A Survey of Occurrence and Risk Assessment of Pharmaceutical Substances in the Great Lakes Basin

The present study is an overview of the literature on the occurrence and potential risks of pharmaceutical substances in the wastewater treatment plants (WWTP), natural waters and drinking water treatment plants served by the Great Lakes Basin (Canada and the USA) between the years of 2007-2012. Large number of pharmaceutical substances, including anti-inflammatories, lipid regulators, antidepressants, antibiotics, beta blockers, anti-epileptics, anti-hypertensions and stimulants, in high ng/L concentrations, has been reported in the WWTP influents. Most of these compounds have also been detected in the WWTP effluents at comparable concentrations with the exception of caffeine, cotinine and salicylic acid suggesting the inefficiency of conventional treatment processes in the degradation of pharmaceutical compounds. Decreasing surface water concentrations have been observed with the distance downstream of the discharge point due to the dilution effect. Surface waters located around septic systems and agricultural areas have also been found to be contaminated with pharmaceutical substances. Carbamazepine, caffeine, its metabolite paraxanthine, ibuprofen, gemfibrozil and sulfamethoxazole have been frequently detected in the surface waters. The number of occurrences of carbamazepine, ibuprofen, naproxen, gemfibrozil, bezafibrate, sulfamethoxazole and macrolide antibiotics in drinking water sources, at ng/L concentration ranges, has been quite high. Although the detection frequencies in treated drinking waters were relatively low, the concentrations of the above mentioned pharmaceutical substances were at the same range as the source water concentrations. Six of the detected pharmaceutical substances, namely, fluoxetine, sulfamethoxazole, clarithromycin, erythromycin, carbamazepine and esterone exhibit a high environmental risk in Great Lakes WWTP effluents and surface waters, while none of the pharmaceutical substances seem to pose a risk for human health at their highest reported concentrations in the drinking water sources from the Great Lakes.