Human health risk assessment of pharmaceuticals in the European Vecht River

Abstract

Active pharmaceutical ingredients (APIs) can reach surface waters used for drinking water extraction and recreational activities, such as swimming and fishing. The aim of the present study was to systematically assess the lifetime human health risks posed by 15 individual APIs and their mixtures occurring in the German-Dutch transboundary Vecht River. An exposure model was developed and used to assess the combined risks of oral and dermal exposure under a variety of exposure conditions. A total of 4500 API uptake values and 165 lifetime risk values were estimated for 15 and 11 APIs, respectively. Overall, the lifetime human health risks posed by the APIs and their mixtures based on modeling results were deemed acceptable under typical exposure conditions. Under very extreme environmental conditions and human behavior, API mixture risks were of potential concern while the risks of individual APIs were negligible, with a few exceptions. The antibiotic doxycycline and analgesic phenazone showed the highest and lowest risks, respectively. The study did not evaluate the potential risks caused by metabolite compounds. Recommendations for water managers are provided to help improve the accuracy and utility of human health risk assessments of pharmaceuticals. Integr Environ Assess Manag 2022;18:1639-1654. © 2022 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Keywords: Human health; Pharmaceutical; Risk assessment; Surface water.

Figure 1

Vecht River basin. The red dashed line and the dark red closed polygons indicate the Dutch–German border and main cities, respectively

Figure 2

Schematic presentation of the human health risk assessment. The lifetime exposure model developed in the present study is demarcated in the red box. Three human activities were accounted for, namely, swimming, water‐drinking, and fishing. Two exposure routes were accounted for, namely, the dermal and oral routes. Five age groups were accounted for, namely, 0–1, 1–5, 5–10, 10–18, and 18–80 age groups. Five main behavioral profiles were accounted for, namely, “Average,” “Fisherman,” “Swimmer,” “Drinker,” and “Extreme” profile. PiE, pharmaceuticals in the environment.

Figure 3

Human health lifetime hazard quotients (HQ) of studied pharmaceuticals in the Vecht River catchment. CBZ, carbamazepine; CIP, ciprofloxacin; CYC, cyclophosphamide; DCF, diclofenac; DOX, doxycycline; EE2, 17α‐ethinylestradiol; ERY, erythromycin; MEP, metoprolol; MET, metformin; PHE, phenazone; VAL, valsartan

Figure 4

Surface water concentrations compared to hazard quotient (HQ) for doxycycline (C _w) in relation to the fish consumption of the target population (Φ). The red curve depicts the target hazard quotient of 1 (HQ _t = 1)