while algae showed a similar sensitivity to ketoprofen, ibuprofen, and naproxen
pharmaceuticals.
Gamarra et al. [25] conducted a study which had as its main objective the
environmental risk assessment of the anti-inflammatory diclofenac and ibuprofen
in cities of the state of Paraná, Brazil (319 cities for Diclofenac and 104 for
ibuprofen), over the course of 3 years, using the available data of the public health
system of Brazil. The environmental risk (ER) was evaluated using the approach of
the European Medicines Agency, and the environmentally planned concentrations
(PEC) were calculated considering the metabolism of the drug, excretion data,
biological filter removal rates and treatment processes of wastewater with activated
sludge to define environmental scenarios. The predicted no-effect concentration
(PNEC) for these drugs was obtained from the literature, and the risk coefficient
(RQ) of the PEC/PNEC ratio was calculated; RQ 1 values suggested an environmental risk. RQ 1 values for diclofenac were found in 12 cities, while for ibuprofen
these values were found in 51 cities in the study area. It is important to keep in mind
that almost all cities reach ER values in the third year. These results suggest an
environmental alert status for some cities due to the current usage and consumption
patterns of both pharmaceutical products. The authors suggest the monitoring of
these patterns by health and environmental authorities to establish public policies, in
order to minimize possible environmental impacts.
In Mendoza et al. [26]’s work, the presence of 25 pharmaceutical compounds
belonging to 7 different therapeutic groups (including nonsteroidal antiinflammatory drugs) and an iodinated contrast medium were analyzed in a
medium-sized Spanish hospital located in the community of Valencia. The analysis
of the compounds in the hospital wastewater was performed, and a risk assessment
of the detection levels was applied. Further the environmental hazard associated with
the various measured compounds was assessed by calculating the persistence,
bioaccumulation, and toxicity index (PBT), which classifies the compounds
according to their harmful characteristics for the environment. It was used in risk
ratio (HQ) to assess the level of toxicological risk. The HQs for each individual
compound were calculated according to the guidelines of the European Union as the
ratio between the measured environmental concentration (MEC) and the predicted
no-effect concentration (PNEC). The maximum individual concentration quantified
for each pharmaceutical product in the various samples of hospital effluents was
taken as MEC. PNEC values were obtained from the available aquatic toxicity data
using three species of different trophic levels, representing the aquatic ecosystem
(algae, crustaceans, and fish). If the HQ values are below 0.1, no adverse effects are
expected, being classified as negligible risk. If the HQ values are between 0.1 and
1, the risk is low but should be considered as potential to generate adverse effects. If
the HQ values are between 1.0 and 10, some adverse effect or moderate risk is likely.
Finally, if the calculated HQ values are above 10, a high risk is anticipated. The antiinflammatory that had the highest concentration was acetaminophen (44.3 μg L
À1 ),
followed by ketoprofen, naproxen, ibuprofen, and diclofenac. The anti-inflammatory
drugs acetaminophen (21.7), diclofenac (13.5), naproxen (21.5), and ibuprofen
(219.6) showed an HQ greater than 10, which means a high risk for aquatic
328
J. D. Cardoso-Vera et al.
pharmaceuticals.
Gamarra et al. [25] conducted a study which had as its main objective the
environmental risk assessment of the anti-inflammatory diclofenac and ibuprofen
in cities of the state of Paraná, Brazil (319 cities for Diclofenac and 104 for
ibuprofen), over the course of 3 years, using the available data of the public health
system of Brazil. The environmental risk (ER) was evaluated using the approach of
the European Medicines Agency, and the environmentally planned concentrations
(PEC) were calculated considering the metabolism of the drug, excretion data,
biological filter removal rates and treatment processes of wastewater with activated
sludge to define environmental scenarios. The predicted no-effect concentration
(PNEC) for these drugs was obtained from the literature, and the risk coefficient
(RQ) of the PEC/PNEC ratio was calculated; RQ 1 values suggested an environmental risk. RQ 1 values for diclofenac were found in 12 cities, while for ibuprofen
these values were found in 51 cities in the study area. It is important to keep in mind
that almost all cities reach ER values in the third year. These results suggest an
environmental alert status for some cities due to the current usage and consumption
patterns of both pharmaceutical products. The authors suggest the monitoring of
these patterns by health and environmental authorities to establish public policies, in
order to minimize possible environmental impacts.
In Mendoza et al. [26]’s work, the presence of 25 pharmaceutical compounds
belonging to 7 different therapeutic groups (including nonsteroidal antiinflammatory drugs) and an iodinated contrast medium were analyzed in a
medium-sized Spanish hospital located in the community of Valencia. The analysis
of the compounds in the hospital wastewater was performed, and a risk assessment
of the detection levels was applied. Further the environmental hazard associated with
the various measured compounds was assessed by calculating the persistence,
bioaccumulation, and toxicity index (PBT), which classifies the compounds
according to their harmful characteristics for the environment. It was used in risk
ratio (HQ) to assess the level of toxicological risk. The HQs for each individual
compound were calculated according to the guidelines of the European Union as the
ratio between the measured environmental concentration (MEC) and the predicted
no-effect concentration (PNEC). The maximum individual concentration quantified
for each pharmaceutical product in the various samples of hospital effluents was
taken as MEC. PNEC values were obtained from the available aquatic toxicity data
using three species of different trophic levels, representing the aquatic ecosystem
(algae, crustaceans, and fish). If the HQ values are below 0.1, no adverse effects are
expected, being classified as negligible risk. If the HQ values are between 0.1 and
1, the risk is low but should be considered as potential to generate adverse effects. If
the HQ values are between 1.0 and 10, some adverse effect or moderate risk is likely.
Finally, if the calculated HQ values are above 10, a high risk is anticipated. The antiinflammatory that had the highest concentration was acetaminophen (44.3 μg L
À1 ),
followed by ketoprofen, naproxen, ibuprofen, and diclofenac. The anti-inflammatory
drugs acetaminophen (21.7), diclofenac (13.5), naproxen (21.5), and ibuprofen
(219.6) showed an HQ greater than 10, which means a high risk for aquatic
328
J. D. Cardoso-Vera et al.