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Occurrence and Fate of Human and Veterinary Medicinal Products

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Soil Components and Human Health

Abstract

Medicinal products are a class of emerging environmental contaminants that are increasingly being used in human and veterinary medicine. These products are designed to have a specific mode of action, and many of them for some persistence in the human body. Up to now, only little is known about ecotoxicological effects of medicinal products on aquatic and terrestrial organisms including wildlife. There is thus a need to focus on sources and long-term exposure assessment regarding specific modes of action of medicinal products to better judge their effects on the environment and on the human body. Contamination of the environment with pharmaceuticals has received increased attention in recent years. Unlike agrochemicals, which are applied to fields in pulsed events, pharmaceuticals enter the environment more or less continuously. Many different pharmaceuticals are used in human medicine, and antibiotics and anti-inflammatory drugs are used in veterinary medicine throughout the world. A number of pharmaceuticals have been detected in many environmental samples worldwide. Their occurrence has been reported in sewage treatment plant effluents, surface water, seawater, groundwater, soils, sediments plants and fish. In several countries of the EU, such as England, Germany, and Austria some pharmaceutical products are used in quantities of more than 100 Mg per year. Sources of human medicinal products include release from industrial production of pharmaceuticals, discharge of pharmaceuticals from wastewater treatment plants into rivers, field-application of sewage sludge as organic fertilizer, and use of treated wastewater for irrigation. Sources of veterinary pharmaceuticals include medical treatment of livestock and medicines from surface-applied liquid or farmyard manure. Pharmaceuticals used in animals raised on pastures are excreted directly to the grassland. Pharmaceuticals entering the terrestrial environment can reach surface water and groundwater.

Medicinal products are bioactive substances that are designed to target-specific metabolic and molecular pathways in humans and animals, but they can also have negative side effects. Pharmaceuticals and their residues may affect significantly the environment. Modes of action of pharmaceutical contaminants on lower organisms are little known and thus make toxicity prediction difficult. Pharmaceutical concentrations measured in surface waters are in a ng L−1 to lower μg L−1 range, and are generally well below concentrations that are known to cause acute toxicity to organisms. However, chronic exposure to pharmaceuticals has the potential for numerous more subtle effects on non-target organisms, such as metabolic or reproductive changes. Despite numerous reports on environmental occurrence of pharmaceuticals the environmental significance is largely unknown. As an exception, the synthetic oestrogen ethinyl-estradiol is well-known for its potential for endocrine disruptive and reproductive effects. Several papers describe such effects after exposure to either natural or synthetic oestrogens in laboratory settings. For instance, exposure to low levels of ethinyl-estradiol delayed the embryonic development in zebrafish and caused vitellogenin induction in rainbow trout. Downstream sewage treatment plants in the UK, fish displayed intersex characteristics, leading to reduced reproductive success were found. These effects are likely to affect the population dynamics locally. Effects observed in the environment, however, are difficult to assign to a specific compound as mixtures with possible overlapping and/or interactive properties are likely to be present.

Although studies showing environmental effects up to now are very scarce, there is indirect evidence that exposure to antibiotics has brought about the resistance of bacteria in the environment. For example, the use of antibiotics in pig production coincided with the discovery of resistant E. coli where there previously was no resistance in the guts of pigs and in meat products. Later, the resistance had spread to the gut flora of pig farmers, their families, and citizens of the community. Sewers receiving effluent from a hospital displayed an increased prevalence of bacteria resistant to oxytetracyline, while sewers receiving effluent from a pharmaceutical plant showed an increased prevalence of bacteria resistant to multiple antibiotics. Fluoroquinolone use in poultry husbandry has promoted the evolution of fluoroquinolone-resistant Campylobacter jejuni, an important human pathogen (see Chap. 13). Antibiotic resistant genes, within microbes or as naked DNA bound to clay particles, were found to persist in soils, river sediments, dairy lagoons, wastewater effluent and water treatment plants. However, further understanding of how resistance is acquired and maintained in bacterial populations is needed before a link between the presence of antibiotics in the environment and antibiotic resistance can be made. Thus, there is an enormous public and scientific need to learn more about the extent of the occurrence of pharmaceutical residues, about their fate during sewage treatment and in the environment, and about natural and technological processes that are able to remove such residues from sewage or raw waters used for drinking water supply.

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Authors and Affiliations

  1. Institute of Geoecology, Technische Universität Braunschweig, Braunschweig, Germany

    Rolf Nieder

  2. Department of Soil Science, Punjab Agricultural University Ludhiana, Ludhiana, India

    Dinesh K. Benbi

  3. Walther-Straub Institute of Pharmacology and Toxicology, LMU, Munich, Germany

    Franz X. Reichl

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Nieder, R., Benbi, D.K., Reichl, F.X. (2018). Occurrence and Fate of Human and Veterinary Medicinal Products. In: Soil Components and Human Health. Springer, Dordrecht. https://doi.org/10.1007/978-94-024-1222-2_12

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