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Pharmaceuticals released from senior residences: occurrence and risk evaluation

Abstract

One of the main pursuits, yet most difficult, in monitoring studies is to identify the sources of environmental pollution. In this study, we have identified health-care facilities from south European countries as an important source of pharmaceuticals in the environment. We have estimated that compounds consumed in by the elderly and released from effluents of senior residences can reach river waters at a concentration higher than 0.01 μg/L, which is the European Medicines Agency (EMA) threshold for risk evaluation of pharmaceuticals in surface waters. This study has been based on five health institutions in Portugal, Spain, and France, with 52 to 130 beds. We have compiled the pharmaceuticals dispensed on a daily base and calculated the consumption rates. From 54.9 to 1801 g of pharmaceuticals are consumed daily, with laxatives, analgesics, antiepileptics, antibiotics, and antidiabetic agents being the main drug families administered. According to excretion rates, dilution in the sewerage system, and elimination in wastewater treatment plants, macrogol, metformin, paracetamol, acetylcysteine, amoxicillin, and gabapentin, among others, are expected to reach river waters. Finally, we discuss the risk management actions related to the discharge of pharmaceuticals from senior residences to surface waters.

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Acknowledgements

This study has been financed by the SUDOE program with the project Innovec’EAU (2016-2019)/Project SOE1/P1/F0173 Interreg Sudoe funded by FEDER (http://innovec-eau.univ-perp.fr). We would like to acknowledge the associated partners of the project: Syndicat National des Établissements et Résidences Privés pour Personnes Âgées (SYNERPA), Jordi Cayetano and Marc Antoni Rovira from Sant Joan de Deu (SJD), Cinta Pascual and Arnald Pannocchia from Llars d’Avis de Catalunya (L’Onada), and Marisa Cristino, Filomena Gerardo, and Sónia Pereira da Silva from Santa Casa da Misericórdia de Lisboa (SCML). We would also like to thank the personnel from the elderly who are acknowledged for their assistance and guidance and for providing consumption data of pharmaceuticals. Silvia Sachetti, Emanuella Scudellaro, and Martina Lula, Erasmus students from the University Federico II in Naples, are gratefully thanked for compiling data and advice on the toxicity of pharmaceuticals.

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Correspondence to Silvia Lacorte.

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Responsible editor: Ester Heath

Electronic supplementary material

Table S1

Compounds consumed in the 5 health institutions from france, Spain and Portugal, the family and the ATC code. (DOCX 22 kb).

Table S2

(DOCX 15 kb).

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Lacorte, S., Luis, S., Gómez-Canela, C. et al. Pharmaceuticals released from senior residences: occurrence and risk evaluation. Environ Sci Pollut Res 25, 6095–6106 (2018). https://doi.org/10.1007/s11356-017-9755-1

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Keywords

  • Health care institutions
  • Pharmaceuticals
  • Predicted environmental concentrations
  • Risk management