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WIREs Water
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Pharmaceuticals in surface waters: sources, behavior, ecological risk, and possible solutions. Case study of Lake Geneva, Switzerland

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Nowadays, pharmaceuticals are present in surface waters as well as in groundwaters of developed countries. In the middle of Lake Geneva, for example, one of the largest European lakes, 14 pharmaceuticals are regularly detected in concentrations up to 0.37 µg/L. This pollution is due to the human consumption of drugs and also veterinary use and industrial releases during production. In the case of Lake Geneva, this latter pollution is significant for some specific compounds. But, as shown in this overview, environmental toxicity data are lacking for most of the pharmaceuticals detected in the aquatic environment. For example, the ecotoxicity of metformin, one of the main compounds detected in Lake Geneva, is mostly unknown for the moment. Furthermore, specific effects like endocrine disruption, genotoxicity, or antibioresistance induction, which may be expected because of the mode of action of some drugs, have not yet been investigated for aquatic species. Ecological risk assessment of pharmaceuticals is therefore tricky and most of the time is not feasible. Owing to this lack of knowledge, also due to high biological potency of the pharmaceuticals, it is critical to reduce the release of these compounds to the aquatic system. This may be achieved by ‘at source’ (e.g., urine collection) methods or ‘end of pipe’ (e.g., wastewater treatment) solutions. WIREs Water 2014, 1:69–86. doi: 10.1002/wat2.1006 This article is categorized under: Science of Water > Water Quality
Lake Geneva, Switzerland.
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Evolution of the average concentration of carbamazepine at SHL2, at the middle of Lake Geneva, from 2006 to 2011 (Source: Refs , and ).
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Concentrations of 11 pharmaceuticals in 2009 and 2010 in the Venoge (CH) and in the Boiron (CH) (Source: Refs and ).
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Concentrations of some pharmaceuticals in four rivers entering Lake Geneva in 2009 (Source: Ref ).
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Scheme of ecological risk assessment. The environmental concentrations are compared to a water quality criterion. If the ratio is above the value of one, risk reduction measures should be envisioned.
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Typical depth profiles for three pharmaceuticals, (a) carbamazepine and mepivacaïne and (b) metformin in Lake Geneva (Source: Refs and ).
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Quantity of antibiotic classes sold in Switzerland in 2008 for veterinary use (Source: Ref ).
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Substance flow analysis for (a) the anti‐inflammatory drug diclofenac and (b) the antibiotic ciprofloxacin. The values are given in (kg/year) for both substances.. WWTP: Waste water treatment plant; CSO: combined sewer overflow.
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