Occurrence of pharmaceuticals and personal care products and associated environmental risks in the central and lower Yangtze river, China

Occurrence and risks of pharmaceuticals, personal care products, and endocrine-disrupting compounds in Chinese surface waters

The continuous and rapid increase of chemical pollution in surface waters has become a pressing and widely recognized global concern. As emerging contaminants (ECs) in surface waters, pharmaceutical and personal care products (PPCPs), and endocrine-disrupting compounds (EDCs) have attracted considerable attention due to their wide occurrence and potential threat to human health. Therefore, a comprehensive understanding of the occurrence and risks of ECs in Chinese surface waters is urgently required. This study summarizes and assesses the environmental occurrence concentrations and ecological risks of 42 pharmaceuticals, 15 personal care products (PCPs), and 20 EDCs frequently detected in Chinese surface waters. The ECs were primarily detected in China's densely populated and highly industrialized regions. Most detected PPCPs and EDCs had concentrations between ng/L to µg/L, whereas norfloxacin, caffeine, and erythromycin had relatively high contamination levels, even exceeding 2000 ng/L. Risk evaluation based on the risk quotient method revealed that 34 PPCPs and EDCs in Chinese surface waters did not pose a significant risk, whereas 4-nonylphenol, 4-tert-octylphenol, 17α-ethinyl estradiol, 17β-estradiol, and triclocarban did. This review provides a comprehensive summary of the occurrence and associated hazards of typical PPCPs and EDCs in Chinese surface waters over the past decade, and will aid in the regulation and control of these ECs in Chinese surface waters.

Antibiotic residues in the cirata reservoir, Indonesia and their effect on ecology and the selection for antibiotic-resistant bacteria

Antibiotic residues, their mixture toxicity, and the potential selection for antibiotic-resistant bacteria could pose a problem for water use and the ecosystem of reservoirs. This study aims to provide a comprehensive understanding of the occurrence, concentration, distribution, and ecological risks associated with various antibiotics in the Cirata reservoir, Indonesia. In our water and sediment samples, we detected 24 out of the 65 antibiotic residues analyzed, revealing a diverse range of antibiotic classes present. Notably, sulphonamides, diaminopyrimidine, and lincosamides were frequently found in the water, while the sediment predominantly contained tetracyclines and fluoroquinolones. Most antibiotic classes reached their highest concentrations in the water during the dry season. However, fluoroquinolones and tetracyclines showed their highest concentrations in the water during the wet season. Ecotoxicological risk assessments indicated that the impact of most antibiotic residues on aquatic organisms was negligible, except for fluoroquinolones. Looking at the impact on cyanobacteria, however, varying risks were indicated, ranging from medium to critical, with antibiotics like sulfamethoxazole, ciprofloxacin, norfloxacin, and lincomycin posing substantial threats. Among these, ciprofloxacin emerged as the antibiotic with the strongest risk. Furthermore, fluoroquinolones may have the potential to contribute to the selection of antibiotic-resistant bacteria. The presence of mixtures of antibiotic residues during the wet season significantly impacted species loss, with Potentially Affected Fraction of Species (msPAF) values exceeding 0.75 in almost 90% of locations. However, the impact of mixtures of antibiotic residues in sediment remained consistently low across all locations and seasons. Based on their occurrences and associated risks, 12 priority antibiotic residues were identified for monitoring in the reservoir and its tributaries. Moreover, the study suggests that river inflow serves as the most significant source of antibiotic residues in the reservoir. Further investigations into the relative share attribution of antibiotic sources in the reservoir is recommended to help identify effective interventions.

Evaluating a river's ecological health: A multidimensional approach

Evaluating the health of river surface water is essential, as rivers support significant biological resources and serve as vital drinking water sources. While the Water Quality Index (WQI) is commonly employed to evaluate surface water quality, it fails to consider biodiversity and does not fully capture the ecological health of rivers. Here we show a comprehensive assessment of the ecological health of surface water in the lower Yangtze River (LYR), integrating chemical and biological metrics. According to traditional WQI metrics, the LYR's surface water generally meets China's Class II standards. However, it also contains 43 high-risk emerging contaminants; nitrobenzenes are found at the highest concentrations, representing 25-90% of total detections, while polycyclic aromatic hydrocarbons present the most substantial environmental risks, accounting for 81-93% of the total risk quotient. Notably, the plankton-based index of biological integrity (P-IBI) rates the ecological health of the majority of LYR water samples (59.7%) as 'fair', with significantly better health observed in autumn compared to other seasons (p < 0.01). Our findings suggest that including emerging contaminants and P-IBI as additional metrics can enhance the traditional WQI analysis in evaluating surface water's ecological health. These results highlight the need for a multidimensional assessment approach and call for improvements to LYR's ecological health, focusing on emerging contaminants and biodiversity rather than solely on reducing conventional indicators.

Study on the Distribution Characteristics and Risk Assessment of Antibiotics and Resistance Genes in Water Sources of Wuhan

In contemporary society, the improper use of antibiotics leads to their persistent presence in the ecological environment. Due to the diverse physical and chemical properties of antibiotics, their spatial and temporal distribution in the environment varies. Moreover, antibiotics can stimulate the emergence of antibiotic resistance genes (ARGs), which complicates the monitoring and regulation of antibiotics and poses a significant threat to both aquatic and terrestrial environments. This study investigated the distribution of 15 antibiotics and 11 typical ARGs across four categories at 19 sites of drinking water sources in Wuhan, China. The findings revealed that the concentration of antibiotics during the dry season (nd~61,883 ng/L) was significantly higher compared to both the normal water season (nd~49,883 ng/L) and the wet season (nd~28,686 ng/L). Sulfamethoxazole (SMX), sulfamethoxazole (SMD), sulfadiazine (SD), and roxithromycin (RTM) were the predominant antibiotics in the target water environments. The study indicated that most of the antibiotics analyzed posed little to no risk to aquatic organisms. The primary ARGs detected in the surface water of the study area were sul1, qnrD, and tetO. Furthermore, some ARGs showed a negative correlation with their respective antibiotics. Additional research is necessary to evaluate the impact of these emerging pollutants (antibiotics and ARGs) on the safety of high-quality drinking water for residents in Wuhan City.

Chronic toxic effects of erythromycin and its photodegradation products on microalgae Chlorella pyrenoidosa

The photodegradation products (PDPs) of antibiotics in the aquatic environment received increasing concern, but their chronic effects on microalgae remain unclear. This study initially focused on examining the acute effects of erythromycin (ERY), then explored the chronic impacts of ERY PDPs on Chlorella pyrenoidosa. ERY of 4.0 - 32 mg/L ERY notably inhibited the cell growth and chlorophyll synthesis. The determined 96 h median effective concentration of ERY to C. pyrenoidosa was 11.78 mg/L. Higher concentrations of ERY induced more serious oxidative damage, antioxidant enzymes alleviated the oxidative stress. 6 PDPs (PDP749, PDP747, PDP719, PDP715, PDP701 and PDP557) were identified in the photodegradation process of ERY. The predicted combined toxicity of PDPs increased in the first 3 h, then decreased. Chronic exposure showed a gradual decreasing inhibition on microalgae growth and chlorophyll content. The acute effect of ERY PDPs manifested as growth stimulation, but the chronic effect manifested as growth inhibition. The malonaldehyde contents decreased with the degradation time of ERY at 7, 14 and 21 d. However, the malonaldehyde contents of ERY PDPs treatments were elevated compared to those in the control group after 21 d. Risk assessment still need to consider the potential toxicity of degradation products under long-term exposure.

Occurrence, fate, and risk assessment of antibiotics in conventional and advanced drinking water treatment systems: From source to tap

The occurrence and removal of 38 antibiotics from nine classes in two drinking water treatment plants (WTPs) were monitored monthly over one year to evaluate the efficiency of typical treatment processes, track the source of antibiotics in tap water and assess their potential risks to ecosystem and human health. In both source waters, 18 antibiotics were detected at least once, with average total antibiotic concentrations of 538.5 ng/L in WTP1 and 569.3 ng/L in WTP2. The coagulation/flocculation and sedimentation, sand filtration and granular activated carbon processes demonstrated limited removal efficiencies. Chlorination, on the other hand, effectively eliminated antibiotics by 48.7 ± 11.9%. Interestingly, negative removal was observed along the distribution system, resulting in a significant antibiotic presence in tap water, with average concentrations of 131.5 ng/L in WTP1 and 362.8 ng/L in WTP2. Source tracking analysis indicates that most antibiotics in tap water may originate from distribution system. The presence of antibiotics in raw water and tap water posed risks to the aquatic ecosystem. Untreated or partially treated raw water could pose a medium risk to infants under six months. Water parameters, for example, temperature, total nitrogen and total organic carbon, can serve as indicators to estimate antibiotic occurrence and associated risks. Furthermore, machine learning models were developed that successfully predicted risk levels using water quality parameters. Our study provides valuable insights into the occurrence, removal and risk of antibiotics in urban WTPs, contributing to the broader understanding of antibiotic pollution in water treatment systems.

Emerging Contaminants in the Effluent of Wastewater Should Be Regulated: Which and to What Extent?

Effluent discharged from urban wastewater treatment plants (WWTPs) is a major source of emerging contaminants (ECs) requiring effective regulation. To this end, we collected discharge datasets of pharmaceuticals (PHACs) and endocrine-disrupting chemicals (EDCs), representing two primary categories of ECs, from Chinese WWTP effluent from 2012 to 2022 to establish an exposure database. Moreover, high-risk ECs' long-term water quality criteria (LWQC) were derived using the species sensitivity distribution (SSD) method. A total of 140 ECs (124 PHACs and 16 EDCs) were identified, with concentrations ranging from N.D. (not detected) to 706 μg/L. Most data were concentrated in coastal regions and Gansu, with high ecological risk observed in Gansu, Hebei, Shandong, Guangdong, and Hong Kong. Using the assessment factor (AF) method, 18 high-risk ECs requiring regulation were identified. However, only three of them, namely carbamazepine, ibuprofen, and bisphenol-A, met the derivation requirements of the SSD method. The LWQC for these three ECs were determined as 96.4, 1010, and 288 ng/L, respectively. Exposure data for carbamazepine and bisphenol-A surpassed their derived LWQC, indicating a need for heightened attention to these contaminants. This study elucidates the occurrence and risks of ECs in Chinese WWTPs and provides theoretical and data foundations for EC management in urban sewage facilities.

Occurrence, distribution, and risk assessment of antibiotics in a typical aquaculture area around the Dongzhai Harbor mangrove forest on Hainan Island

The trees of the Dongzhai Harbor mangrove forest suffer from antibiotic contamination from surrounding aquaculture areas. Despite this being one of the largest mangrove forests in China, few studies have focused on the antibiotic pollution status in these aquaculture areas. In the present study, the occurrence, distribution, and risk assessment of 37 antibiotics in surface water and sediment samples from aquaculture areas around Dongzhai Harbor mangrove forests were analyzed. The concentration of total antibiotics (∑antibiotics) ranged from 78.4 ng/L to 225.6 ng/L in surface water (except S14-A2) and from 19.5 ng/g dry weight (dw) to 229 ng/g dw in sediment. In the sediment, the concentrations of ∑antibiotics were relatively low (19.5-52.3 ng/g dw) at 75 % of the sampling sites, while they were high (95.7-229.0 ng/g dw) at a few sampling sites (S13-A1, S13D, S8D). The correlation analysis results showed that the Kd values of the 9 antibiotics were significantly positively correlated with molecular weight (MW), Kow, and LogKow. Risk assessment revealed that sulfamethoxazole (SMX) in surface water and SMX, enoxacin (ENX), ciprofloxacin (CFX), enrofloxacin (EFX), ofloxacin (OFX), and norfloxacin (NFX) in sediment had medium/high risk quotients (RQs) at 62.5 % and 25-100 %, respectively, of the sampling sites. The antibiotic mixture in surface water (0.06-3.36) and sediment (0.43-309) posed a high risk at 37.5 % and 66.7 %, respectively, of the sampling sites. SMX was selected as an indicator of antibiotic pollution in surface water to assist regulatory authorities in monitoring and managing antibiotic pollution in the aquaculture zone of Dongzhai Harbor. Overall, the results of the present study provide a comprehensive and detailed analysis of the characteristics of antibiotics in the aquaculture environment around the Dongzhai Harbor mangrove system and provide a theoretical basis for the source control of antibiotics in mangrove systems.

O2 plasma-modified carbon nanotube for sulfamethoxazole degradation via peroxymonosulfate activation: Synergism of radical and non-radical pathways boosting water decontamination and detoxification

Sulfamethoxazole (SMX), a widely used antibiotic, has triggered increasing attention due to its extensive detection in wastewater effluent, causing serious ecological threats. Herein, a carbon-based heterogeneous catalyst was developed by the O2 plasma-etching process, regulating oxygen-containing functional groups (OFGs) and defects of carbon nanotubes (O-CNT) to activate peroxymonosulfate (PMS) for highly efficient SMX abatement. Through adjusting the etching time, the desired active sites (i.e., C=O and defects) could be rationally created. Experiments collectively suggested that the degradation of SMX was owing to the contribution of synergism by radical (•OH (17.3%) and SO4•- (39.3%)) and non-radical pathways (1O2, 43.4%), which originated from PMS catalyzed by C=O and defects. In addition, the possible degradation products and transformation pathways of SMX in the system were inferred by combining the Fukui function calculations and the LC-MS/MS analysis. And the possible degradation pathway was effective in reducing the environmental toxicity of SMX, as evidenced by the T.E.S.T. software and the micronucleus experiment on Vicia faba root tip. Also, the catalytic system exhibited excellent performance for different antibiotics removal, such as amoxicillin (AMX), carbamazepine (CBZ) and isopropylphenazone (PRP). This study is expected to provide an alternative strategy for antibiotics removal in water decontamination and detoxification.

Preconception exposure to environmental antibiotics among childbearing couples in Anhui and health risk assessment: A multicenter population-based representative study

Only few studies have assessed the health effects due to preconception exposure to antibiotics among childbearing couples. This study investigated the status of preconception exposure to antibiotics among childbearing couples in Anhui, associated with health risks, and influencing factors. Overall, 1500 childbearing couples were randomly selected from the Reproductive Health of Childbearing Couples - Anhui Cohort (RHCC-AC). The urinary levels of 40 antibiotics and 2 metabolites were determined, and specific gravity (SG) adjusted concentrations of antibiotics were measured to assess health risks. Generalized linear models were used to assess the associations of urinary SG-adjusted concentration of antibiotics with demographic parameters and diet frequency. The total detection rates of all antibiotics were 98.9 % and 99.3 % in wives and husbands, respectively. The detection rates of veterinary antibiotics (VAs) and preferred as VAs (PVAs) were above 90 %. Among eight antibiotics, sulfonamides (95.1 %) and fluoroquinolones (87.6 %) had the highest detection rates in couples. Approximately four-fifths of couples were simultaneously exposed to at least three different antibiotics, and more than half of them were exposed to low concentrations of antibiotics. 8.9 % and 9.2 % of wives and husbands had hazard index value of antibiotics exposure greater than 1. Antibiotic concentrations were associated with residence, sampling season, and diet frequency. In Anhui, nearly 98 % of childbearing couples have environmental exposure to antibiotics, and VAs and PVAs are the primary antibiotics. More than 8 % of couples had health risks due to antibiotic exposure. Several potential determinants of urinary antibiotics deserve more attention in future research.

Spatiotemporal trends of ultraviolet absorbents in oysters from the Pearl River Estuary, south China during 2015-2020

Ultraviolet absorbents (UVAs) are widely used in various industrial materials, pharmaceuticals, and personal care products, resulting in their frequent occurrences in sediment, water, and biota. However, our understanding of the spatiotemporal characteristics and long-term contamination status of UVAs is still limited. Here, a 6-year biomonitoring study with oysters during wet and dry seasons was conducted to examine the annual, seasonal, and spatial characteristics of UVAs in the Pearl River Estuary (PRE), China. The concentrations of Σ₆UVA ranged from 9.1 to 119 (geometric mean ± standard deviation: 31 ± 22) ng/g dry wt. and peaked in 2018. Significant spatiotemporal variations in UVA contamination were observed. The concentrations of UVAs in oysters during the wet season were higher than the dry season, and concentrations in the more industrialized eastern coast were higher than the western coast (p < 0.05). Environmental factors, including precipitation, temperature, and salinity in water significantly impacted the UVA bioaccumulation in the oysters. The present study highlights that long-term biomonitoring with oysters provided valuable insight in the magnitude and seasonal variation of UVAs in this highly dynamic estuary.

Antibiotic profiles and their relationships with multitrophic aquatic communities in an urban river

Antibiotics have garnered worldwide attention due to their omnipresence and detrimental effects on aquatic organisms, yet their potential relationships with multitrophic aquatic communities in natural rivers remain largely unknown. Here, we examined 107 antibiotics in water and sediment from an urban river in Chengdu, Sichuan province (China). The bacterial, algal, macroinvertebrates, and fish communities were synchronously measured based on the environmental DNA (eDNA) metabarcoding approach, and their relationships with antibiotics were further investigated. The results showed that the total antibiotic concentrations ranged from 1.12 to 377 ng/L and from 7.95 to 145 ng/g in water and sediment, respectively. Significant seasonal variations in the concentrations and compositions of antibiotics in water were observed. eDNA metabarcoding revealed great compositional variations of bacterial, algal, macroinvertebrates, and fish communities along the river, and antibiotics had significant negative relationships with the community diversities of aquatic organisms (p < 0.05) except for fish. Meanwhile, significant negative correlations were observed between antibiotic concentrations and the relative abundances of essential metabolism pathways of bacteria, e.g., energy metabolism (p < 0.05), carbohydrate metabolism (p < 0.05), and lipid metabolism (p < 0.01). Moreover, antibiotics demonstrated greater effects on the function of bacterial community compared with environmental variables. The findings highlight the significance of eDNA metabarcoding approach in revealing the relationships between aquatic communities and antibiotics, and call for further studies on the effects of antibiotics on multitrophic aquatic communities in natural waters.

Occurrence, distribution and risk assessment of antibiotics at various aquaculture stages in typical aquaculture areas surrounding the Yellow Sea

The pollution of antibiotics commonly existed throughout the entire aquaculture process, but the residues of antibiotics at different aquaculture stages have rarely been studied. This study investigated the occurrence, distribution and risk assessment of antibiotics at different aquaculture stages (the non-aquaculture stage, the early aquaculture stage, the middle aquaculture stage, and the late aquaculture stage) in two typical marine aquaculture areas (Mahegang River and Dingzi Bay) surrounding the Yellow Sea. Fluoroquinolones and tetracyclines were commonly used antibiotics in the aquaculture of these areas with high detection frequencies (17% to 83%). Compared among four aquaculture stages, the highest concentration of antibiotics (9032.08 ng/L) in aquaculture ponds was detected at the late aquaculture stage. And the antibiotic pollution level of natural water was directly related to the aquaculture stages. Similarly, at the aquaculture stages, the detection frequency of antibiotics in sediments was higher than that at the non-aquaculture stage. Based on the correlation analysis, the concentration of main antibiotics in water showed a positive correlation with total nitrogen (p<0.05) and chlorophyll a (p<0.01), while it showed a negative correlation with salinity (p<0.01) in coastal water of the Dingzi Bay. According to the risk assessment, with the development of aquaculture stages, the selection pressure of fluoroquinolones and tetracyclines on resistant bacteria had increased. And the ecological risks caused by sulfonamides and tetracyclines to aquatic organisms had also increased markedly. Overall, this study may provide a reference for formulating regulatory policies regarding antibiotic use at different aquaculture stages.

Identification of high-concern organic pollutants in tap waters from the Yangtze River in China based on combined screening strategies

Recently, numerous organic pollutants have been detected in water environment. The safety of our drinking water has attracted widespread attention. Effective methods to screen and identify high-concern substances are urgently needed. In this study, the combined workflow for the detection and identification of high-concern organic chemicals was established and applied to tap water samples from the Yangtze River Basin. The solid phase extraction (SPE) sorbents were compared and evaluated and finally the HLB cartridge was selected as the best one for most of the contaminants. Based on target, suspect and non-target analysis, 3023 chemicals/peaks were detected. Thirteen substances such as diundecyl phthalate (DUP), 2-hydroxyatrazine, dioxoaminopyrine and diethyl-2-phenylacetamide were detected in drinking water in the Yangtze River Basin for the very first time. Based on three kinds of prioritization principles, 49 ubiquitous, 103 characteristic chemicals and 13 inefficiently removed chemicals were selected as high-concern substances. Among them, 8, 31, 9, 3, 4 substances overlapped with the toxic, risky or high-concern chemicals lists in China, America, European Union, Japan, Korea, respectively. Specific management and removal strategies were further recommended. The workflow is efficient for identification of key pollutants.

The persistent, bioaccumulative, toxic, and resistance (PBTR) risk assessment framework of antibiotics in the drinking water sources

Antibiotics are emerging pollutants largely considered to have a lower risk based on persistent, bioaccumulative, toxic (PBT) risk assessments. However, an increasing number of studies have illustrated that antibiotics are responsible for the global increase in antimicrobial resistance (AMR), which suggests that the risk of antibiotics has been largely underestimated by using PBT risk assessment. Here, we designed an integrated innovation risk assessment framework of persistent, bioaccumulative, toxic, and resistance (PBTR) that accounts for antibiotic resistance to better represent the antibiotic environmental risk. This novel antibiotic risk assessment framework was further verified via application to 39 target antibiotics in the 23 drinking water sources of the lower Yangtze River (LYR), China, during the normal and flood seasons. In contrast with the PBT assessment, single toxicity assessment and single resistance assessment, in the PBTR assessment, 7 of 39 target antibiotics with bacterial insensitivity were observed to represent a more prominent risk, as were the sites sampled during the flood season with low concentrations but high pollution loads, which confirmed that the sensitivity of PBTR risk assessment was instructive. The PBTR risk assessment for the screened priority antibiotics contributes not only representative data but also an innovative approach for identifying resistance risks. Using the positive matrix factorization (PMF) model, the sources of priority antibiotics can be predicted and thus supported the corresponding policy. Overall, this study first constructed a PBTR risk assessment framework, then applied it to facilitate the accurate management of antibiotic pollution at the basin level.

Occurrence and Distribution of Antibiotics in the Water, Sediment, and Biota of Freshwater and Marine Environments: A Review

Antibiotics, as pollutants of emerging concern, can enter marine environments, rivers, and lakes and endanger ecology and human health. The purpose of this study was to review the studies conducted on the presence of antibiotics in water, sediments, and organisms in aquatic environments (i.e., seas, rivers, and lakes). Most of the reviewed studies were conducted in 2018 (15%) and 2014 (11%). Antibiotics were reported in aqueous media at a concentration of <1 ng/L−100 μg/L. The results showed that the highest number of works were conducted in the Asian continent (seas: 74%, rivers: 78%, lakes: 87%, living organisms: 100%). The highest concentration of antibiotics in water and sea sediments, with a frequency of 49%, was related to fluoroquinolones. According to the results, the highest amounts of antibiotics in water and sediment were reported as 460 ng/L and 406 ng/g, respectively. In rivers, sulfonamides had the highest abundance (30%). Fluoroquinolones (with an abundance of 34%) had the highest concentration in lakes. Moreover, the highest concentration of fluoroquinolones in living organisms was reported at 68,000 ng/g, with a frequency of 39%. According to the obtained results, it can be concluded that sulfonamides and fluoroquinolones are among the most dangerous antibiotics due to their high concentrations in the environment. This review provides timely information regarding the presence of antibiotics in different aquatic environments, which can be helpful for estimating ecological risks, contamination levels, and their management.

Global review of macrolide antibiotics in the aquatic environment: Sources, occurrence, fate, ecotoxicity, and risk assessment

The extensive use of macrolide antibiotics (MCLs) has led to their frequent detection in aquatic environments, affecting water quality and ecological health. In this study, the sources, global distribution, environmental fate, ecotoxicity and global risk assessment of MCLs were analyzed based on recently published literature. The results revealed that there are eight main sources of MCLs in the water environment. These pollution sources resulted in MCL detection at average or median concentrations of up to 3847 ng/L, and the most polluted water bodies were the receiving waters of wastewater treatment plants (WWTPs) and densely inhabited areas. Considering the environmental fate, adsorption, indirect photodegradation, and bioremoval may be the main attenuation mechanisms in natural water environments. N-demethylation, O-demethylation, sugar and side chain loss from MCL molecules were the main pathways of MCLs photodegradation. Demethylation, phosphorylation, N-oxidation, lactone ring hydrolysis, and sugar loss were the main biodegradation pathways. The median effective concentration values of MCLs for microalgae, crustaceans, fish, and invertebrates were 0.21, 39.30, 106.42, and 28.00 mg/L, respectively. MCLs induced the generation of reactive oxygen species, that caused oxidative stress to biomolecules, and affected gene expression related to photosynthesis, energy metabolism, DNA replication, and repair. Moreover, over 50% of the reported water bodies represented a medium to high risk to microalgae. Further studies on the development of tertiary treatment technologies for antibiotic removal in WWTPs, the combined ecotoxicity of antibiotic mixtures at environmental concentration levels, and the development of accurate ecological risk assessment models should be encouraged.

Pharmaceuticals and Personal Care Products across Different Water Bodies in Taihu Lake Basin, China: Occurrence, Source, and Flux

Although pharmaceuticals and personal care products (PPCPs) have attracted great attentions, their occurrence characteristics across different water bodies at a basin scale remain poorly understood. To grasp a more comprehensive understanding of PPCP pollution from the perspective of the whole basin, the occurrence, spatial and seasonal variation, source, and flux of thirteen PPCPs across the different environmental compartments of the northern Taihu Lake Basin (TLB) were studied. The results showed that the non-therapeutic pharmaceuticals caffeine (CFI) and n, n-diethyl-m-toluamide (DEET) were the main components across the different environmental compartments. The total concentrations of detected PPCPs ranged from 0.2 to 2437.9 ng/L. Higher concentrations of PPCPs were observed in spring and autumn, which were mainly attributed to seasonal differences in PPCP consumption. Generally, pollution level was higher in industry and agriculture area and in the inner bay and southwest of Taihu Lake. Source apportionment indicated that untreated water was the main source of PPCPs in river waters of the northern TLB. Flux estimation showed that the mean annual flux of PPCPs from northern TLB to Taihu Lake in 2021 was 1.6 t/a, which was higher in comparison with other areas. Overall, the resulting data will be useful to enrich the research of PPCPs in freshwater for environmental investigations.

Derivation of Water Quality Criteria for Carbamazepine and Ecological Risk Assessment in the Nansi Lake Basin

Carbamazepine, as one of several pharmaceutical and personal care products, has gained much attention in recent years because of its continuous discharge in natural waters and toxicity to aquatic ecosystems. However, it is difficult to evaluate and manage carbamazepine pollution because of the lack of a rational and scientific Water Quality Criteria (WQC) of carbamazepine. In this study, the carbamazepine toxicity data of thirty-five aquatic species from eight taxonomic groups were selected, and the species sensitivity distribution (SSD) method was applied to derive the WQC for carbamazepine based on the Log-logistic model, which was 18.4 ng/L. Meanwhile, the occurrence and distribution of carbamazepine in the Nansi Lake basin was studied. Results showed that concentrations of carbamazepine in 29 sampling sites were in the range of 3.3 to 128.2 ng/L, with the mean of 17.3 ng/L. In general, the levels of carbamazepine in tributaries were higher than those in the lakes. In addition, qualitative and quantitative ecological risk assessment methods were applied to assess the adverse effect of carbamazepine on aquatic systems. The hazard quotient (HQ) method showed that there were 24 and 5 sampling sites, in which risk levels were low and moderate, respectively. The joint probability curve (JPC) method indicated that ecological risks might exist in 1.4% and 1.0% of surface water, while a 5% threshold and 1% threshold were set up to protect aquatic species, respectively. Generally, carbamazepine posed a low risk to the aquatic organisms in the Nansi Lake basin.

Export and risk from antibiotic remobilization from surrounding water to lake in the extreme 2020 Yangtze River basin flooding

Global climate change increased the frequency of extreme rainfall events, leading to higher flood risk. In addition to the personal and property losses, another important consequence of a flood disaster was release and exposure risks from emerging contaminants, which was usually overlooked. The remobilization and fate of the antibiotics induced by floods remain unclear. We captured antibiotic concentrations around the Chaohu Lake after an unprecedented flood with a range of 5.0-317 ng/L. Higher concentrations in polder waters than their receiving rivers were attributed to the antibiotic release from soil particles and the sharp increase of water: soil ratio by flood storage. Source apportionment analysis of antibiotics implied that diffuse pollution by manure application and aquaculture activity was the predominant sources. Commonalities of spatial variations of antibiotics in polders were related to the condition of waterlogging and pollution source. The total antibiotic storage for all submerged polders was estimated at 27.9 kg. The concentrations and risks from pumping floodwater detained by polders into the lake were much higher than that from discharging flood directly into the lake. The retention-reaction-remobilization process would pose unexpectedly high risks for the lake. This study provided a new sight for constructing ecological wetland flood storage areas.

A short review of human exposure to antibiotics based on urinary biomonitoring

Antibiotics play a role in preventing and treating infectious diseases and also contribute to other health risks for humans. With the overuse of antibiotics, they are widely distributed in the environment. Long-term exposure to multiple antibiotics may occur in humans through medication and dietary intake. Therefore, it is critical to estimate daily intake and health risk of antibiotics based on urinary biomonitoring. This review compares the strengths and weaknesses of current analytical methods to determine antibiotics in urine samples, discusses the urinary concentration profiles and hazard quotients of individual antibiotics, and overviews correlations of antibiotic exposure with the risk of diseases. Liquid chromatography-tandem mass spectrometry is most applied to simultaneously determine multiple types of antibiotics at trace levels. Solid-phase extraction with a hydrophilic-lipophilic balance adsorbent is commonly used to extract antibiotics in urine samples. Fifteen major antibiotics with relatively higher detection frequencies and concentrations include sulfaclozine, trimethoprim, erythromycin, azithromycin, penicillin V, amoxicillin, oxytetracycline, chlortetracycline, tetracycline, doxycycline, ofloxacin, enrofloxacin, ciprofloxacin, norfloxacin, and florfenicol. Humans can be easily at microbiological effect-based risk induced by florfenicol, ciprofloxacin, azithromycin, and amoxicillin. Positive associations were observed between specific antibiotic exposure and obesity, allergic diseases, and mental disorders. Overall, the accessible, automated, and environmentally friendly methods are prospected for simultaneous determinations of antibiotics at trace level in urine. To estimate human exposure to antibiotics more accurately, knowledge gaps need to be filled up, including the transformation between parent and metabolic antibiotics, urinary excretion proportions of antibiotics at low-dose exposure and pharmacokinetic data of antibiotics in humans, and the repeated sampling over a long period in future research is needed. Longitudinal studies about antibiotic exposure and the risk of diseases in different developmental windows as well as in-depth research on the pathogenic mechanism of long-term, low-dose, and joint antibiotic exposure are warranted.

Comparison of cognition and alexithymia in patients of schizophrenia with and without comorbid alcohol use: A cross-sectional exploratory study

BACKGROUND

Cognitive impairment and alexithymia are commonly associated with schizophrenia and alcohol use disorder independently. Both can lead to poor prognosis and recovery. In patients with dual diagnosis, this association can be more prevalent and severe.

MATERIALS AND METHODS

A total of 75 participants were grouped into two (35 each): Group A, a Schizophrenia group and Group B with comorbid alcohol use. Sociodemographic factors, clinical profile, cognitive functions, and alexithymia were compared between the two groups using semi-structured pro forma, Positive and Negative Syndrome Scale, Alcohol Use Disorders Identification Test (AUDIT), Montreal Cognitive Assessment (MoCA) Scale, Toronto Alexithymia Scale (TAS-20) (subcategorized into three subscales (1) "Difficulty describing feelings" (DDF), (2) "Difficulty identifying feeling" (DIF), and (3) "Externally-Oriented Thinking" and Brief Psychiatric Rating Scale. Statistical analysis was performed using the Chi-square tests and t-tests as applicable. P < 0.05 was considered statistically significant.

RESULTS

The mean age of the participants was 33.61 (standard deviation [SD]-8.11), mean duration of schizophrenia was 70.8 months (SD-47.5) and mean duration of alcohol consumption was 9.10 years (SD-7.7). MoCA score was significantly lower (mean-21.80, SD-2.98) and TAS total score was significantly higher in Group B (Mean-67.31, SD-8.10). DDF (Mean-19.28, SD-4.02) and DIF scores (Mean-22.86, SD-4.66) were significantly higher in alcohol group compared to nonalcohol group. Furthermore, MoCA score was significantly impaired and TAS total, DDF and DIF scores were significantly higher in participants with AUDIT score >8 (P < 0.05). Lower score on MoCA correlated with the higher score of alexithymia.

CONCLUSION

Cognitive dysfunction and alexithymia were significantly more in patients of schizophrenia with comorbid alcohol use and positively correlated with the severity of alcohol use disorder.

Estimation of Unintended Treated Wastewater Contributions to Streams in the Yangtze River Basin and the Potential Human Health and Ecological Risk Analysis

"Clean water and sanitation" is one of the United Nations Sustainable Development Goals. One primary objective of wastewater treatment is to remove contaminants such as pathogens, nutrient, and organic matter from wastewater, while not all contaminants could be removed effectively. Wastewater treatment plants would inevitably represent concentrated point sources of residual contaminant loadings into surface waters. This study focuses on the populated Yangtze River Basin where emerging contaminants are frequently detected in the rivers in the recent years. A python-based ArcGIS model is developed to estimate the contributions of effluent discharges in water supply sources and quantify fate and environmental risks of human-derived contaminants in the river network. We find that one-third of the river networks are potentially influenced by the effluents through local or upstream inputs. Average fraction of unintended wastewater reuse in water supply intakes is estimated to be lower than 3% under the average flow scenario with an average traveling time of 0.05 day from the nearest effluent input site to water supply intakes. However, under low flow scenario, the percentage of effluent discharge would increase largely, leading to substantial increases in human health and ecological risks. This study provides a systematic investigation to understand extents of impacts of effluent inputs in river networks as well as identify the opportunities to improve the water management in the densely populated regions.

Quantitatively identifying the emission sources of pharmaceutically active compounds (PhACs) in the surface water: Method development, verification and application in Huangpu River, China

Recognizing the main sources of pharmaceutically active compounds (PhACs) found in surface waters has been a challenge to the effective control of PhAC contamination from the sources. In the present study, a novel method based on Characteristic Matrix (ChaMa) model of indicator PhACs to quantitatively identify the contribution of multiple emission sources was developed, verified, and applied in Huangpu River, Shanghai. Carbamazepine (CBZ), caffeine (CF) and sulfadiazine (SDZ) were proposed as indicators. Their occurrence patterns in the corresponding emission sources and the factor analysis of their composition in the surface water samples were employed to construct the ChaMa model and develop the source apportionment method. Samples from typical emission sources were collected and analyzed as hypothetical surface water samples, to verify the method proposed. The results showed that the calculated contribution proportions of emission sources to the corresponding source samples were 45%-85%, proving the feasibility of the method. Finally, the method was applied to different sections in Huangpu River, and the results showed that livestock wastewater was the dominant emission source, accounting for 55%-73% in the upper reach of Huangpu River. Untreated municipal wastewater was dominant in the middle and lower reaches of Huangpu River, accounting for 76%-94%. This novel source apportionment method allows the quantitative identification of the contribution of multiple PhAC emission sources. It can be replicated in other regions where the occurrence of localized indicators was available, and will be helpful to control the contamination of PhACs in the water environment from the major sources.

Safety assessment of drinking water sources along Yangtze River using vulnerability and risk analysis

Recently, the safety of drinking water sources along Yangtze River Basin is received much attention. But few works have carried out large-scale and all-round safety assessment of drinking water sources on the main stream of the whole Yangtze River Basin. In this work, 97 drinking water sources in 8 provinces of the main stream of the Yangtze River were selected as the objects to clarify the spatial distribution of the safety risk levels of drinking water sources in the whole basin and analyze the causes of drinking water source risks. The results showed that 13.4%, 55.7%, 25.8%, 5.1%, and 0% of the 97 drinking water sources were classified as low, moderate, considerate, high, and very high respectively, according to the safety risk level. This indicated that the safety risk of drinking water sources in the mainstream of Yangtze River is generally low, but there are also a number of high safety risk drinking water sources. And the safety risk degree of the lower and upper reaches in the mainstream of Yangtze River is generally higher than that of the middle reaches. The current situation of drinking water sources along the mainstream of Yangtze River could be attributed to the superposition of human activities and natural background factors. This study could contribute to the government's targeted management and control of safety risk sources for drinking water sources along the Yangtze River Basin.

Microalgal mediated antibiotic co-metabolism: Kinetics, transformation products and pathways

The mutual interaction of a microalga Chlorella vulgaris with four antibiotics viz. sulfamethoxazole (SMX), trimethoprim (TMP), azithromycin (AZI), and levofloxacin (LEV) individually and in mixture was studied in batch culture. SMX, TMP, and LEV stimulated algal growth, while AZI inhibited its growth. The Combination Index (CI)-isobologram indicated antagonism of the antibiotic mixture on the growth of C. vulgaris. Higher removal efficiency was observed in the mixed antibiotic than in the single antibiotic batch cultures. Biodegradation was the main antibiotic removal mechanism with a similar antibiotic biosorption pattern in single and mix antibiotic cultures. Scanning electron microscopy and Fourier transform infrared spectrophotometry showed minor biochemical alterations on algal cells surface and a stable algal population. Monod kinetics model was successfully applied to understand the growth with respect to the removal efficiency of C. vulgaris in single and mix antibiotic batch cultures. Results indicated relatively higher specific growth rate in the mix antibiotic batch culture with removal efficiency in the order of SMX > LEV > TMP > AZI. In total, 46 metabolites with 18 novel ones of the four antibiotics were identified by using high-resolution mass spectrometry based on the suspect screening approach to propose the potential transformation pathways. Most of the transformation products demonstrated lower toxicity than their respective parents. These findings implied that C. vulgaris could be an outstanding candidate for advanced treatment of antibiotic removal in wastewater.

Removal of aqueous pharmaceuticals by magnetically functionalized Zr-MOFs: Adsorption Kinetics, Isotherms, and regeneration

The functionalization of metal-organic frameworks (MOFs) is imperative and challenging for the development of practical MOF-based materials. Herein, a magnetically functionalized Zr-MOF (Fe₃O₄@MOF-525) was synthesized via secondary-growth approach to obtain an easily-separated and recyclable adsorbent for the removal of pharmaceuticals (tetracycline (TC) and diclofenac sodium (DF)). After loading Fe₃O₄ nanoparticles (NPs), due to the increase of micropore volume and specific surface area caused by defects, the adsorption performance of Fe₃O₄@MOF-525 was improved. The kinetics could be described by the pseudo-second-order kinetic model. The different adsorption capacity and initial rate were attributed to the properties of the pharmaceuticals, including the molecular size and hydrophobicity/hydrophilicity. In isotherm experiments, the maximum adsorption capacities of DF and TC on Fe₃O₄@MOF-525 calculated by Sips model reached 745 and 277 mg·g^-1, respectively. The thermodynamic studies indicated the adsorption was endothermic and spontaneous. The effect of pH suggested that electrostatic interaction, π-π interaction, anion-π interaction, and H-bonding were possibly involved in the adsorption process. The adsorbent was separated by magnetic and regenerated. Washed with ethanol, Fe₃O₄@MOF-525 remained about 80% adsorption capacity after four cycles. In-situ photo-regeneration under visible-light irradiation was another attractive method, where > 95% TC was degraded in 4 h. The reaction with scavengers revealed that ¹O₂ was the dominant reactive species in our system, indicating the occurrence of Type II photosensitization. The separability, excellent adsorption performance, and recyclability of Fe₃O₄@MOF-525 may lead to its beneficial applications in water treatment.

Which Micropollutants in Water Environments Deserve More Attention Globally?

Increasing chemical pollution of aquatic environments is a growing concern with global relevance. A large number of organic chemicals are termed as "micropollutants" due to their low concentrations, and long-term exposure to micropollutants may pose considerable risks to aquatic organisms and human health. In recent decades, numerous treatment methods and technologies have been proposed to remove micropollutants in water, and typically several micropollutants were chosen as target pollutants to evaluate removal efficiencies. However, it is often unclear whether their toxicity and occurrence levels and frequencies enable them to contribute significantly to the overall chemical pollution in global aquatic environments. This review intends to answer an important lingering question: Which micropollutants or class of micropollutants deserve more attention globally and should be removed with higher priority? Different risk-based prioritization approaches were used to address this question. The risk quotient (RQ) method was found to be a feasible approach to prioritize micropollutants in a large scale due to its relatively simple assessment procedure and extensive use. A total of 83 prioritization case studies using the RQ method in the past decade were compiled, and 473 compounds that were selected by screening 3466 compounds of three broad classes (pharmaceuticals and personal care products (PPCPs), pesticides, and industrial chemicals) were found to have risks (RQ > 0.01). To determine the micropollutants of global importance, we propose an overall risk surrogate, that is, the weighted average risk quotient (WARQ). The WARQ integrates the risk intensity and frequency of micropollutants in global aquatic environments to achieve a more comprehensive priority determination. Through metadata analysis, we recommend a ranked list of 53 micropollutants, including 36 PPCPs (e.g., sulfamethoxazole and ibuprofen), seven pesticides (e.g., heptachlor and diazinon), and 10 industrial chemicals (e.g., perfluorooctanesulfonic acid and 4-nonylphenol) for risk management and remediation efforts. One caveat is that the ranked list of global importance does not consider transformation products of micropollutants (including disinfection byproducts) and new forms of pollutants (including antibiotic resistance genes and microplastics), and this list of global importance may not be directly applicable to a specific region or country. Also, it needs mentioning that there might be no best answer toward this question, and hopefully this review can act as a small step toward a better answer.

Influence of land use type and urbanization level on the distribution of pharmaceuticals and personal care products and risk assessment in Beiyun River, China

Influence of land use type and urbanization level on the distribution of pharmaceuticals and personal care products (PPCPs) from the developed regions of Beijing-Tianjin-Hebei in the northern China was evaluated. The seasonal and spatial variations of the 22 target PPCPs were analyzed in the 63 sampling sites along the whole Beiyun River Basin. Results showed that the total PPCPs concentration had a wide variation range, from 132 ng L^-1 to 25474 ng L^-1. Spatial interpolation analysis showed that agricultural land presented higher PPCPs contamination level than build-up land (p < 0.05) and the concentration was negatively correlated with urbanization level. Source apportionment showed the untreated sewage source contributed to 34%-53% of the PPCPs burden in the Beiyun River. Risk assessment indicated that diethyltoluamide, carbamazepine, octocrylene, gemfibrozil and triclocarban had high risks (RQ > 1), and small tributaries had the highest mixed risk (MRQ = 34). Species sensitivity distribution combined with the safety threshold method showed that PPCPs would have potential risk on aquatic organisms even at very low concentrations and triclocarban posed the highest risk in the Beiyun River.

Pharmaceuticals in drinking water sources and tap water in a city in the middle reaches of the Yangtze River: occurrence, spatiotemporal distribution, and risk assessment

The occurrence of ten target pharmaceuticals was investigated in drinking water sources and tap water in a city in the middle reaches of the Yangtze River, including erythromycin (ERY), roxithromycin (RTM), ciprofloxacin (CPX), ofloxacin (OFX), sulfadiazine (SDZ), sulfamethoxazole (SMX), oxytetracycline (OTC), tetracycline (TC), ibuprofen (IBF), and naproxen (NPX). And the corresponding ecological risk for three classes of aquatic organisms and human health risk for different life stages were estimated. Results demonstrated that nine pharmaceuticals except for TC were detected with the frequencies of 20-100% and the concentrations of <LOQ-118.60 ng/L in drinking water sources. Only SMX and IBF were detected quantitatively with the highest concentrations of 0.69 ng/L and 1.28 ng/L in tap water, respectively. The concentrations of the target pharmaceuticals were lower than or comparable with those in other drinking water systems. The spatiotemporal variations of the target pharmaceuticals might be mainly attributed to their usage object, emission amount, and natural attenuation. The overall discrepancy of concentrations between drinking water sources and tap water might indicate the purification effect of drinking water treatment system. Individual pharmaceutical in drinking water resources posed negligible risks to invertebrate and fish; however, ERY, CPX, OFX, and SMX posed high risk to algae. Moreover, pharmaceutical exposure by tap water caused no risk to human health. Nevertheless, the long-term, chronic, and mixed risks of pharmaceuticals and the potential risk of antibiotic-resistant genes should be concerned. This study enriches environmental monitoring data of pharmaceuticals in drinking water sources and tap water, and provides scientific information for emerging pollutants management in drinking water system.

Occurrence and risk assessment of pharmaceuticals and personal care products (PPCPs) against COVID-19 in lakes and WWTP-river-estuary system in Wuhan, China

The consumption of pharmaceuticals and personal care products (PPCPs) for controlling and preventing the COVID-19 would have sharply increased during the pandemic. To evaluate their post-pandemic environmental impacts, five categories of drugs were detected in lakes and WWTP-river-estuary system near hospitals of Jinyintan, Huoshenshan and Leishenshan in the three regions (J, H and L) (Regions J, H and L) in Wuhan, China. The total amount of PPCPs (ranging from 2.61 to 1122 ng/L in water and 0.11 to 164 ng/g dry weight in sediments) were comparable to historical reports in Yangtze River basin, whereas the detection frequency and concentrations of ribavirin and azithromycin were higher than those of historical studies. The distribution of concerned drugs varied with space, season, media and water types: sampling sites located at WWTPs-river-estuary system around two hospitals (Regions L and J) usually had relatively high waterborne contamination levels, most of which declined in autumn; lakes had relatively low waterborne contamination levels in summer but increased in autumn. The potential risks of detected PPCPs were further evaluated using the multiple-level ecological risk assessment (MLERA): sulfamethoxazole and azithromycin were found to pose potential risks to aquatic organisms according to a semi-probabilistic approach and classified as priority pollutants based on an optimized risk assessment. In general, the COVID-19 pandemic did not cause serious pollution in lakes and WWTPs-river-estuary system in Wuhan City. However, the increased occurrence of certain drugs and their potential ecological risks need further attention. A strict source control policy and an advanced monitoring and risk warning system for emergency response and long-term risk control of PPCPs is urgent.

Ecotoxicological effects, environmental fate and risks of pharmaceutical and personal care products in the water environment: A review

Due to the extensive use and incomplete removal, pharmaceutical and personal care products (PPCPs) are introduced into the water continuously. It has been proved that the unique properties of PPCPs are influential to organisms and the environment, and gradually affect human health. In this paper, the toxicological effects of typical PPCPs, and the environmental behavior of PPCPs in aquatic are reviewed. The risk assessments of PPCPs in the water are summarized. The research directions of environmental toxicology research of PPCPs in the future are proposed. Many PPCPs were found to be toxic or even highly toxic toward aquatic organisms, and have the potential for bioaccumulation. It is essential to study the acute and long-term toxicity of PPCPs and their metabolites, evaluate the environmental behaviors and make a reasonable assessment of ecotoxicology and human health risks of PPCPs.

Assessing the distributions and fate of household and personal care chemicals (HPCCs) in the Songhua Catchment, Northeast China

Many household and personal care chemicals (HPCCs) are of environmental concern due to their potential toxicity to humans and wildlife. However, few studies investigate the spatiotemporal variations and fate of HPCCs in large-scale river systems. Here, river water and sediment samples from the Songhua River in Northeast China were analyzed for seven classes of HPCCs. Correlation analysis suggested similar sources and environmental behavior for compounds from the same HPCC classes. In the river water, the concentrations of most HPCCs in the cold season were significantly higher than that of the warm season (p < 0.01). Significantly higher levels of target compounds were found in the downstream water samples of a city, suggesting the influence of human activities on the distributions of HPCCs. The concentrations and distributions of most HPCCs were controlled by primary emission sources. The derived dissolved concentrations of HPCCs suggested that small amounts of caffeine and parabens were partitioned onto particles, while large amounts of many other HPCCs were bound to the particle phase. Water-sediment distribution coefficients (log K_d) ranged from 1.59 for caffeine to 3.95 for benzalkonium chloride-C14. This work presents new insights into the environmental behavior of HPCCs and the factors affecting their fate in river systems.

Resistance genes and extracellular proteins relieve antibiotic stress on the anammox process

The anaerobic ammonium oxidation (anammox) process is regarded as a promising approach to treat antibiotic-containing wastewater. Therefore, it is urgent to elucidate the effects of various antibiotics on the anammox process. Moreover, the mechanism of extracellular polymeric substance (EPS) as protective barriers to relieve antibiotic stress remain unclear. Therefore, the single and combined effects of erythromycin (ETC) and sulfamethoxazole (SMZ), and interactions between EPS and antibiotics were investigated in this study. Based on a 228-day continuous flow experiment, high concentrations of ETC and SMZ had significant inhibitory effects on the nitrogen removal performance of the anammox process, with the abundances of corresponding antibiotic resistance genes (ARGs) increasing. In addition, the combined inhibitory effect of the two antibiotics on the anammox process was more significant and longer-lasting than that of the single. However, the anammox process was able to quickly recover from deterioration. The tolerance of anammox granules to the stress of low-concentration antibiotics was probably attributed to the increase in ARGs and secretion of EPS. Molecular docking simulation results showed that proteins in EPS could directly bind with SMZ and ETC at the sites of GLU-307, HYS-191, ASP-318 and THR-32, respectively. These findings improved our understanding of various antibiotic effects on the anammox process and the interaction mechanism between antibiotics and proteins in EPS.

Occurrence of antibiotics and antibiotic resistance genes and their correlations in river-type drinking water source, China

The occurrence and distribution of antibiotics and antibiotic resistance genes (ARGs) in natural water has attracted worldwide attention. Antibiotic and ARG pollution in the surface water of drinking water sources might directly/indirectly affect human health. In this study, the distribution of 38 antibiotics, 10 ARGs, 2 integrons, and 16S r DNA in river-type water sources in a large city of China were monitored in winter, which was a period with high level of antibiotic pollution. The results showed that 20 antibiotics were detected with different detection frequencies. The antibiotic pollution in December 2019 was relatively high, with the total concentrations of antibiotics ranging from 281.95 to 472.42 ng/L, followed by that in January 2020 (191.70-337.29 ng/L) and November 2019 (161.25-309.72 ng/L). Sulfacetamide was dominant in November 2019 (23.52-219.00 ng/L) and in January 2020 (113.18-209 ng/L), while norfloxacin in December 2019 (146.72-290.20 ng/L). All the target antibiotics posed low or medium risk for aquatic organisms, and posed low health risk for mankind. Sul1 and erm36 were the predominant ARGs, and intI1 was the predominant integron in drinking water sources. Only tetA showed positive correlations with its corresponding antibiotic (tetracycline). The rest of ARGs showed no correlations with antibiotics or positive / negative correlations with their non-corresponding antibiotics. Overall, the antibiotics and ARG pollution in these water sources was relatively low. These findings provided some reference data for the distribution of antibiotics and ARGs in river-type drinking water sources of large cities in China.

Distribution and ecological risk assessment of typical antibiotics in the surface waters of seven major rivers, China

The consumption and production of antibiotics in China rank highest in the world. As such, the occurrence of antibiotics in environmental media of China has raised significant concerns. Rivers play an important role in the sustainable development of China's economy and society, possibly causing high levels and detection frequencies of antibiotics in the aquatic environment of rivers in China. Therefore, it is necessary to understand the distribution and risk level of antibiotics in rivers. From south to north, China has seven major rivers vertically and horizontally. They are Yangtze River, Yellow River, Hai River, Liao River, Huai River, Songhua River and Pearl River. In this review, we made an extensive literature survey and published all studies on antibiotic concentrations in seven river systems of China from 2010 to 2020 were sorted out to provide a clear draw of the distribution characteristics of antibiotics. We found that 70 antibiotics have been detected in the seven major river systems. 13 typical antibiotics in surface waters of seven river systems were systematically reviewed and ecological risk assessment was conducted. The occurrence frequencies of high-risk antibiotics in surface waters followed the rank order: ETM-H₂O > CIP > OFX > SMX > NOR. The RQ_s values of seven rivers decreased in the order of Hai River (1.58-18 094.3) > Liao River (1.14-290.23) > Pearl River (2.11-118.25) > Yangtze River (0.3-64.78) > Yellow River (7.56-35.45) > Songhua River (0.03-22.26) > Huai River (1.87-20.83).

The challenge of micropollutants in surface water of the Yangtze River

The Yangtze River, the third largest river and supporting nearly one-third of Chinese population, has been severely polluted in recent decades. Among the numerous pollutants, organic micropollutants, as one kind of important emerging contaminants, are currently key contaminants of concern. However, few studies have focused on their mixture environmental impacts, especially for the complex environmental mixtures. In the current study, four categories of organic micropollutants, including 16 polycyclic aromatic hydrocarbons (PAHs), 32 polychlorinated biphenyls (PCBs), 27 organochlorine pesticides (OCPs) and 20 pharmaceutical and personal care products (PPCPs) are analyzed in 10 study sites on the Yangtze River. Subsequently, comprehensive risk assessment for micropollutant mixtures was conducted by risk quotient based on the sum of PEC/PNEC values (RQ_MEC/PNEC) and risk quotient based on the toxic units (RQ_STU). The mixture risk evaluation based on the detected environmental concentrations indicates that micropollutant mixtures in surface water of the Yangtze River exhibited relative high risks for aquatic organisms. The observed results revealed that mixture risk assessments have to consider the complexity of environmental samples; PCBs dominated main mixture risks in the upper stream; PAHs contributed major comprehensive risks in the middle stream; and OCPs were the key micropollutants in the downstream. The outcomes of the present study here can serve for pollution control in the Yangtze River, which provide the scientific underpinnings and regulatory reference for risk management and river protection.

Effects of antibiotics stress on growth variables, ultrastructure, and metabolite pattern of Brassica rapa ssp. chinensis

Antibiotics frequently contaminate agricultural fields and through plant uptake enter into the food chain. This study aimed to explore the effects of antibiotics; tetracycline (TC), oxytetracycline (OTC) and norfloxacin (NF) on the growth, cell ultrastructure, and metabolite pattern of Brassica rapa ssp. chinensis. Oxytetracycline accumulated more than other antibiotics followed by TC and NF. Plant growth, chlorophyll fluorescence, and antioxidant activities were negatively affected under all antibiotic treatments. Ultrastructural investigation of mesophyll of leaves performed by transmission electron microscopy indicated that antibiotic stress caused the changes in thylakoid orientation, number of plastoglobuli, and starch grains. Identification of functional groups through Fourier transform infrared analysis indicated that carboxyl group, carbonate and ammonium ions are involved in the adsorption of antibiotics. The metabolic profiling of B. rapa leaves demonstrated that all of the antibiotics treatments distorted phenylalanine, tyrosine and tryptophan biosynthesis, d-glutamine and d-glutamate metabolism, alanine, aspartate and glutamate metabolism, phenylalanine metabolism and TCA cycle. Metabolic alterations as a result of antibiotics stress provide insights of metabolites that affect the physiological changes attributed to antibiotic stress. These results will improve the understanding of antibiotic contamination effects on plants.

Carbamazepine and Diclofenac Removal Double Treatment: Oxidation and Adsorption

In the present research, the effect of two hybrid treatments, ozone followed by powdered activated carbon (PAC) or PAC followed by ozone (O₃), was studied for the removal of two drugs present in water: diclofenac and carbamazepine. In the study, two initial concentrations of each of the contaminants, 0.7 mg L^-1 and 1.8 mg L^-1, were used. Different doses of PAC between 4-20 mg L^-1 were studied as variables, as well as different doses of O₃ between 0.056-0.280 mg L^-1. The evolution of the concentration of each contaminant over time was evaluated. From the results obtained, it was concluded that the combined treatment with ozone followed by PAC reduces between 50% and 75% the time required to achieve 90% removal of diclofenac when compared with the time required when only activated carbon was used. In the case of carbamazepine, the time required was 97% less. For carbamazepine, to achieve reduction percentages of up to 90%, O₃ treatment followed by PAC acted faster than PAC followed by O₃. In the case of diclofenac, PAC treatment followed by O₃ was faster to reach concentrations of up to 90%. However, to reach yields below 80%, O₃ treatment followed by PAC was more efficient.

Anthropogenic disturbances on distribution and sources of pharmaceuticals and personal care products throughout the Jinsha River Basin, China

Pharmaceuticals and personal care products (PPCPs) are recognized as a group of emerging contaminants closely related to anthropogenic activities, which capture increasing attention worldwide. To evaluate the anthropogenic disturbances on PPCP distribution and sources, this study investigated the distribution and sources of 50 PPCPs along the 2300 km long Jinsha River and revealed different anthropogenic disturbances on PPCPs. Results showed that 40 out of the 50 PPCPs were ubiquitously detected among these river water samples, with the concentrations varied from less than 1 ng/L to more than 500 ng/L. Although most PPCPs concentrations were much lower in the Jinsha River than in highly developed rivers, the prevalence of PPCPs suggested the widespread use and improper disposal of PPCPs in the Jinsha River. The risk assessment also revealed that some PPCPs posed risks to aquatic organisms in the Jinsha River. Anthropogenic activities including human habitation and dam construction had different influence on PPCPs. PPCP distribution varied significantly across the "Hu Huanyong line", indicating human habitation significantly influenced PPCP distribution. Dam construction was insignificant in altering PPCP distribution throughout the Jinsha River. Moreover, the land use index indicated degradation level of multiple lands related to anthropogenic activities and represented the major sources of PPCPs in the Jinsha River. Most PPCPs were correlated with anthropogenic lands, for example, antibiotics, analgesics, and endocrine disrupting chemicals mainly originated from artificial surfaces, whereas other PPCPs mainly originated from cultivated lands. Together, this study indicates the disturbances of multiple anthropogenic activities on PPCP distribution and sources along the Jinsha River, which contributes to PPCP management in rural areas.

Recent trends in advanced oxidation process-based degradation of erythromycin: Pollution status, eco-toxicity and degradation mechanism in aquatic ecosystems

Wide spread documentation of antibiotic pollution is becoming a threat to aquatic environment. Erythromycin (ERY), a macrolide belonging antibiotic is at the top of this list with its concentrations ranging between ng/L to a few μg/L in various global waterbodies giving rise to ERY-resistance genes (ERY-RGs) and ERY- resistance bacteria (ERY-RBs) posing serious threat to the aquatic organisms. ERY seems resistant to various conventional water treatments, remained intact and even increased in terms of mass loads after treatment. Enhanced oxidation potential, wide pH range, elevated selectivity, adaptability and greater efficiency makes advance oxidation processes (AOPs) top priority for degrading pollutants with aromatic rings and unsaturated bonds like ERY. In this manuscript, recent developments in AOPs for ERY degradation are reported along with the factors that affect the degradation mechanism. ERY, marked as a risk prioritized macrolide antibiotic by 2015 released European Union watch list, most probably due to its protein inhibition capability considered third most widely used antibiotic. The current review provides a complete ERY overview including the environmental entry sources, concentration in global waters, ERY status in STPs, as well as factors affecting their functionality. Along with that this study presents complete outlook regarding ERY-RGs and provides an in depth detail regarding ERY's potential threats to aquatic biota. This study helps in figuring out the best possible strategy to tackle antibiotic pollution keeping ERY as a model antibiotic because of extreme toxicity records.

Combined Effects of Sulfamethoxazole and Erythromycin on a Freshwater Microalga, Raphidocelis subcapitata: Toxicity and Oxidative Stress

This study investigated the environmental effects of two familiar emerging contaminants, sulfamethoxazole (SMX) and erythromycin (ERY), and their mixture (10:1 w/w) using a green microalga, R. subcapitata. The cell density, pigment content, and the activities of superoxide dismutase (SOD), catalase (CAT), glutathione (GSH) glutathione peroxidase (GSH-Px), and glutathione S-transferase (GST) were analyzed. The calculated EC₅₀ values of SMX, ERY, and their mixture after 96 h were 0.49, 0.044, and 0.06 mg/L, respectively. High concentrations of antibiotics lead to a decrease in chlorophyll a and total carotenoid content, affecting the ability to photosynthesize ROS scavenging capacity. This may be a factor leading to the inhibition of algal growth. When R. subcapitata was exposed to SMX and the mixture, SOD and CAT increased to resist oxidative damage, while the activities of GSH and GST decreased, suggesting that this algae’s antioxidant system was unbalanced due to oxidative stress. R. subcapitata reduced the ERY-induced ROS by increasing the activities of SOD, GSH, and GST. The difference in the contents of nonenzymatic antioxidants and enzyme antioxidants in R. subcapitata indicated the antioxidant mechanisms to SMX and ERY were not identical. This study provides insights into the oxidative stress process in R. subcapitata under different antibiotics.

A review of distribution and risk of pharmaceuticals and personal care products in the aquatic environment in China

Due to the extensive use and pseudo-persistence of pharmaceuticals and personal care products (PPCPs), they are frequently detected in the aqueous environment, which has attracted global attention. In this paper, accumulation data of 81 PPCPs in surface water or sediment in China were reported. In addition, 20 kinds of PPCPs with high frequency were selected and their ecological risk assessment was conducted by risk quotient (RQs). The results indicated that the concentration detected in surface water and sediment ranged from ng/L (ng/kg) to μg/L (μg/kg) in China, which was similar to concentrations reported globally. However, contamination by certain PPCPs, such as caffeine, oxytetracycline, and erythromycin, was relatively high with a maximum concentration of more than 2000 ng/L in surface water. RQs revealed that 14 kinds of PPCPs pose no significant risk or low risk to aquatic organisms, while 6 kinds of PPCPs pose a high risk. Additionally, the pollution characteristics of PPCPs in each watershed are different. The Haihe River watershed and the central and lower Yangtze River were the regions of high concern for erythromycin. Triclosan has potential risks in the Pearl River watershed. This study determined the occurrence and risk of PPCPs in China in the past decade, providing a scientific basis for PPCPs pollution control and risk prevention.

Prevalence and hazardous impact of pharmaceutical and personal care products and antibiotics in environment: A review on emerging contaminants

Antibiotic resistance is a global health emergency linked to unrestrained use of pharmaceutical and personal care products (PPCPs) as prophylactic agent and therapeutic purposes across various industries. Occurrence of pharmaceuticals are identified in ground water, surface water, soils, and wastewater treatment plants (WWTPs) in ng/L to μg/L concentration range. The prevalence of organic compounds including antimicrobial agents, hormones, antibiotics, preservatives, disinfectants, synthetic musks etc. in environment have posed serious health concerns. The aim of this review is to elucidate the major sources accountable for emergence of antibiotic resistance. For this purpose, variety of introductory sources and fate of PPCPs in aquatic environment including human and veterinary wastes, aquaculture and agriculture related wastes, and other anthropogenic activities have been discussed. Furthermore, genetic and enzymatic factors responsible for transfer and appearance of antibiotic resistance genes are presented. Ecotoxicity of PPCPs has been studied in environment in order to present risk imposed to human and ecological health. As per published literature reports, the removal of antibiotics and related traces being difficult, couples the possibility of emergence of antibiotic resistance and hence sustainability in global water resources. Therefore, research on environmental behavior and control strategies should be conducted along with assessing their chronic toxicity to identify potential human and ecological risks.

Enrichment of antibiotics in an inland lake water

Inland water is very susceptible to the input of pollutants. However, little is known about the occurrence of antibiotics in inland lakes. In this study, a total of 83 target antibiotics were quantified in water and sediment samples collected from the Qinghai Lake, the largest inland lake of China located on the northeast of Qinghai-Tibet plateau, and its inflowing rivers. The results showed that 27 and 25 antibiotics were detected in water and sediments, respectively, with the summed concentrations (SUM) of 1.14-17.3 ng/L and 0.72-8.31 ng/g. Compared with the input rivers, significantly higher levels of sulfonamides (SAs), quinolones (QNs), polyethers (PEs), and SUM in water samples were observed in Qinghai Lake water. The average proportions of SAs (50.9-52.7%) and QNs (22.0-28.3%) in Qinghai Lake water nearly doubled compared to those in input rivers. An enrichment factor (EF) was proposed to reveal the enrichment degree of antibiotics in Qinghai Lake compared to its input river water. Sulfaguanidine (SGD), flumequine (FLU), and nalidixic acid (NDA) were enriched in Qinghai Lake up to several ten times based on the calculated EF values, due to their persistence in such a cold saline lake. Risk assessment showed that most antibiotics except anhydrochlortetracycline (ACTC) had insignificant risks to aquatic organisms and antibiotic resistance selection in Qinghai Lake water. This study was the first to reveal the enrichment of antibiotics in Qinghai Lake water, and suggests the urgent need to investigate the possible long-term enrichment and environmental risks of antibiotics in inland lakes.

A review of the influences of microplastics on toxicity and transgenerational effects of pharmaceutical and personal care products in aquatic environment

PPCPs (pharmaceutical and personal care products) and microplastics (MPs) are two types of emerging pollutants that are ubiquitous and widely concerned in the environment. Both of them can accumulate in fish or aquatic invertebrates and transfer to offspring, thereby producing toxic effects on both parents and offspring, in which the characteristics of MPs also enable them to adsorb PPCPs thus producing carrier effects. In this study, we have conducted a comprehensive review of MPs and PPCPs and found that MPs can act as a carrier of PPCPs to influence the bioaccumulation of PPCPs. MPs and PPCPs have toxicity and transgenerational effects on both fish and aquatic invertebrates in many aspects, and MPs can also affect the toxicity and transgenerational effects of PPCPs due to their carrier effects. This paper revealed that MPs may have an important impact on the bioavailability of PPCPs and the interaction between MPs and PPCPs is a hot topic in future research. This study also puts forward the shortcomings of the current research and related suggestions, and relevant research should be carried out as soon as possible to provide the basis for the prevention and treatment of fresh water.

Occurrence of caffeine in the freshwater environment: Implications for ecopharmacovigilance

Owing to the substantial consumption of caffeinated food, beverages, and medicines worldwide, caffeine is considered the most representative pharmaceutically active compound (PhAC) pollutant based on its high abundance in the environment and its suitability as an indicator of the anthropogenic inputs of PhACs in water bodies. This review presents a worldwide analysis of 132 reports of caffeine residues in freshwater environments. The results indicated that more than 70% of the studies reported were from Asia and Europe, which have densely populated and industrially developed areas. However, caffeine pollution was also found to affect areas isolated from human influence, such as Antarctica. In addition, the maximum concentrations of caffeine in raw wastewater, treated wastewater, river, drinking water, groundwater, lake, catchment, reservoir, and rainwater samples were reported to be 3.60 mg/L, 55.5, 19.3, 3.39, 0.683, 174, 44.6, 4.87, and 5.40 μg/L, respectively. The seasonal variation in caffeine residues in the freshwater environment has been demonstrated. In addition, despite the fact that there was a small proportion of wastewater treatment plants in which the elimination rates of caffeine were below 60%, wastewater treatment is generally believed to have a high caffeine removal efficiency. From a pharmacy perspective, we proposed to adopt effective measures to minimize the environmental risks posed by PhACs, represented by caffeine, through a new concept known as ecopharmacovigilance (EPV). Some measures of EPV aimed at caffeine pollution have been advised, as follows: improving knowledge and perceptions about caffeine pollution among the public; listing caffeine as a high-priority PhAC pollutant, which should be targeted in EPV practices; promoting green design and production, rational consumption, and environmentally preferred disposal of caffeinated medicines, foods, and beverages; implementing intensive EPV measures in high-risk areas and during high-risk seasons; and integrating EPV into wastewater treatment programs.

Pharmaceuticals and personal care products in a drinking water resource of Yangtze River Delta Ecology and Greenery Integration Development Demonstration Zone in China: Occurrence and human health risk assessment

The occurrence, partition, and human health risk of thirteen pharmaceuticals and personal care products (PPCPs) have been investigated in surface water, overlying water, pore water and sediment samples from Dianshan Lake of Yangtze River Delta Ecology and Greenery Integration Development Demonstration Zone in China. PPCPs were ubiquitous in aqueous phase and sediments from Dianshan Lake. Sulfamethazine (SMZ) was dominated in surface water and overlying water, while ketoprofen (KPF) was rich in sediment. The total concentration of PPCPs ranged from 0.38-85.27 ng/L, 24.26-130.03 ng/L and 5.39-149.84 μg/kg in surface water, overlying water and sediment, respectively, which were in middle levels compared with these reported in other aquatic environment in China. Naproxen (NPX), sulfadimethoxine (SDM), sulfamethoxazole (SMX) and sulfamethazine (SMZ) in surface water showed a relatively higher level in lake side than those in lake center suggesting that a mixed containment source of human- and animal-derived from the areas around lake. The significant season variations of most PPCPs were mainly attributed to their usage, water temperature and dilution effect. The partition behaviors of PPCPs in sediment-overlying water and sediment-pore water system were mainly affected by their logK_ow values, and showed weak correlation with total organic carbon (TOC) content in sediment and molecular weights of PPCPs. Preliminary results indicated that PPCPs in Dianshan Lake have not posed a high risk to human health by exposure to drinking water for all age groups. Nevertheless, their potential to cause the mixture toxicity and resistance genes cannot be neglected. This work will contribute to the clear picture of PPCPs contamination in drinking water source in the Demonstration Zone, and provide reliable and simple-to-use information to regulators on the exposure and risk levels of PPCPs, as well as recommendations for future research.

Maternal antibiotic concentrations in pregnant women in Shanghai and their determinants: A biomonitoring-based prospective study

Consumption of antibiotics is continuing to increase, with China accounting for approximately one quarter of the global intake. As a class of emerging environmental contaminants, antibiotics may pose a potential threat to human health, especially in children. However, the internal antibiotic exposure levels in pregnant women and their determinants remain unclear. Here we investigated the urinary creatinine-corrected concentration of 15 antibiotics in 762 pregnant women from the Shanghai Prenatal Cohort, by liquid chromatography-tandem mass spectrometry. Logistic regression analysis identified associations between high-antibiotic-level and maternal dietary factors. Results show that cumulatively antibiotics were detected at a frequency of 0.13 - 82.7%, with veterinary antibiotics (VAs) and preferred veterinary antibiotics (PVAs) detected in 76.9% and 98.2% of samples, respectively; PVAs were the most significant contributors to hazard index values > 1. Further, ciprofloxacin was the predominant antibiotic (median: 73.5 μg/mg creatinine), followed by norfloxacin (54.2 μg/mg creatinine); while sulfamethoxazole, enrofloxacin, and ciprofloxacin levels, used as a PVA or VA, were significantly higher in normal-weight and underweight women compared to overweight and obese women. Also, sulfamethoxazole, sulfadiazine, and ciprofloxacin were more frequently detected in mothers with a relatively low education degree. Interestingly, pregnant women with higher milk intake had a 1.96-times (95% CI: 1.10-3.49) greater risk of high-VA-exposure-level than the lower-intake group. The odds of exposure to high PVA, VA, PVA + VA, and all antibiotics levels for mothers with high egg consumption frequency were more than twice that of low-consumption individuals. Collectively, pregnant women in Shanghai are exposed to multiple environmental antibiotics, primarily as PVAs and VAs. Herein, we provide evidence for the association between dietary factors and maternal environmental antibiotic exposure in China. Special attention to antibiotic exposure and confirmation of potential determinants should be taken in the future.