Assessing the Discharge of Pharmaceuticals Along the Dutch Coast of the North Sea - Reviews of Environmental Contamination and Toxicology - page 2

et al. 1998a,b, 1999; Hartmann et al. 1998; Ternes 1998; Hartig et al. 1999; Ternes
and Hirsch 2000; Heberer 2002; Tixier et al. 2003; Weigel et al. 2004; Comoretto
and Chiron 2005).
To identify the presence of human and veterinary pharmaceuticals in Dutch
surface-, drinking-, sewage-, and industrial water, extensive monitoring campaigns
were conducted between 2000 and 2003 (Schrap et al. 2003; Versteegh et al. 2003;
Mons et al. 2000, 2003; Sacher and Stoks (2003). During these campaigns ~100
active ingredients (AIs) were selected for monitoring from about 850 human and
200 veterinary pharmaceuticals used in the Netherlands. These AIs were selected
on the basis of having (1) analytical techniques adequate to identify and quantify
them, (2) concentrations previously reported in other studies, and (3) risk to the
aquatic environment (Schrap et al. 2003). These monitoring studies emphasized
analysis of the AIs rather than of their metabolites. The categories of pharmaceu-
ticals selected, included antibiotics, coccidiostatics, analgesics, X-ray contrast
media, drugs used to treat coronary vascular disease, antineoplastic drugs, and
antiepileptics.
In general, concentrations of pharmaceuticals in Dutch surface water ranged from
a few to several hundred ng L −1 . Sewage water from a residential area contained
household analgesics, lipid-lowering agents, beta blockers, and antiepileptics, in
concentrations up to tens of µg L −1 (Schrap et al. 2003). The authors found that con-
centrations of pharmaceuticals in municipal sewage water, and in influent water at
sewage treatment plants (STPs), are very similar to those in sewage water effluents
from residential areas. STP effluents, however, contained higher concentrations of
specific antibiotics and X-ray contrast media. Concentrations of pharmaceuticals in
surface waters were significantly lower than those in sewage water (Schrap et al.
2003). Substances most frequently identified in Dutch surface water (in at least 50%
of sampled locations), during the monitoring campaigns described above, were
X-ray contrast media, four analgesics (acetylsalicylic acid, diclofenac, ibuprofen,
and naproxen), two antiepileptics (carbamazepine and primidone), two beta blockers
(sotalol and atenolol), two antibiotics (azitromycin and sulfamethoxazole), and one
anesthetic (lidocaine) (Schrap et al. 2003). Pharmaceuticals were detected only inci-
dentally in Dutch ground- and drinking-water studies (Mons et al. 2003; Vethaak
et al. 2002).
Some pharmaceuticals present in Dutch sewage and surface water ultimately
end up in the North Sea. Unfortunately, concentrations of pharmaceuticals that
reach seawater, along the Dutch coastal zone (DCZ) of the North Sea, have not
been measured. However, in other studies, clofibric acid (Buser et al. 1998a;
Weigel 2003) and caffeine (Weigel 2003) were detected at ng L −1 levels in North
Sea water. Concentrations of diclofenac, ibuprofen, propyphenazone, and keto-
profen were also measured, but were not unambiguously identified in the North
Sea water samples (Weigel 2003). In summary, the number of studies that reported
concentrations of pharmaceuticals in the North Sea is limited ( n = 6); hence, it is
probable that pharmaceuticals (other than clofibric acid) exist in seawater of the
North Sea (German Bight, English Coast, and Norwegian Coast), and will eventually
be detected.