018530 - SWITCH Sustainable Water Management in the City of the Future Integrated Project Global Change and Ecosystems Deliverable 4.1.2 Listing the most important pharmaceutical compounds from various therapeutic groups and the testing and validation of analytical methods for the selected compounds 4.1.2 A. Pre-selection of representative compounds for laboratory degradation tests 4.1.2 B Survey of the mostly used pharmaceutical compounds and hormones in the West Bank/Palestine 4.1.2 C. Estrogens in aquatic environment: A review. Due date of deliverable: 14 th February 2007 Actual submission date: 14 th February 2007 Start date of project: 1 February 2006 Duration: 60 months Authors : Katarzyna Kujawa-Roeleveld, Ime Akanyeti WU, Environmental Technology, Wageningen, The Netherlands Nidal Mahmoud, Water Studies Institute (WSI), Birzeit University, The West Bank, Palestine Wenxin Shi, IHE-UNESCO, Delft, The Netherlands Final Version Reviewer: Adriaan Mels Project co-funded by the European Commission within the Sixth Framework Programme (2002-2006) Dissemination Level PU Public Pu PP Restricted to other programme participants (including the Commission Services) RE Restricted to a group specified by the consortium (including the Commission Services) CO Confidential, only for members of the consortium (including the Commission Services) 1 SWITCH Deliverable Briefing Note (months 0-12) SWITCH Document Deliverable 4.1.2 consists of three parts: (A) Pharmaceutical compounds in environment Pre-selection of representative compounds for laboratory degradation tests (B) Survey of the mostly used pharmaceutical compounds and hormones in the West Bank/ Palestine (C) Estrogens in aquatic environment: A review Audience This document is targeted at scientists, engineers and policy makers. Purpose The purpose of this document was to give: - a general overview on a variety and nature of human pharmaceutical compounds and their pathways into the environment; - a overview of the characteristics of the compounds in relation to their possible behaviour in a wastewater treatment system; - to make a pre-selection of a few representative compounds deserving special attention in further SWITCH laboratory research aiming at the removal potential of pharmaceutical compounds and their metabolites from concentrated domestic wastewater streams using proven biological, chemical-physical treatment technologies. Background Human pharmaceuticals are consumed in high quantities world wide; the consumption is in the range of tons per year per one pharmaceutical compound depending on the size of a country. The expectations are that these amounts will only keep increasing because of improving health care systems worldwide and longer life expectations of people. Conventional, sewer-based, sanitation systems are characterised by a high degree of dilution and many pharmaceutical compounds are not sufficiently removed. Discharge of these compound to surface water may form a threat to aquatic life and in the worst case may re-enter the water cycle through raw water intake from surface water or ground water. To minimise these risks source control is an interesting option. Applying separation of wastewater streams of different origin (black water, grey water) and their target treatment enables to keep pharmaceuticals concentrated in black water and urine and provide for effective removal. The reason that pharmaceutical compounds in the environment receive much attention is that they have been developed to perform a specific biological effect in human (and other) organisms. Next to, they possessed several common features like e.g. polarity or persistence to prevent their inactivation before they pose a therapeutic effect. This already indicates that if these substances are not eliminated prior to discharge they may enter aquatic and terrestrial ecosystems resulting in bioaccumulation and provoking environmental effects. The knowledge on the fate of pharmaceuticals during a variety of treatment technologies is, despite of significant scientific efforts, limited. To design an optimal treatment system that is able to eliminate the majority, if not all, of entering pharmaceutical micro-pollutants has not been possible yet. 2 Potential Impact Retrofit of existing treatment plants- or source control by implementation of source separated based sanitation system to remove human pharmaceutical would eliminate or minimize the potential risk of these compounds entering essential water resources, the risk of exposure of aquatic organisms to these micro-pollutants and the potential effect and accumulation of specific compounds in environment. Examples of proven effects have been already reported in different parts of the world. Since retrofit of the whole sanitation is not possible on a short term, the attention can focus in the first instance on significant point sources of emissions such as hospitals, nursery houses etc. For instance target treatment of (whole) hospital pharmaceuticals containing wastewater (black water = toilet water) would reduce total emission of certain, specific antibiotics even up to 80% (examples: Ampicillin, Penicillin G., Vancomycin). Issues - although the issue of the pharmaceuticals in the environment attracts a lot of attention, especially, of the scientific world. Within the EU there are no policies and standards yet that define which compounds should be removed and to which level. - analytical methods to determine pharmaceuticals in a complex matrix are complex, time-consuming and costly; for many pharmaceutical compounds they have not even been developed/validated yet - the fate of excretion, next to the parent compound, of (active) metabolites/conjugates in wastewater treatment systems is generally unclear. Recommendations The problem of pharmaceuticals in the environment requires wider recognition. Adequate measures are needed to minimize the emissions of human pharmaceuticals to the environment, such as: • technical (upgrading of existing treatment systems, • introduction of source separation and application of appropriate techniques for degradation of persistent pharmaceutical compounds, • on-site treatment for significant point sources like hospitals, elderly houses and • non-technical (increase public awareness, justified use of certain compound (e.g. avoid excessive use of anti-biotics and of very persistent pharmaceuticals), limit sell over the counter, etc.) For technical measures comprehensive knowledge on degradation and removal pathways (biological, chemical, physical) is necessary to establish. 3 Table of content Preface....................................................................................................................................................................6 1 Introduction ...................................................................................................................................................7 2 General characteristics of pharmaceuticals....................................................................................................8 3 Pharmaceutical metabolism and excretion...................................................................................................10 4 Sources of emission of pharmaceutical compounds ....................................................................................12 5 Variety of pharmaceutical compounds ........................................................................................................13 5.1 Group A: alimentary tract and metabolism .......................................................................................13 5.2 Group B: blood and blood forming organs........................................................................................13 5.3 Group C: cardiovascular system........................................................................................................13 5.4 Group J: antibiotics ...........................................................................................................................15 5.5 Group N: nervous system ..................................................................................................................15 5.6 Group pain relievers, antiphlogistics, analgesics, anti-inflammatories, non-steroidal drugs.............17 5.7 Group V: contrast media ...................................................................................................................18 6 Properties of pharmaceuticals......................................................................................................................19 7 Quantities of pharmaceuticals used (Dutch situation) .................................................................................21 8 Occurrence in aquatic environment .............................................................................................................25 8.1 Wastewater........................................................................................................................................25 8.2 Hospital wastewater ..........................................................................................................................25 8.3 Surface water.....................................................................................................................................25 8.4 Ground water.....................................................................................................................................27 8.5 Drinking water...................................................................................................................................27