Pharmaceuticals in the Aquatic Environment: No Answers Yet to the Major Questions

Abstract

The presence of pharmaceuticals in the environment, especially the aquatic environment, has received a lot of attention in the last 20 plus years. Despite that attention, the two most important questions regarding pharmaceuticals in the environment still cannot be answered. It is not possible to put the threat posed by pharmaceuticals into perspective with the many other threats (stressors) facing aquatic organisms, such as low flows due to over‐abstraction of water, inhibited passage of migratory species due to dams and weirs, diseases, algal blooms causing low oxygen levels and releasing toxins, eutrophication, climate change, and so on. Nor is it possible to identify which pharmaceuticals are of concern and which are not. Not only can these key questions not be answered presently, they have received extremely little attention, despite being identified 10 years ago as the two most important questions to answer. That situation must change if resources and expertise are to be effectively used to protect the environment. Environ Toxicol Chem 2022;00:1–6. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Pharmaceuticals and Personal Care Products in the Environment: What Progress Has Been Made in Addressing the Big Research Questions?

“…As demonstrated by the synthesis articles in this special issue, subsequent advances have been palpable, with tools and approaches developed to understand PPCPs also contributing to an improved understanding of other anthropogenic contaminants and natural toxins in environmental matrices. While the science has moved on considerably in the past decade, because of some of the knowledge gaps identified above, Sumpter et al (2024) point out that we are still unable to answer the most important question of 2012: How important are PPCPs relative to other chemicals and nonchemical stressors in terms of biological impacts in the natural environment? This is despite the fact that over 18,000 documents are now available on the occurrence, effects, and risks of PPCPs in the environment (Sumpter et al, 2024).…”

“…While the science has moved on considerably in the past decade, because of some of the knowledge gaps identified above, Sumpter et al (2024) point out that we are still unable to answer the most important question of 2012: How important are PPCPs relative to other chemicals and nonchemical stressors in terms of biological impacts in the natural environment? This is despite the fact that over 18,000 documents are now available on the occurrence, effects, and risks of PPCPs in the environment (Sumpter et al, 2024). It would be depressing if, in 2032, we are in a similar situation.…”

Towards Precision Ecotoxicology: Leveraging Evolutionary Conservation of Pharmaceutical and Personal Care Product Targets to Understand Adverse Outcomes Across Species and Life Stages

“…Acceleration within these efforts, along with developments in precision medicine and precision environmental health science, has provided a foundation from which precision ecotoxicology can move forward. However, much more basic and translational work is needed across scales of biological organization and environmental gradients for PPCPs within the context of other stressors (Mo et al, 2024;Sumpter et al, 2024). As with other basic science advances within the ecotoxicology discipline, translation to the practice of risk assessment will be crucial to advance environmental management (Oldenkamp et al, 2024).…”

Environmental Risks of Pharmaceutical Mixtures in Aquatic Ecosystems: Reflections on a Decade of Research

“…Real‐world exposures are characterized by the co‐occurrence of dozens of different APIs, together with many other environmental chemicals (Bradley et al, 2019; Loos et al, 2013) and with nonchemical stressors such as elevated temperatures, decreased oxygen, and habitat loss; as such, API effects are challenging to isolate from this context (Sumpter et al, 2024). Nonetheless, given that empirical evidence consistently shows that the joint risk of complex exposures exceeds the risk of each individual chemical at the concentration at which it is present (Rudén et al, 2019, and references therein), a realistic assessment of the impacts of APIs on exposed organisms and ecosystems needs to account for mixture effects and could include both prospective and retrospective approaches (Diamond et al, 2018).…”