which were the most consumed NSAIDs, reaching maximum concentrations of up
874 μg/L in the influents and 59.6 μg/L in the effluents.
Other countries with high concentrations of NSAIDs in WWTPs influents and
effluents are the USA, Korea, China, and Spain. In the USA, [34] quantified multiple
NSAIDs in four different removal steps of three WWTPs. According to their results,
NPX and IBF were the most dominant pharmaceuticals in the influents samples.
Furthermore, they also demonstrated that the majority influent load of these pharmaceuticals was removed during secondary treatments. On the other hand, in Korea,
Sim et al. [35] measured multiple pharmaceuticals in ten municipal WWTPs, one
hospital WWTP, and five rivers. Their results agreed with those found by Thomas
and Foster and concluded that the most efficient mechanism for the removal of
NSAIDs is the biological treatment processes. This is because PTC, ASA, IBF, and
NPX showed relatively high removal rates during these processes.
Finally, Huang et al. [56] investigated the behavior and fate of five NSAIDs in
two WWTPs located in South China. In their results, biodegradation was also the
main elimination mechanism for the removal of NSAIDs. Furthermore, they also
demonstrated diclofenac (DCF) which was mainly degraded anaerobically, whereas
ASA, NPX, IBF, and indomethacin (IDM) were largely eliminated under aerobic
conditions.
3.2 Surface Water
Most of the countries have reported low concentrations of NSAIDs in WWTPs
effluents. However, high concentrations of these pharmaceuticals have been found in
Table 1 (continued)
NSAIDs
Country
Prescriptions
per year
Source
Netherlands
1,961,000
Zorginstituut Nederland [14]
Sweden
439,793
Socialstyrelsen [15]
Ketoprofen
North
Ireland
29,692
Mulholland [11]
Scotland
1,111
Information Services Division National
Services Scotland [13]
Sweden
140,353
Socialstyrelsen [15]
Mefenamic
acid
North
Ireland
19,138
Mulholland [11]
Scotland
31,941
Information Services Division National
Services Scotland [13]
Indomethacin
Scotland
12,837
Information Services Division National
Services Scotland [13]
Sweden
861
Socialstyrelsen [15]
a Prescriptions in 2016
Introduction and Historical Findings That Focused Nonsteroidal. . .
5
874 μg/L in the influents and 59.6 μg/L in the effluents.
Other countries with high concentrations of NSAIDs in WWTPs influents and
effluents are the USA, Korea, China, and Spain. In the USA, [34] quantified multiple
NSAIDs in four different removal steps of three WWTPs. According to their results,
NPX and IBF were the most dominant pharmaceuticals in the influents samples.
Furthermore, they also demonstrated that the majority influent load of these pharmaceuticals was removed during secondary treatments. On the other hand, in Korea,
Sim et al. [35] measured multiple pharmaceuticals in ten municipal WWTPs, one
hospital WWTP, and five rivers. Their results agreed with those found by Thomas
and Foster and concluded that the most efficient mechanism for the removal of
NSAIDs is the biological treatment processes. This is because PTC, ASA, IBF, and
NPX showed relatively high removal rates during these processes.
Finally, Huang et al. [56] investigated the behavior and fate of five NSAIDs in
two WWTPs located in South China. In their results, biodegradation was also the
main elimination mechanism for the removal of NSAIDs. Furthermore, they also
demonstrated diclofenac (DCF) which was mainly degraded anaerobically, whereas
ASA, NPX, IBF, and indomethacin (IDM) were largely eliminated under aerobic
conditions.
3.2 Surface Water
Most of the countries have reported low concentrations of NSAIDs in WWTPs
effluents. However, high concentrations of these pharmaceuticals have been found in
Table 1 (continued)
NSAIDs
Country
Prescriptions
per year
Source
Netherlands
1,961,000
Zorginstituut Nederland [14]
Sweden
439,793
Socialstyrelsen [15]
Ketoprofen
North
Ireland
29,692
Mulholland [11]
Scotland
1,111
Information Services Division National
Services Scotland [13]
Sweden
140,353
Socialstyrelsen [15]
Mefenamic
acid
North
Ireland
19,138
Mulholland [11]
Scotland
31,941
Information Services Division National
Services Scotland [13]
Indomethacin
Scotland
12,837
Information Services Division National
Services Scotland [13]
Sweden
861
Socialstyrelsen [15]
a Prescriptions in 2016
Introduction and Historical Findings That Focused Nonsteroidal. . .
5