Environmental Science and Pollution Research

, Volume 21, Issue 22, pp 12941–12950 | Cite as

Consumption-based approach for predicting environmental risk in Greece due to the presence of antimicrobials in domestic wastewater

  • Evangelia I. Iatrou
  • Athanasios S. Stasinakis
  • Nikolaos S. Thomaidis
Research Article


The main objective of the current study was to estimate the potential environmental risks associated with human consumption of antimicrobials in Greece. Consumption data was collected for the 24 most often used antimicrobials for the years 2008–2010, and their predicted environmental concentrations (PECs) in raw and treated wastewater were calculated using mass balances and literature data on human excretion and elimination efficiency during wastewater treatment. The ecotoxicological risk was estimated by calculating the ratio of PEC to predicted no-effect concentration (PNEC) for three categories of aquatic organisms (algae, daphnids, and fish). PNEC values were calculated based on experimental ecotoxicity data and data originated from the Ecological Structure Activity Relationship (ECOSAR). PEC values in raw sewage ranged between 0.02 μg L−1 (erythromycin) and 27 μg L−1 (amoxicillin), while in treated wastewater, the highest concentration was predicted for cefuroxime axetil (6.6 μg L−1). Based on acute toxicity data for algae, risk quotient (RQ) values higher than 1 were obtained for 7 out of the 24 target antimicrobials in raw and treated wastewater, while no significant risk was estimated for daphnids and fish. Regarding the possible risk due to the chronic toxicity of antimicrobials, RQ values higher than 80 were obtained for amoxicillin and clarithromycin in algae. The use of baseline toxicity data from ECOSAR showed that the environmental risk from exposure to mixtures of antimicrobials was low for all three aquatic species. However, further studies on toxicity of mixtures should be performed as calculation of toxicity ratio (TR) values showed that 90 % of the target antimicrobials seem to exhibit a specific mode of toxic action when present in mixtures rather than baseline toxicity. As a result, an underestimation of toxicity based on the ECOSAR model is possible for the mixture of target antimicrobials. For Greek rivers where low (dilution factor, D < 10) and medium (D = 10–100) dilution of wastewater occurs, moderate to high risk is expected due to the existence of individual antimicrobials such as amoxicillin, clarithromycin, ciprofloxacin, azithromycin, erythromycin, and levofloxacin in discharged treated wastewater.


Antibiotics Pharmaceuticals Sewage Occurrence Effects Risk quotient Risk assessment 



The authors would like to thank Greece IMS Health Incorporation for the offer of antimicrobials consumption data for the years 2008, 2009, and 2010. This research has been co‐financed by the European Union (European Social Fund—ESF) and Greek national funds through the Operational Program “Education and Lifelong Learning” of the National Strategic Reference Framework (NSRF)—Research Funding Program: THALES: Investing in knowledge society through the European Social Fund. WATERMICROPOL (www.aegean.gr/environment/watermicropol).

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Evangelia I. Iatrou
    • 1
  • Athanasios S. Stasinakis
    • 1
  • Nikolaos S. Thomaidis
    • 2
  1. 1.Department of Environment, Water and Air Quality LaboratoryUniversity of the AegeanMytileneGreece
  2. 2.Department of Chemistry, Laboratory of Analytical ChemistryNational and Kapodistrian University of AthensAthensGreece

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