Emissions from Medical Care Units

Kümmerer, Klaus

doi:10.1007/978-3-662-09259-0_3

Cited by 12 publications

(4 citation statements)

References 40 publications

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“…However, we assume that the volume must be relatively low. If this is any indication, the total volume of cyclophosphamide used in 1996 in Germany, a country with a higher population than Canada, was only 250 kg [31]. This information would suggest that low use and absence of hospitals in some municipalities, combined with dilution, is the most plausible explanation for why this compound was not detected in final effluents.…”

Section: Resultsmentioning

confidence: 99%

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Pharmaceutically active compounds in Atlantic Canadian sewage treatment plant effluents and receiving waters, and potential for environmental effects as measured by acute and chronic Aquatic Toxicity

Brun

Bernier

Losier

et al. 2006

Enviro Toxic and Chemistry

191

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Ten acidic and two neutral pharmaceuticals were detected in the effluents of eight sewage treatment plants (STPs) from across Atlantic Canada. Concentrations varied between nondetectable and 35 microg/L. The analgesic, nonsteroidal anti-inflammatory drugs ibuprofen and naproxen were predominant. Carbamazepine, a neutral compound used as an antiepileptic drug, was observed consistently at a median concentration of 79 ng/L. Acetaminophen was found in the effluents of the three largest mechanical STPs at a median concentration of 1.9 microg/L, but not in the lagoon treatment systems. The substantially longer hydraulic retention times may have contributed to more effective removal of acetaminophen in the lagoon treatment systems. Drugs generally were not detected at significant concentrations in the larger bodies of receiving water (Saint John River, Hillsborough River, and Bedford Bay, Canada). However, drug residues in the small receiving streams were 15 to 30% of the effluent median concentrations. Six compounds (caffeine, naproxen, salicylic acid, carbamazepine, metoprolol, and sotolol) were found to persist in a small stream for a distance of at least 17 km, suggesting that small stream exposure to pharmaceutically active residues may be relatively greater than that in large bodies of water. Bioassays assessing acute and chronic effects on four organisms were conducted on four high-use drugs: Acetaminophen, ibuprofen, naproxen, and salicylic acid (metabolite of acetyl salicylic acid). Results indicated no negative effects except for the chronic algal (Selanastrum capricornutum) growth test on ibuprofen (no-observed-effect concentration, 10 microg/L; lowest-observed-effect concentration, 32 microg/L). Effects of these four compounds on invertebrates and plants in the receiving environments are unlikely based on the concentrations measured.

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Section: Resultsmentioning

confidence: 99%

“…Cytostatic drugs remain important chemicals to monitor in the environment, because they are relatively persistent and have well‐established carcinogenic, mutagenic, and fetotoxic properties [31]. Ifosfamide is another chemotherapeutic drug very similar to cyclophosphamide that was not incorporated into the 2003 suite of chemicals.…”

Section: Resultsmentioning

confidence: 99%

Pharmaceutically active compounds in Atlantic Canadian sewage treatment plant effluents and receiving waters, and potential for environmental effects as measured by acute and chronic Aquatic Toxicity

Brun

Bernier

Losier

et al. 2006

Enviro Toxic and Chemistry

191

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“…Agents used for the disinfection of medical instruments are also captured by RIVM (2001); however, according to the EC (2008b) these are regulated by the Medical Devices Directive 93/42/EEC (MDD 1993) and do not fall under the scope of the BPD (1998). Frequently used active ingredients in this application field were aldehydes, alkylamines, glycol derivatives, guanidines, and pyridines and QACs (Table 4).…”

Section: Resultsmentioning

confidence: 99%

“…According to the BPD (1998), only those amounts of an active ingredient have to be evaluated that are within the scope of this directive. It is now a common situation that the same biocidal product, e.g., a disinfectant used for both surfaces and medical instruments, falls under 2 different directives, BPD (1998) and MDD (1993). Similarly, in some EU member states, a skin disinfectant may be regarded as a biocide, whereas in others, it comes within the regulations for human pharmaceuticals or medical devices (Stengel 2008).…”

Section: Resultsmentioning

confidence: 99%

Emission of biocides from hospitals: Comparing current survey results with European Union default values

Tluczkiewicz

Bitsch

Hahn

et al. 2010

Integr Envir Assess & Manag

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Under the European Union (EU) Biocidal Products Directive 98/8/EC, comprehensive evaluations on substances of the Third Priority List were conducted until 31 July 2007. This list includes, among other categories, disinfectants for human hygiene (e.g., skin and surface disinfection). For environmental exposure assessment of biocides, the EU emission scenarios apply. Currently available default values for disinfectants are based on consumption data from not more than 8 hospitals and were originally assembled for other purposes. To revalidate these default values, a survey on annual consumption data was performed in 27 German hospitals. These data were analyzed to provide consumption data per bed and day and per nurse and day for particular categories of active ingredients and were compared with default values from the EU emission scenario documents. Although several deviations were detected, an overall acceptable correspondence between Emission Scenario Documents default values and the current survey data was found.

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Detection and Occurrence of PPCPs in the Environment

Jjemba

2008

Pharma‐Ecology

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Emissions from Medical Care Units

Cited by 12 publications

References 40 publications

Pharmaceutically active compounds in Atlantic Canadian sewage treatment plant effluents and receiving waters, and potential for environmental effects as measured by acute and chronic Aquatic Toxicity

Pharmaceutically active compounds in Atlantic Canadian sewage treatment plant effluents and receiving waters, and potential for environmental effects as measured by acute and chronic Aquatic Toxicity

Emission of biocides from hospitals: Comparing current survey results with European Union default values

Detection and Occurrence of PPCPs in the Environment

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