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Volume 23
Issue 7
10.3390/ijerph23070838
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Review

Incorporating a Screening-Level Risk Quotient (RQ_screen) for Assessing Human Health Risk of Pharmaceutical Residues in Consumption Water

by
Gabriel Souza-Silva
1,
Igor F. C. Santos
2,
Inês B. Gomes
3,
Manuel Simões
3,
Micheline R. Silveira
1,
Vítor J. P. Vilar
4 and
Ana I. Gomes
4,*
1
Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil
2
Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil
3
Laboratory for Process Engineering, Environment, Biotechnology and Energy, ALiCE, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
4
Laboratory of Separation and Reaction Engineering-Laboratory of Catalysis and Materials, ALiCE, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2026, 23(7), 838; https://doi.org/10.3390/ijerph23070838 (registering DOI)
Submission received: 14 May 2026 / Revised: 10 June 2026 / Accepted: 23 June 2026 / Published: 25 June 2026
(This article belongs to the Special Issue Pharmaceutical Pollution in Aquatic Ecosystems: Public Health Risks and Sustainable Solutions)
Versions Notes

Abstract

Pharmaceutical residues are increasingly detected in aquatic environments and are recognized as contaminants of emerging concern. This systematic literature review compiled and evaluated published concentrations of pharmaceutical residues in bottled water, tap water, and surface water in Portugal, applying risk quotient (RQ) and screening-level risk quotient (RQ_screen) approaches to evaluate potential human health risks and prioritize contaminants. Assessment based on the compiled literature data across age groups showed bottled and tap water posed low risk, while surface water presented the highest concern, with compounds spanning the full risk spectrum. Key contributors to potential human health risk included hormones (17-alpha-ethinylestradiol, 17-beta-estradiol, estrone), ramipril, betamethasone, citalopram, and amoxicillin. RQ_screen highlighted compounds relevant for ongoing monitoring even in treated waters, such as carbamazepine, diclofenac, salicylic acid, warfarin, fluoxetine, and erythromycin, due to their persistence and toxicological significance. Both RQ and RQ_screen indicated higher risk values for infants and children, reflecting lower body weight and higher water intake per unit mass, underscoring the need for age-specific evaluations. The RQ_screen method proved useful for contaminant prioritization, identifying substances relevant for monitoring despite low concentrations. Overall, this systematic review highlights pharmaceutical residues as an emerging public and environmental health concern in Portugal and emphasizes the importance of targeted monitoring and risk-based management within a One Health framework.
Keywords: aquatic environments; contaminants of emerging concern; human health risk assessment; One Health; pharmaceutical residues aquatic environments; contaminants of emerging concern; human health risk assessment; One Health; pharmaceutical residues

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MDPI and ACS Style

Souza-Silva, G.; Santos, I.F.C.; Gomes, I.B.; Simões, M.; Silveira, M.R.; Vilar, V.J.P.; Gomes, A.I. Incorporating a Screening-Level Risk Quotient (RQ_screen) for Assessing Human Health Risk of Pharmaceutical Residues in Consumption Water. Int. J. Environ. Res. Public Health 2026, 23, 838. https://doi.org/10.3390/ijerph23070838

AMA Style

Souza-Silva G, Santos IFC, Gomes IB, Simões M, Silveira MR, Vilar VJP, Gomes AI. Incorporating a Screening-Level Risk Quotient (RQ_screen) for Assessing Human Health Risk of Pharmaceutical Residues in Consumption Water. International Journal of Environmental Research and Public Health. 2026; 23(7):838. https://doi.org/10.3390/ijerph23070838

Chicago/Turabian Style

Souza-Silva, Gabriel, Igor F. C. Santos, Inês B. Gomes, Manuel Simões, Micheline R. Silveira, Vítor J. P. Vilar, and Ana I. Gomes. 2026. "Incorporating a Screening-Level Risk Quotient (RQ_screen) for Assessing Human Health Risk of Pharmaceutical Residues in Consumption Water" International Journal of Environmental Research and Public Health 23, no. 7: 838. https://doi.org/10.3390/ijerph23070838

APA Style

Souza-Silva, G., Santos, I. F. C., Gomes, I. B., Simões, M., Silveira, M. R., Vilar, V. J. P., & Gomes, A. I. (2026). Incorporating a Screening-Level Risk Quotient (RQ_screen) for Assessing Human Health Risk of Pharmaceutical Residues in Consumption Water. International Journal of Environmental Research and Public Health, 23(7), 838. https://doi.org/10.3390/ijerph23070838

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