Environmental risk assessment of drugs: proposed methodology applicable to Brazilian municipalities

Abstract

Pharmaceuticals are organic micro-pollutants emerging in the aquatic environment and hospitals are point sources of emission of these substances. Environmental risk assessments (ERA) are an important tool to prioritize and prioritize drug monitoring in the environment by integrating their emission, chemical behavior and ecotoxicity. The study analyzes the context of international standards and concluded that adjustments to these standards are necessary so that they can be applied in the country. The study proposes an appropriate approach to the Brazilian case for individual hospital units. The methodology was tested in the environmental risk assessment of the use of 20 antineoplastic drugs by a highly complex public hospital in a municipality with around 500,000 inhabitants   with high levels of sanitation.  The study was conducted for 84 months and estimated consumption, emission and concentrations of drugs in surface waters. This information, associated with the physical and chemical properties of drugs and ecotoxicological studies, allowed to assess their potential environmental risk.  Among the 20 drugs analyzed only two do not present the possibility of degradation, and it is possible to project difficulties in detecting monitoring in surface waters after treatment by the WWTP.  Results do not indicate local environmental risk. The study method acquires relevance in the Brazilian context, based only on consumption and other information available in the literature, without the need for experimental tests, and can be applied in other municipalities and developing countries.