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Human Health Risk Assessment of Pharmaceuticals in Water: Issues and Challenges Ahead

Department of Civil Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India
School of Civil and Environmental Engineering, Georgia Institute of Technology, 215 Sustainable Education Building, 788 Atlantic Drive NW, Atlanta, GA 30332, USA
Department of Civil and Environmental Engineering, A124 Engineering Research Complex, Michigan State University, East Lansing, MI 48824, USA
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2010, 7(11), 3929-3953;
Received: 28 September 2010 / Revised: 22 October 2010 / Accepted: 29 October 2010 / Published: 5 November 2010
(This article belongs to the Special Issue Drinking Water and Health)
This study identified existing issues related to quantitative pharmaceutical risk assessment (QPhRA, hereafter) for pharmaceuticals in water and proposed possible solutions by analyzing methodologies and findings of different published QPhRA studies. Retrospective site-specific QPhRA studies from different parts of the world (U.S.A., United Kingdom, Europe, India, etc.) were reviewed in a structured manner to understand different assumptions, outcomes obtained and issues, identified/addressed/raised by the different QPhRA studies. Till date, most of the published studies have concluded that there is no appreciable risk to human health during environmental exposures of pharmaceuticals; however, attention is still required to following identified issues: (1) Use of measured versus predicted pharmaceutical concentration, (2) Identification of pharmaceuticals-of-concern and compounds needing special considerations, (3) Use of source water versus finished drinking water-related exposure scenarios, (4) Selection of representative exposure routes, (5) Valuation of uncertainty factors, and (6) Risk assessment for mixture of chemicals. To close the existing data and methodology gaps, this study proposed possible ways to address and/or incorporation these considerations within the QPhRA framework; however, more research work is still required to address issues, such as incorporation of short-term to long-term extrapolation and mixture effects in the QPhRA framework. Specifically, this study proposed a development of a new “mixture effects-related uncertainty factor” for mixture of chemicals (i.e., mixUFcomposite), similar to an uncertainty factor of a single chemical, within the QPhRA framework. In addition to all five traditionally used uncertainty factors, this uncertainty factor is also proposed to include concentration effects due to presence of different range of concentration levels of pharmaceuticals in a mixture. However, further work is required to determine values of all six uncertainty factors and incorporate them to use during estimation of point-of-departure values within the QPhRA framework. View Full-Text
Keywords: human health; pharmaceuticals; mixture toxicity; risk assessment; uncertainty human health; pharmaceuticals; mixture toxicity; risk assessment; uncertainty
MDPI and ACS Style

Kumar, A.; Chang, B.; Xagoraraki, I. Human Health Risk Assessment of Pharmaceuticals in Water: Issues and Challenges Ahead. Int. J. Environ. Res. Public Health 2010, 7, 3929-3953.

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