Occurrence and fate of pharmaceutically active compounds in the largest municipal wastewater treatment plant in Southwest China: mass balance analysis and consumption back-calculated model

Occurrence, fate, and ecological risk of antibiotics in wastewater treatment plants in China: A review

This review offers a comprehensive overview of the occurrence, fate, and ecological risk associated with six major categories of antibiotics found in influent, effluent, and sludge from urban wastewater treatment plants (WWTPs) in China. Further exploration includes examining the correlation between antibiotic residual rates in the effluents and process parameters of urban WWTPs across the country. Lastly, a nationwide and urban cluster-specific evaluation of the ecological risk posed by antibiotics in WWTPs is conducted. The findings reveal that the average concentrations of antibiotics in influent, effluent, and sludge from urban WWTPs in China are 786.2 ng/L, 311.2 ng/L, and 186.8 μg/kg, respectively. Among the detected antibiotics, 42% exhibit moderate to high ecological risk in the effluent, with ciprofloxacin, sulfamethoxazole, erythromycin, azithromycin, and tetracycline posing moderate to high ecological risks in sludge. The current biological treatment processes in WWTPs demonstrate inefficacy in removing antibiotics. Hence, there is a pressing need to develop and integrate innovative technologies, such as advanced oxidation processes. This review aims to offer a more comprehensive understanding and identify priority antibiotics for control to effectively manage antibiotic pollution within WWTPs at both national and regional levels.

A state-of-art-review on emerging contaminants: Environmental chemistry, health effect, and modern treatment methods

Pollution problems are increasingly becoming e a priority issue from both scientific and technological points of view. The dispersion and frequency of pollutants in the environment are on the rise, leading to the emergence have been increasing, including of a new class of contaminants that not only impact the environment but also pose risks to people's health. Therefore, developing new methods for identifying and quantifying these pollutants classified as emerging contaminants is imperative. These methods enable regulatory actions that effectively minimize their adverse effects to take steps to regulate and reduce their impact. On the other hand, these new contaminants represent a challenge for current technologies to be adapted to control and remove emerging contaminants and involve innovative, eco-friendly, and sustainable remediation technologies. There is a vast amount of information collected in this review on emerging pollutants, comparing the identification and quantification methods, the technologies applied for their control and remediation, and the policies and regulations necessary for their operation and application. In addition, This review will deal with different aspects of emerging contaminants, their origin, nature, detection, and treatment concerning water and wastewater.

Occurrence, distribution, and potential ecological risks of antibiotics in a seasonal freeze-thaw basin

Antibiotics have gained increasing attention as pharmaceuticals widely existing in human society. Under low temperature conditions, antibiotics tend to have higher environmental persistence, which poses a potential threat to ecological environment, but research on antibiotics in low-temperature basins is still lacking. Therefore, for investigating occurrence, spatio-temporal distributions, and ecological risks of antibiotics in a seasonal freeze-thaw basin, rivers in Tumen River basin were selected and sampled, including 25 samples during the river-freezing season and 27 samples during the non-freezing season. Overall, climate characteristics of different latitudes and renewal frequency of antibiotics are important factors that lead to diversity of antibiotics in basins. Eleven target antibiotics were detected and their average concentrations during the river-freezing season (0.83-27.5 ng L-1) were lower than that during the non-freezing season (2.80-45.30 ng L-1), severely impacted by river flow, ice sealed-melting, and local feeding practices. In addition, total antibiotic concentrations are usually highest in downstream areas of human settlements, receiving input from husbandry and sewage, respectively. Through ecological risk assessment, norfloxacin and amoxicillin posed high risks to algae, which were identified as high-risk pollutants in basin.

Assessment of selected pharmaceuticals in Riyadh wastewater treatment plants, Saudi Arabia: Mass loadings, seasonal variations, removal efficiency and environmental risk

Despite increasing interest in pharmaceutical emissions worldwide, studies of environmental contamination with pharmaceuticals arising from wastewater discharges in Saudi Arabia are scarce. Therefore, this study examined occurrence, mass loads and removal efficiency for 15 pharmaceuticals and one metabolite (oxypurinol) from different therapeutic classes in three wastewater treatment plants (WWTPs), in Riyadh city in Saudi Arabia. A total of 144 samples were collected from the influents and effluents between March 2018 and July 2019 and analyzed using Solid Phase Extraction followed by triple quadrupole LC-MS/MS. The average concentrations in the influents and effluents were generally higher than their corresponding concentrations found either in previous Saudi Arabian or global studies. The four most dominant compounds in the influent were acetaminophen, ciprofloxacin, caffeine, and diclofenac, with caffeine and acetaminophen having the highest concentrations ranging between 943 and 2282 μg/L. Metformin and ciprofloxacin were the most frequently detected compounds in the effluents at concentrations as high as 33.2 μg/L. Ciprofloxacin had the highest mass load in the effluents of all three WWTPs, ranging between 0.20 and 20.7 mg/day/1000 inhabitants for different WWTPs. The overall average removal efficiency was estimated high (≥80), with no significant different (p > 0.05) between the treatment technology applied. Acetaminophen and caffeine were almost completely eliminated in all three WWTPs. The samples collected in the cold season generally had higher levels of detected compounds than those from the warm seasons, particularly for NSAID and antibiotic compounds. The estimated environmental risk from pharmaceutical compounds in the studied effluents was mostly low, except for antibiotic compounds. Thus, antibiotics should be considered for future monitoring programmes of the aquatic environment in Saudi Arabia.

Occurrence, distribution, and risk assessment of quinolone antibiotics in municipal sewage sludges throughout China

A nationwide study of the occurrence, distribution, potential drivers, and ecological risks of 24 quinolone antibiotics (QNs) in 74 Chinese sludge samples from 48 wastewater treatment plants (WWTPs) was conducted. In domestic sludge, the ∑QNs concentrations were <LOD to 21,925.10 ug/kg (mean: 4808.67 ug/kg), and ofloxacin had the highest concentration (<LOD-11,138.52 ug/kg), and detection frequency (98.48%). Of four generations QNs, the levels showed the following order: 2nd-generation QNs > 3rd-generation QNs > 4th-generation QNs > 1st-generation QNs. Meanwhile, abundant veterinary and human/veterinary quinolones (<LOD-2606.96 and <LOD-12,643.47 ug/kg, respectively) were detected in municipal sludge. Interestingly, the relatively low levels of veterinary quinolones (<LOD-299.21 ug/kg) were also found in industrial sludge (the relevant WWTPs receiving ≤ 10% domestic wastewater, without other direct entry of antibiotics). The correlation analysis demonstrated QNs contamination was negatively influenced by the air temperature of sampling days. The positive correlation between moxifloxacin contents and regional economy possibly suggested local regions with relatively high economic levels face a more difficult situation of QNs antibacterial activity. Environmental risk assessment indicated ofloxacin, ciprofloxacin, and moxifloxacin posed high ecological risks to the domestic sludge. This work delineates a valuable nationwide QNs contamination profile to support their safe use and control in China.

Occurrence, consumption level, fate and ecotoxicology risk of beta-agonist pharmaceuticals in a wastewater treatment plant in Eastern China

Beta-agonist pharmaceuticals are widely used in humans and livestock for disease treatment, legal or illegal growth promotion in food animals, bodybuilding, weight loss, and sports doping. The occurrence of beta-agonists in wastewater treatment plants and their subsequent environmental impacts require greater attention. This study determined the levels of 12 beta-agonists in a wastewater treatment plant and evaluated their ecotoxicological risks as well as consumption levels and risks to human health. Among the 12 selected beta-agonists, all were detected in wastewater and 11 in sludge. In most cases, the concentrations of beta-agonists were higher in spring than in summer. Their total average daily mass loads per capita in the influent and effluent were 1.35 μg/d/p and 2.11 μg/d/p, respectively. The overall removal efficiencies of individual beta-agonists ranged from -295.3 to 71.2%. Ecotoxicological risk assessment revealed a low risk to daphnid and green algae from the levels of fenoterol and the mixture of 12 selected beta-agonists in the effluent. The daily consumption levels of individual beta-agonists per capita were 0.028-1.200 μg/d/p. Regular monitoring of beta-agonists in municipal sewage systems and their risk assessment based on toxicological data are urgently required in the future.

Mass flow and consumption calculations of pharmaceuticals in sewage treatment plant with emphasis on the fate and risk quotient assessment

In Egypt, pharmaceuticals consumption increased dramatically owing to the population growth and the unrestricted sale manner. Accordingly, the occurrence and fate of nine common pharmaceutical active compounds (PhACs) were scrutinized at a sewage treatment plant (STP) in Giza, Egypt. The levels of these PhACs were assessed in different the wastewater treatment stages and dewatered sludge phase using high-performance liquid chromatography coupled with photodiode arrays detector. The average concentrations of the total PhACs detected in influent, primary sedimentation effluent (PSE) and final effluent (FE) were 227, 155 and 89 µg L^-1, respectively. The overall removal efficiency of the individual PhACs ranged from 18 to 72% removal. The occurrence trend revealed that biodegradation and adsorption are the concurrently removal mechanisms of the studied PhACs. The overall consumption per day in West of Greater Cairo was estimated based on influent concentration of STP. Sulfamethoxazole, paracetamol and diclofenac were detected with the highest levels in the influent of STP, PSE and FE as well as in the dewatered sludge. Furthermore, the high concentrations of these compounds in the sludge confirm the adsorption pathway removal of theses PhACs. The risk quotient (RQ) assessment for the detected PhACs in FE is greatly higher than the predicted non-effect concentration (PNEC). Conclusively, the FE of STP is considered a risky source for PhACs in adjacent surface water.

Seasonal distribution and dynamic evolution of antibiotics and evaluation of their resistance selection potential and ecotoxicological risk at a wastewater treatment plant in Jinan, China

The seasonal distribution and dynamic evolution of antibiotics in wastewater from main treatment areas and in sludge and their resistance selection potential and ecotoxicological risk were studied at a municipal wastewater treatment plant in Jinan, East China. Ten antibiotics were selected, and all were detected in wastewater and sludge samples, with fluoroquinolones showing the highest detection concentrations and frequencies. Seasonal fluctuations in the antibiotic concentrations in the influent, effluent, and sludge were observed, with the highest values in winter in most cases. The dynamic evolution of antibiotics during the treatment process differed among the seasons. The antibiotic removal efficiencies were incomplete, ranging from - 40.47 to 100%. Mass balance analysis showed that sulfonamides, roxithromycin, and metronidazole were mainly removed through biological processing, whereas fluoroquinolones, doxycycline, and chloramphenicol were removed through sludge adsorption. Levofloxacin, as well as a mixture of the 10 antibiotics from the effluent, could pose a low ecotoxicological risk to Daphnia in the receiving waters. Additionally, levofloxacin and ciprofloxacin in the effluent and ciprofloxacin and metronidazole in the sludge may facilitate the selection of antibiotic-resistant bacteria in the environment.

Photocatalytic degradation of sulfamethoxazole using TiO2-based materials - Perspectives for the development of a sustainable water treatment technology

Heterogeneous photocatalysis using titanium dioxide-based materials is considered a promising and innovative solution to the water pollution problem. However, due to the limitations concerning the use of the developed materials and the applied photodegradation conditions, the research on photoremediation using TiO₂ often stays behind the lab door. The challenge is to convert the basic research into a successful innovation, leading to the implementation of this process into wastewater treatment. For this purpose, the most active materials and optimal photodegradation conditions must be chosen. This article collects and compares the studies on photocatalytic degradation of an emerging pollutant - sulfamethoxazole, an antibacterial drug - and attempts to find the best approaches to be successfully applied on an industrial scale. Various types of TiO₂-based photocatalysts are compared, including different nanoforms, doped or polymer-based composites, composites with graphene, activated carbon, dyes or natural compounds, as well as possible supporting materials for TiO₂. The paper covers the impact of the irradiation source (natural sunlight, LED, mercury or xenon lamps) and water matrix on the photodegradation process, considering the ecological and economic sustainability of the process. Emphasis is put on the stability, ease of separation and reuse of the photocatalyst, power and safety of the irradiation source, identification of photodegradation intermediates and toxicity assays. The main approaches are critically discussed, main challenges and perspectives for an effective photocatalytic water treatment technology are pointed out.

Antibiotics in wastewater of Guangdong, China: distribution patterns, and their environmental risk due to incomplete removal

In this study, the occurrence, removal, spatial distribution and environmental risks of ten antibiotics in 38 wastewater treatment plants (WWTPs) which located in 15 communities (in 12 cities) of the Guangdong province, China. The results indicated that amoxicillin (AMO, 381.00-5230.00 ng·L^-1) and ofloxacin (OFX, 7.01-836.00 ng·L^-1) were predominant in the province with high detection rates (100 %) and high concentrations. The concentration of norfloxacin (NFX) was high in some influents (2070.00 ng·L^-1), but its detection rate was only 47.4 %. In addition, the average daily mass load per 10³ capita (ADMLpc) of AMO (383.34 mg·(10³ capita)^-1·d^-1) was significantly higher than the other antibiotics. The comparison between the ADMLpc and social-economic factors indicated that adult (age between 18 and 60) was the age group mainly consume antibiotics in the province. Furthermore, the ADMLpc of human antibiotics (e.g., AMO and OFX) were positively affected by the economic development of the region. Comparatively, the ADMLpc veterinary antibiotic (e.g., SMM) was positively related to the livestock related factors. In general, no significant difference (p > 0.05) in antibiotic removal efficiencies among four treatment processes applied in all WWTPs. Nevertheless, the low removal rates of sulfamethazine (SMZ, 44.6 %) and OFX (26.3 %) indicated that they were more difficult to be removed than other antibiotics. Furthermore, high ADMLpc of antibiotics in the influent would cause high ADMLpc in effluents. Therefore, heavy consumption of antibiotics could pose high risk to the ecosystem, especially when multiple antibiotics appeared in the effluent of the WWTPs.

Assessment of community-wide antimicrobials usage in Eastern China using wastewater-based epidemiology

Wastewater-based epidemiology (WBE) has potential to identify the epidemiological links between people, animals, and the environment, as part of antimicrobial resistance (AMR) surveillance. In this study, we investigated six wastewater treatment plants (WWTPs) serving six communities located in two regions in Eastern China: Site A in Zhejiang and site B in Jiangsu province to assess the public use of antimicrobial agents (AA). Fifty antimicrobials and 24 of their metabolites were quantified using ultraperformance liquid chromatography coupled with triple quadrupole tandem mass spectrometry (UPLC-MS/MS). Spatiotemporal trends were established for measured concentrations, daily loads, and population-normalised daily loads. Daily AA mass loads varied between 1.6 g/day and 324.6 g/day reflecting the WWTP scales, with macrolides and β-lactams showing the highest overall environmental burden at 223.7 g/day and 173.7 g/day, respectively. Emissions of antibiotic residues from manufacturing have been observed, with the peak daily load 12-fold higher than the overall load from a community serving a population of over 600,000. Community exposure levels of 225.2 ± 156.2 mg/day/1000 inhabitant and 351.9 ± 133.5 mg/day/1000 inhabitant were recorded in site A and B, respectively. Paired parent-metabolites analysis identified a large proportion (64-78%) of un-metabolised metronidazole and clindamycin at site B, indicating improper disposal of unused drugs either in the community or in livestock production. Consumption levels, calculated via WBE, suggested relatively low antimicrobial usage in Eastern China compared to other areas in China. This first application of WBE in Eastern China to assess the community-wide exposure to AAs has potential to inform regional antimicrobial stewardship.

Exploring antibiotic consumption between urban and sub-urban catchments using both parent drugs and related metabolites in wastewater-based epidemiology

Consumption of antibiotics leads to the dissemination of antimicrobial resistance worldwide. Better knowledge of temporal and spatial consumption of antibiotics helps public health authorities to control their usage and combat antimicrobial resistance. However, measuring antibiotic consumption with population surveys, sales data, and production statistics remains challenging due to the complexity of prescription preference, patient compliance, and direct disposal of unused drugs. With the approach of wastewater-based epidemiology (WBE), this study aims to evaluate the consumption of eight commonly-used antibiotics between developed urban and developing sub-urban catchments in China and to characterise the ratios of parent drugs to metabolites in studying the consumption. Seven parent antibiotics were detected in all the wastewater samples (n = 56), whereas some metabolites were detected sporadically. The ratios of parent chemicals to metabolites varied among locations and were often higher than the ratios in pharmacokinetic studies. Estimated consumption of antibiotics ranged from 3.2 ± 2.0 mg/day/1000 inhabitants for trimethoprim to 28,400 ± 7800 mg/day/1000 inhabitants for roxithromycin in the studied catchments. Higher consumption of sulfapyridine, sulfadiazine and roxithromycin was observed in urban than suburban catchments, while consumption of sulfamethoxazole, norfloxacin, and trimethoprim was higher in suburban than in urban catchments. Using the literature data, we found more than 95% reduction of antibiotic use in an urban catchment. Our study revealed the geographical pattern in antibiotic use across different urban and suburban catchments via WBE, and the potential of monitoring parent-to-metabolite ratios for WBE in estimating antibiotic use. These results provide a basis for health authorities to plan different drug-specific control policies between urban and suburban catchments, and for future WBE studies to be aware of other sources, such as animal husbandry and disposals of unused drugs, that can influence the estimated consumption.

Influence of biofilm thickness on the removal of thirteen different organic micropollutants via a Membrane Aerated Biofilm Reactor (MABR)

The presence of organic micropollutants (OMPs) in natural water bodies has become an emerging concern due to their fast dissemination into natural water sources, high persistence, ubiquitous nature, and detrimental impact on the environment and human health. This study evaluated the Membrane Aerated Biofilm Reactor (MABR) efficiency in the removal of 13 OMPs commonly reported in water. Results demonstrated that OMPs removal is dependent on biofilm thickness and bacterial cell density, microbial community composition and physicochemical properties of OMPs. Effective removals of ammonium and organic carbon (COD, >50%), acetaminophen (70%) and triclosan (99%) were obtained even at early stages of biofilm development (thickness < 0.33 mm, 2.9 ×10⁵ cell mL^-1). An increase in biofilm thickness and cell density (1.02 mm, 2.2 ×10⁶ cell mL^-1) enhanced the system performance. MABR achieved over 90% removal of nonpolar, hydrophobic and hydrophilic OMPs and 22-69% removal of negatively charged and acidic OMPs. Relative abundances of Zoogloea, Aquabacterium, Leucobacter, Runella, and Paludilbaculum bacteria correlated with the removal of certain OMPs. In addition, MABR achieved up to 96% nitrification and 80% overall COD removal by the end of the experiment. The findings from this study demonstrated MABRs to be a feasible option to treat municipal wastewater polluted by OMPs.

Persistence, environmental hazards, and mitigation of pharmaceutically active residual contaminants from water matrices

Pharmaceutical compounds are designed to elicit a biological reaction in specific organisms. However, they may also elicit a biological response in non-specific organisms when exposed to ambient quantities. Therefore, the potential human health hazards and environmental effects associated with pharmaceutically active compounds presented in aquatic environments are being studied by researchers all over the world. Owing to their broad-spectrum occurrence in various environmental matrices, direct or indirect environmental hazardous impacts, and human-health related consequences, several pharmaceutically active compounds have been categorized as emerging contaminants (ECs) of top concern. ECs are often recalcitrant and resistant to abate from water matrices. In this review, we have examined the classification, occurrence, and environmental hazards of pharmaceutically active compounds. Moreover, because of their toxicity and the inefficiency of wastewater treatment plants to remove pharmaceutical pollutants, novel wastewater remediation technologies are urgently required. Thus, we have also analyzed the recent advances in microbes-assisted bioremediation as a suitable, cost-effective, and eco-friendly alternative for the decontamination of pharmaceutical pollutants. Finally, the most important factors to reach optimal bioremediation are discussed.

Ecotoxicological impacts caused by high demand surfactants in Latin America and a technological and innovative perspective for their substitution

Nowadays, water pollution represents a great concern due to population growth, industrialization, and urbanization. Every day hazardous chemical products for humans and aquatic organisms are disposed of arbitrarily from homes and industries. Even though detergents are considered an essential market, there is evidence of environmental impacts caused by surfactants like nonylphenol ethoxylate (NPE) and linear alkylbenzene sulfonates (LAS). Regulations about maximum allowable concentrations in sewage, surface water, and drinking water are scarce or null, mostly in developing countries like Latin American countries. Therefore, this review explores these two common toxic surfactants (NPE and LAS) and proposes a technological, innovative, and ecological perspective on detergents. Also, it establishes a starting point for industries to minimize adverse effects on humans and environmental health caused by these compounds.

A Review on the Removal of Carbamazepine from Aqueous Solution by Using Activated Carbon and Biochar

Carbamazepine (CBZ), one of the most used pharmaceuticals worldwide and a Contaminant of Emerging Concern, represents a potential risk for the environment and human health. Wastewater treatment plants (WWTPs) are a significant source of CBZ to the environment, polluting the whole water cycle. In this review, the CBZ presence and fate in the urban water cycle are addressed, with a focus on adsorption as a possible solution for its removal. Specifically, the scientific literature on CBZ removal by activated carbon and its possible substitute Biochar, is comprehensively scanned and summed up, in view of increasing the circularity in water treatments. CBZ adsorption onto activated carbon and biochar is analyzed considering several aspects, such as physicochemical characteristics of the adsorbents, operational conditions of the adsorption processes and adsorption kinetics and isotherms models. WWTPs usually show almost no removal of CBZ (even negative), whereas removal is witnessed in drinking water treatment plants through advanced treatments (even >90%). Among these, adsorption is considered one of the preferable methods, being economical and easier to operate. Adsorption capacity of CBZ is influenced by the characteristics of the adsorbent precursors, pyrolysis temperature and modification or activation processes. Among operational conditions, pH shows low influence on the process, as CBZ has no charge in most pH ranges. Differently, increasing temperature and rotational speed favor the adsorption of CBZ. The presence of other micro-contaminants and organic matter decreases the CBZ adsorption due to competition effects. These results, however, concern mainly laboratory-scale studies, hence, full-scale investigations are recommended to take into account the complexity of the real conditions.

Current and future perspectives for wastewater-based epidemiology as a monitoring tool for pharmaceutical use

The medical and societal consequences of the misuse of pharmaceuticals clearly justify the need for comprehensive drug utilization research (DUR). Wastewater-based epidemiology (WBE) employs the analysis of human metabolic excretion products in wastewater to monitor consumption patterns of xenobiotics at the population level. Recently, WBE has demonstrated its potential to evaluate lifestyle factors such as illicit drug, alcohol and tobacco consumption at the population level, in near real-time and with high spatial and temporal resolution. Up until now there have been fewer WBE studies investigating health biomarkers such as pharmaceuticals. WBE publications monitoring the consumption of pharmaceuticals were systematically reviewed from three databases (PubMed, Web of Science and Google Scholar). 64 publications that reported population-normalised mass loads or defined daily doses of pharmaceuticals were selected. We document that WBE could be employed as a complementary information source for DUR. Interest in using WBE approaches for monitoring pharmaceutical use is growing but more foundation research (e.g. compound-specific uncertainties) is required to link WBE data to routine pharmacoepidemiologic information sources and workflows. WBE offers the possibility of i) estimating consumption of pharmaceuticals through the analysis of human metabolic excretion products in wastewater; ii) monitoring spatial and temporal consumption patterns of pharmaceuticals continuously and in near real-time; and iii) triangulating data with other DUR information sources to assess the impacts of strategies or interventions to reduce inappropriate use of pharmaceuticals.

Showcasing the potential of wastewater-based epidemiology to track pharmaceuticals consumption in cities: Comparison against prescription data collected at fine spatial resolution

While the extent of pharmaceutical consumption within a society/community is of high relevance to its health, economy and general wellbeing, this data is often not readily available. Herein, we strengthen a wastewater-based epidemiology (WBE) approach as a way to track the consumption of pharmaceuticals within the sampled community. This method is less laborious than established questionnaire or databases approaches and allows a higher temporal and spatial resolution. The WBE approach was conducted by sampling influent wastewater from two wastewater treatment plants of different size. A total of 39 targeted compounds were quantified by liquid chromatography coupled with tandem mass spectrometry. The number of prescriptions and the defined daily doses for each prescription was obtained from the reference database of The Catalan Health System to validate the wastewater-based approach. The wastewater sampling and the data inquiry were both executed during the same period (October 2019) and standardised for comparison to treatments per 1,000 inhabitants per day. The back-calculation parameters were improved from previous studies by including the faecal excretion rate of the pharmaceuticals. For prescription only pharmaceuticals, where prescription numbers are expected to be a good estimate of consumption, our WBE approach agreed with 27 out of 32 (<0.7 order of magnitude). Common over-the-counter pharmaceuticals such as acetaminophen, ibuprofen and naproxen showed much higher values for treatments per day per 1,000 inhabitant in wastewater than prescribed, reflecting the usefulness of WBE in obtaining an estimate of the total consumption i.e. with and without a prescription.

Recent advances in the removal of pharmaceuticals and endocrine-disrupting compounds in the aquatic system: A case of polymer inclusion membranes

The presence of pharmaceuticals and endocrine-disrupting compounds in aquatic systems is a matter of great concern. The occurrence, fate, and potential toxicity of these compounds have triggered the interest of the scientific community. As a result of their high solubility and low volatility, they are common in aquatic systems, and wastewater treatment plants (WWTP) are the main reservoir for these contaminants. Conventional WWTPs have demonstrated an inability to remove these contaminants completely; hence, different advanced treatment processes have been explored to compensate for the lapses of the conventional system. The outcome of this study revealed the significant improvements made using advanced treatment processes to diminish the number of contaminants; however, some contaminants have proven to be refractory. Thus, there is a need to modify various advanced treatment processes or employ additional treatment processes. Polymer inclusion membranes (PIMs) are a liquid membrane technology that is highly efficient at removing contaminants from water. They have been widely studied for the removal of heavy metals and nutrients from aquatic systems; however, only a few studies have investigated the use of PIMs to remove pharmaceutically active compounds from aquatic systems. This research aims to raise awareness on the application of PIMs as a promising water treatment technology which has a great potential for the remediation of pharmaceuticals and endocrine disruptors in the aquatic system, due to its versatility, ease/low cost of preparation and high contaminant selectivity.

New insights on the combined removal of antibiotics and ARGs in urban wastewater through the use of two configurations of vertical subsurface flow constructed wetlands

The occurrence and removal of 49 antibiotics and 11 selected antibiotic resistance genes (ARGs) were investigated in 2 vertical subsurface flow (VF) constructed wetlands (1.5 m² each): an unsaturated (UVF) unit and a partially saturated (SVF) unit (0.35 m saturated out of 0.8 m) operating in parallel and treating urban wastewater. Thirteen antibiotics were detected in influent wastewater, 6 of which were present in all samples. The SVF showed statistical significance on the removal of 4 compounds (namely ciprofloxacin, ofloxacin, pipemidic acid and azithromycin), suggesting that the wider range of pH and/or redox conditions of this configuration might promote the microbial degradation of some antibiotics. In contrast, the concentration of the latter (except pipemidic acid) and also clindamycin was higher in the effluent than in the influent of the UVF. Five ARGs were detected in influent wastewater, sul1 and sul2, bla_TEM, ermB and qnrS. All of them were detected also in the biofilm of both wetlands, except qnrS. Average removal rates of ARGs showed no statistical differences between both wetland units, and ranged between 46 and 97% for sul1, 33 and 97% for sul2, 9 and 99% for ermB, 18 and 97% for qnrS and 11 and 98% for bla_TEM.

Recognition of typical antibiotic residues in environmental media related to groundwater in China (2009-2019)

The potential adverse environmental and health-related impacts of antibiotics are becoming more and more concerning. China is globally the largest antibiotic producer and consumer, possibly resulting in the ubiquity and high detection levels of antibiotics in environmental compartments. Clear status on the concentration levels and spatial distribution of antibiotic contamination in China's environment is necessary to gain insight into the establishment of legal and regulatory frameworks. This study collects information from over 170 papers reporting the occurrence and distribution of antibiotics in China's environment. A total of 110 antibiotics were detected, and 28 priority antibiotics were ubiquitous in China in almost all compartments of the environment, excluding the atmosphere. Seven dominant antibiotics in all environment compartments were identified by cluster analysis, including tetracycline, oxytetracycline, chlortetracycline, ofloxacin, enrofloxacin, norfloxacin, and ciprofloxacin. Meanwhile, sulfamethoxazole, sulfadiazine, and sulfamethazine were also frequently found in aqueous phases. Among the main basins where antibiotics were detected, the Haihe River Basin had higher median antibiotic concentrations in surface water compared to other basins, while the Huaihe River Basin had higher median concentrations in sediment. The median values of antibiotic concentrations in the sources were as follows: animal manure, 39 μg/kg (microgram per kilogram); WWTP (wastewater treatment plant) sludge, 39 μg/kg; animal wastewater, 156 ng/L (nanogram per liter); WWTP effluent: 15 ng/L. These concentrations are 1 - 2 orders of magnitude higher than that of the receptors (soil, 2.1 μg/kg; sediment, 4.7 μg/kg; surface water, 8.1 ng/L; groundwater, 2.9 ng/L), whether in solid or aqueous phases. Based on the number of detected antibiotics in various environmental compartments, animal farms and WWTPs are the main sources of antibiotics, and surface water and sediment are the main receptors of antibiotics. Hierarchical clustering identified the two main pathways of antibiotic transfer in various environmental compartments, which are from animal wastewater/WWTP effluent to surface water/sediment and from animal manure/WWTP sludge to soil/groundwater.

Cardiovascular drugs and lipid regulating agents in surface waters at global scale: Occurrence, ecotoxicity and risk assessment

Cardiovascular drugs and lipid regulating agents have emerged as major groups of environmental contaminants over the past decades. However, knowledge about their occurrence in freshwaters and their ecotoxicity is still limited. Here, we critically summarize the presence of 82 cardiovascular drugs and lipid regulating agents at a global-scale and represent their effects on aquatic organisms. Only about 71% of these pharmaceuticals in use have been analyzed for their residues in aquatic ecosystems and only about 24% for their effects. When detected in surface waters, they occurred at concentrations of dozens to hundreds of ng/L. In wastewaters, they reached up to several μg/L. Effects of cardiovascular drugs and lipid regulating agents have been extensively studied in fish and a few in invertebrates, such as Daphnia magna and mussels. These pharmaceuticals affect cardiac physiology, lipid metabolism, growth and reproduction. Besides, effects on spermatogenesis and neurobehavior are observed. Environmental risks are associated with beta-blockers propranolol, metoprolol, and lipid lowering agents bezafibrate and atorvastatin, where adverse effects (biochemical and transcriptional) occurred partially at surface water concentrations. In some cases, reproductive effects occurred at environmentally relevant concentrations. This review summarizes the state of the art on the occurrence of cardiovascular drugs and lipid regulating agents at a global-scale and highlights their risks to fish. Further research is needed to include more subtle changes on heart function and to explore non-investigated drugs. Their occurrence in freshwaters and impact on a diverse array of aquatic organisms are particularly needed to fully assess their environmental hazards and risks.

An overview of organic matters in municipal wastewater: Removal via self-assembly flocculating mechanism and the molecular level characterization

On considering the critical issues in attaining stringent water quality standards and not creating any environmental impacts, we focused for the first time the economically feasible, emerging technology known as Self-assembly flocculating (Saf process). In which, the study investigated the applicability of bioflocculant (a biopolymer-self-assembly in nature) act as a surrogates on relying the removal of broad spectrum of substances under optimized conditions (Dosage: 90 mg/L; pH: 7; CaCl₂). On using different techniques, the results have proved in removing the organic matter such as pharmaceuticals (Gentamycin, Cholecalciferol, Fluvoxamine, 3-OH Desogestrel, and Pheniramine), endocrine disturbing compounds [Phthalic acid, Benzene, 1, 2, 4 -Trimethoxy-5-(1-Propenyl)-, Benzene, 1, 2-Dimethoxy-4-(2-Propenyl)-, 1, 2-Benzenedicarboxylic Acid, 3-Cyclohexen-1-ol], fluorescent components (Polysaccharide like material), and others. The toxicological assessment of self-assembly bioflocculant implemented on zebra fish were statistically correlated [r = 0.95, p < 0.01 and 0.05 for P₁WW; r = 0.91, p < 0.01 and 0.05 for P₂WW] and [r = 0.7 5, p < 0.05 for P₁WT; r = 0.095, p < 0.01 and 0.05 for P₂WT]. This integrated approach supplemented further information of zeta potential (-16 mV in P₁WW and -14.6 mV in P₂WW decreased to -1.05 mV and -1.56 mV) with particle size distribution to explain via Saf process. In this research, the new insight has established non-toxic, self-assembly, biodegradable, bioflocculant for effective bioremediation.

Emerging pollutants (EPs) in Latin América: A critical review of under-studied EPs, case of study -Nonylphenol

Emerging contaminants (EPs) represent a significant risk to human, ecological and environmental health. Although progress has been made in establishing monitoring in environmental matrices, health effects, legislation and control, there are still problems associated with regional bias and the types of EPs commonly assessed, which may underestimate the risk to health. In Latin America there are limited reports on environmental monitoring of EPs and it is generally focused on wastewater. This review identifies the current research deficiencies for emerging contaminants in the Latin American region, and we address the case of nonylphenol as an under-studied EP in the region. Nonylphenol is a degradation product of nonylphenol ethoxylate, which is a surfactant widely used in the manufacture of detergents in Latin America, environmental concentrations have been reported, predominantly in water, and the possible effects on species in this region have been also described. The importance of the review of this compound in the region lies in the fact that the Rotterdam Convention has catalogued nonylphenol as a severely restricted compound, so it is necessary to establish measures for its restriction and change to a sustainable technology. Finally, the example of NP presented in this review highlights the lack of regulation in Latin America regarding to EPs, resulting in the contamination of wastewater, effluents, rivers and drinking water. It is imperative to determine the potential effects, occurrence and concentration levels to improve the regulation of these pollutants in a timely manner.

Accumulation of sulfonamide resistance genes and bacterial community function prediction in microbial fuel cell-constructed wetland treating pharmaceutical wastewater

Microbial fuel cell constructed wetlands (CW-MFCs) with different circuit operation conditions and hydraulic retention time (HRT) were constructed to evaluate their ability to remove and accumulate pharmaceutical and personal care products (PPCPs) (sulfadiazine (SDZ), carbamazepine (CBZ), naproxen (NPX) and ibuprofen (IBP)) during four months running process. The abundance level of corresponding sulfonamide antibiotic resistance genes (ARGs) was also investigated. The results showed that closed circuit operation of CW-MFC contributed to the decrease in mass loading of COD, NH₄⁺-N, PPCPs, and wastewater toxicity in the effluent. Additionally, closed circuit operation with low HRT contributed to enhancing selected PPCP mass accumulation on electrodes by electro-adsorption, and thus the higher sulfonamide ARG abundance was detected in the electrodes and effluent. Moreover, the composition of bacteria was greatly influenced by the mass accumulation of PPCPs revealed by redundancy analysis results. Procrustes analysis results further demonstrated that bacterial community contributed greatly to the ARGs profiles. Therefore, ARGs with their host bacteria revealed by network analysis were partially deposited on electrode substrates, and thus ARGs were effectively accumulated on electrodes. Function analysis of the bacterial community from PICRUSt predicted metagenomes revealed that closed circuit mode enhanced the abundances of the function genes of metabolic and the multiple ARGs, suggesting that closed circuit operation exhibited positive effects on metabolic process and ARG accumulation in CW-MFC system.

Sustainable design of large wastewater treatment plants considering multi-criteria decision analysis and stakeholders' involvement

The typical treatment scheme of a large municipal wastewater treatment plant (LWWTP) is almost always the result of design based on technical and economic criteria. Once a threshold in terms of population equivalent (PE) is reached, it is possible that additional sludge thermal treatment might be required. Aspects such as greenhouse gas (GHG) emissions and land use for the construction of the WWTP or the service landfill are considered marginal in current design practice; in a world that requires increasingly attention to the environment, these criteria cannot be ignored when defining the treatment scheme of a LWWTP. With the intent of providing a sustainable approach to design, this study aims to identify the best treatment scheme for a LWWTP with a 720,000 PE size. Methodologically, the study involves the development of an approach based on multi-criteria decision analysis (MCDA). Six alternative treatment schemes were considered; two simplified schemes, without primary sedimentation, with extended aeration activated sludge processes and aerobic sludge stabilization; four full schemes, with primary sedimentation and anaerobic sludge digestion. Some schemes differ for the organic loading rate applied; others for the use of sludge incineration. Subsequently, six evaluation criteria (ECs) such as GHG emissions, electricity consumption, running costs, WWTP planimetric area, surface for the service landfill, as well as WWTP as biorefinery have been considered. The weighting of the ECs involved the participation of the main stakeholders in such a decision-making process, following a bottom-up approach. The resolution of the MCDA problem allowed the identification of the full scheme based on primary sedimentation, biological activated sludge at low organic load (0.210 kgBOD₅/kgVSS/d) and anaerobic sludge digestion as the best solution. The sensitivity analysis, able to indirectly take into account the multitude of decision makers involved, allowed corroborating the results. The obtained treatment scheme was different from that generally adopted in current design practice for LWWTPs.

Occurrence, interactive effects and ecological risk of diclofenac in environmental compartments and biota - a review

Diclofenac, a nonsteroidal anti-inflammatory drug has turned into a contaminant of emerging concern; hence, it was included in the previous Watch List of the EU Water Framework Directive. This review paper aims to highlight the metabolism of diclofenac at different trophic levels, its occurrence, ecological risks, and interactive effects in the water cycle and biota over the past two decades. Increased exposure to diclofenac not only raises health concerns for vultures, aquatic organisms, and higher plants but also causes serious threats to mammals. The ubiquitous nature of diclofenac in surface water (river, lake canal, estuary, and sea) is compared with drinking water, groundwater, and wastewater effluent in the environment. This comprehensive survey from previous studies suggests the fate of diclofenac in wastewater treatment plants (WWTPs) and may predict its persistence in the environment. This review offers evidence of fragmentary available data for the water environment, soil, sediment, and biota worldwide and supports the need for further data to address the risks associated with the presence of diclofenac in the environment. Finally, we suggest that the presence of diclofenac and its metabolites in the environment may represent a high risk because of their synergistic interactions with existing contaminants, leading to the development of drug-resistant strains and the formation of newly emerging pollutants.

Effects of graphite and Mn ore media on electro-active bacteria enrichment and fate of antibiotic and corresponding resistance gene in up flow microbial fuel cell constructed wetland

This study assessed the influence of substrate type on pollutants removal, antibiotic resistance gene (ARG) fate and bacterial community evolution in up-flow microbial fuel cell constructed wetlands (UCW-MFC) with graphite and Mn ore electrode substrates. Better COD removal and higher bacterial community diversity and electricity generation performance were achieved in Mn ore constructed UCW-MFC (Mn). However, the lower concentration of sulfadiazine (SDZ) and the total abundances of ARGs were obtained in the effluent in the graphite constructed UCW-MFC (s), which may be related to higher graphite adsorption and filter capacity. Notably, both reactors can remove more than 97.8% of ciprofloxacin. In addition, significant negative correlations were observed between SDZ, COD concentration, ARG abundances and bacterial a-diversity indices. The LEfse analysis revealed significantly different bacterial communities due to the substrate differences in the two reactors, and Geobacter, a typical model electro-active bacteria (EAB), was greatly enriched on the anode of UCW-MFC (Mn). In contrast, the relative abundance of methanogens (Methanosaeta) was inhibited. PICRUSt analysis results further demonstrated that the abundance of extracellular electron transfer related functional genes was increased, but the methanogen function genes and multiple antibiotic resistance genes in UCW-MFC (Mn) anode were reduced. Redundancy analyses indicated that substrate type, antibiotic accumulation and bacterial community were the main factors affecting ARGs. Moreover, the potential ARG hosts and the co-occurrence of ARGs and intI1 were revealed by network analysis.

Occurrence and removal of sulfonamides and their acetyl metabolites in a biological aerated filter (BAF) of wastewater treatment plant in Xiamen, South China

Most sulfonamides, widely used around the world, are excreted via feces and urine along with their metabolites in humans and animals. Therefore, understanding the potential removal pathway of sulfonamides and their metabolites in wastewater treatment systems is of importance. The occurrence and fate of four sulfonamides and their acetyl metabolites in wastewater and sludge in a biological aerated filter in Xiamen city were evaluated. Six of the target compounds were detected in wastewater, but only parent compounds were detected in sludge. The highest concentration in wastewater was acetyl-sulfamethoxazole (Ac-SMZ) with a concentration of 75.2 ng/L. Removal efficiency and mass load in wastewater treatment systems were calculated. In terms of the overall removal efficiency, they ranged from 24.4 to 100%. The removal efficiencies of sulfamerazine (SM1), sulfamethazine (SM2), and sulfadiazine (SD) were up to 100% while N-acetyl sulfamerazine (Ac-SM1) showed the lowest removal efficiency. Biodegradation was the dominant remove pathway according to the mass balance analysis while SD and SM2 were sludge adsorption. The results can provide an insight into the fate of target sulfonamides in BAF systems and provide data to assess their potential ecological risks.

Removal and dissipation pathway of typical fluoroquinolones in sewage sludge during aerobic composting

To observe the effect of aeration strategies on the dissipation of fluoroquinolones (FQs) during aerobic composting and explore their dissipation pathways, 60-L composting and 0.5-L incubation experiments were carried out in this study. Three aeration strategies (windrow, static aeration, feedback aeration) were applied to remove two typical FQs (Norfloxacin (NOR) and Ofloxacin (OFL)) during the 60-L composting of sewage sludge with 5 mg kg^-1 of FQs added. Then, three 0.5 L-sample groups were taken during the three phases of the 60-L composting matrixes without FQs under static aeration, and were inoculated separately at 35 °C, 55 °C and 40 °C after being added with 5 mg kg^-1 of FQs. In each group, incubation was carried out for three treatments (sterilization + no aeration, sterilization + aeration, and no sterilization + aeration). The FQs in the sewage sludge were mainly removed in the mesophilic and thermophilic phases in all the aeration strategies. The removal efficiencies were high for the whole process: 89.6-95.4% for NOR and 87.2-95.4% for OFL. The order of removal efficiency of FQs was static aeration > feedback aeration > windrow. The combination of composting phases facilitated to the rapid dissipation of FQs, which reduced the half-life to about 1/6 to 1/5 of the values in each phase. In the mesophilic and thermophilic compost, biodegradation was the main pathway for the dissipation of FQs followed by irreversible adsorption. Irreversible adsorption and biodegradation provided similar removal efficiencies for the curing compost. The volatilization of FQs was non-negligible in all phases.

A method to study antibiotic emission and fate for data-scarce rural catchments

Estimations of antibiotic emission and fate and thereby ecological risk in rural catchments still lack feasible methods due to data scarcity. This study developed a new framework to evaluate the emission and fate of typical antibiotics for data-scarce catchments with uncertainty analysis. We estimated antibiotic discharge through questionnaire surveys; predicted antibiotic fate in air, water, soil, and sediment phases using a multimedia fugacity model; and analyzed the uncertainties of predicted environmental concentrations (PECs) and ecological risks of antibiotics. The developed method was tested in the Meijiang River catchment in China, and the uncertainty was systematically analyzed. Results showed that the discharge of tetracycline antibiotics (TCs) in the studied watershed was 8.56 t/a, with approximately 93% from veterinary medicine. TCs existed dominantly in the soil phase, accounting for 87.3% of total discharge. TC levels at the equilibrium states were the highest in sediment and soil, followed by water and air. The emission levels of TCs may cause slight risk to algae, daphniids, and fish in the receiving water based on the ecological risk evaluation of PECs. Despite of some uncertainties, the developed method provided an effective alternative to evaluate the ecological risks of antibiotics in catchments where sufficient monitored data are unavailable.

Fate and Occurrence of Pharmaceutically Active Organic Compounds during Typical Pharmaceutical Wastewater Treatment

The chemical composition, distribution, and fate of pharmaceutically active compounds (PhACs) present in typical pharmaceutical wastewater treatment plants were investigated with the aim of effectively removing these pollutants while minimizing waste of resources and energy. The results of this study indicate that the relative content of an organic compound class is unrelated to the number of organic compounds in the influent and effluent, yet it is directly proportional to the pollution contribution in pharmaceutical wastewater. In wastewater influent, the organic compound classes with the highest relative contents and pollution contributions were acids (relative content = 63.65%, contribution to pollution = 67.22%), esters (44.96%, 41.24%), and heterocyclic compounds (30.24%, 35.23%); in wastewater effluent, these classes were organic acids (62.54%, 65.13%), esters (52.66%, 59.02%), and organosilicon compounds (42.46%, 37.45%). The different physicochemical characteristics of these pollutants result in different removal efficiencies. For example, N,N-dimethylformamide, 4-methyloctane, N-ethylmorpholine, and 4-amino-N,N- and N,N-diethylbenzamide are refractory and are not degraded by microorganisms; thus, these compounds are discharged into the aquatic environment. Other organic compound classes including organosilicon compounds, acids, esters, heterocycles, and alcohols are mostly biodegraded, which leads to high concentrations of hydrocarbons in the wastewater effluent. The results of this study provide a foundation for the improvement of pharmaceutical wastewater treatment.

Organic micropollutants in a large wastewater treatment plant: What are the benefits of an advanced treatment by activated carbon adsorption in comparison to conventional treatment?

Several advanced treatments, such as ozonation or activated carbon adsorption, are currently considered for the removal of organic micropollutants (OMPs) in wastewater treatment plants (WWTP). However, little is known on the overall performances of a WWTP upgraded with those processes and the benefits provided regarding the elimination of multiple families of OMPs. In this study, 5 sampling campaigns were performed to determine the removal of 48 OMPs in a WWTP followed by an activated carbon pilot. The primary treatment had no effect on OMPs (removals < 20%), whereas the biological treatment removed OMPs that can be easily sorbed onto sludges or biodegraded (>60%). The additional elimination provided by the advanced treatment was not significant (<10%) for OMPs already well removed in the WWTP) but was substantial (>30%) for recalcitrant OMPs. Removals higher than 60% were obtained for all OMPs (except azithromycin and sulfamethoxazole) over the WWTP and the activated carbon pilot. The adsorption conditions (10 g/m³ fresh activated carbon addition) were not sufficient to achieve the 80% removal targeted in Switzerland for compounds suggested as indicator substances for wastewater treatment. A higher dose of activated carbon or the combination with another advanced treatment should be used to achieve a satisfactory removal of those compounds.

Seasonal occurrence, removal and risk assessment of 10 pharmaceuticals in 2 sewage treatment plants of Guangdong, China

A long-term investigation, which covered 10 sampling campaigns over 3 years, was performed to evaluate the occurrence, removal and risk of 10 pharmaceuticals in 2 full-scale sewage treatment plants (STPs) in Guangdong, South China. Target pharmaceuticals except for clofibrate and ibuprofen were detected in every sample, with mean concentrations of 12.5-685.6 and 7.9-130.3 ng/L in the influent and effluent, respectively. Salicylic acid was the most abundant compound in both the influents and effluents in the two STPs. For most pharmaceuticals, the seasonal variation in the influent showed the highest concentrations in January and lowest concentrations in July due to their consumption and rainfall. Ibuprofen and fenoprofen presented high removal rates (>90%) and some of the targets such as gemfibrozil, mefenamic acid, tolfenamic acid and diclofenac were detectable with significantly higher mass loads in effluents than in influents. Studies of the five efficiently eliminated pharmaceuticals show that the primary treatment and secondary treatment contributed to most pharmaceutical removal, the anoxic tank made a negligible contribution to their elimination. According to the results produced from the calculation of the risk quotient, only diclofenac might pose a risk to the aquatic environment.

Assessment of Pharmaceuticals, Personal Care Products, and Hormones in Wastewater Treatment Plants Receiving Inflows from Health Facilities in North West Province, South Africa

The presence of 17 pharmaceutical and personal care products (PPCPs) belonging to various therapeutic categories was investigated in two hospital wastewater treatment plants (WWTPs) in North West Province, South Africa. The compounds were extracted from wastewater samples by solid-phase extraction and analysed by liquid chromatography-tandem mass spectrometry. The results showed that ofloxacin, chloramphenicol, and bezafibrate were generally below the limit of quantification (LOQ) in the analysed samples. Acetaminophen and ibuprofen were the dominant pharmaceuticals in the influent streams with corresponding concentrations ranging from 21 to 119 μg/L and 0.3 to 63 μg/L, respectively. Both WWTPs were shown to have the capability to remove some of the target PPCPs, including acetaminophen (76-98%), tetracycline (15-93%), ibuprofen (44-99%), and triclocarban (13-98%). The monitoring of the target PPCPs in both influent and effluent samples of the investigated WWTPs revealed that the discharge of inadequately treated effluents could be contributing to the possible increase in the concentrations of these contaminants in the receiving environmental compartments. Further studies must be focused on the broader characterisation of these matrices in order to assess the potential ecological impacts of this waste disposal practice.

The influence of solid-liquid coefficient in the fate of pharmaceuticals and personal care products in aerobic wastewater treatment

Wastewater treatment plants (WWTPs) are considered to be a source of environmental contamination by micropollutants, especially from pharmaceuticals and personal care products (PCPs). The pathway of those compounds during sewage treatment has been investigated, but data from real-scale WWTPs is still missing (for example, the values of the solid-liquid coefficient (K_d) during treatment). This paper uses the K_d values for some pharmaceuticals and PCPs (fenofibrate, gemfibrozil, propranolol, metoprolol, salicylic acid, acetylsalicylic acid, ibuprofen, diclofenac, naproxen, fenoprofen, caffeine, triclosan, methylparaben, ethylparaben, propylparaben, butylparaben, and benzylparaben) to describe the micropollutants' behavior in the treatment process. In order to attain this data, an aerobic wastewater treatment plant located in Brazil was studied. Six samplings were carried out and a mass balance was performed, associating the concentrations of the micropollutants in the liquid phase with the solid phase (sludge and suspended solids). Of all the compounds analyzed, caffeine was the most biodegradable pollutant, as almost 98% of its mass was biodegraded. In contrast, triclosan had the highest load in sludge (median of 163.0 mg day^-1) and adsorbed in SS (median of 0.593 mg day^-1) at the output. Summing up, each micropollutant had a specific way to be removed during wastewater treatment.

Occurrence and Distribution of Tetracycline Antibiotics and Resistance Genes in Longshore Sediments of the Three Gorges Reservoir, China

The widespread use of antibiotics and the induced antibiotic resistance genes have attracted much attention in recent years. The longshore sediments in the water-level-fluctuating zone of the Three Gorges Reservoir were selected to investigate the spatial-temporal distribution of antibiotics and antibiotic resistance genes in two different operation stages (low-water level in summer and high-water level in winter). Three kinds of tetracycline antibiotics (tetracycline, oxytetracycline, and chlortetracycline) and three kinds of tetracycline resistance genes [tet(A), tet(C), and tet(M)] were analyzed and quantified. The results showed that the distribution of tetracyclines and resistance genes in riverine, transition and lacustrine zones showed a certain regularity, and the tetracycline antibiotics concentration and the total abundance of the tetracycline resistance genes were highest in the transition zone, and then the riverine zone. Meanwhile, there were significant seasonal variations of tetracycline and the resistance genes. The concentrations of the tetracycline and resistance genes were higher in summer than those in winter, while the relative abundance of resistance genes was higher in winter. It was suggested that the different seasonal distribution of antibiotics and resistance genes may be correlated with the reservoir operation in the Three Gorges Reservoir and the higher use of antibiotics in winter. In addition, Pearson correlation analysis showed that the concentrations of the tetracycline, class 1 integron and 16S rRNA were positively correlated with the abundance of the tetracycline resistance genes.

Linking the Effect of Antibiotics on Partial-Nitritation Biofilters: Performance, Microbial Communities and Microbial Activities

The emergence and spread of antibiotics resistance in wastewater treatment systems have been pointed as a major environmental health problem. Nevertheless, research about adaptation and antibiotics resistance gain in wastewater treatment systems subjected to antibiotics has not been successfully developed considering bioreactor performance, microbial community dynamics and microbial activity dynamics at the same time. To observe this in autotrophic nitrogen removal systems, a partial-nitritation biofilter was subjected to a continuous loading of antibiotics mix of azithromycin, norfloxacin, trimethoprim, and sulfamethoxazole. The effect of the antibiotics mix over the performance, bacterial communities and bacterial activity in the system was evaluated. The addition of antibiotics caused a drop of ammonium oxidation efficiency (from 50 to 5%) and of biomass concentration in the bioreactor, which was coupled to the loss of ammonium oxidizing bacteria Nitrosomonas in the bacterial community from 40 to 3%. Biomass in the partial nitritation biofilter experienced a sharp decrease of about 80% due to antibiotics loading, but the biomass adapted and experienced a growth by stabilization under antibiotics feeding. During the experiment several bacterial genera appeared, such as Alcaligenes, Paracoccus, and Acidovorax, clearly dominating the bacterial community with >20% relative abundance. The system reached around 30% ammonium oxidation efficiency after adaptation to antibiotics, but no effluent nitrite was found, suggesting that dominant antibiotics-resistant phylotypes could be involved in nitrification–denitrification metabolisms. The activity of ammonium oxidation measured as amoA and hao gene expression dropped a 98.25% and 99.21%, respectively, comparing the system before and after the addition of antibiotics. On the other hand, denitrifying activity increased as observed by higher expression of nir and nos genes (83.14% and 252.54%, respectively). In addition, heterotrophic nitrification cyt c-551 was active only after the antibiotics addition. Resistance to the antibiotics was presumably given by ermF, carA and msrA for azithromycin, mutations of the gyrA and grlB for norfloxacin, and by sul123 genes for sulfamethoxazole. Joined physicochemical and microbiological characterization of the system were used to investigate the effect of the antibiotics over the bioprocess. Despite the antibiotics resistance, activity of Bacteria decreased while the activity of Archaea and Fungi increased.

Mass loading and emission of thirty-seven pharmaceuticals in a typical municipal wastewater treatment plant in Hunan Province, Southern China

The occurrence, fate, mass loading and environmental emission of 37 pharmaceuticals were studied through an integrated approach involving both dissolved and adsorbed phase at a typical wastewater treatment plant in Hunan Province, Southern China. The results displayed the prevalence of 24 and 23 compounds in dissolved phase of influent and effluent, respectively. Fourteen compounds were found adsorbed onto sludge with a mean concentration ranging from 0.85 to 2900μg/kg dry weight. Twelve compounds exhibited high adsorption potential onto suspended particulate matter (SPM) with a mean fraction ranging from 8.8% (trimethoprim) to 97% (tetracycline). Furthermore, SPM showed a diverse absorbability in influent and effluent water circumstance. The overall elimination varied from -16% for lincomycin to 99% for paracetamol, while macrolides were able to withstand the whole treatment process. Mass balance analysis indicated that degradation was the predominant removal pathway for most compounds, and adsorption onto sludge combined with a minor portion of degradation explained for the reduction of tetracyclines and fluoroquinolones, whereas macrolides were recalcitrant to both two processes. The total mass loading was estimated to be up to 2800mg/d/1000 inhabitants and most compounds exhibited lower or comparable level comparing to the global published data. The total environmental emission was estimated up to be 1000mg/d/1000 inhabitants, and a value of 650mg/d/1000 inhabitants was obtained when considering merely the dissolved phase. This work would be helpful for the better understanding of ultimate fate and real pollution of pharmaceuticals in the water environment.

Review of antibiotic resistance in China and its environment

Antibiotic resistance is a global health crisis linked to increased, and often unrestricted, antibiotic use in humans and animals. As one of the world's largest producers and consumers of antibiotics, China is witness to some of the most acute symptoms of this crisis. Antibiotics and antibiotic resistance genes (ARGs) are widely distributed in surface water, sewage treatment plant effluent, soils and animal wastes. The emergence and increased prevalence of ARGs in the clinic/hospitals, especially carbapenem-resistant gram negative bacteria, has raised the concern of public health officials. It is important to understand the current state of antibiotic use in China and its relationship to ARG prevalence and diversity in the environment. Here we review these relationships and their relevance to antimicrobial resistance (AMR) trends witnessed in the clinical setting. This review highlights the issues of enrichment and dissemination of ARGs in the environment, and also future needs in mitigating the spread of antibiotic resistance in the environment, particularly under the 'planetary health' perspective, i.e., the systems that sustain or threaten human health.

Temporal dynamics of human-excreted pollutants in wastewater treatment plant influents: Toward a better knowledge of mass load fluctuations

The occurrence of 25 drug target residues (illicit drugs or pharmaceutically active compounds) was investigated during 85 consecutive days in the influents of a wastewater treatment plant in the Region Centre-Val de Loire, France. This long tracking period allowed a better understanding of the patterns affecting the occurrence of this type of contaminants. Among them, 2 were never detected (i.e. heroin and amphetamine). Concerning illicit drugs two patterns were found. Cocaine and ecstasy median loads varied considerably between weekdays and weekend days (i.e. 18.3 and 35.9% respectively) whereas cannabis and heroin (based on 6-mono-acetylmorphine loads) loads were within the same order of magnitude with a significant statistical correlation with pharmaceuticals such as acetaminophen or ketoprofen. The consumption of selected drugs was back-calculated from the loads. Among illicit drugs the highest consumption was found for cannabis with a median consumption of 51mg·day^-1·inhabitant^-1 (inh) whereas the median consumption for cocaine (based on benzoylecgonine loads) and ecstasy was 32 and 6mg·day^-1·10³·inh^-1 respectively. The highest consumption values of pharmaceutically active compounds (PACs) were found for acetaminophen and acetylsalicylic acid with 108.8 and 34.1mg·day^-1·inh^-1 respectively, in good agreement with national sales data. A statistically significant weekly pattern was found for several PACs such as metoprolol and trimethoprim, but with the opposite pattern to that of illicit drugs. The variations in daily PAC loads could provide information about the mobility of people in the catchment, especially on the basis of daily taken PACs (i.e. to treat chronicle diseases).

Estimating population size in wastewater-based epidemiology. Valencia metropolitan area as a case study

Wastewater can provide a wealth of epidemiologic data on common drugs consumed and on health and nutritional problems based on the biomarkers excreted into community sewage systems. One of the biggest uncertainties of these studies is the estimation of the number of inhabitants served by the treatment plants. Twelve human urine biomarkers -5-hydroxyindoleacetic acid (5-HIAA), acesulfame, atenolol, caffeine, carbamazepine, codeine, cotinine, creatinine, hydrochlorothiazide (HCTZ), naproxen, salicylic acid (SA) and hydroxycotinine (OHCOT)- were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS) to estimate population size. The results reveal that populations calculated from cotinine, 5-HIAA and caffeine are commonly in agreement with those calculated by the hydrochemical parameters. Creatinine is too unstable to be applicable. HCTZ, naproxen, codeine, OHCOT and carbamazepine, under or overestimate the population compared to the hydrochemical population estimates but showed constant results through the weekdays. The consumption of cannabis, cocaine, heroin and bufotenine in Valencia was estimated for a week using different population calculations.

Procedures of determining organic trace compounds in municipal sewage sludge-a review

Sewage sludge is the largest by-product generated during the wastewater treatment process. Since large amounts of sludge are being produced, different ways of disposal have been introduced. One tempting option is to use it as fertilizer in agricultural fields due to its high contents of inorganic nutrients. This, however, can be limited by the amount of trace contaminants in the sewage sludge, containing a variety of microbiological pollutants and pathogens but also inorganic and organic contaminants. The bioavailability and the effects of trace contaminants on the microorganisms of soil are still largely unknown as well as their mixture effects. Therefore, there is a need to analyze the sludge to test its suitability before further use. In this article, a variety of sampling, pretreatment, extraction, and analysis methods have been reviewed. Additionally, different organic trace compounds often found in the sewage sludge and their methods of analysis have been compiled. In addition to traditional Soxhlet extraction, the most common extraction methods of organic contaminants in sludge include ultrasonic extraction (USE), supercritical fluid extraction (SFE), microwave-assisted extraction (MAE), and pressurized liquid extraction (PLE) followed by instrumental analysis based on gas or liquid chromatography and mass spectrometry.

Considering ionic state in modeling sorption of pharmaceuticals to sewage sludge

Information on the partitioning of chemicals between particulate matter and water in sewage treatment plants (STPs) can be used to predict their subsequent environmental fate. However, this information can be challenging to acquire, especially for pharmaceuticals that are frequently present in ionized forms. This study investigated the relationship between the ionization state of active pharmaceutical ingredients (APIs) and their partitioning between water and sludge in STPs. We also investigated the underlying mechanisms of sludge sorption by using chemical descriptors based on ionized structures, and evaluated the usefulness of these descriptors in quantitative structure-property relationship (QSPR) modeling. K_D values were collected for 110 APIs, which were classified as neutral, positive, or negative at pH 7. The models with the highest performance had the R²Y and Q² values of above 0.75 and 0.65, respectively. We found that the dominant intermolecular forces governing the interactions of neutral and positively charged APIs with sludge are hydrophobic, pi-pi, and dipole-dipole interactions, whereas the interactions of negatively charged APIs with sludge were mainly governed by covalent bonding as well as ion-ion, ion-dipole, and dipole-dipole interactions; hydrophobicity-driven interactions were rather unimportant. Including charge-related descriptors improved the models' performance by 5-10%, underlining the importance of electrostatic interactions. The use of descriptors calculated for ionized structures did not improve the model statistics for positive and negative APIs, but slightly increased model performance for neutral APIs. We attribute this to a better description of neutral zwitterions.

The implementation of data reconciliation for evaluating a full-scale petrochemical wastewater treatment plant

Data reconciliation and mass balance analysis were conducted for the first time to improve the data obtained from a petrochemical wastewater treatment plant (WWTP), and the results were applied to evaluate the performance of the plant. Daily average values for 209 days from the inlet and outlet of the plant obtained from WWTP documentation center along with the results of four sampling runs in this work were used for data reconciliation and performance evaluation of the plant. Results showed that standard deviation and relative errors in the balanced data of each measurement decreased, especially for the process wastewater from 24.5 to 8.6 % for flow and 24.5 to 1.5 % for chemical oxygen demand (COD). The errors of measured data were -137 m³/day (-4.41 %) and 281 kg/day (7.92 %) for flow and COD, respectively. According to the balanced data, the removal rates of COD and 5-day biological oxygen demand (BOD₅) through the aeration unit were equal to 37 and 46 %, respectively. In addition, the COD and BOD₅ concentrations were reduced by about 61.9 % (2137 kg/day) and 78.1 % (1976 kg/day), respectively, prior to the biological process. At the same time, the removal rates of benzene, toluene, and styrene were 56, 38, and 69 %, respectively. The results revealed that about 40 % of influent benzene (75.5 kg/day) is emitted to the ambient air at the overhead of the equalization basin. It can be concluded that the volatilization of organic compounds is the basic mechanism for the removal of volatile organic compounds (VOCs) and it corresponds to the main part of total COD removal from the WWTP.

Reflection of Socioeconomic Changes in Wastewater: Licit and Illicit Drug Use Patterns

The economic crisis plaguing Greece was expected to impact consumption of pharmaceuticals and illicit drugs - a priori to an unknown extent. We quantified the change of use for various classes of licit and illicit drugs by monitoring Athens' wastewater from 2010 to 2014. A high increase in the use of psychoactive drugs was detected between 2010 and 2014, especially for antipsychotics (35-fold), benzodiazepines (19-fold), and antidepressants (11-fold). This directly reflects the perceived increase of incidences associated with mental illnesses in the population, as a consequence of severe socioeconomic changes. Other therapeutic classes, like antiepileptics, hypertensives, and gastric and ulcer drugs also showed an increase in use (from 2-fold increase for antiepileptics to 13-fold for hypertensives). In contrast, the overall use of antibiotics and NSAIDs decreased. For mefenamic acid, an almost 28-fold decrease was observed. This finding is likely related to the reduction in drug expenditure applied in public health. A 2-fold increase of methamphetamine use was detected, associated with a cheap street drug called ″sisa″ (related to marginal conducts), which is a health concern. MDMA (5-fold) and methadone (7-fold) use showed also an increase, while cocaine and cannabis estimates did not show a clear trend.

Reduced persistence of the macrolide antibiotics erythromycin, clarithromycin and azithromycin in agricultural soil following several years of exposure in the field

The macrolide antibiotics erythromycin, clarithromycin and azithromycin are very important in human and animal medicine, and can be entrained onto agricultural ground through application of sewage sludge or manures. In the present study, a series of replicated field plots were left untreated or received up to five annual spring applications of a mixture of three drugs to achieve a nominal concentration for each of 10 or 0.1mgkg(-1) soil; the latter an environmentally relevant concentration. Soil samples were incubated in the laboratory, and supplemented with antibiotics to establish the dissipation kinetics of erythromycin and clarithromycin using radioisotope methods, and azithromycin using HPLC-MS/MS. All three drugs were dissipated significantly more rapidly in soils with a history of field exposure to 10mgkg(-1) macrolides, and erythromycin and clarithromycin were also degraded more rapidly in field soil exposed to 0.1mgkg(-1) macrolides. Rapid mineralization of (14)C-labelled erythromycin and clarithromycin are consistent with biodegradation. Analysis of field soils revealed no carryover of parent compound from year to year. Azithromycin transformation products were detected consistent with removal of the desosamine and cladinose moieties. Overall, these results have revealed that following several years of exposure to macrolide antibiotics these are amenable to accelerated degradation. The potential accelerated degradation of these drugs in soils amended with manure and sewage sludge should be investigated as this phenomenon would attenuate environmental exposure and selection pressure for clinically relevant resistance.