Occurrence and distribution of pharmaceuticals in wastewater from households, livestock farms, hospitals and pharmaceutical manufactures

Contribution of hospital effluents to the load of pharmaceuticals in urban wastewaters: Identification of ecologically relevant pharmaceuticals

“…The levels of carbamazepine reported in this study are in agreement with previous findings reported in Greece (up to 1900 ng L − 1 ) (Kosma et al, 2010). However, higher concentrations (up to 14,400 ng L − 1 ) were detected in the effluents of four general hospitals in Korea (Sim et al, 2011), while in Italy the levels of carbamazepine ranged from 640 to 1200 ng L − 1 (Verlicchi et al, 2012a) and in USA did not exceed 37 ng L − 1 (Nagarnaik et al, 2011). In what concern to lorazepam, lower concentrations (from 170 to 790 ng L − 1 ) were reported in Italy (Verlicchi et al, 2012a).…”

“…Comparatively to previous findings, Thomas et al (2007) reported higher levels of acetaminophen (329,852 ng L − 1 ) in the effluents of hospitals from Oslo (Norway), while ibuprofen did not exceed 8957 ng L − 1 .On the other hand, lower concentrations of these pharmaceuticals were detected in the effluents of two Italian hospitals, where acetaminophen levels went from 1400 to 5900 ng L − 1 and ibuprofen from 380 to 3200 ng L − 1 (Verlicchi et al, 2012a). Opposite to this trend, Sim et al (2011) never detected acetaminophen or ibuprofen in effluents from four general hospitals in Korea. These findings may be correlated with differences in pharmaceuticals consumption among countries.…”

“…Nevertheless, levels up to 12,800 ng L − 1 were detected in hospital effluents in Sweden (Lindberg et al, 2004). Sim et al (2011) studied the presence of different antibiotics in the effluents of four general hospitals, in Korea, showing that only trimethoprim had higher concentrations (95,100 ng L − 1 ) than those reported in the present study (3963 ng L − 1 ), while ciprofloxacin, sulfamethoxazole and erythromycin showed lower concentrations (up to 3080, 3840 and 470 ng L − 1 , respectively). Moreover, Ohlsen et al (2003) also determined the presence of several antibiotics in the effluent of a university hospital in Würzburg (Germany), reporting concentrations of erythromycin (up to 6000 ng L − 1 ), which are in agreement with the present findings (up to 7545 ng L − 1 in the maternity hospital).…”

“…These changes will have impact on pharmaceuticals detected in hospital effluents, since they are closely related with the substances that are being administered in a certain hospital as well as their quantities. Several authors have shown the presence of pharmaceuticals in hospital wastewaters (Gómez et al, 2006;Lin and Tsai, 2009;Sim et al, 2011;Verlicchi et al, 2012a;Weissbrodt et al, 2009). Furthermore, hospital effluents also play an important role in the introduction of pathogens into public wastewaters, especially concerning multi-resistant bacteria, contributing to the spread of antibiotic resistance into the environment (Kümmerer, 2009).…”

Ecological effects of pharmaceuticals in aquatic systems—impacts through behavioural alterations

“…In surface waters, concentrations of pharmaceuticals usually range from low ng l 21 to low mg l 21 , and are correlated to human population density in the drainage area, volume of the receiving water body and technologies used in STPs [21,24,25], but certain point sources, such as pharmaceutical production and manufacturing facilities, can result in concentrations as high as mg l 21 in receiving surface waters [25 -27]. A wide range of pharmaceuticals has been found in freshwater systems [21,28,29].…”