Fate of three anti-influenza drugs during ozonation of wastewater effluents - degradation and formation of transformation products

Antiviral drugs against influenza: Treatment methods, environmental risk assessment and analytical determination

Over the past few years, antiviral drugs against influenza are considered emerging contaminants since they cause environmental toxicity even at low concentrations. They have been found in environmental matrices all around the world, showing that conventional treatment methods fail to remove them from water and wastewater. In addition, the metabolites and transformation products of these drugs can be more persistent than original in the environment. Several techniques to degrade/remove antiviral drugs against influenza have been investigated to prevent this contamination. In this study, the characteristics of antiviral drugs against influenza, their measurement by analytical methods, and their removal in both water and wastewater treatment plants (WWTPs) were presented. Different treatment methods, such as traditional procedures (biological processes, filtration, coagulation, flocculation, and sedimentation), advanced oxidation processes (AOPs), adsorption and combined methods, were assessed. Ecotoxicological effects of both the antiviral drug and its metabolites as well as the transformation products formed as a result of treatment were evaluated. In addition, future perspectives for improving the removal of antiviral drugs against influenza, their metabolites and transformation products were further discussed. The research indicated that the main tested techniques in this study were ozonation, photolysis and photocatalysis. Combined methods, particularly those that use renewable energy and waste materials, appear to be the optimum approach for the treatment of effluents containing antiviral drugs against influenza. In light of high concentrations or probable antiviral resistance, this comprehensive assessment suggests that antiviral drug monitoring is required, and some of those substances may cause toxicological effects.

On-Site Pilot Testing of Hospital Wastewater Ozonation to Reduce Pharmaceutical Residues and Antibiotic-Resistant Bacteria

Hospital sewage constitutes an important point source for antibiotics and antibiotic-resistant bacteria due to the high antibiotic use. Antibiotic resistance can develop and cause problems in sewage systems within hospitals and municipal wastewater treatment plants, thus, interventions to treat hospital sewage on-site are important. Ozonation has proven effective in treating relatively clean wastewater, but the effect on untreated wastewater is unclear. Therefore, we piloted implementation of ozonation to treat wastewater in a tertiary hospital in Uppsala, Sweden. We measured active pharmaceutical ingredients (APIs) using liquid chromatography-mass spectrometry and antibiotic-resistant Enterobacteriaceae using selective culturing pre- and post-ozonation. Comparing low (1 m³/h) and high (2 m³/h) flow, we obtained a 'dose-dependent' effect of API reduction (significant reduction of 12/29 APIs using low and 2/29 APIs using high flow, and a mean reduction of antibiotics of 41% using low vs. 6% using high flow, 25% vs. 6% for all APIs). There was no significant difference in the amount of antibiotic-resistant Enterobacteiaceae pre- and post-ozonation. Our results demonstrate that ozonation of untreated wastewater can reduce API content. However, due to the moderate API decrease and numerous practical challenges in the on-site setting, this specific ozonation system is not suitable to implement at full scale in our hospital.

Contaminants of emerging concern: a review of new approach in AOP technologies

The presence of contaminants of emerging concern (CECs) such as pharmaceuticals and personal care products (PPCPs), endocrine-disrupting compounds (EDCs), flame retardants (FRs), pesticides, and artificial sweeteners (ASWs) in the aquatic environments remains a major challenge to the environment and human health. In this review, the classification and occurrence of emerging contaminants in aquatic environments were discussed in detail. It is well documented that CECs are susceptible to poor removal during the conventional wastewater treatment plants, which introduce them back to the environment ranging from nanogram per liter (e.g., carbamazepine) up to milligram per liter (e.g., acesulfame) concentration level. Meanwhile, a deep insight into the application of advanced oxidation processes (AOPs) on mitigation of the CECs from aquatic environment was presented. In this regard, the utilization of various treatment technologies based on AOPs including ozonation, Fenton processes, sonochemical, and TiO₂ heterogeneous photocatalysis was reviewed. Additionally, some innovations (e.g., visible light heterogeneous photocatalysis, electro-Fenton) concerning the AOPs and the combined utilization of AOPs (e.g., sono-Fenton) were documented.

Fate of new three anti-influenza drugs and one prodrug in the water environment

We evaluated the environmental fate of new three anti-influenza drugs, favipiravir (FAV), peramivir (PER), and laninamivir (LAN), and an active prodrug of LAN, laninamivir octanoate (LANO), in comparison with four conventional drugs, oseltamivir (OS), oseltamivir carboxylate (OC), amantadine (AMN), and zanamivir (ZAN) by photodegradation, biodegradation, and sorption to river sediments. In addition, we conducted 9-month survey of urban rivers in the Yodo River basin from 2015 to 2016 (including the influenza season) to investigate the current status of occurrence of these drugs in the river environment. The results clearly showed that FAV and LAN rapidly disappeared through photodegradation (half-lives 1 and 8 h, respectively), followed by LANO which gradually disappeared through biodegradation (half-life, 2 days). The remained PER and conventional drugs were, however, persistent and transported from upstream to downstream sites. Rates of their sorption to river sediments were negligibly small. Detected levels remained were in the range from N.D. to 89 ng/L for the river waters and from N.D. to 906 ng/L in sewage effluent. However, all of the remained drugs were effectively removed by ozonation after chlorination at a sewage treatment plant. These findings suggest the importance of introducing ozonation for reduction of pollution loads in rivers, helping to keep river environments safe. To the best of our knowledge, this is the first evaluation of the removal effects of natural sunlight, biodegradation, and sorption to river sediments on FAV, PER, LAN, LANO, and a conventional drug, AMN.

Risk of resistant avian influenza A virus in wild waterfowl as a result of environmental release of oseltamivir

Oseltamivir is the best available anti-influenza drug and has therefore been stockpiled worldwide in large quantities as part of influenza pandemic preparedness planning. The active metabolite oseltamivir carboxylate (OC) is stable and is not removed by conventional sewage treatment. Active OC has been detected in river water at concentrations up to 0.86 µg/L. Although the natural reservoir hosts of influenza A virus (IAV) are wild waterfowl that reside in aquatic environments, the ecologic risks associated with environmental OC release and its potential to generate resistant viral variants among wild birds has largely been unknown. However, in recent years a number of in vivo mallard (Anas platyrhynchos) studies have been conducted regarding the potential of avian IAVs to become resistant to OC in natural reservoir birds if these are drug exposed. Development of resistance to OC was observed both in Group 1 (N1) and Group 2 (N2, N9) neuraminidase subtypes, when infected ducks were exposed to OC at concentrations between 0.95 and 12 µg/L in their water. All resistant variants maintained replication and transmission between ducks during drug exposure. In an A(H1N1)/H274Y virus, the OC resistance mutation persisted without selective drug pressure, demonstrating the potential of an IAV with a permissive genetic background to acquire and maintain OC resistance, potentially allowing circulation of the resistant variant among wild birds. The experimental studies have improved the appreciation of the risks associated with the environmental release of OC related to resistance development of avian IAVs among wild birds. Combined with knowledge of efficient methods for improved sewage treatment, the observations warrant implementation of novel efficient wastewater treatment methods, rational use of anti-influenza drugs, and improved surveillance of IAV resistance in wild birds.