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.

Sewage epidemiology is a rapidly expanding field that can provide information on illicit drug usage in communities, based on the measured concentrations in samples from wastewater treatment plants (WWTPs). In this study, select illicit drugs (six drugs and eight metabolites) were determined on a daily basis for a week in wastewater, suspended particulate matter (SPM), and sludge from two WWTPs in the Albany area in New York State. The WWTP that served a larger population (∼100 000, with a flow rate of 83 300 m(3)/d) showed 3.2 (methadone) to 51 (3,4-methylenedioxyamphetamine; MDA) times higher mass flows of illicit drugs than did the WWTP that served a smaller population (∼15 000, with a flow rate of 6850 m(3)/d). The consumption rate of target illicit drugs in the communities served by the two WWTPs was estimated to range from 1.67 to 3510 mg/d/1000 people. Between the dissolved and particulate phases, the fraction of methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), amphetamine, and MDA sorbed to SPM ranged from 34.3% to 41.1% of the total mass in the waste stream. The removal efficiencies of illicit drugs from the two WWTPs ranged from 4% (norcocaine) to 99% (cocaine); however, methamphetamine, methadone, and EDDP showed a negative removal in WWTPs. The environmental emission of illicit drugs from WWTP discharges was calculated to range from 0.38 (MDEA) to 67.5 (EDDP) mg/d/1000 people. Other markers such as caffeine, paraxanthine, nicotine, and cotinine were found to predict the concentrations of select illicit drugs in raw wastewater (r(2) = 0.20-0.79; p ≤ 0.029).

Very few studies describe the fate of artificial sweeteners (ASWs) in wastewater treatment plants (WWTPs). In this study, mass loadings, removal efficiencies, and environmental emission of sucralose, saccharin, aspartame, and acesulfame were determined based on the concentrations measured in wastewater influent, primary effluent, effluent, suspended particulate matter (SPM), and sludge collected from two WWTPs in the Albany area of New York State, U.S.A. All ASWs were detected at a mean concentration that ranged from 0.13 (aspartame) to 29.4 μg/L (sucralose) in wastewater influent, 0.49 (aspartame) to 27.7 μg/L (sucralose) in primary influent, 0.11 (aspartame) to 29.6 μg/L (sucralose) in effluent, and from 0.08 (aspartame) to 0.65 μg/g dw (sucralose) in sludge. Aspartame was found in 92% of influent SPM samples at a mean concentration of 444 ng/g dw, followed by acesulfame (92 ng/g) and saccharin (49 ng/g). The fraction of the total mass of ASWs sorbed to SPM was in the rank order: aspartame (50.4%) > acesulfame (10.9%) > saccharin and sucralose (0.8%). The sorption coefficients of ASWs ranged from 4.10 (saccharin) to 4540 L/kg (aspartame). Significant removal of aspartame (68.2%) and saccharin (90.3%) was found in WWTPs; however, sucralose and acesulfame were less efficiently removed (<2.0%). The total mass loading of sucralose, saccharin, and acesulfame in the WWTP that served a smaller population (∼15 000) was 1.3−1.5 times lower than that in another WWTP that served a larger population (∼100 000). The average daily loading of sucralose in both WWTPs (18.5 g/d/1000 people) was ∼2 times higher than the average loading of saccharin. The daily discharge of sucralose from the WWTPs was the highest (17.6 g/d/1000 people), followed by acesulfame (1.22 g/d/1000 people), and saccharin (1.07 g/d/1000 people). Approximately, 1180 g of saccharin and 291 g of acesulfame were transformed in or removed daily from the two WWTPs. This is the first study to describe the fate of ASWs, including the fraction found in SPM and in sludge, in addition to the aqueous portion of wastewater in WWTPs.