Temporal dynamics of antibiotics in wastewater treatment plant influent

The combination of ciprofloxacin and dialkyldimethyl ammonium compound synergistically proliferated intracellular resistance genes in nitrifying system

Antibiotics and quaternary ammonium compounds (QACs) usually co-exist in wastewater treatment plants. Hence, three sequencing batch reactors were established and named as R1, R2 and R3, to investigate the effects of individual and combined exposure of different concentrations of ciprofloxacin (CIP) (0.2, 1.0 and 2.0 mg/L) and dialkyldimethyl ammonium compound (DADMAC) (0.4, 2.0 and 4.0 mg/L) on the performance, microbial community structures and resistance genes (RGs) in nitrifying system during 150 days. Results showed that CIP had a slight effect on ammonia oxidation activity, while 2.0 and 4.0 mg/L DADAMAC could obviously inhibit it, and the combination of CIP and DADMAC had a synergistic inhibitory effect. Besides, both CIP and DADMAC caused partial nitrification, and the order of nitrite accumulation rate was ranked as R3 > R2 > R1. The combination of CIP and DADMAC had an antagonistic effect on the increase of sludge particle size and α-Helix/(β-Sheet + Random coil) was lowest in R3 (0.40). The combination of CIP and DADMAC synergistically stimulated most intracellular RGs in sludge, and the relative abundances of target RGs (e.g., qacEdelta1-01, qacH-01 and qnrS) at the end of operation in R3 were increased by 4.61-18.19 folds compared with those in CK, which were 1.34-5.57 folds higher than the R1 and R2. Moreover, the combination of CIP and DADMAC also promoted the transfer of RGs from sludge to water and enriched more potential hosts of RGs, further promoting the spread of RGs in nitrifying system. Thus, the combined pollution of CIP and DADMAC in wastewaters should attract more attentions.

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

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

A modeling pipeline to relate municipal wastewater surveillance and regional public health data

As COVID-19 becomes endemic, public health departments benefit from improved passive indicators, which are independent of voluntary testing data, to estimate the prevalence of COVID-19 in local communities. Quantification of SARS-CoV-2 RNA from wastewater has the potential to be a powerful passive indicator. However, connecting measured SARS-CoV-2 RNA to community prevalence is challenging due to the high noise typical of environmental samples. We have developed a generalized pipeline using in- and out-of-sample model selection to test the ability of different correction models to reduce the variance in wastewater measurements and applied it to data collected from treatment plants in the Chicago area. We built and compared a set of multi-linear regression models, which incorporate pepper mild mottle virus (PMMoV) as a population biomarker, Bovine coronavirus (BCoV) as a recovery control, and wastewater system flow rate into a corrected estimate for SARS-CoV-2 RNA concentration. For our data, models with BCoV performed better than those with PMMoV, but the pipeline should be used to reevaluate any new data set as the sources of variance may change across locations, lab methods, and disease states. Using our best-fit model, we investigated the utility of RNA measurements in wastewater as a leading indicator of COVID-19 trends. We did this in a rolling manner for corrected wastewater data and for other prevalence indicators and statistically compared the temporal relationship between new increases in the wastewater data and those in other prevalence indicators. We found that wastewater trends often lead other COVID-19 indicators in predicting new surges.

Wastewater surveillance for antibiotics and resistance genes in a river catchment: Spatiotemporal variations and the main drivers

Wastewater-based epidemiology (WBE) is used for mining information about public health such as antibiotics resistance. This study investigated the distribution profiles of six types of antibiotic resistance genes (ARGs) in wastewater and rivers in Wuhu City, China. The levels of ARGs found in the Qingyijiang River were significantly higher than other rivers, and were comparable to effluent levels. Among the ARGs, sulfonamides ARGs and intI1 were the predominant in both wastewaters and rivers. Additionally, the concentrations of ARGs were higher on weekends as opposed to weekdays. Their distribution patterns remained consistent inter-week and inter-season using linear regression analysis (p < 0.001). Interestingly, the occurrence levels of ARGs in wastewaters during spring were significantly higher than in autumn, although insignificant in rivers. The apparent removal rate of ARGs in domestic wastewater sources ranged from 61.52-99.29%, except for qepA (-1.91% to 81.09%), whereas the removal rates in mixed domestic and industrial wastewaters showed a marked decrease (-92.94% to 76.67%). A correlation network analysis revealed that azithromycin and erythromycin were key antibiotics, while blaNDM-1, tetM, tetB, and ermB were identified as key ARGs. Sulfonamide and fluoroquinolone antibiotics, and tetracycline and macrolide ARGs were the primary contributors. Linear mixed models demonstrated that socio-economic variables positively impacted the occurrence levels of ARGs, whereas wastewater flow and river runoff were the negative drivers for their concentrations in wastewaters and surface waters, respectively. Overall, this WBE study contributes to the understanding of spatiotemporal profiles and main drivers of the occurrence of ARGs in wastewater and receiving water.

Short-term mass loads of per- and polyfluoroalkyl substances in a wastewater treatment plant from South China

Wastewater treatment plants (WWTPs) are one of the most important sources and sinks for per- and polyfluoroalkyl substances (PFAS). However, limited studies have evaluated short-term temporal variability of PFAS in WWTPs, particularly for their intra-day variations. For this purpose, a time-composite sampling campaign was carried out at a WWTP influent from South China for 1 week. Five out of ten PFAS were found in the influent, i.e., perfluoroheptanoic acid (PFHpA), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorobutane sulfonic acid (PFBS), and perfluorooctanesulfonic acid (PFOS). PFOA was the most domain PFAS whereas PFOS was detected occasionally, which might be associated with the prohibition of PFOS use in China. For the first time, we observed significant intra-day fluctuations in mass fluxes for PFOS. Different from a morning peak of pharmaceuticals reported previously, PFOS mass loads fluctuated sharply at noon and night on the weekdays. Furthermore, the mass fluxes of PFOA on the weekend were significantly elevated. For the other PFAS detected, no significant diurnal variations in mass loads were identified. Correlation analysis indicated that domestic activities (e.g., home cleaning) are likely to be the major source of these perfluorocarboxylic acids especially PFOA. In addition, flow fluxes had little effects on these PFAS mass load. These results can aid in future sampling campaigns and optimizing removal strategies for PFAS in wastewater.

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

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

Metal Oxide Nanostructures (MONs) as Photocatalysts for Ciprofloxacin Degradation

In recent years, organic pollutants have become a global problem due to their negative impact on human health and the environment. Photocatalysis is one of the most promising methods for the removal of organic pollutants from wastewater, and oxide semiconductor materials have proven to be among the best in this regard. This paper presents the evolution of the development of metal oxide nanostructures (MONs) as photocatalysts for ciprofloxacin degradation. It begins with an overview of the role of these materials in photocatalysis; then, it discusses methods of obtaining them. Then, a detailed review of the most important oxide semiconductors (ZnO, TiO₂, CuO, etc.) and alternatives for improving their photocatalytic performance is provided. Finally, a study of the degradation of ciprofloxacin in the presence of oxide semiconductor materials and the main factors affecting photocatalytic degradation is carried out. It is well known that antibiotics (in this case, ciprofloxacin) are toxic and non-biodegradable, which can pose a threat to the environment and human health. Antibiotic residues have several negative impacts, including antibiotic resistance and disruption of photosynthetic processes.

Calibration of a microporous polyethylene tube passive sampler for polar organic compounds in wastewater effluent

Water resources are vulnerable to contamination from polar organic compounds (POCs) originating from sources such as wastewater effluent. Two configurations of a microporous polyethylene tube (MPT) passive sampler were investigated for the time-integrative detection and quantification of POCs in effluent. One configuration contained the polymeric reversed phase sorbent Strata-X (SX) and the other Strata-X suspended in agarose gel (SX-Gel). These were deployed for up to 29 days and analysed for forty-nine POCs including pesticides, pharmaceuticals and personal care products (PPCPs) together with illicit drugs. Complementary composite samples were collected on days 6, 12, 20 and 26 representing the previous 24 h. Thirty-eight contaminants were detected in composite samples and MPT extracts, with MPT sampling rates (R_s) for 11 pesticides and 9 PPCPs/drugs ranging from 0.81 to 10.32 mL d^-1 in SX and 1.35-32.83 mL d^-1 in SX-Gel. Half-times to equilibrium of contaminants with the SX and SX-Gel equipped samplers ranged from two days to >29 days. MPT (SX) samplers were also deployed at 10 wastewater treatment effluent discharge sites across Australia for 7 days (again with complementary composite samples), to validate the sampler performance under varying conditions. Extracts from these MPTs detected 48 contaminants in comparison with 46 in composite samples, with concentrations ranging from 0.1 to 138 ng mL^-1. An advantage of the MPT was preconcentration of contaminants, resulting in extract levels often markedly above instrument analytical detection limits. The validation study demonstrated a high correlation between accumulated contaminant mass in the MPTs and wastewater concentrations from composite samples (r² > 0.70, where concentrations in composite samples were > 3× LOD). The MPT sampler shows promise as a sensitive tool for detecting POCs at trace levels in wastewater effluent and also quantifying these levels if temporal concentration variations are not significant.

Combining environmental, health, and safety features with a conductor like Screening Model for selecting green solvents for antibiotic analyses

Extraction and chromatographic techniques for analyzing pharmaceutically active compounds necessitate large quantities of organic solvents, resulting in a high volume of hazardous waste. The concept of green solvents focuses on protecting the environment by reducing or even eliminating the use of toxic solvents. The main objective of this critical review article is to build a framework for choosing green solvents for antibiotic analyses. The article briefly discusses the chemical properties of ciprofloxacin, sulfamethoxazole, tetracycline, and trimethoprim, and the current state of methodologies for their analyses in water and wastewater. It evaluates the greenness of solvents used for antibiotic analyses and includes insights on the comparison between conventional and green solvents for the analyses. An economic and environmental health and safety analysis combined with a Conductor-like Screening Model for Real Solvent (COSMO-RS) molecular simulation technique for predicting extraction efficiency was used in the evaluation. Methyl acetate and propylene carbonate tied for the greenest solvents from an environmental and economic perspective, whereas the COSMO-RS approach suggests dimethyl sulfoxide (DMSO) as the most suitable candidate. Although DMSO ranked third environmentally and economically, after methyl acetate and propylene carbonate, it would be an ideal replacement of hazardous solvents if it could be manufactured at a lower cost. DMSO showed the highest extraction capacity, as it can interact with antibiotics through hydrophobic interaction and hydrogen bonding. This article can be used as a green solvent selection guide for developing sustainable processes for antibiotic analyses.

Monitoring the exposure and emissions of antibiotic resistance: Co-occurrence of antibiotics and resistance genes in wastewater treatment plants

The COVID-19 pandemic has brought new momentum to 'wastewater-based epidemiology' (WBE). This approach can be applied to monitor the levels of antibiotic-resistant genes (ARGs), which in terms are used to make inferences about the burden of antimicrobial resistance (AMR) in human settlements. However, there is still little information about temporal variability in ARG levels measured in wastewater streams and how these influence the inferences made about the occurrence of AMR in communities. The goal of this study was hence to gain insights into the variability in ARG levels measured in the influent and effluent of two wastewater treatment plants in The Netherlands and link these to levels of antibiotic residues measured in the same samples. Eleven antibiotics were detected, together with all selected ARGs, except for VanB. Among the measured antibiotics, significant positive correlations (p > 0.70) with the corresponding resistance genes and some non-corresponding ARGs were found. Mass loads varied up to a factor of 35 between days and in concomitance with rainfall. Adequate sampling schemes need to be designed to ensure that conclusions are drawn from valid and representative data. Additionally, we advocate for the use of mass loads to interpret levels of AMR measured in wastewater.

Critical review on negative emerging contaminant removal efficiency of wastewater treatment systems: Concept, consistency and consequences

Emerging contaminants (ECs) are not completely removed by wastewater treatment owing to their capabilities of making complexes, toxic derivatives, byproduct formation, and dynamic partitioning. Negative contaminant removal i.e., higher concentrations (up to 5731%) of these ECs in the effluent with respect to the influent sampled on the same occasions, is globally prevalent in almost all types of treatment systems. Conventional WWTPs showed the highest negative removal (NR) for Carbamazepine, and Carbadox. Conjugation-deconjugation, types of WWTPs, transformations, leaching, operational parameters, sampling schemes, and nature of substance governs the NR efficiencies. Among the various categories of micropollutants, pesticides and beta-blockers are reported to exhibit the maximum percentage of NR, posing threat to human and the environment. With > 200% of NR for beta-blockers, low blood-pressure related symptoms may likely to get more prevalent in the near future. Study red-flags this phenomenon of negative removal that needs urgent attention.

Abundance, fate, and effects of pharmaceuticals and personal care products in aquatic environments

Pharmaceuticals and personal care products (PPCPs) are found in wastewater, and thus, the environment. In this study, current knowledge about the occurrence and fate of PPCPs in aquatic systems-including wastewater treatment plants (WWTPs) and natural waters around the world-is critically reviewed to inform the state of the science and highlight existing knowledge gaps. Excretion by humans is the primary route of PPCPs entry into municipal wastewater systems, but significant contributions also occur through emissions from hospitals, PPCPs manufacturers, and agriculture. Abundance of PPCPs in raw wastewater is influenced by several factors, including the population density and demography served by WWTPs, presence of hospitals and drugs manufacturers in the sewershed, disease burden of the population served, local regulations, and climatic conditions. Based on the data obtained from WWTPs, analgesics, antibiotics, and stimulants (e.g., caffeine) are the most abundant PPCPs in raw wastewater. In conventional WWTPs, most removal of PPCPs occurs during secondary treatment, and overall removal exceeds 90% for treatable PPCPs. Regardless, the total PPCP mass discharged with effluent by an average WWTP into receiving waters (7.35-20,160 g/day) is still considerable, because potential adverse effects of some PPCPs (such as ibuprofen) on aquatic organisms occur within measured concentrations found in surface waters.

Occurrence, transformation, bioaccumulation, risk and analysis of pharmaceutical and personal care products from wastewater: a review

Almost all aspects of society from food security to disease control and prevention have benefited from pharmaceutical and personal care products, yet these products are a major source of contamination that ends up in wastewater and ecosystems. This issue has been sharply accentuated during the coronavirus disease pandemic 2019 (COVID-19) due to the higher use of disinfectants and other products. Here we review pharmaceutical and personal care products with focus on their occurrence in the environment, detection, risk, and removal.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10311-022-01498-7.

Influence of cosubstrate and hydraulic retention time on the removal of drugs and hygiene products in sanitary sewage in an anaerobic Expanded Granular Sludge Bed reactor

Diclofenac (DCF), ibuprofen (IBU), propranolol (PRO), triclosan (TCS) and linear alkylbenzene sulfonate (LAS) can be recalcitrant in Wastewater Treatment Plants (WWTP). The removal of these compounds was investigated in scale-up (69 L) Expanded Granular Sludge Bed (EGSB) reactor, fed with sanitary sewage from the São Carlos-SP (Brazil) WWTP and 200 mg L^-1 of ethanol. The EGSB was operated in three phases: (I) hydraulic retention time (HRT) of 36±4 h; (II) HRT of 20±2 h and (III) HRT of 20±2 h with ethanol. Phases I and II showed no significant difference in the removal of LAS (63 ± 11-65 ± 12 %), DCF (37 ± 18-35 ± 11 %), IBU (43 ± 18-44 ± 16 %) and PRO (46 ± 25-51 ± 23 %) for 13±2-15 ± 2 mg L^-1, 106 ± 32-462 ± 294 μg L^-1, 166 ± 55-462 ± 213 μg L^-1 and 201 ± 113-250 ± 141 μg L^-1 influent, respectively. Higher TCS removal was obtained in phase I (72 ± 17 % for 127 ± 120 μg L^-1 influent) when compared to phase II (51 ± 13 % for 135 ± 119 μg L^-1 influent). This was due to its greater adsorption (40 %) in the initial phase. Phase III had higher removal of DCF (42 ± 10 % for 107 ± 26 μg L^-1 influent), IBU (50 ± 15 % for 164 ± 47 μg L^-1 influent) and TCS (85 ± 15 % for 185 ± 148 μg L^-1 influent) and lower removal of LAS (35 ± 14 % for 12 ± 3 mg L^-1 influent) and PRO (-142 ± 177 % for 188 ± 88 μg L^-1 influent). Bacteria similar to Syntrophobacter, Smithella, Macellibacteroides, Syntrophus, Blvii28_wastewater-sludge_group and Bacteroides were identified in phase I with relative abundance of 3.1 %-4.7 %. Syntrophobacter was more abundant (15.4 %) in phase II, while in phase III, it was Smithella (12.7 %) and Caldisericum (15.1 %). Regarding the Archaea Domain, Methanosaeta was more abundant in phases I (84 %) and II (67 %), while in phase III it was Methanobacterium (86 %).

Insights into the removal of pharmaceutically active compounds from sewage sludge by two-stage mesophilic anaerobic digestion

The removal efficiencies (REs) of twenty-seven pharmaceutically active compounds (PhACs) (eight analgesic/anti-inflammatories, six antibiotics, four β-blockers, two antihypertensives/diuretics, three lipid regulators and four psychiatric drugs) were evaluated in a pilot-scale two-stage mesophilic anaerobic digestion (MAD) system treating thickened sewage sludge from a pilot-scale A²O™ wastewater treatment plant (WWTP) which was fed with wastewater from the pre-treatment of the full-scale WWTP Murcia Este (Murcia, Spain). The MAD system was long-term operated using two different sets of sludge retention times (SRTs) for the acidogenic (AcD) and methanogenic (MD) digesters (phase I, 2 and 12 days; and phase II, 5 and 24 days, in AcD and MD, respectively). Quantitative PCR (qPCR) and Illumina MiSeq sequencing were used to estimate the absolute abundance of Bacteria, Archaea, and Fungi and investigate the structure, diversity and population dynamics of their communities in the AcD and MD effluents. The extension of the SRT from 12 (phase I) to 24 days (phase II) in the MD was significantly linked with an improved removal of carbamazepine, clarithromycin, codeine, gemfibrozil, ibuprofen, lorazepam, and propranolol. The absolute abundances of total Bacteria and Archaea were higher in the MD regardless of the phase, while the diversity of bacterial and archaeal communities was lower in phase II, in both digesters. Non-metric multidimensional scaling (MDS) plots showed strong negative correlations among phyla Proteobacteria and Firmicutes and between genera Methanosaeta and Methanosarcina throughout the full experimental period. Strong positive correlations were revealed between the relative abundances of Methanospirillum and Methanoculleus and the methanogenesis performance parameters (volatile solids removal, CH₄ recovery rate and %CH₄ in the biogas), which were also related to longer SRT. The REs of several PhACs (naproxen, ketoprofen, ofloxacin, fenofibrate, trimethoprim, and atenolol) correlated positively (r > 0.75) with the relative abundances of specific bacterial and archaeal groups, suggesting their participation in biodegradation/biotransformation pathways.

Dosing the Coast: Leaking Sewage Infrastructure Delivers Large Annual Doses and Dynamic Mixtures of Pharmaceuticals to Urban Rivers

Pharmaceuticals are commonly detected at low concentrations in surface waters, where they disrupt biological and ecological processes. Despite their ubiquity, the annual mass of pharmaceuticals exported from watersheds is rarely quantified. We used liquid chromatography-mass spectroscopy to screen for 92 pharmaceuticals in weekly samples from an urban stream network in Baltimore, MD, USA, that lacks wastewater treatment effluents. Across the network, we detected 37 unique compounds, with higher concentrations and more compounds in streams with higher population densities. We also used concentrations and stream discharge to calculate annual pharmaceutical loads at the watershed outlet, which range from less than 1 kg to ∼15 kg and are equivalent to tens of thousands of human doses. By calculating annual watershed mass balances for eight compounds, we show that ∼0.05 to ∼42% of the pharmaceuticals consumed by humans in this watershed are released to surface waters, with the importance of different pathways (leaking sewage vs treated wastewater effluent) differing among compounds. These results demonstrate the importance of developing, maintaining, and improving sewage infrastructure to protect water resources from pharmaceutical contamination.

Colorimetric Sensing of Amoxicillin Facilitated by Molecularly Imprinted Polymers

The scope of the presented research orientates itself towards the development of a Molecularly Imprinted Polymer (MIP)-based dye displacement assay for the colorimetric detection of the antibiotic amoxicillin in aqueous medium. With this in mind, the initial development of an MIP capable of such a task sets focus on monolithic bulk polymerization to assess monomer/crosslinker combinations that have potential towards the binding of amoxicillin. The best performing composition (based on specificity and binding capacity) is utilized in the synthesis of MIP particles by emulsion polymerization, yielding particles that prove to be more homogenous in size and morphology compared to that of the crushed monolithic MIP, which is an essential trait when it comes to the accuracy of the resulting assay. The specificity and selectivity of the emulsion MIP proceeds to be highlighted, demonstrating a higher affinity towards amoxicillin compared to other compounds of the aminopenicillin class (ampicillin and cloxacillin). Conversion of the polymeric receptor is then undertaken, identifying a suitable dye for the displacement assay by means of binding experiments with malachite green, crystal violet, and mordant orange. Once identified, the optimal dye is then loaded onto the synthetic receptor, and the displaceability of the dye deduced by means of a dose response experiment. Alongside the sensitivity, the selectivity of the assay is scrutinized against cloxacillin and ampicillin. Yielding a dye displacement assay that can be used (semi-)quantitatively in a rapid manner.

SARS-CoV-2: sewage surveillance as an early warning system and challenges in developing countries

Transmission of novel coronavirus (SARS-CoV-2) in humans happens either through airway exposure to respiratory droplets from an infected patient or by touching the virus contaminated surface or objects (fomites). Presence of SARS-CoV-2 in human feces and its passage to sewage system is an emerging concern for public health. Pieces of evidence of the occurrence of viral RNA in feces and municipal wastewater (sewage) systems have not only warned reinforcing the treatment facilities but also suggest that these systems can be monitored to get epidemiological data for checking trend of COVID-19 infection in the community. This review summarizes the occurrence and persistence of novel coronavirus in sewage with an emphasis on the possible water environment contamination. Monitoring of novel coronavirus (SARS-CoV-2) via sewage-based epidemiology could deliver promising information regarding rate of infection providing a valid and complementary tool for tracking and diagnosing COVID-19 across communities. Tracking the sewage systems could act as an early warning tool for alerting the public health authorities for necessary actions. Given the impracticality of testing every citizen with limited diagnostic resources, it is imperative that sewage-based epidemiology can be tested as an early warning system. The need for the development of robust sampling strategies and subsequent detection methodologies and challenges for developing countries are also discussed.

Annual dynamics of antimicrobials and resistance determinants in flocculent and aerobic granular sludge treatment systems

The occurrence and removal patterns of 24 antimicrobial agents and antimicrobial resistant determinants namely 6 antibiotic resistance genes (ARGs) and 2 mobile genetic elements (MGEs), and the fecal indicator E. coli were investigated in three full-scale wastewater treatment plants. Their waterlines and biosolids lines (including secondary treatment based on both granular and activated sludge) were sampled monthly throughout one year. Samples were analyzed by means of LC-MS/MS, qPCR and cell enumeration, respectively. The influence of rainfall, temperature, and turbidity on the occurrence and removal of the aforementioned agents was assessed through statistical linear mixed models. Ten of the antimicrobial agents (macrolides, fluoroquinolones, tetracyclines, and sulfonamides) were commonly found in influent in concentrations of 0.1-2 µg L^-1, and the predominant ARGs were ermB and sul1 (6.4 and 5.9 log₁₀ mL^-1 respectively). Warmer temperatures slightly reduced gene concentrations in influent whilst increasing that of E. coli and produced an uneven effect on the antimicrobial concentrations across plants. Rainfall diluted both E. coli (-0.25 logs, p < 0.001) and antimicrobials but not genes. The wastewater treatment reduced the absolute abundance of both genes (1.86 logs on average) and E. coli (2.31 logs on average). The antimicrobials agents were also partly removed, but 8 of them were still detectable after treatment, and 6 accumulated in the biosolids. ARGs were also found in biosolids with patterns resembling those of influent. No significant differences in the removal of antimicrobials, genes and E. coli were observed when comparing conventional activated sludge with aerobic granular sludge. Irrespective of the type of sludge treatment, the removal of genes was significantly reduced with increasing hydraulic loads caused by rainfall (-0.35 logs per ∆ average daily flow p < 0.01), and slightly decreased with increasing turbidity (-0.02 logs per ∆1 nephelometric turbidy unit p < 0.05) .

Treatment technologies for emerging contaminants in wastewater treatment plants: A review

The "emerging contaminants" (ECs) are predominantly unregulated anthropogenic chemicals that occur in air, soil, water, food, and human/animal tissues in trace concentrations. The ECs are persistent in the environment, capable of perturbing the physiology of target receptors and, therefore, are regarded as contaminants of emerging environmental concerns in recent years. The prominent classes of ECs include pharmaceuticals and personal care products (PCPs), surfactants, plasticizers, pesticides, fire retardants, and nanomaterials. Some of the ECs with harmful effects on endocrine systems have been recognized as endocrine disrupting chemicals (EDCs). Since the 1990s intensive research has been done covering environmental occurrence, fate, ecological effects, and treatment technologies of ECs. However, a comprehensive summary of the EC removal techniques, particularly in wastewater treatment plants (WWTPs) are limited. Though the WWTPs are inefficient when it comes to ECs removal, they act as primary barriers against the spread of ECs. Therefore, this paper reviews the treatment technologies currently engaged for ECs removal in WWTPs for further possible upgrades of the existing designs. Results of this review indicate that the fate and distribution of ECs can be approximately estimated based on physicochemical properties like octanol-water partitioning coefficient (e.g., log K_OW > 4, maximum sorption potential) and solid-water distribution coefficient [e.g., K_d < 300-500 L/kg MLSS (mixed liquor suspended solids), insignificant sorption into sludge]. Biodegradation potential of ECs can be predicted from biodegradation constant values (e.g., K_bio < 0.01 = low biodegradation and >10 = high biodegradation). In WWTPs, the EC removal efficiency varies in the range of 20-50%, 30-70%, and >90% during the primary, secondary, and tertiary treatment steps, respectively. Tertiary treatment technologies are considered as the most suitable alternatives for ECs treatment, but complete ECs removal is yet to be achieved. Further advancements in the treatment technologies will unquestionably be necessary in the future.

Micropollutant fluxes in urban environment - A catchment perspective

This study provided a holistic understanding of the sources, fate and behaviour of 142 compounds of emerging concern (CECs) throughout a river catchment impacted by 5 major urban areas. Of the incoming 169.3 kg d^-1 of CECs entering the WwTWs, 167.9 kg d^-1 were present in the liquid phase of influent and 1.4 kg d^-1 were present in the solid phase (solid particulate matter, SPM). Analysis of SPM was important to determine accurate loads of incoming antidepressants and antifungal compounds, which are primarily found in the solid phase. Furthermore, these classes and the plasticiser, bisphenol A (BPA) were the highest contributors to CEC load in digested solids. Population normalised loads showed little variation across the catchment at 154 ± 12 mg d^-1 inhabitant^-1 indicating that population size is the main driver of CECs in the studied catchment. Across the catchment 154.6 kg d^-1 were removed from the liquid phase during treatment processes. CECs discharged into surface waters from individual WwTWs contributed between 0.19 kg d^-1 at WwTW A to 7.3 kg d^-1 at WwTW E, which correlated strongly with the respective contributing populations. Spatial and temporal variations of individual CECs and their respective classes were found in WwTW influent (both solid (influent_SPM) and liquid phases (influent_AQ)) throughout the catchment, showing that different urban areas impact the catchment in different ways, with key variables being lifestyle, use of over-the-counter pharmaceuticals and industrial activity. Understanding of both spatial and temporal variation of CECs at the catchment level helped to identify possible instances of direct disposal, as in the case of carbamazepine. Analysis of surface waters throughout the catchment showed increasing mass loads of CECs from upstream of WwTW A to downstream at WwTW D, showing clear individual contributions from WwTWs. Many CECs were ubiquitous throughout the river water in the catchment. Daily loads ranged from 0.005 g d^-1 (ketamine, WwTW A) up to 1890.3 g d^-1 (metformin, WwTW C) for the 84/138 CECs that were detected downstream of the WwTWs. For metformin this represents the equivalent of ∼1,890 tablets (1,000 mg per tablet) dissolved in the river water downstream of WwTW C.

Occurrence, fate, and mass balance of selected pharmaceutical and personal care products (PPCPs) in an urbanized river

The identification and quantification of pharmaceutical and personal care products (PPCPs) in aquatic ecosystems is critical to further studies and elucidation of their fate as well as the potential threats to aquatic ecology and human health. This study used mass balances to analyse the sources, transformation, and transport of PPCPs in rivers based on the population and consumption habits of residents, the removal level of sewage treatment, the persistence and partitioning mechanisms of PPCPs, hydrological conditions, and other natural factors. Our results suggested that in an urbanized river of Guangzhou City, China, the daily consumption of PPCPs was the main reason for the variety of species and concentrations of PPCPs. Through the determination of PPCPs in the river water samples and a central composite design (CCD) methodology, the dominant elimination mechanisms of caffeine and carbamazepine from river water were photolysis and biodegradation, but that of triclosan was sorption rather than biodegradation. The mass data of 3 PPCPs were estimated and corroborated using the measured data to evaluate the accuracy of the mass balance. Finally, caffeine, carbamazepine and triclosan discharged from the Shijing River into the Pearl River accounted for 97.81%, 99.52%, and 28.00%, respectively, of the total mass of these three compounds in the surface water of Shijing River. The results suggest that photolysis are the main process of natural attenuation for selected PPCPs in surface waters of river systems, and the transfer processes of PPCPs is mainly attributed to riverine advection. In addition, the low concentration of dissolved oxygen inhibited the degradation of PPCPs in the surface water of Shijing River.

Modelling the fate of micropollutants in integrated urban wastewater systems: Extending the applicability to pharmaceuticals

Pharmaceutical active compounds (PhACs) are a category of micropollutants frequently detected across integrated urban wastewater systems. Existing modelling tools supporting the evaluation of micropollutant fate in such complex systems, such as the IUWS_MP model library (which acronym IUWS stands for Integrated Urban Wastewater System), do not consider fate processes and fractions that are typical for PhACs. This limitation was overcome by extending the existing IUWS_MP model library with new fractions (conjugated metabolites, sequestrated fraction) and processes (consumption-excretion, deconjugation). The performance of the extended library was evaluated for five PhACs (carbamazepine, ibuprofen, diclofenac, paracetamol, furosemide) in two different integrated urban wastewater systems where measurements were available. Despite data uncertainty and the simplicity of the modelling approach, chosen to minimize data requirements, model prediction uncertainty overlapped with the measurements ranges across both systems, stressing the robustness of the proposed modelling approach. Possible applications of the extended IUWS_MP model library are presented, illustrating how this tool can support urban water managers in reducing environmental impacts from PhACs discharges.

Implementation of environmental surveillance for SARS-CoV-2 virus to support public health decisions: Opportunities and challenges

Analysing wastewater can be used to track infectious disease agents that are shed via stool and urine. Sewage surveillance of SARS-CoV-2 has been suggested as a tool to determine the extent of COVID-19 in cities and serve as an early warning for (re-)emergence of SARS-CoV-2 circulation in communities. The focus of this review is on the strength of evidence, opportunities and challenges for the application of sewage surveillance to inform public health decision making. Considerations for undertaking sampling programs are reviewed including sampling sites, strategies, sample transport, storage and quantification methods; together with the approach and evidence base for quantifying prevalence of infection from measured wastewater concentration. Published SARS-CoV-2 sewage surveillance studies (11 peer reviewed and 10 preprints) were reviewed to demonstrate the current status of implementation to support public health decisions. Although being very promising, a number of areas were identified requiring additional research to further strengthen this approach and take full advantage of its potential. In particular, design of adequate sampling strategies, spatial and temporal resolution of sampling, sample storage, replicate sampling and analysis, controls for the molecular methods used for the quantification of SARS-CoV-2 RNA in wastewater. The use of appropriate prevalence data and methods to correlate or even translate SARS-CoV-2 concentrations in wastewater to prevalence of virus shedders in the population is discussed.

In Situ Catchment Scale Sampling of Emerging Contaminants Using Diffusive Gradients in Thin Films (DGT) and Traditional Grab Sampling: A Case Study of the River Thames, UK

The in situ passive sampling technique, diffusive gradients in thin films (DGT), confronts many of the challenges associated with current sampling methods used for emerging contaminants (ECs) in aquatic systems. This study compared DGT and grab sampling for their suitability to screen and monitor ECs at the catchment scale in the River Thames system (U.K.) and explored their sources and environmental fate. The ubiquitous presence of endocrine disrupting chemicals, parabens, and their metabolites is of concern. This study is the first to report organophosphate esters (OPEs) in the study area. TEP (summer 13-160 and winter 18-46, ng/L) and TCPP (summer 242-4282 and winter 215-854, ng/L) were the main OPEs. For chemicals which were relatively stable in the rivers, DGT and grab sampling were in good agreement. For chemicals which showed high variation in water bodies, DGT provided a better integral of loadings and exposure than grab sampling. DGT was not as sensitive as grab sampling under the procedures employed here, but there are several options to improve it to give comparable/better performance. DGT samples require shorter preparation time for analysis in the laboratory than grab samples. Overall, DGT can be a powerful tool to characterize ECs throughout a large dynamic water system.

Future perspectives of wastewater-based epidemiology: Monitoring infectious disease spread and resistance to the community level

Infectious diseases are acknowledged as one of the most critical threats to global public health today. Climate change, unprecedented population growth with accelerated rates of antimicrobial resistance, have resulted in both the emergence of novel pathogenic organisms and the re-emergence of infections that were once controlled. The consequences have led to an increased vulnerability to infectious diseases globally. The ability to rapidly monitor the spread of diseases is key for prevention, intervention and control, however several limitations exist for current surveillance systems and the capacity to cope with the rapid population growth and environmental changes. Wastewater-Based Epidemiology (WBE) is a new epidemiology tool that has potential to act as a complementary approach for current infectious disease surveillance systems and an early warning system for disease outbreaks. WBE postulates that through the analysis of population pooled wastewater, infectious disease and resistance spread, the emergence of new disease outbreak to the community level can be monitored comprehensively and in real-time. This manuscript provides critical overview of current infectious disease surveillance status, as well as it introduces WBE and its recent advancements. It also provides recommendations for further development required for WBE application as an effective tool for infectious disease surveillance.

Enantiomeric profiling of quinolones and quinolones resistance gene qnrS in European wastewaters

Wastewater-based epidemiology (WBE) was applied for the first time in seven cities across Europe with the aim of estimating quinolones consumption via the analysis of human urinary metabolites in wastewater. This report is also the first pan-European study focussed on the enantiomeric profiling of chiral quinolones in wastewater. By considering loads of (fluoro)quinolones in wastewater within the context of human stereoselective metabolism, we identified cities in Southern Europe characterised by both high usage and direct disposal of unused ofloxacin. In Northern European cities, S-(-)-ofloxacin loads were predominant with respect to R-(+)-ofloxacin. Much more potent, enantiomerically pure S-(-)-ofloxacin was detected in wastewaters from Southern European cities, reflecting consumption of the enantiomerically pure antibiotic. Nalidixic acid, norfloxacin and lomefloxacin were detected in wastewater even though they were not prescribed according to official prescription data. S,S-(-)-moxifloxacin and S,S-(-)-moxifloxacin-N-sulphate were detected in wastewater due to metabolism of moxifloxacin. For the first time, average population-normalised ulifloxacin loads of 22.3 and 1.5 mg day^-1 1000 people^-1 were reported for Milan and Castellón as a result of prulifloxacin metabolism. Enrichment of flumequine with first-eluting enantiomer in all the samples indicated animal metabolism rather than its direct disposal. Fluoroquinolone loads were compared with qnrS gene encoding quinolone resistance to correlate usage of fluoroquinolone and prevalence of resistance. The highest daily loads of the qnrS gene in Milan corresponded with the highest total quinolone load in Milan proving the hypothesis that higher usage of quinolones is linked with higher prevalence of quinolone resistance genes. Utrecht, with the lowest quinolones usage (low daily loads) had also one of the lowest daily loads of the qnrS gene. However, a similar trend was not observed in Oslo nor Bristol where higher qnrS gene loads were observed despite low quinolone usage.

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

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

Linking microbial diversity and population dynamics to the removal efficiency of pharmaceutically active compounds (PhACs) in an anaerobic/anoxic/aerobic (A2O) system

The removal efficiencies (REs) of nineteen pharmaceutically active compounds (PhACs) (six antibiotics-clarithromycin, ofloxacin, sulfadiazine, sulfamethazine, sulfamethoxazole and trimethoprim -, four β-blockers -atenolol, metoprolol, propranolol and sotalol-, two antihypertensives/diuretics -furosemide and hydrochlorothiazide-, three lipid regulators -bezafibrate, fenofibrate and gemfibrozil-, and four psychiatric medications -carbamazepine, diazepam, lorazepam and paroxetine) were ascertained in a pilot-scale anaerobic/anoxic/aerobic (A²O) system treating urban wastewater, long term operated during two experimental phases using different sets of environmental conditions and operating parameters. Illumina MiSeq sequencing was used to investigate the structure, diversity and population dynamics of bacteria, archaea and fungi communities in the activated sludge. The results showed that mixed liquor suspended solids (MLSS) and food-to-microorganisms ratio (F/M) were operational parameters significantly influencing the REs of five of the analyzed PhACs in the A²O system. Biota-environment (BIO-ENV) analysis revealed strong correlations between population shifts of the activated sludge community and the REs of PhACs of the different pharmaceutical families. Increased REs of clarithromycin, furosemide, bezafibrate and gemfibrozil were concomitant to higher relative abundances of bacterial phylotypes classified within the Rhodobacteraceae and Sphingomonadaceae (Alphaproteobacteria), while those of Betaproteobacteria, Chloroflexi and Methanomethylovorans (Euryarchaea) correlated positively with the REs of up to seven PhACs belonging to different therapeutic groups.

Impact of meteorological and social events on human-excreted contaminant loads in raw wastewater: From daily to weekly dynamics

The temporal dynamics of the wastewater influent loads of 25 drug target residues (DTR, both pharmaceuticals and illicit drugs) was assessed during 84 consecutive days. This monitoring scale enables longer temporal patterns than weekday/weekend patterns to be explored. In this study, we focus on day to day variations and the potential statistical correlation of each DTR analyzed in order to better understand the potential forcings that lead to the load variation of DTRs (alone or in clusters). The weekly patterns based on the weekly loads of DTRs were also analyzed and the impact of social and meteorological events on their variations was investigated. Two cold events occurred during the monitoring period and were associated with the highest loads of analgesics and non-steroidal anti-inflammatory drugs, as well as the lowest loads of stimulants. During the Easter holidays, a significant decrease in some year-long medication as well as analgesics was found, consistent with the demographic decrease within the catchment during this period. Lastly, a good correlation between the academic calendar and the loads of stimulants was found, emphasizing the overrepresentation of students in the consumption of recreational drugs. This study furnishes new insights in order to better understand the variations in DTR loads in wastewater influents, beyond the weekday/weekend pattern and the seasonal effect. Further investigations remain necessary, especially a real-time monitoring of the population figures within the catchment in order to improve our understanding of these results.

Characterizing the removal routes of seven pharmaceuticals in the activated sludge process

The removal routes of pharmaceuticals especially biodegradation routes in the activated sludge process are still unclear. Some studies indicated pharmaceuticals were mainly removed via nitrification process (autotrophic biodegradation), while others suggested pharmaceuticals were mainly removed via COD degradation process (heterotrophic biodegradation). These unclear problems limited the improvements of pharmaceuticals removal. In this study, in order to elucidate three biodegradation routes (nitrification, COD degradation, or both nitrification and COD degradation), autotrophic and heterotrophic reactors were individually developed to separate nitrification and COD degradation form the activated sludge process (mix-trophic process including nitrification and COD degradation). Furthermore, the pharmaceuticals removal routes of adsorption, hydrolysis, and oxidation were also studied. Among six degradable pharmaceuticals, heterotrophic biodegradation and adsorption were the major removal routes. Two sulfonamides of five antibiotics were predominantly removed by COD degradation process, while nitrification and adsorption had no contributions. Adsorption, hydrolysis, nitrification, and COD degradation were the main elimination routes of cefalexin. COD degradation and adsorption were the dominant removal routes of norfloxacin. Tetracycline was mainly removed by the adsorption route, and hydrolysis and oxidation also played a role. For two drugs, ibuprofen was removed mainly via nitrification and COD degradation, and no adsorption occurred. Diclofenac could not be removed at all and was persistent in the aerobic conditions. Kinetic studies showed that biodegradation of the two sulfonamides, cefalexin, norfloxacin, and ibuprofen followed first-order kinetics rather than zero-order or second-order kinetics.

Diverse and abundant antibiotics and antibiotic resistance genes in an urban water system

The widespread use of antibiotics has resulted in pollution associated with antibiotics and antibiotic resistance genes (ARGs) in urban water systems, threatening the public health and the ecological security. In this study, the patterns of the diversity and abundance of the antibiotics and ARGs in a typical city (Kunming, China) were analyzed by monitoring their presence in the tap water, the land block sewage discharge units, the sewage pipes, the influent of WWTP, the effluent of WWTP, and the urban river channel. The results showed that although the average concentration of total antibiotics in tap water was 10 ng/L, the concentrations reached hundreds or even thousands of ng/L in all the other sections, indicating antibiotics entering water system through human or pets discharge. The relative abundances of ARG copies to 16S rRNA gene copies in the effluent of WWTP, the urban river channel which was the downstream of WWTP were higher than those of the sewage pipes, increasing risk of ARG transfer after treatment by WWTP. In general, the relative abundance of ARGs in spring was higher than that in winter. There was no significant correlation between antibiotics concentrations and their corresponding ARGs, except for a correlation between tetracyclines and tet-resistance genes. Due to the existence of transposases, the urban water system is exposed to a widespread risk of horizontal transfer of ARGs.

Assessment of 83 pharmaceuticals in WWTP influent and effluent samples by UHPLC-MS/MS: Hourly variation

The removal efficiency of pharmaceuticals in wastewater treatment plants (WWTPs) is variable and some of these compounds pass these plants almost intact and others presenting a removal efficiency close to 100%. Their incomplete removal results in a continuous discharge of pharmaceuticals into the environment. To assess the profile of contamination of influents and effluents over a day, a set of 83 pharmaceuticals were evaluated hourly in a WWTP in Leiria, Portugal. The composite samples of the influent and effluent were also collected. Concentrations varied from <MDL for ketoprofen, clarithromycin, ofloxacin, and diltiazem to 63.97 μg/L for caffeine in the WWTP influent composite sample and <MDL for clarithromycin, bupropion, and diltiazem to 2.01 μg/L for O-desmethylvenlafaxine for effluent composite sample. Concentrations in the range of μg/L were found for hydroxyibuprofen, salicylic acid, d,l-norephedrine, and caffeine in the WWTP influent, and diclofenac, carbamazepine, O-desmethylvenlafaxine in the WWTP effluents. For the samples collected hourly, thirty-eight and twenty-nine pharmaceuticals were detected in at least one WWTP sample. In the WWTP influent the total concentration of detected pharmaceuticals was higher between 15 and 22 h and lower in the period from 23 to 10 h in the morning. In the WWTP effluent, a slight variation was noticed throughout the sampling hours. Carbamazepine, fluoxetine, sertraline, atorvastatin, caffeine, simvastatin, and trazodone were the pharmaceuticals with risk quotient (RQ) >1 in WWTP influents, and carbamazepine, fluoxetine, sertraline the pharmaceuticals with an RQ > 1 in WWTP effluents.

Selective effect and elimination of antibiotics in membrane bioreactor of urban wastewater treatment plant

Analyzing the temporal dynamics of antibiotics, antibiotic resistance genes (ARGs) and the functional community could contribute to the regulation and optimization of wastewater treatment plant (WWTP) operation to achieve better antibiotics and ARGs removal performances during different seasons. However, there is little research in this area. Therefore, in this study, samples were collected from the influent, activated sludge (AS), and permeate of the membrane bioreactor (MBR) in a WWTP located in Beijing, China, biweekly over 13 months, and then analyzed systematically. The removal efficiency for all detected antibiotics through biodegradation and adsorption was 59.25 ± 2.79%, with the highest rate of 64.79 ± 4.68% observed in summer, indicating that the higher temperature in summer may promote biodegradation in MBR. In contrast, the elimination of antibiotics through microfiltration was negligible and unfavorable, with negative overall removal rates. However, a positive rejection rate of 9.48 ± 8.92% was only observed in winter, indicating that a colder temperature might lead to better, but still limited, antibiotics rejection. Sulfonamides (SAs) were more likely to impose a selective pressure on their corresponding ARGs. However, due to the degradability of tetracyclines (TCs) and potential selection of ARGs in wastewater before entering WWTP, there were still TC resistances with non-detectable TCs. Significantly negative relationships were observed between the relative abundance of nitrifying bacteria (Nitrosomonas and Nitrospira) and the concentrations of certain antibiotic classes, indicating that nitrifying bacteria could be involved in the co-metabolic biodegradation of certain antibiotics through enzyme catalyzation during nitrification.

Application of experimental design methodology to optimize antibiotics removal by walnut shell based activated carbon

Three-level Box-Behnken experimental design with three factors (pH, temperature and antibiotic initial concentration) combined with response surface methodology (RSM) was applied to study the removal of Metronidazole and Sulfamethoxazole by walnut shell based activated carbon. This methodology enabled to identify the effects of the different factors studied and their interactions in the response of each antibiotic. The relationship between the independent variable (sorption capacity) and the dependent variables (pH, temperature and antibiotic concentration) was adequately modelled by second-order polynomial equation. The pH factor exerted a significant but distinct influence on the removal efficiency of both antibiotics. The removal of Metronidazole is favoured by increasing pH values, with the maximum value obtained for pH 8 - upper limit of the study domain; while Sulfamethoxazole displays a maximum value around 5.5, with a decrease in the extent of adsorption as the pH increases. The best conditions, predicted by the model, for the removal of the antibiotic Sulfamethoxazole (106.9 mg/g) are obtained at a temperature of 30 °C, initial concentration of 40 mg/L and a pH value of 5.5. For the antibiotic Metronidazole, the highest removal value (127 mg/g) is expected to occur at the maximum levels attributed to each of the factors (pH = 8, C_in = 40 mg/L, T = 30 °C). The results of isotherm experiments (at 20 °C and pH 6) displayed a good agreement with the models predictions. The maximum sorption capacity, estimated by the Langmuir model, was 107.4 mg/g for Metronidazole and 93.5 mg/g for Sulfamethoxazole.

An evaluation on the intra-day dynamics, seasonal variations and removal of selected pharmaceuticals and personal care products from urban wastewater treatment plants

Pharmaceuticals and personal care products (PPCPs) in wastewater have become an emerging issue due to their negative effects on human health and aquatic ecosystems. Two full-scale municipal and industrial wastewater treatment plants (WWTPs) along the Songhua River were chosen to evaluate the intra-day dynamics, seasonal variations and removal of 12 selected PPCPs. Our results suggested that the selected PPCPs were frequently detected in the influent and effluent. Caffeine was the predominant compound in the influent; while the selected PPCPs was dominated by TCS in the effluent, suggesting the different fates of selected PPCPs in the WWTPs. The intra-day dynamics of PPCPs in the influent were evaluated, suggesting that the 12 PPCPs can be grouped into three categories because of their different use patterns. The analysis of seasonal changes of PPCPs concentrations in the WWTPs suggested that the concentrations of some PPCPs were influenced by the chemical usage, degradation and temperature. The removal efficiency for the PPCPs were very high with the values ranged from 70.0% to 99.7% for WWTP#1, and from 62.5% to 99.4% for WWTP#2. Significant seasonal variations of PPCPs removal efficiency were observed. Base on the mass loading of PPCPs in the two WWTPs, our results suggested that WWTP#1 in the urban core received much more PPCPs in comparison to WWTP#2 in the suburban regions, suggesting that influences of the service population.

Enantioselective fractionation of fluoroquinolones in the aqueous environment using chiral liquid chromatography coupled with tandem mass spectrometry

This paper aims to examine the multiresidue enantiomeric profiling of (fluoro)quinolones and their metabolites in solid and liquid environmental matrices using chiral HPLC-MS/MS method and a CHIRALCEL^® OZ-RH column. Simultaneous chiral separation was obtained for chiral ofloxacin and its main metabolites ofloxacin-N-oxide and desmethyl-ofloxacin; moxifloxacin; the prodrug prulifloxacin and its active compound ulifloxacin; flumequine; nadifloxacin and R-(+)-besifloxacin. Achiral antibiotics (ciprofloxacin, norfloxacin and nalidixic acid) were also included in the method to enable the analysis of all targeted quinolones within one analytical run. Satisfactory enantiomeric resolution (Rs ≥ 1) was obtained for five out of eight chiral drugs enabling quantitative analysis. The overall performance of the method was satisfactory with a method precision <20%, relative recoveries >70% for most of the analytes and method detection limits (MDL) at low ng L^-1 levels (0.1 < MDL (ng L^-1)< 6.4, 0.1 < MDL (ng L^-1)< 6.6 and 0.1 < MDL (ng L^-1)< 7.0 in influent, effluent and river waters for 83% compounds, 0.01 < MDL (ng g^-1)< 4.9 in solids for 91% compounds). Enantiomeric profiling from a week-long monitoring campaign in the UK showed that (±)-ofloxacin was found to be racemic in upstream waters but it was enriched with S-(-)-enantiomer in wastewater and in receiving waters. This could be due to the fact that ofloxacin can be used both as a racemate and as a S-(-)-enantiomer. Its consumption was further confirmed by the chiral signature of the investigated ofloxacin metabolites. As a result, alterations in the enantiomeric composition of antibiotics could influence not only their activity and toxicity in the environment, but also could induce changes in the microbial communities constantly exposed to them.

Monitoring and mass balance analysis of endocrine disrupting compounds and their transformation products in an anaerobic-anoxic-oxic wastewater treatment system in Xiamen, China

We investigated the occurrence, removal and mass balance of 8 endocrine disrupting compounds (EDCs), including estrone (E1), estradiol (E2), estriol (E3), ethinylestradiol (EE2), triclosan (TCS), triclocarbon (TCC), 4-n-nonyl phenol (NP) and 4-n-octyl phenol (OP), along with 5 of their transformation products (TPs), including 4-hydroxy estrone (4-OH E1), 4-hydroxy estradiol (4-OH E2), methyl triclosan (MeTCS), carbanilide (NCC), dichlorocarbanilide (DCC) in a wastewater treatment plant. Generally, E3 showed the highest concentrations in wastewater with median value of 514 ng/L in influent, while TCS and TCC showed highest level in sludge and suspended solids (SS) with median value of 960 and 724 μg/kg, respectively. Spatial variations were observed along each unit of the wastewater treatment processes for dissolved analytes in wastewater and adsorbed analytes in suspended solids and sludge. Special emphasis was placed to understand the mass load of EDCs and their TPs to the wastewater treatment unit and mass loss during the wastewater treatment processes. Mass loss based on both aqueous and suspended phase concentration revealed that majority of these chemicals were significantly removed during the treatment process except for TCS, TCC, and three of their TPs (MeTCS, NCC, DCC), which were released or generated during the treatment process. Mass load results showed that 42.4 g of these EDCs and their TPs entered this wastewater treatment system daily via influent, whereas 6.15 g and 7.60 g were discharged through effluent and sludge.

Antibiotics in the aquatic environments: A review of lakes, China

The potential threat of antibiotics to the environment and human health has raised significant concerns in recent years. The consumption and production of antibiotics in China are the highest in the world due to its rapid economic development and huge population, possibly resulting in the high detection frequencies and concentrations of antibiotics in aquatic environments of China. As a water resource, lakes in China play an important role in sustainable economic and social development. Understanding the current state of antibiotics in lakes in China is important. Closed and semi-closed lakes provide an ideal medium for the accumulation of antibiotics and antibiotic resistance genes (ARGs). This review summarizes the current levels of antibiotic exposure in relevant environmental compartments in lakes. The ecological and health risks of antibiotics are also evaluated. This review concludes that 39 antibiotics have been detected in the aquatic environments of lakes in China. The levels of antibiotic contamination in lakes in China is relatively high on the global scale. Antibiotic contamination is higher in sediment than water and aquatic organisms. Quinolone antibiotics (QNs) pose the greatest risks. The contents of antibiotics in aquatic organisms are far lower than their maximum residual limits (MRLs), with the exception of the organisms in Honghu Lake. The lakes experience high levels of ARG contamination. A greater assessment of ARG presence and antibiotic exposure are urgent.

Effect of ciprofloxacin on biological nitrogen and phosphorus removal from wastewater

In this work, both short-term and long-term experiments were therefore conducted to assess the effects of ciprofloxacin (0.2 and 2mg·L^-1) on wastewater nutrient removal. The results showed that both levels of ciprofloxacin had no acute and chronic adverse effects on the surface integrity and viability of activated sludge. Short-term exposure to all the ciprofloxacin levels induced negligible influences on wastewater nutrient removal. However, the prolonged exposure to ciprofloxacin decreased total phosphorus and nitrogen removal efficiencies from 96.8, 95.8% (control) to 91.7, 84.9% (0.2mg·L^-1) and 90.5%, 80.2% (2mg·L^-1), respectively. The mechanism study showed that ciprofloxacin exposure suppressed denitrification and phosphorus uptake processes. It was also found that ciprofloxacin affected the transformations of intracellular polyhydroxyalkanoates and glycogen in the oxic and anoxic stages. Moreover the activities of nitrite reductase and polyphosphate kinase were inhibited by the presence of ciprofloxacin. Further analysis with high-throughput sequencing revealed that compared with the control, the abundances of polyphosphate accumulating organisms, glycogen accumulating organisms and denitrifying bacteria in ciprofloxacin exposure reactors reduced, which were consistent with the decreased nutrient removal performance measured in these reactors.

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

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

A review of the occurrence of pharmaceuticals and personal care products in Indian water bodies

Little information exists on the occurrence and the ultimate fate of pharmaceuticals in the water bodies in India despite being one of the world leaders in pharmaceutical production and consumption. This paper has reviewed 19 published reports of pharmaceutical occurrence in the aquatic environment in India [conventional activated sludge wastewater treatment plants (WTPs), hospital WTPs, rivers, and groundwater]. Carbamazepine (antipsychoactive), atenolol (antihypertensive), triclocarban and triclosan (antimicrobials), trimethoprim and sulfamethoxazole (antibacterials), ibuprofen and acetaminophen (analgesics), and caffeine (stimulant) are the most commonly detected at higher concentrations in Indian WTPs that treat predominantly the domestic sewage. The concentration of ciprofloxacin, sulfamethoxazole, amoxicillin, norfloxacin, and ofloxacin in Indian WTPs were up to 40 times higher than that in other countries in Europe, Australia, Asia, and North America. A very few studies in Indian rivers reported the presence of ciprofloxacin, enoxacin, ketoprofen, erythromycin, naproxen, ibuprofen, diclofenac and enrofloxacin. Similar compounds were reported in rivers in China, indicating a similar usage pattern in both of these developing countries. In a study reported from an open well in southern India, the groundwater showed the presence of cetirizine, ciprofloxacin, enoxacin, citalopram and terbinafine, which was close to a WTP receiving effluents from pharmaceutical production.

Linking changes in antibiotic effluent concentrations to flow, removal and consumption in four different UK sewage treatment plants over four years

The arrival and discharge of seven antibiotics were monitored at two trickling filter sewage treatment plants of 6000 and 11,000 population equivalents (PE) and two activated sludge plants of 33,000 and 162,000 PE in Southern England. The investigation consisted of 24 h composite samples taken on two separate days every summer from 2012 to 2015 and in the winter of 2015 (January) from influent and effluent. The average influent concentrations generally matched predictions based on England-wide prescription data for trimethoprim, sulfamethoxazole, azithromycin, oxytetracycline and levofloxacin (within 3-fold), but were 3-10 times less for clarithromycin, whilst tetracycline influent concentrations were 5-17 times greater than expected. Over the four years, effluent concentrations at a single sewage plant varied by up to 16-fold for clarithromycin, 10-fold for levofloxacin and sulfamethoxazole, 7-fold for oxytetracycline, 6-fold for tetracycline, 4-fold for azithromycin and 3-fold for trimethoprim. The study attempted to identify the principal reasons for this variation in effluent concentration. By measuring carbamazepine and using it as a conservative indicator of transport through the treatment process, it was found that flow and hence concentration could alter by up to 5-fold. Measuring influent and effluent concentrations allowed assessments to be made of removal efficiency. In the two activated sludge plants, antibiotic removal rates were similar for the tested antibiotics but could vary by several-fold at the trickling filter plants. However, for clarithromycin and levofloxacin the variations in effluent concentration were above that which could be explained by either flow and/or removal alone so here year on year changes in consumption are likely to have played a role.

Removal of Antibiotics in Biological Wastewater Treatment Systems-A Critical Assessment Using the Activated Sludge Modeling Framework for Xenobiotics (ASM-X)

Many scientific studies present removal efficiencies for pharmaceuticals in laboratory-, pilot-, and full-scale wastewater treatment plants, based on observations that may be impacted by theoretical and methodological approaches used. In this Critical Review, we evaluated factors influencing observed removal efficiencies of three antibiotics (sulfamethoxazole, ciprofloxacin, tetracycline) in pilot- and full-scale biological treatment systems. Factors assessed include (i) retransformation to parent pharmaceuticals from e.g., conjugated metabolites and analogues, (ii) solid retention time (SRT), (iii) fractions sorbed onto solids, and (iv) dynamics in influent and effluent loading. A recently developed methodology was used, relying on the comparison of removal efficiency predictions (obtained with the Activated Sludge Model for Xenobiotics (ASM-X)) with representative measured data from literature. By applying this methodology, we demonstrated that (a) the elimination of sulfamethoxazole may be significantly underestimated when not considering retransformation from conjugated metabolites, depending on the type (urban or hospital) and size of upstream catchments; (b) operation at extended SRT may enhance antibiotic removal, as shown for sulfamethoxazole; (c) not accounting for fractions sorbed in influent and effluent solids may cause slight underestimation of ciprofloxacin removal efficiency. Using tetracycline as example substance, we ultimately evaluated implications of effluent dynamics and retransformation on environmental exposure and risk prediction.

Seasonality of antibiotic prescriptions for outpatients and resistance genes in sewers and wastewater treatment plant outflow

To test the hypothesis of a seasonal relationship of antibiotic prescriptions for outpatients and the abundance of antibiotic resistance genes (ARGs) in the wastewater, we investigated the distribution of prescriptions and different ARGs in the Dresden sewer system and wastewater treatment plant during a two-year sampling campaign. Based on quantitative PCR (qPCR), our results show a clear seasonal pattern for relative ARGs abundances. The higher ARGs levels in autumn and winter coincide with the higher rates of overall antibiotic prescriptions. While no significant differences of relative abundances were observed before and after the wastewater treatment for most of the relative ARGs, the treatment clearly influenced the microbial community composition and abundance. This indicates that the ARGs are probably not part of the dominant bacterial taxa, which are mainly influenced by the wastewater treatment processes, or that plasmid carrying bacteria remain constant, while plasmid free bacteria decrease. An exception was vancomycin (vanA), showing higher relative abundance in treated wastewater. It is likely that a positive selection or community changes during wastewater treatment lead to an enrichment of vanA. Our results demonstrate that in a medium-term study the combination of qPCR and next generation sequencing corroborated by drug-related health data is a suitable approach to characterize seasonal changes of ARGs in wastewater and treated wastewater.

New Framework To Diagnose the Direct Disposal of Prescribed Drugs in Wastewater - A Case Study of the Antidepressant Fluoxetine

Intentional or accidental release (direct disposal) of high loads of unused pharmaceuticals into wastewater can go unnoticed. Here, direct disposal of a pharmaceutical drug via the sewer network was identified for the first time using wastewater analysis. An irregularly high load of the antidepressant fluoxetine in raw wastewater (10.5 ± 2.4 g d(-1)) was up to 11 times greater than any other day. National prescription data revealed a predicted daily fluoxetine load for the studied treatment works to be 0.4-1.6 g d(-1). Enantio-selective analysis showed the high load of fluoxetine was present as a racemic mixture, which is typical for fluoxetine in dispensed formulations. As fluoxetine undergoes stereoselective metabolism within the body, a racemic mixture in wastewater suggests a nonconsumed drug was the major contributor of the high load. This was confirmed by its major metabolite norfluoxetine whose load did not increase on this day. Considering the most commonly prescribed formulation of fluoxetine, this increased load accounts for the disposal of ∼915 capsules. Furthermore, as fluoxetine is prescribed as one capsule per day, disposal is unlikely to be at the patient level. It is postulated that direct disposal was from a facility which handles larger quantities of the drug (e.g., a pharmacy).

Dynamics of active pharmaceutical ingredients loads in a Swiss university hospital wastewaters and prediction of the related environmental risk for the aquatic ecosystems

The wastewater contamination of a Swiss university hospital by active pharmaceutical ingredient (API) residues was evaluated with a three months monitoring campaign at the outlet of the main building. Flow-proportional samples were collected with an automatic refrigerated sampler and analyzed for 15 API, including antibiotics, analgesics, antiepileptic and anti-inflammatory drugs, by using a validated LC-MS/MS method. The metals Gd and Pt were also analyzed using ICP-MS. Measured concentrations were compared to the predicted ones calculated after the drug average consumption data obtained from the hospital pharmacy. The hospital contribution to the total urban load was calculated according to the consumption data obtained from city pharmacies. Lastly, the environmental hazard and risk quotients (RQ) related to the hospital fraction and the total urban consumption were calculated. Median concentrations of the 15 selected compounds were ranging from 0.04 to 675 μg/L, with a mean detection frequency of 84%. The ratio between predicted and measured environmental concentrations (PEC/MEC) has shown a good accuracy for 5 out of 15 compounds, revealing over- and under-estimations of the PEC model. Mean daily loads were ranging between 0.01 and 14.2g/d, with the exception of paracetamol (109.7 g/d). The hospital contribution to the total urban loads varied from 2.1 to 100% according to the compound. While taking into account dilution and removal efficiencies in wastewater treatment plant, only the hospital fraction of the antibiotics ciprofloxacin and sulfamethoxazole showed, respectively, a high (RQ>1) and moderate (RQ>0.1) risk for the aquatic ecosystems. Nevertheless, when considering the total urban consumption, 7 compounds showed potential deleterious effects on aquatic organisms (RQ>1): gabapentin, sulfamethoxazole, ciprofloxacin, piperacillin, ibuprofen, diclofenac and mefenamic acid. In order to reduce inputs of API residues originating from hospitals various solutions can be envisioned. With results of the present study, hospital managers can start handling this important issue.

Concentration and risk of pharmaceuticals in freshwater systems are related to the population density and the livestock units in Iberian Rivers

Considerable amounts of pharmaceuticals are used in human and veterinary medicine, which are not efficiently removed during wastewater and slurries treatment and subsequently entering continuously into freshwater systems. The intrinsic biological activity of these non-regulated pollutants turns their presence in the aquatic environment into an ecological matter of concern. We present the first quantitative study relating the presence of pharmaceuticals and their predicted ecotoxicological effects with human population and livestock units. Four representative Iberian River basins (Spain) were studied: Llobregat, Ebro, Júcar and Guadalquivir. The levels of pharmaceuticals were determined in surface water and sediment samples collected from 77 locations along their stream networks. Predicted total toxic units to algae, Daphnia and fish were estimated for pharmaceuticals detected in surface waters. The use of chemometrics enabled the study of pharmaceuticals for: their spatial distribution along the rivers in two consecutive years; their potential ecotoxicological risk to aquatic organisms; and the relationships among their occurrence and predicted ecotoxicity with human population and animal farming pressure. The Llobregat and the Ebro River basins were characterized as the most polluted and at highest ecotoxicological risk, followed by Júcar and Guadalquivir. No significant acute risks of pharmaceuticals to aquatic organisms were observed. However potential chronic ecotoxicological effects on algae could be expected at two hot spots of pharmaceuticals pollution identified in the Llobregat and Ebro basins. Analgesics/antiinflammatories, antibiotics and diuretics were the most relevant therapeutic groups across the four river basins. Among them, hydrochlorothiazide and gemfibrozil, as well as azithromycin and ibuprofen were widely spread and concentrated pharmaceuticals in surface waters and sediments, respectively. Regarding their predicted ecotoxicity, sertraline, gemfibrozil and loratidine were identified as the more concerning compounds. Significantly positive relationships were found among levels of pharmaceuticals and toxic units and population density and livestock units in both surface water and sediment matrices.

Passive sampling: A cost-effective method for understanding antibiotic fate, behaviour and impact

The occurrence of antibiotics in the environment has raised much concern in recent years. Understanding their release, fate and behaviour in the environment is vital to assess potential risks. In this study, a novel passive water sampler - diffusion gradients in thin-films for organics (o-DGT) - was employed to assess the occurrence and removal of antibiotics in two waste water treatment plants (WWTPs) - one in China and the other in the United Kingdom (UK). Of the targeted compounds, 11 of 19 were detected in the Chinese WWTP (ND-200ng/L) and 10 of 40 were found in the UK plant (ND-1380ng/L). Florfenicol, lincomycin, ofloxacin and roxithromycin were most abundant in the Chinese WWTP (influent), while anhydrous erythromycin, ciprofloxacin, trimethoprim, ofloxacin and sulfapyridine were the most abundant in the UK influent samples. Estimated Chinese and UK consumption data are used to interpret the results. Neither of the WWTPs was very effective at removing antibiotics: ~40-50% (overall) was removed by the two plants, with the rest being discharged into the receiving rivers. This is the first study using o-DGT to assess the occurrence and removal of antibiotics in WWTPs. o-DGT is a useful, cost-effective tool to assess WWTP performance and can highlight the effectiveness of treatment steps, which can be applied to wastewater based epidemiology studies.