Pharmaceuticals in Environment and Their Implication in Environmental Health

의약물질의 환경오염과 환경보건

  • Choi, Kyung-Ho (Department of Environmental Health, School of Public Health, Seoul National University) ;
  • Kim, Pan-Gyi (Department of Occupational and Environmental Health, College of Natural Sciences, Yongin University) ;
  • Park, Jeong-Im (Department of Environmental Health Science, College of Natural Sciences, Soonchunhyang University)
  • 최경호 (서울대학교 보건대학원 환경보건학과) ;
  • 김판기 (용인대학교 자연과학대학 산업환경보건학과) ;
  • 박정임 (순천향대학교 자연과학대학 환경보건학과)
  • Received : 2009.10.17
  • Accepted : 2009.12.01
  • Published : 2009.12.31


Pharmaceuticals in the aquatic environment are trace contaminants of growing importance in environmental health due to their physiologically active nature. Pharmaceuticals could affect non-target species and might eventually damage sustainability of susceptible populations in the ecosystem. Potentials for health consequences among susceptible human population cannot be ruled out since long-term exposure to cocktails of pharmaceuticals, which might be present in drinking water, is possible. Selection of antibiotic resistant microorganisms is of another concern. In order to understand, and if needed, to properly address the environmental health issues of pharmaceutical residues, knowledge gaps need to be filled. Knowledge gaps exist in many important areas such as prioritization of target pharmaceuticals for further risk studies, occurrence patterns in different environments, chronic toxicities, and toxicities of pharmaceutical mixtures. Appropriate treatment technologies for drinking water and wastewater could be developed when they are deemed necessary. One of the simplest, yet most efficient measures that could be undertaken is to implement a return program for unused or expired drugs. In addition, implementation of environmental risk assessment frameworks for pharmaceuticals would make it possible to efficiently manage potential environmental health problems associated with pharmaceutical residues in the environment.




  1. Kim, Y. H., Choi, K., Jung, J. Y., Park, S. J., Kim, P. G., Park, J. : Aquatic toxicity of acetaminophen, carbamazepine, cimetidine, diltiazem and six major sulfonamides, and their potential ecological risks in Korea. Environment International, 33(3), 370-375, 2007
  2. Park, J., Kim, M.-H., Choi, K., Kim, Y., Kim, M.-Y. : Environmental Risk Assessment of Pharmaceutical: Model Application for Estimating Pharmaceutical Exposu res in t he H an R iver Basin. Korea Environment Institute. (KEI 2007 RE-06), 2007
  3. Kang, Y. H. : Developing Management Policy on Unused/expired Pharmaceuticals. Seoul National University, Master of Public Health thesis, 2006
  4. Fent, K., Weston, A. A., Caminada, D. : Ecotoxicology of human pharmaceuticals. Aquatic Toxicology, 76(2), 122-159, 2006
  5. Harries, J. E., Sheahan, D. A., Jobling, S., Matthiessen, P., Neall, P., Sumpter, J. P., Tylor, T., Zaman, N. : Estrogenic activity in five United Kingdom rivers detected by measurement of vitellogenesis in caged male trout. Environmental Toxicology and Chemistry, 16(3), 534-542, 1997
  6. Sapkota, A. R., Curriero, F. C., Gibson, K. E., Schwab, K. J. : Antibiotic-resistant enterococci and fecal i ndicators in su rface w ater a nd g roundwater impacted by a concentrated Swine feeding operation. Environmental Health Perspectives, 115(7), 1040-1045, 2007
  7. Schwab, B. W., Heyes, E. P., Fiori, J. M., Mastrocco, F. J., Roden, N. M., Cragin, D., Meyerhoff, R. D., D'Aco, V. J., Anderson, P. D. : Human pharmaceuticals in U S su rface w aters: A h uman health r isk assessment. Regulatory Toxicology and Pharmacology, 42(3), 296-312, 2005
  8. Kim, P. G., Kim, M. Y., Choi, K. H. : Pharmaceutical residues in Han River and their impact on freshwater ecosystem. Report, Korea Research Foundation, 2005
  9. National Institute of Environmental Research : Development of analytical method and study of exposure of pharmaceuticals and personal care products in environment. Kyonggi University, Korea Institute of Science and Technology, Interface InfoTech, 2006
  10. Choi, K., Kim, Y., Park, J., Park, C., Kim, M., Kim, H., Kim, P. : Seasonal variations of several pharmaceutical residues in surface water and sewage treatment plants of Han River, Korea. Science of the Total Environment, 405(1-3), 120-128, 2008
  11. US Environmental Protection Agency : Development document for final effluent limitations guidelines and standards for the pharmaceutical manufacturing point source category, Office of Water, EPA-921-R-98-005, 1998
  12. Directive 2001/82/EC of the European Parliament and of the Council of 6 November 2001 on the community code relating to veterinary medicinal products. Official Journal, L 311, 1-66, 2001
  13. Naidoo, V., Wolter, K., Cuthbert, R., Duncan, N. : Veterinary diclofenac threatens Africa's endangered vulture species. Regulatory Toxicology and Pharmacology, 53, 205-208, 2009. In press
  14. National Institute of Environmental Research. : Development of analytical method and study of exposure of pharmaceuticals and personal care products in environment (II). Kyonggi University, Korea Institute of Science and Technology, Interface InfoTech, 2007
  15. Persson, M., Sabelstr$\"{o}$m, E., Gunnarsson, B. : Handling of unused prescription drugs- knowledge, behavior and attitude among Swedish people. Environment International 35(5), 771-774, 2009
  16. Food and Drug Administration : Human Exposure Assessment for Antibiotics in the Water Environment. Seoul National University, 2007
  17. Calabrese, E. J., Baldwin, L. A. : Toxicology rethinks its central belief. Hormesis demands a reappraisal of the way risks are assessed. Nature, 421(6924), 691-692, 2003
  18. Directive 2001/83/EC of the European Parliament and of the Council of 6 November 2001 on the community code relating to human medicinal products. Official Journal, L 311, 67-128, 2001
  19. Yang, H., Dettman, B., Beam, J., Mix, C., Jiang, X. : Occurrence of ceftriaxone-resistant commensal bacteria on a dairy farm and a poultry farm. Canadian Journal of Microbiology, 52(10), 942-950, 2006
  20. Jobling, S., Nolan, M., Tyler, C. R., Brighty, G., Sumpter, J . P. : Ecotoxicology of human pharmaceu -ticals. Environmental Science and Technology, 32(17), 2498-2506, 1998
  21. Proffitt, F., Bagla, P. : Ecology. Circling in on a vulture killer. Science, 306(5694), 223, 2004
  22. Kim, P. G., Kim, M. Y., Choi, K. H. : Contamination of major veterinary antibiotics and antimicrobials in upstream Han River, and human health and ecological risk assessment. Report, Korea Research Foundation, 2006
  23. US Food and Drug Administration. : Guidance for Industry; Environmental Assessment for Human Drug and Biologics Applications, 1998
  24. Focazio, M. J., Kolpin, D. W., Barnes, K. K., Furlong, E. T., Meyer, M. T., Zaugg, S. D., Barber, L. B., Thurman, M. E. : A national reconnaissance for pharmaceuticals and other organic wastewater contaminants in the United States- II) untreated drinking water sources. The Science of the Total Environment, 402(2-3), 201-216, 2008
  25. Bound, J. P., Voulvoulis, N. : Household disposal of pharmaceuticals as a pathway for aquatic contamination in the United Kingdom. Environmental Health Perspectives 112(12), 1705-1711, 2005
  26. Han, G. H., Hur, H. G., Kim, S. D. : Ecotoxicological risk of pharmaceuticals from wastewater treatment plants in Korea: occurrence and toxicity to Daphnia magna. Environmental Toxicology and Chemistry, 25(1), 265-271, 2006
  27. Barcel$\'{o}$, D. : Pharmaceutical-residue analysis. Trends in Analytical Chemistry, 26(6), 454-455, 2007
  28. Kim, Y. H., Jung, J. Y., Park, J., Kim, M. H., Boxall, A. B. A., Choi, K. : Prioritizing veterinary pharmaceuticals for aquatic environment in Korea. Environmental Toxicology and Pharmacology, 26(2), 167-176, 2008
  29. Ohlsen, K., Ternes, T., Werner, G., Wallner, U., L$\"{o}$ffler, D., Ziebuhr, W., Witte, W., Hacker, J. : Impact of antibiotics on conjugational resistance gene transfer in Staphylococcus aureus in sewage. Environmental Microbiology, 5(8), 711-716, 2003
  30. Cattoir, V., Poirel, L., Aubert, C., Soussy, C. J., Nordmann, P. : Unexpected occurrence of plasmid-mediated quinolone resistance determinants in environmental Aeromonas spp. Emerging Infectious Diseases, 14(2), 231-237, 2008
  31. K$\"{u}$mmerer, K. : The presence of pharmaceuticals in the environment due to human use- present knowledge and future challenges. Journal of Environmental Management, 90(8), 2354-2366, 2009
  32. Park, J. : Environmental risk management of pharmaceuticals. In: New Challenges and Directions of Environmental Policy, Korea Environment Institute, pp.247-268, 2008
  33. Chung, Y. H. : Occurrence of antimicrobial resistant microbes in Korean environment. 2008 Annual Conference of Korean Society of Environmental Agriculture. 35-40, 2008
  34. National Institute of Environmental Research. : Development of analytical method and study of exposure of pharmaceuticals and personal care products in environment (III). Yongin University, Korea Water Resources Corporation, Seoul Research Institute of Public Health and Environment, 2008
  35. Jjemba, P. : Excretion and ecotoxicity of pharmaceutical and personal care products in the environment. Ecotoxicology and Environmental Safety, 63(1), 113- 130, 2006
  36. Webb, S. T., Ternes, T., Gibert, M., Olejniczak, K. : Indirect human exposure to pharmaceuticqals via drinking water. Toxicology Letters, 142(3) 157-167, 2003
  37. Kidd, K. A., Blanchfield, P. J., Mills, K. H., Palace, V. P., Evans, R. E., Lazorchak, J. M., Flick, R. W. : Collapse of a fish population after exposure to a synthetic estrogen. Proceedings of National Academy of Science of the USA 104(21), 8897-8901, 2007
  38. Kim, S. D., Cho, J., Kim, I. S., Vanderford, B. J., Snyder, S. A. : Occurrence and removal of pharmaceuticals and endocrine disruptors in South Korean surface, drinking, and waste waters. Water Research, 41(5), 1013-1021, 2007
  39. Oh, S. J., Park, J., Lee, M. J., Park, S. Y., Lee, J. H., Choi, K. : Ecological hazard assessment of major veterinary benzimidazoles: acute and chronic toxicities to aquatic microbes and invertebrates. Environmental Toxicology and Chemistry, 25(8), 2221-2226, 2006
  40. Meisel, M. L ., d o Ceu Costa, M., Pena, A. : R egu - latory approach on environmental risk assessment. Risk management recommendations, reasonable and prudent alternatives. Ecotoxicology, 18(8), 1176-1181, 2009
  41. Folmar, L. C., Denslow, N. D., Kroll, K., Orlando, E. F., Enblom, J., Marcino, J., Metcalfe, C., Guillette, L. J. Jr. : Altered serum sex steroids and vitellogenin induction in walleye (Stizostedion vitreum) collected near a metropolitan sewage treatment plant. Archives of Environmental Contamination and Toxicology, 40(3), 392-398, 2001
  42. Oaks, J. L., Gilbert, M., Virani, M. Z., Watson, R. T., Meteyer, C. U., Rideout, B. A., Shivaprasad, H. L., Ahmed, S., Chaudhry, M. J., Arshad, M., Mahmood, S., Ali, A., Khan, A. A. : Diclofenac residues as the cause of vulture population decline in Pakistan. Nature, 427(6975), 630-603, 2004
  43. Kim, S., Aga, D. S. : Potential ecological and human health impacts of antibiotics and antibiotic-resistant bacteria from wastewater treatment plants. Journal of Toxicology and Environmental Health Part B, 10(8), 559-573, 2007
  44. Brandt, K. K., Sj${\o}$holm, O. R., Krogh, K. A., Halling-S${\o}$rensen, B., Nybroe, O. : Increased pollutioninduced bacterial community tolerance to sulfadiazine in soil hotspots amended with artificial root exudates. Environmental Science and Technology, 43(8), 2963-2968, 2009
  45. Park, J. : An Approach for Developing Aquatic Environmental Risk Assessment Framework for Pharmaceuticals in Korea. Korea Environment Institute. (KEI 2006 RE-05), 2006
  46. Martinez, J. L. : Environmental pollution by antibiotics and by antibiotic resistance determinants. Environmental Pollution, 157(11), 2893-2902, 2009
  47. Cunningham, V. L., Binks, S. P., Olson, M. J. : Human health risk assessment from the presence of human pharmaceuticals in the aquatic environment. Regulatory Toxicology and Pharmacology, 53(1), 39-45, 2009
  48. Kolpin, D. W., Furlong, E. T., Meyer, M. T., Thurman, E. M., Zaugg, S. D., Barber, L. B., Buxton, H. T. : Pharmaceu ticals, h ormones, a nd o ther w astewater contaminants in U.S. streams, 1999-2000: A national reconnaissance. Environmental Science and Technology, 36(6), 1202-1211, 2002
  49. Desbrow, C., Routledge, E. J., Brighty, G. C., Sumpter, J. P., Waldock, M. J. : Identification of estrogenic chemicals in STW effluent 1. Chemical fractionation and in vitro biological screening. Environmental Science and Technology, 32 (11), 1549-1558, 1998
  50. EMEA/CHMP-European Medicines Evaluation Agency/Committee for Medicinal Products for Human Use : Doc. Ref. EMEA/CHMP/SWP/4447/00, Guideline on the Environmental Assessment of Medicinal Products for Human Use, pp. 12, 2006
  51. K$\"{u}$mmerer, K., Henninger, A. : Promoting resistance by the emission of antibiotics from hospitals and households into effluent. Clinical Microbiology and Infection, 9(12), 1203-1214, 2003
  52. Choi, K., Kim, Y. H., Jung, J. Y., Kim, M.-H., Kim, C.-S., Kim, N.-H., Park, J. : Occurrences and ecological risks of roxithromycin, trimethoprim, and chloramphenicol in Han River, Korea. Environmental Toxicology and Chemistry, 27(3), 711-719, 2008

Cited by

  1. Characteristics of Occurrence of Pharmaceuticals in the Nakdong River vol.35, pp.1, 2013,