Environmental side effects of pharmaceutical cocktails: What we know and what we should know

Abstract

Cocktails of pharmaceuticals are released in the environment after human consumption and due to the incomplete removal at the wastewater treatment plants. Pharmaceuticals are considered as contaminants of emerging concern and, a plethora of journal articles addressing their possible adverse effects have been published during the past 20 years. The emphasis during the early years of research within this field, was on the assessment of acute effects of pharmaceuticals applied singly, leading to results regarding their environmental risk, potentially not realistic or relevant to the actual environmental conditions. Only recently has the focus been shifted to chronic exposure and to the assessment of cocktail effects. To this end, this review provides an up-to-date compilation of 57 environmental and human toxicology studies published during 2000-2014 dealing with the adverse effects of pharmaceutical mixtures. The main challenges regarding the design of experiments and the analysis of the results regarding the effects of pharmaceutical mixtures to different biological systems are presented and discussed herein. The gaps of knowledge are critically reviewed highlighting specific future research needs and perspectives.

Implementation of the method of electrochemical destruction during disposal of pharmaceutical glass waste

“…It was determined that pharmaceuticals, which include many therapeutic groups, such as antibiotics, analgesics, anticancer drugs, contraceptives, and antidepressants, exhibit pronounced toxic effects to the environment [7]. The interaction of the components can occur and the toxicity of total exposure to organisms can be increased in a mixture which contains several pharmaceutical substances.…”

Dissipation of Micropollutants in a Rewetted Fen Peatland: A Field Study Using Treated Wastewater

“…The interaction between the plants, substrate and associated microbial communities, as well as the mixture of micropollutants, triggers the removal and transformation processes [14,15]. Wetland plant communities (e.g., Phragmites australis and Typha latifolia) contribute to the removal of micropollutants either by direct uptake or by Hypothetical scheme for the improved elimination of micropollutants present in treated wastewater used to rewet peatlands that serve as buffer zones for surface water (instead of directly discharging treated wastewater from the WWTP into the receiving surface water).…”

“…The interaction between the plants, substrate and associated microbial communities, as well as the mixture of micropollutants, triggers the removal and transformation processes [14,15]. Wetland plant communities (e.g., Phragmites australis and Typha latifolia) contribute to the removal of micropollutants either by direct uptake or by enabling aerobic degradation by pumping oxygen into the wet ground via their aerenchym [16].…”

The Enhancement of H2O2/UV AOPs for the Removal of Selected Organic Pollutants from Drinking Water with Hydrodynamic Cavitation

“…8,6,7 Due to the presence of numerous species, their harmful effects are multiplied by the so-called "cocktail effect". 9 Their persistency in the environment and the bioaccumulation are of further concern, as well as the challenges of drinking and waste water treatment, since they are poorly responsive to the removal by traditional technologies (e.g. coagulation, flocculation, oxidation, filtration, biological treatment etc.).…”

“…coagulation, flocculation, oxidation, filtration, biological treatment etc.). 8,6,9 Advanced oxidation processes (AOPs) have already been well-researched and practically applied for the treatment of recalcitrant natural and synthetic organic pollutants in drinking water.…”