Wastewater analysis: the mean of the monitoring of frequently prescribed pharmaceuticals in Slovakia.

The estimation of medication use is based on the statistical data from pharmacies and hospitals. Excessive use or misuse of some compounds, especially psychoactive medications, has not yet been monitored in Slovakia. Wastewater analysis provides useful data about the medication use and misuse in individual regions. This study is focused on the analysis of 23 substances in the wastewaters of Slovakia. The monitoring programme has included stimulants, opioid and morphine derivatives, benzodiazepines, antidepressants, drug precursors and their metabolites. Urinary markers of these compounds were analysed at WWTP influent in seven regions (Bratislava, Kosice, Zvolen, Banská Bystrica, Trencín, Presov a Piestany) using LC-MS/MS technique. The analysis was performed from March to October 2013. The pattern in use of these compounds was also monitored. Tramadol and venlafaxine were found to be the most concentrated compounds among of all studied psychoactive pharmaceuticals. The highest specific loads of tramadol were detected in Piestany (409 mg/day/1000 inhabitants) and Zvolen (366 mg/day/1000 inhabitants). There is a considerable number of spa facilities (hotels) situated in these cities and this fact contributes to a higher occurrence of these psychoactive compounds in respective wastewaters.

National monitoring of nicotine use in Czech and Slovak Republic based on wastewater analysis.

The aim of this study was to compare estimation of nicotine use in Slovakia (SR) and the Czech Republic (CR) based on cotinine analysis in wastewater from seven selected wastewater treatment plants (WWTPs) with conventional estimation based on tobacco product sales. Urinary bio-markers of nicotine use were analyzed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). The study was performed concurrently at all the WWTPs (from 11 to 18 March 2014). Representative 24 h composite samples were analyzed with on line SPE/LC-MS/MS method. Based on the average residence time of wastewater in the sewers and the average time in the sampling device, specific correction coefficients were designed to improve estimation of nicotine consumption. Nicotine ingestion level was back-calculated and expressed as mass of pure drug consumed per day and per 1000 inhabitants for selected cities of both countries (mean, 2.2 g for Piestany and 8.0 g for Nitra, respectively). Consequently, the cigarette consumption results were recalculated for each country separately and compared with the data of both national statistical offices (2362 cigarettes/year/person--SR and 2088 cigarettes/year/person--CR). Our results highly correspond to the data of national statistical offices (up to 99.9% in SR and to 96% in CR). The average amount of money invested in cigarette sales was estimated in the capitals of both countries. It is about 1 million EUR/day for Prague and about 0.3 million EUR/day for Bratislava. The calculation of nicotine consumption, utilizing a specific correction coefficient, is the correct way to obtain more accurate data in drug studies of this kind, thus allowing a better drug abuse assessment.

Fate of psychoactive compounds in wastewater treatment plant and the possibility of their degradation using aquatic plants.

In this study we analyzed and characterized 29 psychoactive remedies, illicit drugs and their metabolites in single stages of wastewater treatment plants in the capital city of Slovakia. Psychoactive compounds were present within all stages, and tramadol was detected at a very high concentration (706 ng/L). Significant decreases of codeine, THC-COOH, cocaine and buprenorphine concentration were observed in the biological stage. Consequently, we were interested in the possibility of alternative tertiary post-treatment of effluent water with the following aquatic plants: Cabomba caroliniana, Limnophila sessiliflora, Egeria najas and Iris pseudacorus. The most effective plant for tertiary cleansing was I. pseudacorus which demonstrated the best pharmaceutical removal capacity. After 48 h codeine and citalopram was removed with 87% efficiency. After 96 h were all analyzed compounds were eliminated with efficiencies above 58%.

National study of illicit drug use in Slovakia based on wastewater analysis.

The aim of this study was to analyze illicit drugs and their metabolites in wastewater from eight selected wastewater treatment plants (WWTPs) in Slovakia. The effect of two of the biggest music festivals in Slovakia on illicit drugs in wastewater was also investigated. Urinary bio-markers of amphetamine, methamphetamine, cocaine, cannabis and ecstasy use were analyzed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). We then compared our results with data obtained in other parts of Europe and the world. This study demonstrates that Slovakia has one of highest methamphetamine consumption rates in Europe. Within Slovakia, the highest level of methamphetamine consumption was found in Petrzalka, where the mean specific load of this drug in sewage was 169 mg/day/1000 inhabitants; the next highest loads were detected in Piestany (128 mg/day/1000 inhabitants) and Bratislava (124 mg/day/1000 inhabitants). Amphetamine, ecstasy and cannabis consumption in our study were comparable to that found in other European cities, whereas cocaine consumption was lower. We also analyzed the pattern of drug consumption over the course of a week. The load of the cocaine metabolite benzoylecgonine in wastewater increased during the weekend. The use of this drug was most common in the capital of Slovakia. Increased consumption was also found during a folk festival in Piestany. The ecstasy load in wastewater from larger cities also significantly increased over the weekend. An increase of drug consumption was also detected during a music festival in Trencín, especially for ecstasy. The specific load of ecstasy during this festival increased from 3mg/day/1000 inhabitants to 29 mg/day/1000 inhabitants. The possible influence of music styles on the consumption of certain drugs was also observed. During a folk festival, methamphetamine and cocaine were more commonly used.

Pilot study of seasonal occurrence and distribution of antibiotics and drug resistant bacteria in wastewater treatment plants in Slovakia.

This work presents environmental and quality-control data from the analyses of 33 antibiotics in influent and effluent water from two waste water treatment plants (WWTPs) in the capital and the biggest city of Slovakia. Seeing that consumption of antibiotics depends on epidemiological season, samples were collected during February and August. Among assessed antibiotics ciprofloxacin and clarithromycin were detected in highest concentrations in influent water. Seasonal changes were observed only in plant A when antibiotic concentrations decreased. On the other hand an increase in some cases was observed in plant B. Insufficient degradation of some macrolides, sulfonamides and trimethoprim was detected according to their higher concentrations in effluent water. Contact of antibiotics in subinhibitory concentrations and sludge bacteria in WWTPs represent the base for the development of significant levels of microbial resistance. Simultaneously, antibiotic resistance of fecal coliforms and fecal streptococci from sewage sludge was evaluated. Majority of coliform bacteria were found to be resistant to ampicillin and gentamicin. A significant seasonal difference was determined only in case of high-level resistance. In summer samples, an increase in the strains resistant to concentrations higher than the resistance breakpoints established by EUCAST and NCCLS was observed. No antibiotic resistance in streptococci was observed. However, as a part of sewage sludge is mixed with compost and utilized in agriculture, better processing of sludge should be considered.