Release of effluents with chemoerápicos in water bodies: the state of art

Abstract

The presence of chemotherapy drugs in the effluents of healthcare facilities can be an expressive source responsible for their entry into the aquatic environment. These compounds are classified as emerging organic micropollutants (MPOE) and their degradation process in the environment and their ecotoxicity are still poorly understood. Considering the increase in the number of cancer cases and the emergence of new pharmaceutical compositions, it is important that legislation is in line with the situation, regulating the presence of these compounds in the environment. The objective was to discuss the set of regulations in force regarding the discharge of effluents with antineoplastic chemotherapy into surface water, identifying, based on technical criteria, existing gaps in the national and state legislation of Rondônia. The methodology was a systematic literature review with emphasis on studies that presented data on the identification and quantification of antineoplastic compounds released by human excreta, environmental implications and on requirements in regulatory legislation for the release of hospital effluents. Brazilian legislation is still incipient with regard to regulation and surveillance of effluents containing drugs and/or their metabolites, given that federal and state legal and regulatory provisions do not address release standards for these compounds, nor detection limits. CONAMA Resolução 430/2011 and RDC ANVISA 222/2018 are the regulations that come closest to the topic, but they are still inconsistent in terms of criteria for treatment, release or monitoring of hospital effluents