Cytostatics in Dutch surface water Use, presence and risks to the aquatic environment RIVM Letter report 2018-0067 C. Moermond et al. Cytostatics in Dutch surface water Use, presence and risks to the aquatic environment RIVM Letter report 2018-0067 C. Moermond et al. RIVM Letter report 2018-0067 Colophon © RIVM 2018 Parts of this publication may be reproduced, provided acknowledgement is given to: National Institute for Public Health and the Environment, along with the title and year of publication. DOI 10.21945/RIVM-2018-0067 C. Moermond (auteur/coördinator), RIVM B. Venhuis (auteur/coördinator),RIVM M. van Elk (auteur), RIVM A. Oostlander (auteur), RIVM P. van Vlaardingen (auteur), RIVM M. Marinković (auteur), RIVM J. van Dijk (stagiair; auteur) RIVM Contact: Caroline Moermond VSP-MSP
[email protected] This investigation has been performed by order and for the account of the Ministry of Infrastructure and Water management (IenW), within the framework of Green Deal Zorg en Ketenaanpak medicijnresten uit water. This is a publication of: National Institute for Public Health and the Environment P.O. Box 1 | 3720 BA Bilthoven The Netherlands www.rivm.nl/en Page 2 of 140 RIVM Letter report 2018-0067 Synopsis Cytostatics in Dutch surface water Cytostatics are important medicines to treat cancer patients. Via urine, cytostatic residues end up in waste water that is treated in waste water treatment plants and subsequently discharged into surface waters. Research from RIVM shows that for most cytostatics, their residues do not pose a risk to the environment. They are sufficiently metabolised in the human body and removed in waste water treatment plants.