Identification and prioritization of bioaccumulable pharmaceutical substances discharged in hospital effluents

Jean, Julien; Perrodin, Yves; Pivot, C.; Trepo, D.; Perraud, M.; Droguet, J.; Tissot-Guerraz, F.; Locher, François

doi:10.1016/j.jenvman.2012.03.005

Cited by 80 publications

(52 citation statements)

References 56 publications

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“…The absence of diversity at point 5, which receives the discharge of effluents from a morgue and hospital, may have been due to difficulty of isolating Gram-positive bacteria and the lack of selectivity of the blood agar used for bacterial cultures. Another possible explanation for the difficulty in isolating Grampositive bacteria was the presence of high concentrations of toxic substances in hospital effluents, such as antibiotics, cytostatic agents, heavy metals, disinfectants and hormones, which could have a genotoxic effect on these bacteria (Jean et al, 2012;Devarajan et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Microbiota sampled from a polluted stream in Recife-PE, Brazil and its importance to public health

PurificaÃ§ao¹,

Araujo²,

Lópes³

et al. 2017

Afr. J. Microbiol. Res.

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Pollution of water bodies can cause environmental and public health problems. The Cavouco stream is a tributary of the Capibaribe River, one of the main rivers in the state of Pernambuco, Brazil, and receives a high pollution load from residential, laboratory and hospital effluents. The aim of the present study was to perform phenotypic and molecular characterization in this stream, and evaluate the water quality using microbiological parameters. Water was collected from five sampling points, and bacterial species were identified using biochemical and molecular methods through 16S rRNA gene sequence analysis. Total and thermotolerant coliforms were also quantified. Fermenting Gram-negative bacilli from the family Enterobacteriaceae (Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis), non-fermenting bacilli (Pseudomonas aeruginosa and Pseudomonas putida) and Gram-positive bacilli (Bacillus cereus, Bacillus licheniformis, Bacillus pumilus and Staphylococcus hominis) were identified. A total of 25 bacterial isolates were phenotypically identified. All phenotypic identifications were confirmed by molecular analysis, except for S. hominis, which was molecularly identified as Exiguobacterium. Regarding water quality, all analyzed samples were positive for total and thermotolerant coliforms. The results obtained suggest that the Cavouco stream presents a potential risk for transmission of water-borne diseases, because of the presence of pathogenic bacteria. In addition, the current state of the stream also threatens the conservation of its native species.

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Section: Discussionmentioning

confidence: 99%

Microbiota sampled from a polluted stream in Recife-PE, Brazil and its importance to public health

PurificaÃ§ao¹,

Araujo²,

Lópes³

et al. 2017

Afr. J. Microbiol. Res.

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“…L'établissement de cette liste a été effectué en deux étapes (JEAN et al, 2012). Le premier travail a consisté en l'établissement de la liste de l'ensemble des médicaments consommés dans l'ensemble des hôpitaux des HCL.…”

Section: Etablissement D'une Liste De Médicaments Bioaccumulables Priunclassified

“…Dans un deuxième temps, nous avons identifié parmi ceux-ci, et à l'aide de bases de données internationales, les médicaments dont le facteur de bioconcentration (BCF) théorique était supérieur à 1000. Enfin, à l'aide de trois critères de sélection supplémentaires (quantité consommée, biodégradabilité, et écotoxicité), nous avons sélectionné une liste finale de 14 molécules considérées comme prioritaires à caractériser expérimentalement (JEAN et al, 2012). …”

Section: Etablissement D'une Liste De Médicaments Bioaccumulables Priunclassified

Évaluation des risques écotoxicologiques liés aux effluents hospitaliers et recommandations de gestion

Perrodin

Orias

Boillot

et al. 2015

rseau

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L’évaluation des risques écotoxicologiques des effluents hospitaliers est nécessaire pour leur gestion, étant donnée leur richesse en polluants potentiellement toxiques pour les organismes aquatiques, tels que les désinfectants, les détergents, ou les résidus médicamenteux. Pour ce faire, une batterie de tests d’écotoxicité complémentaires a tout d’abord été déployée sur différents sites des Hospices Civils de Lyon. Le suivi de l’écotoxicité des effluents au cours d’une journée moyenne d’activité a montré la forte évolution de ces derniers en fonction des activités du site. La mesure de l’écotoxicité de la fraction particulaire des effluents a démontré la contribution majeure de cette dernière à l’écotoxicité globale de l’effluent. Parallèlement à ces travaux expérimentaux, une étude théorique, portant sur l’ensemble des médicaments consommés dans les hôpitaux de Lyon, a mis en évidence 14 médicaments prioritaires à étudier en raison de leur caractère particulièrement bioaccumulables, et pouvant de ce fait conduire à un impact important sur les organismes et les chaines trophiques. Une évaluation des risques écotoxicologiques de ces médicaments a ensuite été engagée, couplant l’estimation de leur concentration dans le milieu récepteur, et la caractérisation de leur écotoxicité. Cette évaluation des risques écotoxicologiques a montré l’importance des médicaments bioaccumulables dans le risque global présenté par les effluents hospitaliers. Sur la base de l’ensemble de ces résultats, des réflexions ont été engagées en vue de la réduction des risques, via le traitement à la source et/ou le prétraitement de ces effluents avant rejet au réseau urbain.

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“…Hospitals and patient care facilities are major dispensers of pharmaceuticals [12,25] with a number of studies and reviews evaluating hospital drug dispensing patterns and estimations of sewage outflow concentrations [12]. These have led to conflicting conclusions as to the magnitude of this pollution discharge relative to other non-hospital based activities.…”

Section: Introductionmentioning

confidence: 99%

Pharmaceutical Dispensing and Wasting In Health Care Facilities, Amounts, Costs and Evaluation of Potential Ecologic Effects

Mankes¹,

Silver²

2017

SOJPPS

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Drug waste from hospitals contributes to environmental contamination. Patient excreta, bathing or discarding of excess drugs are some sources of drug waste. We report on the wasting of 84 drugs of 14 therapeutic classes in two hospitals in Albany, NY. We consider drug metabolism, excretion, disposal and ecotoxicity in strategies for reducing drug waste, costs and potential environmental damage.Medication (12,345) and waste collection (199) records for: drugs dispensed, returned and wasted were examined. Of 2,700 drugs available, 84 drugs from 14 classes, weighing 56 kg were dispensed to patients, and 2.3 kg were wasted. Twelve drugs accounted for 80 percent of the drug waste and cost $111,000. Of the top wasted and dispensed drugs, all but ibuprofen are persistant and none were bioaccumulative. Ibuprofen, ipratropium ondansetron and oxymetazoline are "very highly toxic" or "highly toxic". Environmental Risk Ratio (PEC/PNEC) for the 20 top drugs were"Insignificant" or "Cannot Be Excluded".Acetazolamide is the most toxic to fish. Dexamethasone has the greatest chronic toxicity to Ceriodaphnia. Ibuprofen is predicted to be very highly toxic (acute and chronic) to zebra mussel, crab and fish. Neostigmine is the most acutely toxic (LC50<1 mg/L) to Daphnia. Ondansetron is the most acutely toxic to green algae. All but 2 of the drugs were 5 to 100% excreted. Fourteen were metabolised. Active metabolites were formed from 2 drugs. Nicardipine, ondansetron and prednisone formed drug conjugates which were excreted. Incineration was the manufacturer's recommended disposal method.We recommend excess drugs be returned to the hospital pharmacy for disposal by incineration. Drug use and disposal should be monitored by an expert committee according to recognized guidelines of pharmaceutical management. Knowledge of the adverse impacts from the release of highly toxic drugs into the environment must influence drug selection and disposal.Key words: Waste; Ecotoxicity; Wastewater; Abbreviations AMCH = Academic Medical Center Hospital; ASTER = Assessment Tools for the Evaluation of Risk. United States Environmental Protection Agency https://archive.epa.gov/med/med_archive_03/web/html/ aster.html Last accessed 6/4/17; B = Bioaccumulation is the general term describing a process by which chemicals are taken up by an organism either directly from exposure to a contaminated medium or by consumption of food containing the chemical; EC50 = Effective Concentration producing an adverse effect in 50% of a test species; EbC50 or ErC50 = EC50 in terms of reduction of growth rate; EyC50 = EC50 in terms of change in biomass yield; Ecosar = Ecologic Structure Activity Relationships is a computerized predictive system that estimates aquatic toxicity. The program estimates a chemical's acute (short-term) toxicity and chronic (long-term or delayed) toxicity to aquatic organisms such as fish, invertebrates, and plants by using computerized Structure Activity Relationships (SARs). https://www.epa.gov/tsca-screening-tools/ ecological-structure-...

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Identification and prioritization of bioaccumulable pharmaceutical substances discharged in hospital effluents

Cited by 80 publications

References 56 publications

Microbiota sampled from a polluted stream in Recife-PE, Brazil and its importance to public health

Microbiota sampled from a polluted stream in Recife-PE, Brazil and its importance to public health

Évaluation des risques écotoxicologiques liés aux effluents hospitaliers et recommandations de gestion

Pharmaceutical Dispensing and Wasting In Health Care Facilities, Amounts, Costs and Evaluation of Potential Ecologic Effects

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