Factors Affecting Spatial and Temporal Concentration Variability of Pharmaceuticals: Comparison between Two WWTPs

The behavior of pharmaceutically active compounds and contrast agents during wastewater treatment - Combining sampling strategies and analytical techniques: A critical review

Increasing consumption of pharmaceuticals and the respective consequences for the aquatic environment have been the focus of many studies over the last thirty years. Various aspects in this field were investigated, considering diverse pharmaceutical groups and employing a wide range of research methodologies. Various questions from the perspectives of different research areas were devised and answered, resulting in a large mix of individual findings and conclusions. Collectively, the results of the studies offer a comprehensive overview. The large variety of methods and strategies, however, demands close attention when comparing and combining information from heterogeneous projects. This review critically examines the application of diverse sampling techniques as well as analytical methods in investigations concerning the behavior of pharmaceutically active compounds (PhACs) and contrast agents (CAs) in wastewater treatment plants (WWTPs). The combination of sampling and analysis is discussed with regard to its suitability for specific scientific problems. Different research focuses need different methods and answer different questions. An overview of studies dealing with the fate and degradation of PhACs and CAs in WWTPs is presented, discussing their strategic approaches and findings. This review includes surveys of anticancer drugs, antibiotics, analgesics and anti-inflammatory drugs, antidiabetics, beta blockers, hormonal contraceptives, lipid lowering agents, antidepressants as well as contrast agents for X-ray and magnetic resonance imaging.

A Review on Fluoroquinolones' Toxicity to Freshwater Organisms and a Risk Assessment

Fluoroquinolones (FQs) have achieved significant success in both human and veterinary medicine. However, regulatory authorities have recommended limiting their use, firstly because they can have disabling side effects; secondly, because of the need to limit the spread of antibiotic resistance. This review addresses another concerning consequence of the excessive use of FQs: the freshwater environments contamination and the impact on non-target organisms. Here, an overview of the highest concentrations found in Europe, Asia, and the USA is provided, the sensitivity of various taxa is presented through a comparison of the lowest EC50s from about a hundred acute toxicity tests, and primary mechanisms of FQ toxicity are described. A risk assessment is conducted based on the estimation of the Predicted No Effect Concentration (PNEC). This is calculated traditionally and, in a more contemporary manner, by constructing a normalized Species Sensitivity Distribution curve. The lowest individual HC5 (6.52 µg L-1) was obtained for levofloxacin, followed by ciprofloxacin (7.51 µg L-1), sarafloxacin and clinafloxacin (12.23 µg L-1), and ofloxacin (17.12 µg L-1). By comparing the calculated PNEC with detected concentrations, it is evident that the risk cannot be denied: the potential impact of FQs on freshwater ecosystems is a further reason to minimize their use.

Electron beam degradation of the cardiovascular drug salbutamol: Mechanisms and degradation pathways

With the increasing incidence and mortality of cardiovascular diseases, high consumption of the cardiovascular drug salbutamol (SAL) has made this compound an emerging pollutant in natural water and a challenge for traditional wastewater treatment. In this paper, an efficient advanced oxidation process was used to degrade SAL by electron beam (EB) irradiation. The results revealed that 100 mg L^-1 of SAL could be nearly completely removed (95.1%) at 10 kGy and the degradation kinetic well followed pseudo first-order kinetic model. Different factors, including pH, inorganic ions and water matrix, had varying effects on the degradation of SAL owing to their important influence on the formation of reactive species in the aqueous solution. And it was found that e_aq^- played a major role in the degradation of SAL parent. Moreover, the addition of K₂S₂O₈ (20 mM) increased the SAL mineralization rate from 2.9% to 64.2%, suggesting that oxidation free radicals could greatly improve the mineralization rate of SAL. Combining with the theoretical calculations and determined degradation by-products, four possible degradation pathways of SAL by EB irradiation were proposed, including H•, •OH and e_aq^- all participated in the degradation of SAL. Finally, toxicity evaluation suggested that the toxicity of SAL aqueous solution reduced after EB irradiation, indicating that it is an effective method to degrade SAL.

Literature Review: Evaluation of Drug Removal Techniques in Municipal and Hospital Wastewater

There are several techniques for the removal of pharmaceuticals (drugs) from wastewater; however, strengths and weaknesses have been observed in their elimination processes that limit their applicability. Therefore, we aimed to evaluate the best techniques for the removal of pharmaceuticals from municipal and hospital wastewater. For this, a non-experimental, descriptive, qualitative-quantitative design was used, corresponding to a systematic review without meta-analysis. Based on established inclusion and exclusion criteria, 31 open-access articles were selected from the Scopus, ProQuest, EBSCOhost, and ScienceDirect databases. The results showed that high concentrations of analgesics such as naproxen (1.37 mg/L) and antibiotics such as norfloxacin (0.561 mg/L) are frequently found in wastewater and that techniques such as reverse osmosis, ozonation, and activated sludge have the best removal efficiency, achieving values of 99%. It was concluded that reverse osmosis is one of the most efficient techniques for eliminating ofloxacin, sulfamethoxazole, carbamazepine, and diclofenac from municipal wastewater, with removal rates ranging from 96 to 99.9%, while for hospital wastewater the activated sludge technique proved to be efficient, eliminating analgesics and antibiotics in the range of 41-99%.

Industrial Symbiosis through the Use of Biosolids as Fertilizer in Romanian Agriculture

Biosolids’ use in agriculture is an example of industrial symbiosis. The application of biosolids (BS) in agriculture is considered one of the most sustainable sewage sludge (SS) management options, but the quality of biosolids has to meet certain requirements regarding the characteristics of the sludge, those of the land and of the type of crop. Web of Science database has been used to search for the relevant literature. The review of studies undertaken in order to determine the economic effects of the use of biosolids in agriculture shows, in the majority, an increase in crop yield and the reduction in costs, due to the reduction in the requirements for the application of chemical or synthetic fertilizers. If the entire sewage sludge production in Romania for 2019 had been used as fertilizer, the estimated cost reduction for farmers would have been almost 3 million Euros—considering the 230.59 thousand tons of dry matter produced in 2019. The estimated savings for 2019 of the sewage and water utilities, if the sewage sludge had been used in agriculture instead of depositing it at the landfill, would have been about 3.9 million Euros. However, the limits of the symbiosis are due to the size of the farms, the type of plants cultivated, pH, slope inclination, heavy metal content and social acceptance. It is impossible to use all the sewage sludge in agriculture, but these figures are a good estimation of the economic effects.

Spatio-Temporal Distribution and Influencing Factors of Human and Veterinary Pharmaceuticals in the Tributary Surface Waters of the Han River Watershed, South Korea

Human and veterinary pharmaceuticals are being increasingly used for disease treatment; hence, their distribution and factors influencing them in the aquatic environment need to be investigated. This study observed the effect of human and animal populations, usage, purchasing criteria (prescription vs. non-prescription), and land use to identify the spatio-temporal distribution of eight pharmaceuticals at twenty-four sites of the tributaries of the Han River watershed. In rural areas, the mean concentration (detection frequency) of non-prescription pharmaceuticals (NPPs) was higher (lower) compared to that of prescription pharmaceuticals (PPs); in urban areas, a reverse trend was observed. Pharmaceutical concentrations in urban and rural areas were mainly affected by wastewater treatment plants (WWTPs) and non-point sources, respectively; concentrations were higher downstream (4.9 times) than upstream of the WWTPs. The concentration distribution (according to the target) was as follows: human–veterinary > human > veterinary. Correlation between total concentration and total usage of the pharmaceuticals was high, except for NPPs. Most livestock and land use (except cropland) were significantly positively correlated with pharmaceutical concentrations. Concentrations were mainly higher (1.5 times) during cold seasons than during warm seasons. The results of this study can assist policymakers in managing pharmaceutical pollutants while prioritizing emerging pollutants.

Zero-valent iron enhanced in-situ advanced anaerobic digestion for the removal of antibiotics and antibiotic resistance genes in sewage sludge

The in-situ advanced anaerobic digestion (AAD) enhanced with zero-valent iron powder (ZVI) under mesophilic condition was investigated to remove 5 antibiotics (sulfamerazine (SMR), sulfamethoxazole (SMZ), ofloxacin (OFL), tetracycline (TC), and roxithromycin (ROX)) and 11 antibiotic resistance genes (ARGs) (AAC (6')-IB-CR, qnrS, ermF, ermT, ermX, sul1, sul2, sul3, tetA, tetB, and tetG) in sewage sludge. The effects of different ZVI dosages, antibiotic concentrations, and solid retention time (SRTs) on the removal were explored. Also, the correlation coefficient of antibiotics and ARGs, microbial community structure, biogas production and methane yield were analyzed. All conducted treatments operated stably, and the modified Gompertz model described the cumulative methane yield well. The antibiotics, with the exception of OFL, were effectively removed in the sewage sludge at a dosage of 1000 mg/L ZVI, SRT 20 d, and an antibiotic concentration of 20 μg/L during AAD. The removal rates of SMZ, SMR, TC, and ROX reached 97.39%, 74.54%, 78.61%, and 56.58%, respectively. AAC (6')-IB-CR and tetB could be effectively reduced during the in-situ AAD. Through the redundancy analysis, AAC (6')-IB-CR, ermT, ermX, sul2, tetB, and tetG had strong positive correlations with the antibiotics in the reactor. The principle component analysis revealed that the community structure was similar when the SRT was 10 d and 20 d at the same amount of ZVI and antibiotic concentrations in the sludge. Under the operating parameters of 1000 mg/L ZVI dosage, SRT 20 d, and an antibiotic concentration of 20 μg/L, Erysipelotrichia, Verrucomicrobia, Clostridia, Caldiserica, and Alphaproteobacteria of the class were dominated microorganisms in the anaerobic digestion.

Fate of antibiotics, antibiotic-resistant bacteria, and cell-free antibiotic-resistant genes in full-scale membrane bioreactor wastewater treatment plants

The removal of antibiotics, antibiotic-resistant bacteria (ARB), and cell-free antibiotic-resistant genes (ARGs) and the microbial community of ARB were investigated in detail to understand their fate and provide valuable information on the feasibility of full-scale membrane bioreactor (MBR). The potential risks of cell-free ARGs to the receiving environment were discovered. High influent antibiotic concentration could inhibit the microbial activity of MBR sludge, whereas good antibiotic removal could be maintained because of relatively long solid retention time and high biomass retention. Approximately 61.8%-77.5% of the total antibiotics were degraded, and 22.5%-38.2% of the total antibiotics were adsorbed by MBR sludge on average. The individual antibiotic removal presented intense discrepancy because of the chemical construction and distribution coefficient of antibiotics. Aeromonas exhibited specific antibiotic resistance to ampicillin and erythromycin, Escherichia became the predominant genera in kanamycin-ARB and tetracycline-ARB, and Klebsiella and Bacteroides were the particular genera that exhibited distinct antibiotic resistance to ciprofloxacin. A significant correlation was found between cell-free ARG abundance and ARB content, and relatively high effluent cell-free ARG abundance facilitated the proliferation and transmission of ARB. The impacts of the receiving environment to eliminate the ecological risks and severe threats to human health should be investigated because of the low decay ratio and long-term persistence of cell-free ARGs.

The cotton-strip assay as an environmental surveillance tool for ecological integrity assessment of rivers affected by WWTP effluents

Environmental impact studies of rivers affected by wastewater treatment plant (WWTP) effluents have been greatly restricted by the difficulties associated with carrying out bioassays in the field and also by the complex interactions between the pollutants contained in the discharges. The cotton-strip assay (CSA) enables study of the organic matter decomposition potential, an important ecosystem process in rivers, by taking all of the factors affecting this process into account. However, the CSA has never been used for assessment of WWTP effluents. In the present study, we selected six fluvial zones affected by discharges from small WWTPs and placed cotton strips at increasing distances from the discharge points in each zone. After 17 days, we evaluated decay of the strips by measuring cotton tensile strength loss (CTSL) and cotton mass loss (CML). We then determined the relationships between these parameters and various physico-chemical and biological properties in the water, as well as the δ¹⁵N isotopic signal and metal contents of aquatic mosses transplanted in the same sampling sites and used as biomonitors. Although the WWTPs were similar, some of the discharges stimulated and others inhibited decomposition of the cotton strips. This was probably due to differences in the proportions of various types of pollutants (with trophic or toxic effects) in the discharges. The CSA proved to be a simple, practical and economic bioassay and suitable for evaluating the ecological integrity of fluvial ecosystems.

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.

Testing wastewater treatment plant effluent effects on microbial and detritivore performance: A combined field and laboratory experiment

The amount of pollutants and nutrients entering rivers via point sources is increasing along with human population and activity. Although wastewater treatment plants (WWTPs) greatly reduce pollutant loads into the environment, excess nutrient loading is a problem in many streams. Using a Community and Ecosystem Function (CEF) approach, we quantified the effects of WWTP effluent on the performance of microbes and detritivores associated to organic matter decomposition, a key ecosystem process. We measured organic matter breakdown rates, respiration rates and exo-enzymatic activities of aquatic microbes. We also measured food consumption and growth rates and RNA to body-mass ratios (RNA:BM) of a dominant amphipod Echinogammarus berilloni. We predicted responses to follow a subsidy-stress pattern and differences between treatments to increase over time. To examine temporal effects of effluent, we performed a laboratory microcosm experiment under a range of effluent concentrations (0, 20, 40, 60, 80 and 100%), taking samples over time (days 8, 15 and 30; 4 and 10 replicates to assess microbe and detritivore performance respectively, per treatment and day). This experiment was combined with a field in situ Before-After Control-Impact Paired (BACIP) experiment whereby we added WWTP effluent poured (10 L s^-1 during 20-40 min every 2 h) into a stream and collected microbial and detritivore samples at days 8 and 15 (5 and 15 replicates to assess the microbe and detritivore performance respectively, per period, reach and sampling day). Responses were clearer in the laboratory experiment, where the effluent caused a general subsidy response. Field measures did not show any significant response, probably because of the high dilution of the effluent in stream water (average of 1.6%). None of the measured variables in any of the experiments followed the predicted subsidy-stress response. Microbial breakdown, respiration rates, exo-enzymatic activities and invertebrate RNA:BM increased with effluent concentrations. Differences in microbial respiration and exo-enzymatic activities among effluent treatments increased with incubation time, whereas microbial breakdown rates and RNA:BM were consistent over time. At the end of the laboratory experiment, microbial respiration rates increased 156% and RN:BM 115% at 100% effluent concentration. Detritivore consumption and growth rates increased asymptotically, and both responses increased with by incubation time. Our results indicate that WWTP effluent stimulates microbial activities and alters detritivore performance, and stream water dilution may mitigate these effects.

Aspects Regarding the Pharmaceutical Waste Management in Romania

The issue of drug disposal, as well as the development and implementation of efficient collection strategies, represents an important concern at the highest European level. This research looks into the factors that could have an impact on the efficiency of pharmacies in collecting and disposing the medicinal waste of the population. There were 521 pharmacists from all over the country who filled in a questionnaire on their opinion/attitude related to the system of collecting and disposing the pharmaceutical waste of the population. Of the surveyed pharmacists, 16% work in pharmacies that do not collect unused/expired drugs from the population, and nearly 33% of those investigated have refused, at least once, to take the unused medicines from the people. Pharmacists’ most important reasons for refusing to collect the pharmaceutical waste were the lack of procedure, incomplete legislation, exceeding the amount contracted with the operators, and high costs. Results show that pharmacies in Romania face several deficiencies in the pharmaceutical waste collection services. The lack of implemented programs has contributed considerably to lower standards of pharmaceutical waste management in Romania. This study is the first research on this topic in Romania, a country where the management of drug-based waste generated by the population is at the beginning. The results shown in this survey can provide a reference point for competent authorities in developing and implementing a take-back program for waste medicine whose efficiency is superior to the existing ones.