Human health risk assessment of pharmaceuticals in the European Vecht River

Abstract

Active pharmaceutical ingredients (APIs) can reach surface waters used for drinking water extraction and recreational activities, such as swimming and fishing. The aim of the present study was to systematically assess the lifetime human health risks posed by 15 individual APIs and their mixtures occurring in the German-Dutch transboundary Vecht River. An exposure model was developed and used to assess the combined risks of oral and dermal exposure under a variety of exposure conditions. A total of 4500 API uptake values and 165 lifetime risk values were estimated for 15 and 11 APIs, respectively. Overall, the lifetime human health risks posed by the APIs and their mixtures based on modeling results were deemed acceptable under typical exposure conditions. Under very extreme environmental conditions and human behavior, API mixture risks were of potential concern while the risks of individual APIs were negligible, with a few exceptions. The antibiotic doxycycline and analgesic phenazone showed the highest and lowest risks, respectively. The study did not evaluate the potential risks caused by metabolite compounds. Recommendations for water managers are provided to help improve the accuracy and utility of human health risk assessments of pharmaceuticals.

Drinking Water Systems as a Cocktail of Emerging Organic Contaminants: Occurrence, Public Health Risks, and Research Needs

“…A previous study detected extremely high concentrations of amoxicillin (87-272.150 ng/L) in drinking water systems, which is linked to the development of ARB, posing a challenge in disease management [45]. In a study, the exposure risks and hazard quotients (HQ) of antibiotics commonly found in drinking water ranged from 10-9 to 2.5 [166]. Doxycycline had the highest HQ, exceeding the risk threshold (HQ=1).…”

“…All the other antibiotics studied had HQs below the risk threshold, indicating a low likelihood of causing health risks. Risks of pharmaceutical mixtures were higher (HQ ranging from 10 −2 to 2.6) than any individual [166]. Despite the increase in HQ values, the hazard index (HI) fell below those that can cause lifetime health risks.…”