article · Proceedings of the National Academy of Sciences
A global study investigated pharmaceutical pollution in 258 rivers across 104 countries, analysing 61 active pharmaceutical ingredients (APIs) at 1,052 locations. The research found the highest cumulative API concentrations in sub-Saharan Africa, south Asia, and South America. Most contaminated sites were in low- to middle-income countries, linked to poor wastewater and waste management infrastructure, and pharmaceutical manufacturing. Common APIs detected included carbamazepine, metformin, and caffeine. Critically, 25.7% of sampling sites had at least one API concentration exceeding levels considered safe for aquatic organisms or posing a risk for antimicrobial resistance. This highlights pharmaceutical pollution as a global threat to environmental and human health.
Pharmaceuticals in rivers are a widespread and serious problem, harming aquatic ecosystems and potentially human health. This research reveals the global scale of this pollution, identifying hotspots and key contributing factors. Understanding where and why this pollution occurs is crucial for developing effective strategies to protect our water resources and achieve sustainable development goals.
This research provides critical baseline data for policymakers, environmental organisations, and technology developers. It highlights the urgent need for improved wastewater treatment and waste management infrastructure, particularly in low- to middle-income countries. The findings could inform the development of advanced water purification technologies or targeted monitoring solutions. This is foundational research identifying a widespread problem, indicating a significant market for applied solutions in environmental remediation and public health.
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Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, measure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world's rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.
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DOI: 10.1073/pnas.2113947119
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