Retrospective environmental risk assessment of human pharmaceuticals in the Nordic countries 1997-2007

Analysis, occurrence, fate and risks of proton pump inhibitors, their metabolites and transformation products in aquatic environment: A review

“…General findings from the study, showed more limited utilization of the PPIs among Central and Eastern European countries compared with Western European countries (Godman et al, 2011). Furthermore, Woldegiorgis et al (2009), reported that omeprazole and esomeprazole belong to the top-40 selling drugs in Nordic countries during 1997Nordic countries during -2007. In all Nordic countries, omeprazole is the major PPI substance on the markets.…”

“…Nevertheless for both compounds sales in Sweden have increased by 63% (from 1 tonne in 1997 to approximately 2.5 tonnes in 2007). In Denmark, and Norway the consumption has increased in a similar fashion (74-77%), while the sales increase in Finland and Iceland in amounts of 89-90%, respectively (Woldegiorgis et al, 2009). Finally, Ortiz de García et al (2013), estimated the consumption of PPIs sold taking into account the number of packages commercialized in 2009, and the results showed that the consumption of omeprazole, pantoprazole, lansoprazole and esomeprazole was 13, 850-27,710, 3410-6820, 2020 and 806-3226 kg/year, respectively.…”

“…Recent studies have reported the increment of PPIs utilization and consumption, in European countries year by year (Godman et al, 2009(Godman et al, , 2011Woldegiorgis et al, 2009). In particular, Godman et al (2009), captured utilization of dispensed prescriptions of PPIs in ambulatory care from 2001 to 2007, using defined daily doses (DDD) as well as DDDs/1000 inhabitants/day (DDD/TID) for patients covered by the social health insurance system, in Austria.…”

“…Based on this aspect, a retrospective environmental risk assessment study of PPIs was conducted by Woldegiorgis et al (2009) in the Nordic countries during the period 1997-2007, concerning surface water. In particular, initially a retrospective environmental risk assessment was made based on the sales over the preceding decade (based on PEC/PNEC-quotients) in surface water.…”

“…For example, low concentrations of omeprazole were detected in urban and hospital WWTPs as well as in surface and river waters Kosma et al, 2014b;Pedrouzo et al, 2008;Valcárcel et al, 2011). Although, PPIs are not regularly detected, considering their high use (Godman et al, 2009(Godman et al, , 2011Woldegiorgis et al, 2009) its analytical monitoring becomes relevant. In addition, in view of the recent reports dealing with the detection of many metabolites and environmental Transformation Products (TPs) in aqueous samples (Boix et al, 2013(Boix et al, , 2014Boleda et al, 2013;Hernández et al, 2011;Gracia-Lor et al, 2014;Ibáñez et al, 2016;López et al, 2014;Ibáñez et al, 2016), environmental contamination by PPIs should be checked and evaluated more thoroughly.…”