Landfill disposal of unused medicines reduces surface water releases.

The pharmaceutical industry is conducting research to evaluate the pathways and fate of active pharmaceutical ingredients from the consumer to surface waters. One potential pathway identified by the researchers is the disposal of unused pharmaceutical products that are discarded by consumers in household trash and disposed of in municipal solid waste landfills. This study was designed to evaluate relative amounts of surface water exposures through the landfill disposal pathway compared to patient use and flushing of unused medicine pathways. The estimated releases to surface water of 24 example active pharmaceutical ingredients (APIs) in landfill leachate were calculated for 3 assumed disposal scenarios: 5%, 10%, and 15% of the total annual quantity of API sold is discarded and unused. The estimated releases from landfills to surface waters, after treatment of the leachate, were compared to the total amount of each example API that would be released to surface waters from publicly owned treatment works, generated by patient use and excretion. This study indicates that the disposal of unused medications in municipal solid waste landfills effectively eliminates the unused medicine contribution of APIs to surface waters; greater than 99.9% of APIs disposed of in a landfill are permanently retained.

Predicting concentrations of trace organic compounds in municipal wastewater treatment plant sludge and biosolids using the PhATE™ model.

This article presents the capability expansion of the PhATE™ (pharmaceutical assessment and transport evaluation) model to predict concentrations of trace organics in sludges and biosolids from municipal wastewater treatment plants (WWTPs). PhATE was originally developed as an empirical model to estimate potential concentrations of active pharmaceutical ingredients (APIs) in US surface and drinking waters that could result from patient use of medicines. However, many compounds, including pharmaceuticals, are not completely transformed in WWTPs and remain in biosolids that may be applied to land as a soil amendment. This practice leads to concerns about potential exposures of people who may come into contact with amended soils and also about potential effects to plants and animals living in or contacting such soils. The model estimates the mass of API in WWTP influent based on the population served, the API per capita use, and the potential loss of the compound associated with human use (e.g., metabolism). The mass of API on the treated biosolids is then estimated based on partitioning to primary and secondary solids, potential loss due to biodegradation in secondary treatment (e.g., activated sludge), and potential loss during sludge treatment (e.g., aerobic digestion, anaerobic digestion, composting). Simulations using 2 surrogate compounds show that predicted environmental concentrations (PECs) generated by PhATE are in very good agreement with measured concentrations, i.e., well within 1 order of magnitude. Model simulations were then carried out for 18 APIs representing a broad range of chemical and use characteristics. These simulations yielded 4 categories of results: 1) PECs are in good agreement with measured data for 9 compounds with high analytical detection frequencies, 2) PECs are greater than measured data for 3 compounds with high analytical detection frequencies, possibly as a result of as yet unidentified depletion mechanisms, 3) PECs are less than analytical reporting limits for 5 compounds with low analytical detection frequencies, and 4) the PEC is greater than the analytical method reporting limit for 1 compound with a low analytical detection frequency, possibly again as a result of insufficient depletion data. Overall, these results demonstrate that PhATE has the potential to be a very useful tool in the evaluation of APIs in biosolids. Possible applications include: prioritizing APIs for assessment even in the absence of analytical methods; evaluating sludge processing scenarios to explore potential mitigation approaches; using in risk assessments; and developing realistic nationwide concentrations, because PECs can be represented as a cumulative probability distribution. Finally, comparison of PECs to measured concentrations can also be used to identify the need for fate studies of compounds of interest in biosolids.

Human health risk assessment of carbamazepine in surface waters of North America and Europe.

A human health risk assessment was carried out for environmental exposures to carbamazepine (CBZ) and its major human metabolites, carbamazepine diol (CBZ-DiOH) and carbamazepine N-glucuronide (CBZ-N-Glu). Carbamazepine is an active pharmaceutical ingredient (API) used worldwide as a medicine for treating epileptic seizures and trigeminal neuralgia. Carbamazepine tends to be detected in surface water more frequently, and at relatively higher concentrations, than most other APIs. Predicted no effect levels (PNECs) for CBZ and its major human metabolites were developed for surface waters to be protective of human health from environmental exposures from drinking water and fish consumption. These PNECs were compared to both measured (MEC) and predicted (PEC) environmental concentrations for North America and Europe. PECs were calculated using the geo-referenced models PhATE for North America and GREAT-ER for Europe. The combined PNEC for drinking water and fish consumption for CBZ is 226,000ng/L. Ninetieth percentile MECs ranged from 150 to 220ng/L, while 90th percentile PECs ranged from 333 to 658ng/L. Calculated margins of safety (MOS) therefore range from 340 to 1500. MOS for the major metabolites are significantly higher. This assessment indicates that CBZ and its major metabolites have high MOS (>>1) and thus should have no appreciable risk to human health through environmental exposures based on available human data.

Exposure assessment of 17alpha-ethinylestradiol in surface waters of the United States and Europe.

An evaluation of measured and predicted concentrations of 17-ethinylestradiol in surface waters of the United States and Europe was conducted to develop expected long-term exposure concentrations for this compound. Measured environmental concentrations (MECs) in surface waters were identified from the literature. Predicted environmental concentrations (PECs) were generated for European and U.S. watersheds using the GREAT-ER and PhATE models, respectively. The majority of MECs are nondetect and generally consistent with model PECs and conservative mass balance calculations. However, the highest MECs are not consistent with concentrations derived from conservative (worst-case) mass balance estimates or model PECs. A review of analytical methods suggests that tandem or high-resolution mass spectrometry methods with extract cleanup result in lower detection limits and lower reported concentrations consistent with model predictions and bounding estimates. Based on model results using PhATE and GREAT-ER, the 90th-percentile low-flow PECs in surface water are approximately 0.2 and 0.3 ng/L for the United States and Europe, respectively. These levels represent conservative estimates of long-term exposure that can be used for risk assessment purposes. Our analysis also indicates that average concentrations are one to two orders of magnitude lower than these 90th-percentile estimates. Higher reported concentrations (e.g., greater than the 99th-percentile PEC of approximately 1 ng/L) could result from methodological problems or unusual environmental circumstances; however, such concentrations are not representative of levels generally found in the environment, warrant special scrutiny, and are not appropriate for use in risk assessments of long-term exposures.

Human health risk assessment from the presence of human pharmaceuticals in the aquatic environment.

Assessments for potential impact to human health from environmental exposures were carried out for 44 active pharmaceutical ingredients (APIs) marketed by GlaxoSmithKline (GSK), representing approximately 22 general pharmacological classes exhibiting a broad spectrum of therapeutic activities. These assessments use the considerable amount of information available on the human pharmacology and toxicology of the APIs to develop acceptable daily intakes (ADIs) which are believed to be without pharmacological or toxicological effect. With the exception of the anti-cancer drugs and some antibiotics, the minimum dose producing the intended therapeutic effect was typically used as the point of departure for calculation of ADIs. The ADI values were used to generate predicted no effect concentrations from environmental exposure for human health (PNEC(HH)s) from drinking water or fish consumption. These PNECs were compared to predicted environmental concentrations (PECs) calculated using the regional assessment models PhATE for North America and GREAT-ER for Europe. Risk was characterized by calculating the ratio of the 90th percentile PECs to the PNEC(HH)s. For the APIs reported here, these ratios are less than one for all of the compounds, varying from 7x10(-2) to 6x10(-11), indicating that based upon currently available data, these compounds do not appear to pose an appreciable risk to human health from potential environmental exposure from drinking water and fish consumption.

Consideration of exposure and species sensitivity of triclosan in the freshwater environment.

Triclosan (TCS) is a broad-spectrum antimicrobial used in consumer products including toothpaste and hand soap. After being used, TCS is washed or rinsed off and residuals that are not biodegraded or otherwise removed during wastewater treatment can enter the aquatic environment in wastewater effluents and sludges. The environmental exposure and toxicity of TCS has been the subject of various scientific and regulatory discussions in recent years. There have been a number of publications in the past 5 y reporting toxicity, fate and transport, and in-stream monitoring data as well as predictions from aquatic risk assessments. State-of-the-science probabilistic exposure models, including Geography-referenced Regional Exposure Assessment Tool for European Rivers (GREAT-ER) for European surface waters and Pharmaceutical Assessment and Transport Evalutation (PhATE) for US surface waters, have been used to predict in-stream concentrations (PECs). These models take into account spatial and temporal variability in river flows and wastewater emissions based on empirically derived estimates of chemical removal in wastewater treatment and in receiving waters. These model simulations (based on realistic use levels of TCS) have been validated with river monitoring data in areas known to be receiving high wastewater loads. The results suggest that 90th percentile (low flow) TCS concentrations are less than 200 ng/L for the Aire-Calder catchment in the United Kingdom and between 250 ng/L (with in-stream removal) and 850 ng/L (without in-stream removal) for a range of US surface waters. To better identify the aquatic risk of TCS, a species sensitivity distribution (SSD) was constructed based on chronic toxicity values, either no observed effect concentrations (NOECs) or various percentile adverse effect concentrations (EC10-25 values) for 14 aquatic species including fish, invertebrates, macrophytes, and algae. The SSD approach is believed to represent a more realistic threshold of effect than a predicted no effect concentration (PNEC) based on the data from the single most sensitive species tested. The log-logistic SSD was used to estimate a PNEC, based on an HC5,50 (the concentration estimated to affect the survival, reproduction and/or growth of 5% of species with a 50% confidence interval). The PNEC for TCS was 1,550 ng/L. Comparing the SSD-based PNEC with the PECs derived from GREATER and PhATE modeling to simulate in-river conditions in Europe and the United States, the PEC to PNEC ratios are less than unity suggesting risks to pelagic species are low even under the highest likely exposures which would occur immediately downstream of wastewater treatment plant (WWTP) discharge points. In-stream sorption, biodegradation, and photodegradation will further reduce pelagic exposures of TCS. Monitoring data in Europe and the United States corroborate the modeled PEC estimates and reductions in TCS concentrations with distance downstream of WWTP discharges. Environmental metabolites, bioaccumulation, biochemical responses including endocrine-related effects, and community level effects are far less well studied for this chemical but are addressed in the discussion. The aquatic risk assessment for TCS should be refined as additional information becomes available.

Environmental risk assessment of paroxetine.

Paroxetine hydrochloride hemihydrate (the active ingredient in Paxil) is a pharmaceutical compound used for the treatment of depression, social anxiety disorder, obsessive compulsive disorder, panic disorder, and generalized anxiety disorder. Paroxetine (PA) is extensively metabolized in humans, with about 97% of the parent compound being excreted as metabolites through the urine and feces of patients. Therefore PA and metabolites have the potential to be discharged into wastewater treatment systems after therapeutic use. PA and its major human metabolite (PM) were investigated using studies designed to describe physical/chemical characteristics and determine their fate and effects in the aquatic environment. A significant portion of the PM entering a wastewater treatment plant would be expected to biodegrade given the higher activated sludge solids concentrations present in a typical wastewater treatment plant. The potential for direct photolysis of PM is also possible based on photolysis results for PA itself. These results provide strong support for expecting that PA and PM residuals will not persist in the aquatic environment after discharge from a wastewater treatment facility. This conclusion is also supported by the results of a USGS monitoring study, where no PM was detected in any of the samples at the 260 ng/L reporting limit. The results presented here also demonstrate the importance of understanding the human metabolism of a pharmaceutical so that the appropriate molecule(s) is used for fate and effects studies. In addition to the PA fate studies, PM was investigated using studies designed to determine potential environmental effects and a predicted no effect level (PNEC). The average measured activated sludge respiration inhibition value (EC50) for PM was 82 mg/L. The measured Microtox EC50 value was 33.0 mg/L, while the Daphnia magna EC50 value was 35.0 mg/L. The PNEC for PM was calculated to be 35.0 microg/L. Fate data were then used in a new watershed-based environmental risk assessment model, PhATE, to predict environmental concentrations (PECs). Comparison of the calculated PECs with the PNEC allows an assessment of potential environmental risk. Within the 1-99% of stream segments in the PhATE model, PEC values ranged from 0.003 to 100 ng/L. The risk assessment PEC/PNEC ratios ranged from approximately 3 x 10(-8) to approximately 3 x 10(-3), indicating a wide margin of safety, since a PEC/PNEC ratio <1 is generally considered to represent a low risk to the environment. In addition, Microtox studies carried out on PM biodegradation byproducts indicated no detectable residual toxicity. Any compounds in the environment as a result of the biodegradation of PM should be innocuous polar byproducts that should not exert any toxic effects.

Screening analysis of human pharmaceutical compounds in U.S. surface waters.

The PhATE (Pharmaceutical Assessment and Transport Evaluation) model presented in this paper was developed as a tool to estimate concentrations of active pharmaceutical ingredients (APIs) in U.S. surface waters that result from patient use (or consumption) of medicines. PhATE uses a mass balance approach to model predicted environmental concentrations (PECs) in 11 watersheds selected to be representative of most hydrologic regions of the United States. The model divides rivers into discrete segments. It estimates the mass of API that enters a segment from upstream or from publicly owned treatment works (POTW) and is subsequently lost from the segment via in-stream loss mechanisms or flow diversions (i.e., man-made withdrawals). POTW discharge loads are estimated based on the population served, the API use per capita, the potential loss of the compound associated with human use (e.g., metabolism), and the portion of the API mass removed in the POTW. Simulations using three surrogate compounds showthat PECs generated by PhATE are generally within an order of magnitude of measured concentrations and that the cumulative probability distribution of PECs for all watersheds included in PhATE is consistent with the nationwide distribution of measured concentrations of the surrogate compounds. Model simulations for 11 APIs yielded four categories of results. (1) PECs fit measured data for two compounds. (2) PECs are below analytical method detection limits and thus are consistent with measured data for three compounds. (3) PECs are higher than (i.e., not consistent with) measured data for three compounds. However, this may be the consequence of as yet unidentified depletion mechanisms. (4) PECs are several orders of magnitude below some measured data but consistentwith most measured data forthree compounds. For the fourth category, closer examination of sampling locations suggests that the field-measured concentrations for these compounds do not accurately reflect human use. Overall, these results demonstrate that PhATE may be used to predict screening-level concentrations of APIs and related compounds in the environment as well as to evaluate the suitability of existing fate information for an API.

Aquatic toxicity of triclosan.

The aquatic toxicity of triclosan (TCS), a chlorinated biphenyl ether used as an antimicrobial in consumer products, was studied with activated-sludge microorganisms, algae, invertebrates, and fish. Triclosan, a compound used for inhibiting microbial growth, was not toxic to wastewater microorganisms at concentrations less than aqueous solubility. The 48-h Daphnia magna median effective concentration (EC50) was 390 microg/L and the 96-h median lethal concentration values for Pimephales promelas and Lepomis macrochirus were 260 and 370 microg/L, respectively. A no-observed-effect concentration (NOEC) and lowest-observed-effect concentration of 34.1 microg/L and 71.3 microg/L, respectively, were determined with an early life-stage toxicity test with Oncorhynchus mykiss. During a 96-h Scenedesmus study, the 96-h biomass EC50 was 1.4 microg/L and the 96-h NOEC was 0.69 microg/L. Other algae and Lemna also were investigated. Bioconcentration was assessed with Danio rerio. The average TCS accumulation factor over the five-week test period was 4,157 at 3 microg/L and 2,532 at 30 microg/L. Algae were determined to be the most susceptible organisms. Toxicity of a TCS-containing wastewater secondary effluent to P. promelas and Ceriodaphnia was evaluated and no observed differences in toxicity between control and TCS-treated laboratory units were detected. The neutral form of TCS was determined to be associated with toxic effects. Ionization and sorption will mitigate those effects in the aquatic compartment.