Environmental Pollution from Pharmaceuticals
Abstract
1. Introduction
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- Discharge of effluents from urban wastewater treatment plants containing pharmaceuticals and unused medications improperly disposed of in toilets and sinks, despite the existence of proper collection systems;
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- Spreading of livestock effluents;
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- Aquaculture, where pharmaceuticals are often administered with feed.
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- Discharge of effluents from manufacturing plants (particularly outside the European Union);
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- Spreading of sewage sludge containing drugs eliminated from wastewater;
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- Livestock grazing;
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- Pet care;
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- Improper disposal of unused drugs and contaminated waste in landfills.
2. Impact on Ecosystems
Pharmacological Class |
---|
Analgesics |
Antibiotics |
Antidepressants |
Antidiabetics |
Antiepileptics |
Antihypertensives |
Anti-Inflammatories |
Antineoplastics |
Antipsychotics |
Antivirals |
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- EE2 excretion in urine from individuals taking oral contraceptives; wastewater treatment plants cannot always eliminate it completely;
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- Entry into rivers, lakes, and eventually oceans, causing several negative effects on marine ecosystems;
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- Hormonal dysfunctions, as EE2 acts as an endocrine disruptor, altering the hormonal systems of aquatic organisms;
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- Feminization of male fish, leading to abnormal production of female-typical proteins (such as vitellogenin) and, in some cases, reduced fertility.
3. Risks to Human Health
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- Fertilizer usage quantities;
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- Drinking water treatment methods;
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- Drug exposure concentrations.
4. Studies and Results
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- Ofloxacin
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- Furosemide
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- Atenolol
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- Hydrochlorothiazide
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- Carbamazepine
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- Ibuprofen
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- Spiramycin
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- Bezafibrate
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- Erythromycin
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- Lincomycin
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- Clarithromycin
5. Risk Scenarios
6. Possible Non-Legislative Actions
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- Developing and harmonizing unused medicine collection systems;
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- Strengthening source separation and wastewater treatment measures;
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- Disseminating information and educating the population;
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- Making medicines more environmentally friendly.
7. Legislative Factors
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- Innovate to obtain safe and sustainable chemicals in the EU;
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- Strengthen the EU legal framework to address urgent environmental and health concerns;
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- Simplify and consolidate measures to improve the legal framework;
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- Build a comprehensive knowledge base regarding chemicals;
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- Set an example for good global chemical management.
8. Ecopharmacovigilance (EPV)
9. Environmental Risk Assessment
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- Article 8 Directive 2001/83/EC;
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- Article 12 Directive 2001/83/EC.
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- Electrolytes, peptides, proteins, vitamins, and other compounds naturally present in the environment;
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- Companion animal medicines, and medicines for minor species bred and treated similarly to major species with existing environmental risk assessments;
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- Medicines used to treat small numbers of animals within flocks or herds.
10. Union Policy
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- All agglomerations serving at least 1000 population equivalents (p.e.) must have secondary treatment for biodegradable pollutant removal by 2035;
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- All agglomerations serving at least 150,000 p.e. must have tertiary treatment for nitrogen and phosphorus removal by 2039;
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- All agglomerations serving at least 150,000 p.e., and in some cases more than 10,000 p.e., must have quaternary treatment for certain micropollutant removal by 2045.
11. Water Safety Plan
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- Physical methods: Various filter types (sand, membrane, etc.) can remove particle-bound medicines through different processes, such as reverse osmosis, depending on membrane pore diameter;
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- Chemical methods: Advanced oxidation processes with specific reagents used to oxidize medicines.
12. Watch List
13. Analytical Strategies for the Identification of Pharmaceutical Products
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- Mass spectrometry (4%);
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- Capillary electrophoresis (3%);
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- Gas chromatography (2%);
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- Electrochemical methods (1.2%).
14. Conclusions
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- Avoid accumulation and improper use: Purchase only necessary medicines and avoid self-medication to reduce waste risk and drug resistance, especially antibiotic resistance [16];
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- Dispose of expired or unused medicines correctly: Do not dispose of them in sinks or regular waste; place them in appropriate containers available at pharmacies, which ensure safe disposal;
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- Support research into greener medicines: Promote the development of medicines with lower environmental impact, both in composition and packaging;
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- Spread best practices: Raise population awareness through educational campaigns involving schools, pharmacies, and health facilities.
Author Contributions
Funding
Conflicts of Interest
References
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Substance | Class | Effect |
---|---|---|
Fenfluramine | Anorectic | Enhances serotonin (5-HT) release in shrimp, triggering ovarian stimulating hormone release, resulting in increased oocyte and vitelline quantities in fiddler crabs; stimulates gonad stimulating hormone production, accelerating testicular maturation |
17α-ethinyl estradiol | Synthetic steroid | Endocrine interference effects on fish, reptiles, and invertebrates |
Methyltestosterone | Synthetic steroid | Intersex conditions, reduced fecundity, altered oogenesis and spermatogenesis in snails |
Avermectins | Antiparasitic | Adult insects: water balance loss, feeding disruption, reduced fat accumulation, delayed ovarian development, decreased fecundity, impaired mating. Juvenile insects: developmental delay, reduced growth rates, physical abnormalities, impaired pupation or emergence, loss of developmental symmetry |
Tetracyclines, Macrolides, Streptomycin | Antibacterial | Antibacterial resistance measured in soil bacteria from pig slurry-treated sites |
Cypermethrin | Ectoparasiticide | Impact on manure decomposition |
Fenbendazole | Antiparasitic | Impact on manure decomposition |
Tylosin | Antibacterial | Impact on soil microbial community digestion |
Erythromycin | Antibacterial | Growth inhibition in cyanobacteria and aquatic plants |
Tetracycline | Antibacterial | Growth inhibition in cyanobacteria and aquatic plants |
Ibuprofen | Anti-inflammatory | Growth stimulation in cyanobacteria and growth inhibition in aquatic plants |
Fenofibrate | Lipid regulator | Inhibition of basal EROD activity in rainbow trout hepatocyte cultures |
Carbamazepine | Analgesic | Inhibition of basal EROD activity in rainbow trout hepatocyte cultures, inhibition of Chironomus riparius emergence |
Diclofenac | Analgesic | Inhibition of basal EROD activity in rainbow trout hepatocyte cultures |
Drug | Average Purifier Concentrations (IN) ng/L | Average Purifier Concentrations (OUT) ng/L | Average Surface Water Concentrations ng/L |
---|---|---|---|
Paracetamol | 2715 | 8 | 17 |
Atenolol | 1682 | 526 | 220 |
Ibuprofen | 1406 | 60 | 98 |
Naproxen | 1057 | 209 | 86 |
Ketoprofen | 1011 | 173 | 14 |
Clarithromycin | 960 | 466 | 195 |
Bezafibrate | 829 | 457 | 46 |
Diclofenac | 675 | 469 | 260 |
Carbamazepine | 636 | 245 | 121 |
Ciprofloxacin | 618 | 202 | 34 |
Ofloxacin | 546 | 294 | 97 |
Hydrochlorothiazide | 531 | 349 | 174 |
Furosemide | 508 | 554 | 59 |
Dehydro-erythromycin | 269 | 202 | 62 |
Gemfibrozil | 211 | 23 | 16 |
Ranitidine | 115 | 78 | 8 |
Sulfamethoxazole | 90 | 75 | 7 |
Enalapril | 87 | 12 | 5 |
Vancomycin | 65 | 22 | 8 |
Atorvastatin | 64 | 11 | 2 |
Name of Substance or Group | CAS Number (1) | EU Number (2) | Analysis Methods (3), (4) | Maximum Detection Limit (ng/L) |
---|---|---|---|---|
Metaflumizone | 139968-49-3 | 604-167-6 | LLE-LC-MS-MS or SPE-LC-MS-MS | 65 |
Amoxicillin | 78 | |||
Ciprofloxacin | 89 | |||
Sulfamethoxazole (5) | 100 | |||
Trimethoprim (5) | 100 | |||
Venlafaxine and O-desmethylvenlafaxine (6) | 6 | |||
Azole compounds: (7) | ||||
Clotrimazole | 23593-75-1 | 245-764-8 | 20 | |
Fluconazole | 86386-73-4 | 627-806-0 | 250 | |
Imazalil | 35554-44-0 | 252-615-0 | 800 | |
Ipconazole | 125225-28-7 | 603-038-1 | 44 | |
Metconazole | 125116-23-6 | 603-031-3 | 29 | |
Penconazole | 66246-88-6 | 245-324-5 | 200 | |
Prochloraz | 67747-09-5 | 266-276-6 | 1700 | |
Tebuconazole | 107534-96-3 | 266-994-5 | 161 | |
Tetraconazole | 112281-77-3 | 403-640-2 | 240 | |
407-760-6 | 1900 | |||
Dimoxystrobin | 149961-32-4 | 604-712-8 | SPE-LC-MS-MS | 32 |
Famoxadone | 131807-57-3 | 603-520-1 | SPE-LC-MS-MS | 8.5 |
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Zampelli, S.; Verna, R. Environmental Pollution from Pharmaceuticals. Life 2025, 15, 1341. https://doi.org/10.3390/life15091341
Zampelli S, Verna R. Environmental Pollution from Pharmaceuticals. Life. 2025; 15(9):1341. https://doi.org/10.3390/life15091341
Chicago/Turabian StyleZampelli, Stefania, and Roberto Verna. 2025. "Environmental Pollution from Pharmaceuticals" Life 15, no. 9: 1341. https://doi.org/10.3390/life15091341
APA StyleZampelli, S., & Verna, R. (2025). Environmental Pollution from Pharmaceuticals. Life, 15(9), 1341. https://doi.org/10.3390/life15091341