Pharmaceutical manufacturing facility discharges can substantially increase the pharmaceutical load to U.S. wastewaters

Wastewater reuse and pharmaceutical pollution in agriculture: Uptake, transport, accumulation and metabolism of pharmaceutical pollutants within plants

The presence of pharmaceutical pollutants in water sources has become a growing concern due to its potential impacts on human health and other organisms. The physicochemical properties of pharmaceuticals based on their intended therapeutical application, which include antibiotics, hormones, analgesics, and antidepressants, is quite diverse. Their presence in wastewater, sewerage water, surface water, ground water and even in drinking water is reported by many researchers throughout the world. Human exposure to these pollutants through drinking water or consumption of aquatic and terrestrial organisms has raised concerns about potential adverse effects, such as endocrine disruption, antibiotic resistance, and developmental abnormalities. Once in the environment, they can persist, undergo transformation, or degrade, leading to a complex mixture of contaminants. Application of treated wastewater, compost, manures or biosolids in agricultural fields introduce pharmaceutical pollutants in the environment. As pharmaceuticals are diverse in nature, significant differences are observed during their uptake and accumulation in plants. While there have been extensive studies on aquatic ecosystems, the effect on agricultural land is more disparate. As of now, there are few reports available on the potential of plant uptake and transportation of pharmaceuticals within and between plant organs. This review summarizes the occurrence of pharmaceuticals in aquatic water bodies at a range of concentrations and their uptake, accumulation, and transport within plant tissues. Research gaps on pharmaceutical pollutants' specific effect on plant growth and future research scopes are highlighted. The factors affecting uptake of pharmaceuticals including hydrophobicity, ionization, physicochemical properties (pKa, logKow, pH, Henry's law constant) are discussed. Finally, metabolism of pharmaceuticals within plant cells through metabolism phase enzymes and plant responses to pharmaceuticals are reviewed.

Accumulation of antibiotics in the environment: Have appropriate measures been taken to protect Canadian human and ecological health?

In Canada, every day, contaminants of emerging concern (CEC) are discharged from waste treatment facilities into freshwaters. CECs such as pharmaceutical active compounds (PhACs), personal care products (PCPs), per- and polyfluoroalkyl substances (PFAS), and microplastics are legally discharged from sewage treatment plants (STPs), water reclamation plants (WRPs), hospital wastewater treatment plants (HWWTPs), or other forms of wastewater treatment facilities (WWTFs). In 2006, the Government of Canada established the Chemicals Management Plan (CMP) to classify chemicals based on a risk-priority assessment, which ranked many CECs such as PhACs as being of low urgency, therefore permitting these substances to continue being released into the environment at unmonitored rates. The problem with ranking PhACs as a low priority is that CMP's risk management assessment overlooks the long-term environmental and synergistic effects of PhAC accumulation, such as the long-term risk of antibiotic CEC accumulation in the spread of antibiotic resistance genes. The goal of this review is to specifically investigate antibiotic CEC accumulation and associated environmental risks to human and environmental health, as well as to determine whether appropriate legislative strategies are in place within Canada's governance framework. In this research, secondary data on antibiotic CEC levels in Canadian and international wastewaters, their potential to promote antibiotic-resistant residues, associated environmental short- and long-term risks, and synergistic effects were all considered. Unlike similar past reviews, this review employed an interdisciplinary approach to propose new strategies from the perspectives of science, engineering, and law.

Seasonal variation in structural and functional distribution of periphyton in a macrolide antibiotics-contaminated river

Periphyton, a microbial assemblage of autotrophic and heterotrophic organisms, is vital to aquatic ecosystems. While exposure to macrolide antibiotics has been confirmed to reduce the biodiversity and damage the critical ecological functions in indoor microcosm bioassays, the distribution of periphyton along a macrolide antibiotic pollution gradient in a river has yet to be determined. Herein, we established the spatiotemporal distribution of five major macrolides, i.e., azithromycin (AZI), roxithromycin (ROX), erythromycin (ERY), clarithromycin (CLA), and anhydro erythromycin (ERY-H2O) in water and periphyton of Zao River (Xi'an, China), after which we evaluated the effects on the structures, photosynthetic activity, and carbon utilization capacity of periphyton in March, June, and September 2023. In contrast with the reference sites, the macrolides were identified in all sewage treatment plants (STPs) impacted sites with concentrations ranging from 0.05 to 2.18 μg/L in water and from not detected - 9.67 μg/g in periphyton. Regarding community structure, the occurrence of macrolides was negatively linked to FirmicutesExiguobacterium undae and Exiguobacterium sibiricum, CyanobacteriaOscillatoriales and Vischeria sp., and ChlorophytaMonostroma grevillei, Selenastrum sp. LU21 and Desmodesmus subspicatus. At the functional level, only the metabolism of phenolic acids was significantly decreased in river reach with high antibiotic levels in June, compared to the other five carbon sources that were not altered. The overall photosynthetic activity of periphytic photosystem II remained unchanged in both reference and STPs impacted groups throughout three seasons. Overall, the macrolides released from STPs were correlated with the altered periphytic structures in the river, whereas a similar trend was not detected for the community functions owing to the functional redundancy. A mesocosm experiments warrants further consideration to validate the field results.

Removal of emergent pollutants: A review on recent updates and future perspectives on polysaccharide-based composites vis-à-vis traditional adsorbents

There is a growing incidence in the presence of emergent pollutants like the pesticides and pharmaceuticals in water bodies. The matter of environmental concern is their synthetic and persistent nature which has resulted in induced toxicity/damaging effect to the vital functioning of the different organs in the aquatic community. Traditional adsorbents have exhibited limitations like low stability and minimum reuse ability. Composites of such adsorbents with polysaccharides have demonstrated distinct features like improved surface area, porosity, adsorptivity; improved reusability and structural integrity; improved mechanical strength, thermal stability when applied for the removal of the emergent pollutants. The biocompatibility and biodegradability of such fabricated composites is established; thereby making the water treatment process cost effective, sustainable and environmentally friendly. The present review has dealt with an in-depth, up-dated literature compilation of traditional as well as polysaccharide based composite adsorbents and addressed their performance evaluation for the removal of pharmaceuticals and pesticides from wastewater. A comparative study has revealed the merits of polysaccharide based composites and discussions have been made with a focus on future research directions in the related area.

Delivering on sustainable development goals in wastewater reuse for agriculture: Initial prioritization of emerging pollutants in the Tula Valley, Mexico

Wastewater reuse for agricultural irrigation is a widespread beneficial practice, in line with the sustainable development goals. However, contaminants of emerging concern (CECs) present in wastewater, such as pharmaceuticals, pose an environmental risk. The Tula Valley in Mexico is one of the world's largest agricultural areas reusing wastewater for agriculture. However, no untargeted CEC monitoring has been undertaken there, limiting the information available to prioritise local environmental risk assessment. Furthermore, CEC environmental presence in the Global South remains understudied, compared to the Global North. There is a risk that current research efforts focus on CECs predominantly found in the Global North, leading to strategies that may not be appropriate for the Global South where the pollution profile may be different. To address these knowledge gaps, a sampling campaign at five key sites in the Tula Valley was undertaken and samples analysed using multi-residue targeted and untargeted liquid chromatography mass spectrometry methods. Using the targeted data, ten CECs were found to be of environmental risk for at least one sampling site: 4‑tert-octylphenol, acetaminophen, bezafibrate, diclofenac, erythromycin, levonorgestrel, simvastatin, sulfamethoxazole, trimethoprim and tramadol as well as total estrogenicity (combination of three steroid hormones). Six of these have not been previously quantified in the Tula Valley. Over one hundred pollutants never previously measured in the area were identified through untargeted analysis supported by library spectrum match. Examples include diclofenac and carbamazepine metabolites and area-specific pollutants such as the herbicide fomesafen. This research contributes to characterising the presence of CECs in the Global South, as well as providing site-specific data for the Tula Valley.

Hospitals and households as primary emission sources for risk-posing pharmaceuticals in municipal wastewater

A wide range of pharmaceutical residues is known to occur in the environment. While they are released into surface waters mainly through centralized wastewater treatment plants (WWTPs), their primary emission sources are located upstream in the sewer network. Information on emissions from different types of primary emission sources is scarce. However, such information could help direct emission reduction measures more efficiently. In this study, we analysed the concentrations of selected active pharmaceutical ingredients (APIs) in wastewater samples taken from altogether ten sites, covering primary emission sources (hospitals and households), and conventional WWTPs. The concentrations in WWTP effluents were used to identify APIs causing risk in recipient waterbodies. Furthermore, the API loads from households and hospitals were compared to those reaching the WWTP in mixed influents. Our results confirm previously published observations of several pharmaceuticals exceeding their predicted no-effect concentrations in effluent wastewaters. Moreover, the concentrations of most of the analysed APIs are comparatively high in hospital wastewaters, resulting in elevated risk quotients. While the total API loads are relatively low from primary emission sources, owing to the low wastewater volume generated at those sites, per capita emissions were shown to be several times higher at hospital sites than at household sites for APIs such as metronidazole, trimethoprim, and ofloxacin. These findings indicate, that directing emission reduction measures to hospitals could be an effective way to decrease the loads of several risk-posing APIs into the environment, especially where hospital contribution to overall wastewater flow to WWTPs is high.

A review of hybrid enzymatic-chemical treatment for wastewater containing antiepileptic drugs

Epilepsy is one of the most common neurological diseases worldwide and requires treatment with antiepileptic drugs for many years or for life. This fact leads to the need for constant production and use of these compounds, placing them among the four pharmaceutical classes most found in wastewater. Even at low concentrations, antiepileptics pose risks to human and environmental health and are considered organic contaminants of emerging concern. Conventional treatments have shown low removal of these drugs, requiring advanced and innovative approaches. In this context, this review covers the results and perspectives on (1) consumption and occurrence of antiepileptics in water, (2) toxicological effects in aquatic ecosystems, (3) enzymatic and advanced oxidation processes for degrading antiepileptics drugs from a molecular point of view (biochemical and chemical phenomena), (4) improvements in treatment efficiency by hybridization, and (5) technical aspects of the enzymatic-AOP reactors.

Current research trends on emerging contaminants pharmaceutical and personal care products (PPCPs): A comprehensive review

Pharmaceutical and personnel care products (PPCPs) from wastewater are a potential hazard to the human health and wildlife, and their occurrence in wastewater has caught the concern of researchers recently. To deal with PPCPs, various treatment technologies have been evolved such as physical, biological, and chemical methods. Nevertheless, modern and efficient techniques such as advance oxidation processes (AOPs) demand expensive chemicals and energy, which ultimately leads to a high treatment cost. Therefore, integration of chemical techniques with biological processes has been recently suggested to decrease the expenses. Furthermore, combining ozonation with activated carbon (AC) can significantly enhance the removal efficiency. There are some other emerging technologies of lower operational cost like photo-Fenton method and solar radiation-based methods as well as constructed wetland, which are promising. However, feasibility and practicality in pilot-scale have not been estimated for most of these advanced treatment technologies. In this context, the present review work explores the treatment of emerging PPCPs in wastewater, via available conventional, non-conventional, and integrated technologies. Furthermore, this work focused on the state-of-art technologies via an extensive literature search, highlights the limitations and challenges of the prevailing commercial technologies. Finally, this work provides a brief discussion and offers future research directions on technologies needed for treatment of wastewater containing PPCPs, accompanied by techno-economic feasibility assessment.

Assessing the exposure to human and veterinary pharmaceuticals in waterbirds: The use of feathers for monitoring antidepressants and nonsteroidal anti-inflammatory drugs

Exposure to active pharmaceutical ingredients (APIs) from both human and veterinary sources is an increasing threat to wildlife welfare and conservation. Notwithstanding, tracking the exposure to pharmaceuticals in non-target and sensitive vertebrates, including birds, is seldom performed and relies almost exclusively on analysing internal organs retrieved from carcasses or from experimentally exposed and sacrificed birds. Clearly, this excludes the possibility of performing large-scale monitoring. Analysing feathers collected from healthy birds may permit this, by detecting APIs in wild birds, including protected and declining species of waterbirds, without affecting their welfare. To this end, we set up a non-destructive method for analysing the presence of non-steroidal anti-inflammatory drugs (NSAIDs), selective serotonin reuptake inhibitors (SSRIs) and noradrenaline reuptake inhibitors (SNRIs) in the feathers of fledglings of both the Mediterranean gull (Ichtyaetus melanocephalus) and the Sandwich tern (Thalasseus sandvicensis). The presence of several NSAIDs and SSRIs above the method quantification limits have confirmed that feathers might be a suitable means of evaluating the exposure of birds to APIs. Moreover, the concentrations indicated that waterbirds are exposed to NSAIDs, such as diclofenac, ibuprofen and naproxen, and SSRIs, such as citalopram, desmethylcitalopram, fluvoxamine and sertraline, possibly due to their widespread use and incomplete removal in wastewater treatment plants (WWTPs). The active ingredient diclofenac raises a the primary concern for the ecosystem and the welfare of the waterbirds, due to its high prevalence (100% and 83.3% in Mediterranean gull and Sandwich tern, respectively), its concentrations detected in feathers (11.9 ng g^-1 and 6.7 ng g^-1 in Mediterranean gull and Sandwich tern, respectively), and its documented toxicity toward certain birds.

Large-scale assessment of organic contaminant emissions from chemical and pharmaceutical manufacturing into Swiss surface waters

This study presents a nation-wide assessment of the influence of chemical and pharmaceutical manufacturing (CPM) wastewaters on synthetic organic contaminant (SOC) emissions to Swiss surface waters. Geographic Information System (GIS) based analysis of the presence of CPM in wastewater treatment plant (WWTP) catchments revealed wide distribution of this industrial sector across Switzerland, suggesting that one-third of the 718 Swiss WWTPs may be influenced by CPM wastewaters. To reflect the diversity of this type of wastewaters, we investigated the effluents of 11 WWTPs of diverse sizes and technologies, which treated 0-100% wastewater from a variety of CPM activities. In an extensive sampling campaign, we collected temporally high resolved (i.e., daily) samples for 2-3 months to capture the dynamics of CPM discharges. The > 850 samples were then measured with liquid chromatography high-resolution mass spectrometry (LC-HRMS). Non-target characterization of the LC-HRMS time series datasets revealed that CPM wastewaters left a highly variable and site-specific signature in the effluents of the WWTPs. Particularly, compared to WWTPs with purely domestic input, a larger variety of substances (up to 15 times more compounds) with higher maximum concentrations (1-2 orders of magnitude) and more uncommon substances were found in CPM-influenced effluents. Moreover, in the latter, highly fluctuating discharges often contributed to a substantial fraction of the overall emissions. The largely varying characteristics of CPM discharges between different facilities were primarily related to the type of activities at the industries (i.e., production versus processing of chemicals) as well as to the pre-treatment and storage of CPM wastewaters. Eventually, for one WWTP, LC-HRMS time series were correlated with ecotoxicity time series obtained from bioassays and major toxic components could be identified. Overall, in view of their potential relevance to water quality, a strong focus on SOC discharges from CPM is essential, including the design of situation-specific monitoring, as well as risk assessment and mitigation strategies that consider the variability of industrial emissions.

Synthetic Progestins in Waste and Surface Waters: Concentrations, Impacts and Ecological Risk

Synthetic progestins (PGs) are a large family of hormones used in continuously growing amounts in human and animal contraception and medicinal therapies. Because wastewater treatment plants (WWTPs) are unable to eradicate PGs after excretion, they are discharged into aquatic systems, where they can also be regenerated from conjugated PG metabolites. This review summarises the concentrations of 12 PGs in waters from 2015 to 2021. The selected PGs were considered of particular interest due to their wide use, activity, and hormonal derivation (from testosterone, progesterone, and spirolactone). We concluded that PGs had been analysed in WWTPs influents and effluents and, to a lesser extent, in other matrices, including surface waters, where their concentrations range from ng/L to a few µg/L. Because of their high affinity for cell hormone receptors, PGs are endocrine disruptor compounds that may alter the reproductive fitness and development of biota. This review focused on their biological effects in fish, which are the most used aquatic model organisms to qualify the impacts of PGs, highlighting the risks that environmental concentrations pose to their health, fecundity, and fertility. It is concluded that PGs research should be expanded because of the still limited data on their environmental concentrations and effects.

Voltammetric Determination of Active Pharmaceutical Ingredients Using Screen-Printed Electrodes

A simple, fast, sensitive and low-cost voltammetric method using a screen-printed carbon electrode (SPCE) is presented in this work for the simultaneous determination of ascorbic acid (AA), paracetamol (PA), dextromethorphan (DX) and caffeine (CF) in both pharmaceutical formulations and samples of environmental interest. The oxidative peak current displayed linear dependence on concentration within the range 1.7–60.5, 0.6–40.0, 0.9–8.4 (1st linear part) and 1.8–22.0 mg L−1 for AA, PA, DX and CF, respectively; and detection limits of 0.5, 0.2, 0.3 and 0.5 mg L−1, respectively. The developed differential pulse voltammetric (DPV) method was validated using both a pharmaceutical product and a spiked well water sample. A very good agreement between the determined and the theoretical label drug content and recoveries in the range of 99.5–100.8% were obtained for pharmaceutical product and well water samples, respectively.

Synthesis of glutaraldehyde-modified silica/chitosan composites for the removal of water-soluble diclofenac sodium

Composite materials are effective adsorbents for the removal of various types of contaminants, such as pharmaceutical products. However, they require improvement to achieve a good adsorption capacity. This study presents the development of a promising adsorbent: silica/chitosan modified with different proportions of glutaraldehyde, which involves the D-glucosamine units from chitosan. The developed materials were evaluated for their ability to remove diclofenac sodium. The adsorption data showed that the diclofenac adsorption efficiency increased with increasing degree of glutaraldehyde crosslinking. The equilibrium and kinetic data were well fit by the Liu and Elovich models, respectively, and the maximum adsorption capacity was 237.8 mg/g. Therefore, it can be assumed that the process is predominantly chemical and exothermic, with a high affinity between the adsorbents and diclofenac sodium. The adsorption mechanisms were investigated to better understand the interactions, and the predominance of covalent bonds with the self-polymerized glutaraldehyde was verified.

Delayed toxicity of three fluoroquinolones and their mixtures after neonatal or embryonic exposure, in Daphnia magna

Fluoroquinolones (FQs) are antibacterial drugs, used both in human and veterinary medicine, that are currently considered as emerging micropollutants. This study investigated the delayed toxic effects of enrofloxacin (ENR), flumequine (FLU), levofloxacin (LEV) and their binary mixtures in D. magna. For this purpose, a 10-day follow-up in pure medium was added to the standard D. magna immobilization test. During this follow-up, phenotypic alterations were evidenced, which were related to scarce or zeroed egg production and early mortality. Consequently, the EC_50 s recalculated at the end of the follow-up were always remarkably lower than those obtained after the 48 h immobilization test: ENR 3.13 vs. 16.72 mg L^-1; FLU 7.18 vs. 25.35 mg L^-1; LEV 15.11 vs. > 40 mg L^-1. To analyse the possible interactions within the binary mixtures, the method of nonlinear additive isoboles was applied. The three compounds showed invariably to follow the principle of concentration addition. Furthermore, as previous experiments showed toxicity of FLU and ENR after embryonic exposure of D. magna at a concentration of 2 mg L^-1, an additional two embryonic tests were conducted with identical design: one with 2 mg L^-1 LEV and the other with a ternary mixture containing 0.66 mg L^-1 of each of the three FQs. The embryos were exposed for three days in vitro to the drug solutions and were then reconducted to pure medium for 21 days observation. Both the tests ended-up with only non-significant effects on growth and reproduction, confirming the lower toxicity of LEV, when compared to ENR and FLU, and the absence of any evident synergistic interaction among the three FQs. Overall, these studies have shown two relevant features related to the toxicity of the three FQs: (1) they give rise to delayed toxic effects in D. magna that are undetectable by the standard immobilization test; (2) their interaction in mixtures follow the principle of Concentration Addition. Both these indications concern the Environmental Risk Assessment of FQs and may be of interest to regulatory authorities.

Superior Technique for the Production of Agarose Dressing Containing Sericin and Its Wound Healing Property

Finding a simple and eco-friendly production technique that matches to the natural agent and results in a truly valuable natural scaffold production is still limited amongst the intensively competitive natural scaffold development. Therefore, the purpose of this study was to develop natural scaffolds that were environmentally friendly, low cost, and easily produced, using natural agents and a physical crosslinking technique. These scaffolds were prepared from agarose and sericin using the freeze-drying method (D) or freeze-thawing together with the freeze-drying method (TD). Moreover, plasticizers were added into the scaffold to improve their properties. Their physical, mechanical, and biological properties were investigated. The results showed that scaffolds that were prepared using the TD method had stronger bonding between sericin and other compounds, leading to a low swelling ratio and low protein release of the scaffolds. This property may be applied in the development of further material as a controlled drug release scaffold. Adding plasticizers, especially glycerin, into the scaffolds significantly increased elongation properties, leading to an increase in elasticity of the scaffold. Moreover, all scaffolds could activate cell migration, which had an advantage on wound healing acceleration. Accordingly, this study was successful in developing natural scaffolds using natural agents and simple and green crosslinking methods.

Effective treatment of hospital wastewater with high-concentration diclofenac and ibuprofen using a promising technology based on degradation reaction catalyzed by Fe0 under microwave irradiation

Real hospital wastewater was effectively treated by a promising technology based on degradation reaction catalyzed by Fe⁰ under microwave irradiation in this work. Fe⁰ powders were synthesized and characterized by different techniques, resulting in a single-phase sample with spherical particles. Optimum experimental conditions were determined by a central composite rotatable design combined with a response surface methodology, resulting in 96.8% of chemical oxygen demand reduction and 100% organic carbon removal, after applying MW power of 780 W and Fe⁰ dosage of 0.36 g L^-1 for 60 min. Amongst the several organic compounds identified in the wastewater sample, diclofenac and ibuprofen were present in higher concentrations; therefore, they were set as target pollutants. Both compounds were completely degraded in 35 min of reaction time. Their plausible degradation pathways were investigated and proposed. Overall, the method developed in this work effectively removed high concentrations of pharmaceuticals in hospital wastewater.

Emerging contaminants detected in aquaculture sites in Java, Indonesia

Pharmaceuticals of emerging concern (acetaminophen (ACM), trimethoprim (TMP), oxytetracycline (OTC), and sulfamethoxazole (SMX)) were detected in water samples from aquaculture environments and nonaquaculture sites in four regions located on the northern coast of Central Java. ACM was the most prevalent pharmaceutical, with a mean concentration ranging from not detected (n.d.) to 5.5 ± 1.9 ngL^-1 (Brebes). Among the target antibiotics (TMP, OTC, SMX), OTC was the most ubiquitous, with a mean concentration varying from n.d. to 8.0 ± 3.3 ngL^-1. Correlation analysis demonstrated that there was a significant correlation between TMP and SMX concentrations. Based on ecological risk assessment evaluation, the use of OTC requires serious consideration, as it presented high health risks to algae, while ACM, TMP, and SMX posed an insignificant to moderate risk to algae, invertebrates, and fish. The findings obtained from this study highlight OTC as an emerging contaminant of prominent concern. More attention needs to be given to managing and planning for the sustainable management of shrimp farms, particularly in the northern part of Central Java.

Ecotoxicity and genotoxicity assessment of losartan after UV/H2O2 and UVC/photolysis treatments

Losartan potassium (LOS) is one of the most antihypertensives used in the world, and its presence in environmental matrices can cause impacts to biota. In this study, the ecotoxicity and genotoxicity of LOS was assessed before and after treatment by UVC/photolysis and UV/H₂O₂. The photodegradations were carried out at LOS solutions (2.5 mg L^-1; 4.6 μM) for 30, 60, 90, 120, 240, and 480 min of treatment. For chromatographic analysis, the samples were submitted to solid-phase extraction (SPE) and analyzed by HPLC-DAD. Ecotoxicity bioassays were conducted using Daphnia magna (acute) and Desmodesmus subspicatus (chronic) for all the degradation times. To evaluate the genotoxicity, the comet assay was performed with a D. magna whole organism cell suspension applying the alkaline gel electrophoresis technique. For both process, the degradation rate was over 99% at 30 min, which reduced the acute toxicity of LOS to D. magna. In addition, only the sample treated at 240 min by UV/H₂O₂ showed significant chronic and acute toxicity. However, the genotoxicity effect was observed for samples treated LOS before treatment and at 480 min by UV/H₂O₂. Therefore, even reaching high LOS degradation rates, for both processes, the bioassays demonstrated the importance of ecotoxicological analyses by AOPs treatment.

Ozonation products of zidovudine and thymidine in oxidative water treatment

Ozonation is an advanced treatment technology that is increasingly used for the removal of organic micropollutants from wastewater and drinking water. However, reaction of organic compounds with ozone can also result in the formation of toxic transformation products. In the present study, the degradation of the antiviral drug zidovudine during ozonation was investigated. To obtain further insights into the reaction mechanisms and pathways, results of zidovudine were compared with the transformation of the naturally occurring derivative thymidine. Kinetic experiments were accompanied by elucidation of formed transformation products using lab-scale batch experiments and subsequent liquid chromatography - high resolution mass spectrometry (LC-HRMS) analysis. Degradation rate constants for zidovudine with ozone in the presence of t-BuOH as radical scavenger varied between 2.8 ∙ 10⁴ M^-1 s^-1 (pH 7) and 3.2 ∙ 10⁴ M^-1 s^-1 (pH 3). The structural difference of zidovudine to thymidine is the exchange of the OH-moiety by the azide function at position 3'. In contrast to inorganic azide, no reaction with ozone was observed for the organic bound azide. In total, nine transformation products (TPs) were identified for both zidovudine and thymidine. Their formation can be attributed to the attack of ozone at the C-C-double bond of the pyrimidine-base. As a result of rearrangements, the primary ozonide decomposed in three pathways forming two different TPs, including hydroperoxide TPs. Rearrangement reactions followed by hydrolysis and subsequent release of H₂O₂ further revealed a cascade of TPs containing amide moieties. In addition, a formyl amide riboside and a urea riboside were identified as TPs indicating that oxidations of amide groups occur during ozonation processes.

Pharmaceutical pollution sources and solutions: Survey of human and veterinary medication purchasing, use, and disposal

Human and veterinary pharmaceuticals offer many benefits, but they also pose risks to both the environment and public health. Life-cycle stewardship of medications offers multiple strategies for minimizing the risks posed by pharmaceuticals, and further insight is required for developing best practices for pharmaceutical management. The goal of this study was to clarify points of intervention for minimizing environmental and public health risks associated with pharmaceuticals. Specifically, our objectives were to provide insight on purchasing, use, and disposal behaviors associated with human and veterinary medications. This study used a state-wide representative sample of Vermont adults (n = 421) to survey both human and veterinary pharmaceuticals as potential sources of the unintended consequences of prescribed and over-the-counter (OTC) medications. The majority (93%) of respondents had purchased some form of medication within the past twelve months, including OTC (85%), prescription (74%), and veterinary (41%) drugs. Leftover drugs of any kind were reported by 59% of respondents. While 56% of people were aware of drug take-back programs, the majority reported never being told what to do with leftover medications by their physician (78%), pharmacist (76%), or veterinarian (53%). Among all respondents, take-back programs were the most common disposal method (22%), followed by trash (19%), and flushing (9%), while 26% of respondents reported keeping unused drugs. Awareness of pharmaceutical pollution in the environment and having received information about proper disposal were both significantly associated with participation in take-back programs. These findings indicate that a large volume of drugs are going unused annually, and that only a portion of leftover medications are returned to take-back programs where they can be appropriately disposed. Our results warrant further investigation of clinical interventions that support lower dose prescribing and dispensing practices in order to reduce the unintended environmental and public health consequences of pharmaceuticals within the consumer sphere. In addition, our findings suggest that directed efforts to raise awareness of proper disposal may be more effective than broad awareness campaigns, and we recommend research on the efficacy of providing disposal instructions on drug packaging.

Pharmaceuticals Market, Consumption Trends and Disease Incidence Are Not Driving the Pharmaceutical Research on Water and Wastewater

Pharmaceuticals enhance our quality of life; consequently, their consumption is growing as a result of the need to treat ageing-related and chronic diseases and changes in the clinical practice. The market revenues also show an historic growth worldwide motivated by the increase on the drug demand. However, this positivism on the market is fogged because the discharge of pharmaceuticals and their metabolites into the environment, including water, also increases due to their inappropriate management, treatment and disposal; now, worldwide, this fact is recognized as an environmental concern and human health risk. Intriguingly, researchers have studied the most effective methods for pharmaceutical removal in wastewater; however, the types of pharmaceuticals investigated in most of these studies do not reflect the most produced and consumed pharmaceuticals on the market. Hence, an attempt was done to analyze the pharmaceutical market, drugs consumption trends and the pharmaceutical research interests worldwide. Notwithstanding, the intensive research work done in different pharmaceutical research fronts such as disposal and fate, environmental impacts and concerns, human health risks, removal, degradation and development of treatment technologies, found that such research is not totally aligned with the market trends and consumption patterns. There are other drivers and interests that promote the pharmaceutical research. Thus, this review is an important contribution to those that are interested not only on the pharmaceutical market and drugs consumption, but also on the links, the drivers and interests that motivate and determine the research work on certain groups of pharmaceuticals on water and wastewater.

Monensin occurrence in surface water and its impact on aquatic biota in a stream of the southeast Pampas, Argentina

Monensin is an ionophore antibiotic used as a feed additive and growth promoter in cattle production worldwide. The occurrence of monensin in aquatic surficial ecosystems is of concern due to its possible detrimental effects on human health and native biota. Argentina is one of the most important cattle beef producers worldwide; however, there is little knowledge on the environmental occurrence of monensin and the associated risks to aquatic biota. In this study, we developed a method for the extraction and quantification of monensin in surface water; then, we evaluated the occurrence of monensin in a stream impacted by different animal husbandry's operations, and then, we analyzed the ecological implications of monensin residues on aquatic organisms using the risk quotient (RQ) method. Sampling was carried out on August 2017 from the headwaters to the floodplain of the El Pantanoso stream, Buenos Aires province, Argentina. Monensin detection frequency was 75% (n = 20). The median level was 0.40 μg/L and the maximum concentration was 4.70 μg/L. The main input of monensin was from a cattle slaughterhouse, an activity that has not been considered before in the literature as a source of emission of veterinary pharmaceuticals into the environment. The RQ assessment showed that monensin levels could have potential negative effects on aquatic biota in the sampling site closest to the cattle slaughterhouse. The data obtained in this study shows that monensin was present in El Pantanoso surface waters at levels of high ecotoxicological risk to aquatic biota.

Removal and toxicity evaluation of a diverse group of drugs from water by a cyclodextrin polymer/pulsed light system

The presence of pharmaceutical compounds (PhCs) in the effluents of wastewater treatment plants (WWTPs) is an ecological concern. The issue could be alleviated by trapping those substances by cyclodextrin (CD) polymers or photolyzing them by pulsed light (PL). Consequently, a sequential CD polymer/PL system was tested for the removal of PhCs. Firstly, a survey detected the presence of recurrent PhCs in the effluents of local WWTPs. Then, pure water was spiked with 21 PhCs, 100 μg/L each one. The three-dimensional network provides amphiphilic features to the CD polymer that reduced the pollutant concentration by 77 %. Sorption involves a plead of physical and chemical mechanisms hindering the establishment of a general removal model for all compounds. The performed simulations hint that the retention capacity mainly correlates with the computed binding energies, so that theoretical models are revealed as valuable tools for further improvements. The complementary action of PL rose the elimination to 91 %. The polymer can be reused at least 10 times for ibuprofen (model compound) removal, and was able to eliminate the ecotoxicity of an ibuprofen solution. Therefore, this novel sequential CD polymer/PL process seems to be an efficient alternative to eliminate PhCs from wastewater.

Photocatalytic materials and light-driven continuous processes to remove emerging pharmaceutical pollutants from water and selectively close the carbon cycle

Past and present technologies for wastewater purification and future research directions are critically discussed in this review.

Quantification of Active Ingredient Losses from Formulating Pharmaceutical Industries and Contribution to Wastewater Treatment Plant Emissions

In this work, emissions of active pharmaceutical ingredients (APIs) from formulating pharmaceutical industries (FPIs) were investigated for the first time based on detailed production information and compared to overall API emissions in wastewater treatment plant (WWTP) effluents. At two municipal WWTPs, both receiving wastewater from several FPIs, two months' daily effluent samples were collected and measured using liquid chromatography high-resolution mass spectrometry (LC-HRMS). Thirty-three APIs formulated during the sampling period as well as >120 organic contaminants commonly present in WWTP effluents were quantified. On the basis of their time patterns and manufacturing data, industrial contributions were found for 22 of 26 APIs (85%) detected in the samples and processed by the FPIs. API emissions from FPIs led to daily concentration increases of up to 300-fold, despite pretreatment of the industrial wastewater. However, emissions from FPIs seemed to depend on the type of formulating activity, with granulation and mixing being most prone to API losses. Losses from FPIs were responsible for the highest concentrations and for up to 60% of the daily total API emissions measured. Furthermore, screening for suspects in LC-HRMS data resulted in the detection of unexpected emissions from FPIs, demonstrating the value of these data to comprehensively assess industrial API losses. Overall, this study showed that FPIs were relevant contributors of APIs emitted in the WWTP effluents, although only a minor fraction (<1%) of the total processed API quantity was lost to the wastewater, and despite the small percentage (<5%) of FPI wastewater compared to the total wastewater flow.

Antibiotic Resistance in Recreational Waters: State of the Science

Ambient recreational waters can act as both recipients and natural reservoirs for antimicrobial resistant (AMR) bacteria and antimicrobial resistant genes (ARGs), where they may persist and replicate. Contact with AMR bacteria and ARGs potentially puts recreators at risk, which can thus decrease their ability to fight infections. A variety of point and nonpoint sources, including contaminated wastewater effluents, runoff from animal feeding operations, and sewer overflow events, can contribute to environmental loading of AMR bacteria and ARGs. The overall goal of this article is to provide the state of the science related to recreational exposure and AMR, which has been an area of increasing interest. Specific objectives of the review include (1) a description of potential sources of antibiotics, AMR bacteria, and ARGs in recreational waters, as documented in the available literature; (2) a discussion of what is known about human recreational exposures to AMR bacteria and ARGs, using findings from health studies and exposure assessments; and (3) identification of knowledge gaps and future research needs. To better understand the dynamics related to AMR and associated recreational water risks, future research should focus on source contribution, fate and transport-across treatment and in the environment; human health risk assessment; and standardized methods.

Occurrence and distribution of priority pharmaceuticals in the Yellow River and the Huai River in Henan, China

The occurrence and spatial distribution of priority pharmaceuticals (PPs) in water samples from the Yellow River and the Huai River in the Henan region of China were investigated in this study. The concentration of the total PPs (ΣPPs; sum of the 10 observed PPs) ranged from not detected to 3474 ng L^-1 in samples from the Yellow River and from 4.35 to 146 ng L^-1 in samples from the Huai River. The level of the ΣPPs in the Huai River was much lower than that found in the Yellow River. The composition of the PPs differed between the two rivers. Norfloxacin, carbamazepine, and 5,5-diphenylhydantoin were detected at high concentrations in the Yellow River, whereas sulfamethazine, ampicillin trihydrate, carbamazepine, and 5,5-diphenylhydantoin were the dominant species in the Huai River, suggesting there were different pollution sources. In comparison to other studies around China, most of the PPs in water samples from the Yellow River and the Huai River were at low concentrations, except for norfloxacin and ofloxacin. There were significant seasonal variations among the PPs in water samples from the Huai River, whereas spatial distinctions were recorded among the PPs in the Yellow River. Dissolved organic carbon content did not correlate with the PPs in the studied area.

Assessing Emissions from Pharmaceutical Manufacturing Based on Temporal High-Resolution Mass Spectrometry Data

This study presents a nontarget approach to detect discharges from pharmaceutical production in municipal wastewater treatment plant (WWTP) effluents and to estimate their relevance on the total emissions. Daily composite samples were collected for 3 months at two WWTPs in Switzerland, measured using liquid chromatography high-resolution mass spectrometry, and time series were generated for all features detected. The extent of intensity variation in the time series was used to differentiate relatively constant domestic inputs from highly fluctuating industrial emissions. We show that an intensity variation threshold of 10 correctly classifies compounds of known origin and reveals clear differences between the two WWTPs. At the WWTP receiving wastewater from a pharmaceutical manufacturing site, (i) 10 times as many potential industrial emissions were detected as compared to the WWTP receiving purely domestic wastewater; (ii) for 11 pharmaceuticals peak concentrations, >10 μg/L and up to 214 μg/L were quantified, which are clearly above typical municipal wastewater concentrations; and (iii) a pharmaceutical not authorized in Switzerland was identified. Signatures of potential industrial emissions were even traceable at the downstream Rhine monitoring station at a >4000-fold dilution. Several of them occurred repeatedly, suggesting that they were linked to regular production, not to accidents. Our results demonstrate that small wastewater volumes from a single industry not only left a clear signature in the effluents of the respective WWTP but also influenced the water quality of one of Europe's most important river systems. Overall, these findings indicate that pharmaceutical production is a relevant emission source even in highly developed countries with a strong focus on water quality, such as Switzerland.

Survival and malformation rate in oocytes and larvae of Cyprinus carpio by exposure to an industrial effluent

Pharmaceuticals are used for the prevention or treatment of diseases, and due to their manufacturing process they are continuously released to water bodies. One of the pharmacological groups detected in aquatic environments is non-steroidal anti-inflammatory drugs (NSAIDs) at trace concentrations. This study evaluated the survival and malformation rate in oocytes and larvae of Cyprinus carpio (C. carpio) after exposure to different proportions of an industrial effluent. Initially, the industrial effluent was sampled from an NSAID manufacturing plant located in the city of Toluca, State of Mexico, subsequently the physicochemical characterization and determination of the concentration of chemical compounds present were carried out. On the other hand, the lethal concentration 50 (LC50) and the effective concentration 50 (EC50) were calculated to determine the teratogenic index (TI), as well as the alterations to the embryonic development and the teratogenic effects on oocytes and larvae of C. carpio at the following proportions of the industrial effluent: 0.1, 0.3, 0.5, 0.7, 0.9 and 1.1%, following the Test Guideline 236, which describes a Fish Embryo Acute Toxicity test, the exposure times were 12, 24, 48, 72 and 96 h post-fertilization. The contaminants detected were NaClO (2.6 mg L^-1) and NSAIDs such as diclofenac, ibuprofen, naproxen and paracetamol in the range of 1.09-2.68 mg L^-1. In this study the LC50 was 0.275%, the EC50 0.133% and the TI 2.068. Several malformations were observed in all proportions of the industrial effluent evaluated, however the most severe such as spina bifida and paravertebral hemorrhage were observed at the highest effluent proportion. The industrial effluent evaluated in this study represents a risk for organisms that are in contact with it, since it contains chemical compounds that induce embryotoxic and teratogenic effects as observed in oocytes and larvae of C. carpio.

Modelling micropollutant fate in sewer systems - A new systematic approach to support conceptual model construction based on in-sewer hydraulic retention time

Conceptual sewer models are useful tools to assess the fate of micropollutants (MPs) in integrated wastewater systems. However, the definition of their model structure is highly subjective, and obtaining a realistic simulation of the in-sewer hydraulic retention time (HRT) is a major challenge without detailed hydrodynamic information or with limited measurements from the sewer network. This study presents an objective approach for defining the structure of conceptual sewer models in view of modelling MP fate in large urban catchments. The proposed approach relies on GIS-based information and a Gaussian mixture model to identify the model optimal structure, providing a multi-catchment conceptual model that accounts for HRT variability across urban catchment. This approach was tested in a catchment located in a highly urbanized Italian city and it was compared against a traditional single-catchment conceptual model (using a single average HRT) for the fate assessment of reactive MPs. Results showed that the multi-catchment model allows for a successful simulation of dry weather flow patterns and for an improved simulation of MP fate compared to the classical single-catchment model. Specifically, results suggested that a multi-catchment model should be preferred for (i) degradable MPs with half-life lower than the average HRT of the catchment and (ii) MPs undergoing formation from other compounds (e.g. human metabolites); or (iii) assessing MP loads entering the wastewater treatment plant from point sources, depending on their location in the catchment. Overall, the proposed approach is expected to ease the building of conceptual sewer models, allowing to properly account for HRT distribution and consequently improving MP fate estimation.

Emerging contaminants in a river receiving untreated wastewater from an Indian urban centre

Research over the last decade on emerging trace organic contaminants in aquatic systems has largely focused on sources such as treated wastewaters in high income countries, with relatively few studies relating to wastewater sources of these contaminants in low and middle income countries. We undertook a longitudinal survey of the Ahar River for a number of emerging organic contaminants (including pharmaceuticals, hormones, personal care products and industrial chemicals) which flows through the city of Udaipur, India. Udaipur is a city of approximately 450,000 people with no wastewater treatment occurring at the time of this survey. We found the concentrations of many of the contaminants within the river water were similar to those commonly reported in untreated wastewater in high income countries. For example, concentrations of pharmaceuticals, such as carbamazepine, antibiotics and non-steroidal anti-inflammatory drugs, ranged up to 1900 ng/L. Other organic contaminants, such as steroid estrogens (up to 124 ng/L), steroid androgens (up to 1560 ng/L), benzotriazoles (up to 11 μg/L), DEET (up to 390 ng/L), BPA (up to 300 ng/L) and caffeine (up to 37.5 μg/L), were all similar to previously reported concentrations in wastewaters in high income countries. An assessment of the population densities in the watersheds feeding into the river showed increasing population density of a watershed led to a corresponding downstream increase in the concentrations of the organic contaminants, with quantifiable concentrations still present up to 10 km downstream of the areas directly adjacent to the highest population densities. Overall, this study highlights how a relatively clean river can be contaminated by untreated wastewater released from an urban centre.

Environmental risk assessment of psychoactive drugs in the aquatic environment

The consumption of psychoactive pharmaceuticals has increased worldwide, and wastewater treatment plants are not able to eliminate them from the effluent. An extensive review was carried out to assess the environmental risk (ERA model) based on secondary data about potential impacts on non-target organisms of seven psychoactive drugs consumed worldwide (alprazolam, bromazepam, citalopram, clonazepam, diazepam, lorazepam, and oxazepam). Risk quotients (RQs) were calculated according to the European Medicines Agency (EMA) on ERA of Medicinal Products For Human Use based on (i) the predicted and measured environmental concentrations (PEC and MEC, respectively) of the psychoactive drug in surface water, groundwater, and wastewater effluent and (ii) the predicted no-effect concentration (PNEC) derived from ecotoxicological assays or ECOSAR software. Furthermore, this study reviews and discusses non-standardized ecotoxicity assays, such as sublethal and behavioral effects on different organisms. In total, 903 MEC entries of psychoactive drugs and 162 data on ecotoxicological assays were gathered from the literature survey addressing behavioral effects (115), acute/chronic effects (35), and sublethal effects (12). Citalopram and diazepam were the only substances that are likely to pose an environmental risk (RQ > 1) to surface waters. Even though there is considerable amount of data on behavioral effects of psychoactive drugs to aquatic species, results are currently not integrated into the EMA risk assessment framework. The large amount of data on psychoactive drug concentrations and effects on non-target organisms collected, interpreted, and discussed in the present study should be used as a baseline for future improvement of ERA strategies.

Green pharmacy - a narrative review

Introduction

Active pharmaceutical ingredients are present in various sections of the environment, because of both the human and veterinary use of medicinal products. Ways of minimizing the risk of environmental contamination should be observed during all pharmaceutical activities (research, manufacturing, prescribing, dispensing and disposal of medicinal products).

Methods

For the present study we searched specific literature on this subject, using the main international databases (Thomson Reuters – Web of Science, SCOPUS and Science Direct).

Results

This narrative review focuses on the main aspects concerning environmental contamination with medicinal products. Consequently, the present study is structured on four different topics: environmental research on medicinal products, minimizing environmental contamination, waste disposal management and towards a greener community pharmacy.

Conclusion

Waste management activities are important for reducing the presence of active pharmaceutical ingredients in the environment. Pharmacists should inform patients on proper pharmaceutical waste disposal and organize collection programs for unused and expired medicines, in order to develop a greener pharmacy for the future.