Micropollutant point sources in the built environment: identification and monitoring of priority pharmaceutical substances in hospital effluents

A method is described for the identification of priority micropollutants (pharmaceuticals) in the aquatic environment originating from hospitals. The lack of data on the range and volume of prescribed pharmaceuticals, and on their behaviour in the environment, presented a considerable challenge to the initial selection process. The final selection of pharmaceutical substances to be included in the monitoring campaigns was based on literature data, existing priority lists, national consumption patterns and expert input from within the regions (Northwest Europe). Fifteen micropollutant compounds were identified from the diverse range of reported and prescribed pharmaceuticals in the healthcare sector:atenolol, carbamazepine, diclofenac, naproxen, lidocaine, ifosphamide, cyclophosphamide, ciprofloxacin, erythromycin, clarithromycin, sulfamethoxazole, iopromide, iopamidol, diatrizoate, and bezafibrate. Eight hospital locations in six countries were monitored for periods ranging from several weeks to one year.