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Background: Antimicrobial resistance (AMR) is one of the most significant health threats to society. A growing body of research demonstrates selection for AMR likely occurs at environmental concentrations of antibiotics. However, no standardized experimental approaches for determining selective concentrations of antimicrobials currently exist, preventing appropriate environmental and human health risk assessment of AMR., Objectives: We aimed to design a rapid, simple, and cost-effective novel experimental assay to determine selective effect concentrations of antibiotics and to generate the largest experimental data set of selective effect concentrations of antibiotics to date., Methods: Previously published methods and data were used to validate the assay, which determines the effect concentration based on reduction of bacterial community (wastewater) growth. Risk quotients for test antibiotics were generated to quantify risk., Results: The assay (SELection End points in Communities of bacTeria, or the SELECT method) was used to rapidly determine selective effect concentrations of antibiotics. These were in good agreement with quantitative polymerase chain reaction effect concentrations determined within the same experimental system. The SELECT method predicted no effect concentrations were minimally affected by changes in the assay temperature, growth media, or microbial community used as the inoculum. The predicted no effect concentrations for antibiotics tested ranged from 0.05 μ g / L for ciprofloxacin to 1,250 μ g / L for erythromycin., Discussion: The lack of evidence demonstrating environmental selection for AMR, and of associated human health risks, is a primary reason for the lack of action in the mitigation of release of antibiotics into the aquatic environment. We present a novel method that can reliably and rapidly fill this data gap to enable regulation and subsequent mitigation (where required) to lower the risk of selection for, and human exposure to, AMR in aquatic environments. In particular, ciprofloxacin and, to a lesser extent, azithromycin, cefotaxime, and trimethoprim all pose a significant risk for selection of AMR in the environment. https://doi.org/10.1289/EHP6635.

Current biodegradation screening tests are not specifically designed for persistence assessment of chemicals, often show high inter- and intra-test variability, and often give false negative biodegradation results. Based on previous studies and recommendations, an international ring test involving 13 laboratories validated a new test method for marine biodegradation with a focus on improving the reliability of screening to determine the environmental degradation potential of chemicals. The new method incorporated increased bacterial cell concentrations to better represent the microbial diversity; a chemical is likely to be exposed in the sampled environments and ran beyond 60 days, which is the half-life threshold for chemical persistence in the marine environment. The new test provided a more reliable and less variable characterization of the biodegradation behavior of five reference chemicals (sodium benzoate, triethanolamine, 4-nitrophenol, anionic polyacrylamide, and pentachlorophenol), with respect to REACH and OSPAR persistence thresholds, than the current OECD 306 test. The proposed new method provides a cost-effective screening test for non-persistence that could streamline chemical regulation and reduce the cost and animal welfare implications of further higher tier testing.

The largely uncontrolled release of active pharmaceuticals ingredients (APIs) within untreated wastewater discharged to waterbodies, associated with many rapidly urbanising centres is of growing concern owing to potential antimicrobial resistance, endocrine disruption and potential toxicity. A sampling campaign has been undertaken to assess the source, occurrence, magnitude and risk associated with APIs and other chemicals within the Nairobi/Athi river basin, in Kenya, East Africa. The catchment showed an extensive downstream impact zone estimated to extend 75 km, mostly, but not exclusively, derived from the direct discharge of untreated wastewater from the urban centre of Nairobi city. The exact extent of the downstream boundary of the Nairobi city impact zone was unclear owing to the inputs of untreated wastewater sources from the continuous urbanized areas along the river, which counteracted the natural attenuation caused by dilution and degradation. The most frequently detected APIs and chemicals were caffeine, carbamazepine, trimethoprim, nicotine, and sulfamethoxazole. Paracetamol, caffeine, sulfamethoxazole, and trimethoprim alone contributed 86% of the total amount of APIs determined along the Nairobi/Athi catchment. In addition to direct discharge of untreated domestic wastewater attributed to the informal settlements within the conurbation, other sources were linked to the industrial area in Nairobi City where drug formulation is known to occur, the Dandora landfill and veterinary medicines from upstream agriculture. It was shown that there was a possible environmental risk of API ecotoxicological effects beyond the end of the traditional impact zone defined by elevated biochemical oxygen demand concentrations; with metronidazole and sulfamethoxazole exhibiting the highest risk., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: The presence of pharmaceuticals in the environment is a growing global concern and although environmental risk assessment is required for approval of new drugs in Europe and the USA, the adequacy of the current triggers and the effects-based assessments has been questioned., Objective: To provide a comprehensive analysis of all regulatory compliant aquatic ecotoxicity data and evaluate the current triggers and effects-based environmental assessments to facilitate the development of more efficient approaches for pharmaceuticals toxicity testing., Methods: Publicly-available regulatory compliant ecotoxicity data for drugs targeting human proteins was compiled together with pharmacological information including drug targets, Cmax and lipophilicity. Possible links between these factors and the ecotoxicity data for effects on, growth, mortality and/or reproduction, were evaluated. The environmental risks were then assessed based on a combined analysis of drug toxicity and predicted environmental concentrations based on European patient consumption data., Results: For most (88%) of the of 975 approved small molecule drugs targeting human proteins a complete set of regulatory compliant ecotoxicity data in the public domain was lacking, highlighting the need for both intelligent approaches to prioritize legacy human drugs for a tailored environmental risk assessment and a transparent database that captures environmental data. We show that presence/absence of drug-target orthologues are predictive of susceptible species for the more potent drugs. Drugs that target the endocrine system represent the highest potency and greatest risk. However, for most drugs (>80%) with a full set of ecotoxicity data, risk quotients assuming worst-case exposure assessments were below one in all European countries indicating low environmental risks for the endpoints assessed., Conclusion: We believe that the presented analysis can guide improvements to current testing procedures, and provide valuable approaches for prioritising legacy drugs (i.e. those registered before 2006) for further ecotoxicity testing. For drugs where effects of possible concern (e.g. behaviour) are not captured in regulatory tests, additional mechanistic testing may be required to provide the highest confidence for avoiding environmental impacts., (Copyright © 2019. Published by Elsevier Ltd.)

In 2016, the United Nations declared the need for urgent action to combat the global threat of antimicrobial resistance (AMR). In support of this effort, the pharmaceutical industry has committed to measures aimed at improving the stewardship of antibiotics both within and outside the clinic. Notably, a group of companies collaborated to specifically address concerns related to antibiotic residues being discharged from manufacturing sites. In addition to developing a framework of minimum environmental expectations for antibiotic manufacturers, science-based receiving water targets were established for antibiotics discharged from manufacturing operations. This paper summarizes the holistic approach taken to derive these targets and includes previously unpublished, company-generated, environmental toxicity data., (© 2019 The Authors.)

With improving healthcare and an aging population, the consumption of human pharmaceuticals in China has been increasing dramatically. Environmental risks posed by many active pharmaceutical ingredients (APIs) are still unknown. This study used a spatially explicit dilution-factor methodology to model predicted environmental concentrations (PECs) of 11 human-use APIs in surface water for a preliminary environmental risk assessment (ERA). Median PECs in surface water across China range between 0.01 and 8.0 × 10 3 ng/L for the different APIs, under a moderate patient use scenario. Higher environmental risks of APIs in surface water are in regions with high water stress, e.g., northern China. Levonorgestrel, estradiol, ethinyl estradiol and abiraterone acetate were predicted to potentially pose a high or moderate environmental risk in China if consumption levels reach those in Europe. Relative risks of these four APIs have the potential to be among those chemicals with the highest impact on surface water in China when compared to the risks associated with other regulated chemicals, including triclosan and some standard water quality parameters including BOD 5 (5-day biological oxygen demand), COD (chemical oxygen demand), Cu, Zn, and Hg and linear alkylbenzene sulfonate. This method could support the regulation of this category of chemicals and risk mitigation strategies in China.

Concentrating cells from aqueous samples is a common requirement for the enumeration of biomass, investigations of microbial diversity and detection of relatively rare organisms in the environment. Accurately representing the initial sampled environments in the concentrated cells is of particular importance when the subsequent analyses have tangible environmental, economic and societal consequences, as is the case with environmental exposure and risk assessment of chemicals. This study investigated the potential use of four different cell concentration methods: centrifugation, membrane filtration, tangential flow filtration and column colonisation. These methods were assessed against a series of scientific and practical criteria, including: similarity of concentrated community to initial environmental sample; cell concentration achieved; biodegradation test outcome; sample throughput; and capital and maintenance costs. All methods increased cell concentration by as little as 10-fold to as much as 1000-fold. DGGE and 454 pyrosequencing analysis showed concentrated communities to have >60% similarity to each other, and the initial sample. There was a general trend for a more reliable assessment of 4-nitrophenol biodegradation in 96-well plate biodegradation assays, with increasing cell concentration. Based on the selection criteria, it is recommended that there is not one concentration method fit for all purposes, rather, the appropriate method should be selected on a case-by-case basis. Membrane filtration would be the most suitable method for low sample volumes; the increased throughput capacity of tangential flow filtration renders it most suitable for large volumes; and centrifugation is most suitable for samples with high initial biomass concentrations. The poor similarity in microbial community composition of the column colonised samples compared to the initial samples, suggested a concentration basis; this combined with its low sample throughput precluded this approach for future concentration studies of planktonic bacterial samples., (Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.)

Pharmaceuticals are ubiquitous in the natural environment with concentrations expected to rise as human population increases. Environmental risk assessments are available for a small portion of pharmaceuticals in use, raising concerns over the potential risks posed by other drugs that have little or no data. With >1900 active pharmaceutical ingredients in use, it would be a major task to test all of the compounds with little or no data. Desk-based prioritization studies provide a potential solution by identifying those substances that are likely to pose the greatest risk to the environment and which, therefore, need to be considered a priority for further study. The aim of this review was to (1) provide an overview of different prioritization exercises performed for pharmaceuticals in the environment and the results obtained; and (2) propose a new holistic risk-based prioritization framework for drugs in the environment. The suggested models to underpin this framework are discussed in terms of validity and applicability. The availability of data required to run the models was assessed and data gaps identified. The implementation of this framework may harmonize pharmaceutical prioritization efforts and ensure that, in the future, experimental resources are focused on molecules, endpoints, and environmental compartments that are biologically relevant.

Ecopharmacovigilance (EPV) is a developing science and it is currently very unclear what it might mean in practice. We have performed a comparison between pharmacovigilance (PV) and EPV and have identified that there are similarities, but also some important differences that must be considered before any practical implementation of EPV. The biggest difference and greatest challenge concerns signal detection in the environment and the difficulty of identifying cause and effect. We reflect on the dramatic vulture decline in Asia, which was caused by the veterinary use of diclofenac, versus the relative difficulty in identifying the specific causes of intersex fish in European rivers. We explore what EPV might mean in practice and have identified that there are some practical measures that can be taken to assess environmental risks across product life cycle, particularly after launch of a new drug, to ensure that our risk assessments and scientific understanding of pharmaceuticals in the environment remain scientifically and ecologically relevant. These include: Tracking environmental risks after launch of the product, via literature monitoring for emerging data on exposure and effects Using Environmental Risk Management Plans (ERMPs) as a centralized resource to assess and manage the risks of a drug throughout its life cycle Further research, testing or monitoring in the environment when a risk is identified Keeping a global EPV perspective Increasing transparency and availability of environmental data for medicinal products. These measures will help to ensure that any significant environmental issues associated with pharmaceuticals in the environment (PIE) are identified in a timely way, and can be managed appropriately.

Environmental persistence is an important property that can enhance the potential of a chemical substance to exert adverse effects and be transported to remote environments. The persistence of organic compounds is governed by the rates at which they are removed by biological and chemical processes, such as biodegradation, hydrolysis, atmospheric oxidation, and photolysis. The persistence workgroup in a recent Society of Environmental Toxicology and Chemistry (SETAC) Pellston workshop (Pensacola, FL, USA, January 2008) focused on evaluating persistence of organic compounds in environmental media (air, water, soil, sediment) in terms of their single-medium degradation half-lives. The primary aim was to provide guidance to authors and reviewers of chemical dossiers for persistent organic pollutants (POPs) and persistent, bioaccumulative, and toxic substances (PBTs) proposed for action. A second objective was to provide a summary of the current state of the science with respect to POP fate assessment. Assessing the persistence of chemical substances in the environment is not straightforward. A common misconception is that, like many chemical properties, environmental persistence is an inherent property of the substance and can be readily measured. In fact, rates of degradation of a substance in the environment are determined by a combination of substance-specific properties and environmental conditions. This article addresses how persistence can be evaluated based on an assortment of supporting information. Special attention is given to several critical issues, including transformation products, nonextractable residues, and treatment of uncertainty and conflicting data as part of a weight-of-evidence assessment.

Wastewater treatment is one of the largest scale and arguably the most commercially important biotechnological process in the world. Bacterial breakdown of waste materials facilitates the safe disposal of effluents into receiving water bodies. Given this significance, research has focused on identifying the keystone species on which efficient treatment is based. However, unravelling the microbial diversity within such systems has proven difficult. This is highlighted by our lack of detailed knowledge of the microbial interactions within these complex populations, limiting our ability to fully exploit bacterial degradative abilities. Even with the incorporation of new emerging molecular techniques, there have been no investigations linking genetic sequence to microbial function and successful treatment operation. To reach this goal, researchers need the ability to identify, enumerate and monitor the metabolic functions of subpopulations within these complex bacterial communities. Flow cytometry (FCM) combined with fluorescence-based molecular identification techniques provides a method for such studies. Moreover, single-cell sorting provides a unique opportunity to identify and remove individual cells of interest. Laboratory culture of sorted cells is often possible and permits the use of more traditional microbiological techniques to backup molecular investigations. Utilising this approach will advance our understanding of wastewater treatment processes and help maintain and enhance plant operation to improve efficiency.