Search

Compared to other countries in the Middle East and North Africa region, Lebanon is considered the richest in water resources. However, due to inadequate water management, Lebanese water resources are under stress. Previous studies in Lebanon were mainly focused on heavy metals and microbiological analysis. Following the increase in cancer rates in Lebanon, the occurrence of six anticancer drugs estimated to be the most administered in Lebanon was assessed in samples collected from wastewater treatment plants (WWTPs), sewage outfalls, and surface water. Two SPE–LC–MS/MS methods were developed and validated for the detection of the selected anticancer drugs with LOD values ranging between 0.1 and 0.9 ng/L and LOQ values ranging between 0.3 and 2.8 ng/L. Three anticancer drugs were detected using this technique, 5-fluorouracil, methotrexate, and cyclophosphamide, with an overall concentration range of 1 to 305 ng/L. The detection of these drugs in WWTP effluents, sewage outfalls, and rivers confirmed the weaknesses prevailing in the management of wastewater and the treatment technologies adopted by the few operational WWTPs in Lebanon.

Lebanon is a Middle Eastern country located on the eastern Mediterranean coast. Compared to other countries in the MENA (Middle East North Africa) region, Lebanon is considered the richest in water resources. However, due to inadequate water management, Lebanese water resources are under stress. Water pollution is one of the main problems causing major concerns. The contamination of Lebanese surface water originates predominantly from the discharge of untreated municipal and industrial wastewater. With only a few studies investigating the level of water contamination in Lebanon, this research is the first to report the level of platinum in numerous rivers, three wastewater treatment plants, and two untreated sewage outfalls in coastal areas across Lebanon. To determine the platinum levels, an Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) method was developed and validated in compliance with the ICH guidelines. The method demonstrated acceptable sensitivity with LOQ and LOD equal to 2.35 and 0.56 ng L−1, respectively. The level of total platinum in the Lebanese water samples ranged between 22.44–53.32 ng L−1. These concentrations were all above the baseline concentration of platinum in tap water indicated by WHO and aligned with previous studies in other countries. Although the baseline concentration of platinum in Lebanese water resources is unknown and the source of the total platinum detected in this study could not be identified, these preliminary findings could serve as a foundation for future research.

Introduction To achieve continuous environmental sustainability and protect the population's health, healthcare waste (in liquid or solid form) needs appropriate management and suitable treatment strategies before its final disposal in the environment in order to reduce its adverse impacts. This study aims to identify disparities in the waste management of anti-cancer drugs and the wastewater generated in Lebanese hospitals. Methods Three questionnaires were designed to evaluate the level of knowledge, awareness and experience of hospital personnel regardless of their job levels. Data was collected in December 2019 from three departments of each participating hospital: pharmacy, oncology and maintenance departments. A descriptive analysis was conducted to summarise the survey results. Results The results revealed a lack of transparency and awareness of the participants, with a high frequency of ‘prefer not to say’ responses when asked about the disposal methods of anti-cancer drugs and with only 5.7% of the participants in the pharmacy department sharing their disposal procedures. The same perception was deduced regarding hospitals’ wastewater treatment, where responses were often contradicting, preventing making assumptions about the fate of hospital wastewater. Conclusion The results of this survey support the need to establish a more comprehensive waste management programme in Lebanon that would be maintained through regular training and supervision.

Anticancer drugs in the aquatic environment have drawn a lot of attention in the last decade. Since wastewater treatment plants are inefficient at fully eliminating trace concentrations of anticancer drugs, these compounds are continuously discharged into the aquatic environment. Subsequently, non-target organisms such as the aquatic biota are directly exposed to a variety of anticancer drugs. To understand the potential impact on the aquatic organisms, a systematic review was conducted in compliance with the PRISMA guidelines. The results acquired from the 152 included studies were analysed and sorted into four categories: the impact of each included anticancer drug, the effect of metabolites, the effect of a mixture of drugs, and risk assessment. Findings showed that risk to the aquatic biota was unlikely to occur as the concentrations needed to induce effects were much higher than those detected in the environment. However, these data were based on acute toxicity and included only basic toxicity endpoints. The concentrations that produced significant effects were much lower when tested in the long-term or in multi-generational studies. Heterogeneity in results was also observed; this depended on the organism tested, the assessment adopted, and the endpoints selected. In this systematic review, an overall view of the research studies was generated by which all the variability factors to be considered were reported and recommendations to guide future studies were proposed.

Water contamination with pharmaceutical products is a well-studied problem. Numerous studies have demonstrated the presence of anticancer drugs in different water resources that failed to be eliminated by conventional wastewater treatment plants. The purpose of this report was to conduct a systematic review of anticancer drugs in the aquatic environment. The methodology adopted was carried out in compliance with the PRISMA guidelines. From the 75 studies that met the specific requirements for inclusion, data extracted showed that the most common anticancer drugs studied are cyclophosphamide, tamoxifen, ifosfamide and methotrexate with concentrations measured ranging between 0.01 and 86,200 ng/L. There was significant variation in the methodologies employed due to lack of available guidelines to address sampling techniques, seasonal variability and analytical strategy. The most routinely used technique for quantitative determination was found to be solid-phase extraction followed by LC-MS analysis. The lowest reported recovery percentage was 11%, and the highest limit of detection was 1700 ng/L. This indicated the inadequacy of some methods to analyse anticancer drugs and the failure to obtain reliable results. The significant heterogeneity within methodologies made it difficult to compare results and draw conclusions, nevertheless, this study aids in the extrapolation of proposed recommendations to guide future studies and reviews. Graphical abstract Electronic supplementary material The online version of this article (10.1007/s11356-019-07045-2) contains supplementary material, which is available to authorized users.