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Pharmaceutical pollution of the world’s rivers

March 1, 2022

Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, measure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.

Citation Information

Publication Year 2022
Title Pharmaceutical pollution of the world’s rivers
DOI 10.1073/pnas.2113947119
Authors John L. Wilkinson, Alistair B. A. Boxall, Dana W. Kolpin, Kenneth M. Y. Leung, Racliffe W. S. Lai, Cristóbal Galbán-Malagón, Aiko D. Adell, J. Mondon, M. Metian, R. Marchant, Alejandra Bouzas-Monroy, Aida Cuni-Sanchez, A. Coors, Carriquiriborde P., M. Rojo, C. Gordon, Magdalena Cara, M. Moermond, Thais Luarte, V. Petrosyan, Yekaterina Perikhanyan, Clare S. Mahon, Christopher J. McGurk, T. Hofmann, T. Kormoker, V. Iniguez, J. Guzman-Otazo, Jean L. Tavares, Francisco Gildasio de Figueiredo, Maria T. P. Razzolini, V. Dougnon, G. Gbaguidi, Oumar Traoré, Jules M. Blais, Linda E. Kimpe, M. Wong, D. Wong, R. Ntchantcho, J. Pizarro, Guang-Guo Ying, Chang-Er Chen, Martha Páez, Jina Martínez-Lara, Jean-Paul Otamonga, John Poté, Suspense A. Ifo, Penelope J. Wilson, Silvia Echeverría-Sáenz, N. Udikovic-Kolic, M. Milakovic, D. Fatta-Kassinos, L. Ioannou-Ttofa, Vladimíra Belušová, J. Vymazal, María Cárdenas-Bustamante, Bayable A. Kassa, J Garric, A. Chaumot, Peter Gibba, I. Kunchulia, Seidensticker S., G. Lyberatos, Halldór P. Halldórsson, Molly Melling, T. Shashidhar, Manisha Lamba, A. Nastiti, A. Supriatin, N. Pourang, A. Abedini, Omar Abdullah, Salem S. Gharbia, F. Pilla, B. Chefetz, T. Topaz, Koffi Marcellin Yao, B. Aubakirova, R. Beisenova, L. Olaka, Jemimah Mulu, P. Chatanga, V. Ntuli, Nathaniel T. Blama, S. Sherif, Ahmad Zaharin Aris, Ley Juen Looi, M. Niang, Seydou T. Traore, Rik Oldenkamp, O. Ogunbanwo, M. Ashfaq, M. Iqbal, Z. Abdeen, A. O'Dea, Jorge Manuel Morales-Saldaña, M. Custodio, H. de la Cruz, I. Navarrete, F. Carvalho, Alhaji B. Gogra, Bashiru M. Koroma, Vesna Cerkvenik-Flajs, Mitja Gombać, M. Thwala, K. Choi, H. Kang, John L. Celestino Ladu, A. Rico, P. Amerashinghe, A. Sobek, G. Horlitz, Armin K. Zenker, Alex C. King, Jheng-Jie Jiang, Rebecca Kariuki, M. Tumbo, U. Tezel, Turgut T. Onay, Julius B. Lejju, Y. Vystavna, Y. Vergeles, H. Heinzen, Andrés Pérez-Parada, Douglas B. Sims, M. Figy, David Good, C. Teta
Publication Type Article
Publication Subtype Journal Article
Series Title Proceedings of the National Academy of Sciences
Series Number
Index ID 70229135
Record Source USGS Publications Warehouse
USGS Organization Central Midwest Water Science Center