesulfame, sucralose, saccharin and cyclamate) and potentially, certain pesticides (atrazine and simazine).