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Local emission estimates of pharmaceuticals: case study for Lithuania. Jolita Kruopien ė Kaunas University of Technology, Institute of Environmental Engineering (APINI). Data on sales / consumption of pharmaceuticals. Sales data in Lithuania in 2005 – from IMS Health
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Local emission estimates of pharmaceuticals:case study for Lithuania Jolita Kruopienė Kaunas University of Technology, Institute of Environmental Engineering (APINI)
Dataon sales / consumption of pharmaceuticals • Sales data in Lithuania in 2005 – from IMS Health • Further on the data are referred to as “consumption data”.
Dataon sales / consumption of pharmaceuticals • Sales data in Lithuania in 2005 – from IMS Health • Further on the data are referred to as “consumption data”.
Consumption data Mass = (DOT x DDD) / F One substance – single ATC code & single DDD value e.g. fluoxetine ATC code: N06AB03, DDD is: 20 mg.
Consumption data One substance – two or more ATC codes, two or more DDD values The worst case assumption by using the biggest DDD value for calculations possible overestimation e.g. Finasteride: ATC code D11AX10, DDD = 1 mg, ATC code G04CB0, DDD = 5 mg
Consumption of pharmaceuticals Use of pahamaceuticals: 517 substances. • vitamins (e.g. ascorbic acid), • microelements (e.g. calcium), • substances synthesized in human body (e.g. insuline) • 436 substances remain
Consumption of pharmaceuticals Aspirin: 37681 kg Paracetamol: 14101 kg Amoxicillin: 11148.5 kg Metformin: 10957.5 kg
Load to the environment Emission estimates are a worse worst case scenario assuming • sales figures equal consumption, • outlet from WWTP is the only gate to the environment, • no human metabolism, • no degradation in WWTP.
Load to the environment Emission estimates are a worse worst case scenario assuming • sales figures equal consumption, • outlet from WWTP is the only gate to the environment, • no human metabolism, • no degradation in WWTP.
Load to the environment Emission estimates are a worse worst case scenario assuming • sales figures equal consumption, • outlet from WWTP is the only gate to the environment, • no human metabolism, • no degradation in WWTP.
Load to the environment Emission estimates are a worse worst case scenario assuming • sales figures equal consumption, • outlet from WWTP is the only gate to the environment, • no human metabolism, • no degradation in WWTP.
Load to the environment Emission estimates are a worse worst case scenario assuming • sales figures equal consumption, • outlet from WWTP is the only gate to the environment, • no human metabolism, • no degradation in WWTP.
Load to the environment Emission estimates are a worse worst case scenario assuming • sales figures equal consumption, • outlet from WWTP is the only gate to the environment, • no human metabolism, • no degradation in WWTP. Total load depends on population density only.
Environmental concentrations Worst case scenario: • PEC values for 147 pharmaceuticals used in Lithuania in 2005 exceed the EU action level of 0.01 mg/l, • i.e. pharmaceuticals used in amount higher than 37.5 kg/year might cause a risk to the environment.
Environmental concentrations Worst case scenario: • PEC values for 147 pharmaceuticals used in Lithuania in 2005 exceed the EU action level of 0.01 mg/l, • i.e. pharmaceuticals used in amount higher than 37.5 kg/year might cause a risk to the environment.
Environmental concentrations Worst case scenario: • PEC values for 147 pharmaceuticals used in Lithuania in 2005 exceed the EU action level of 0.01 mg/l, • i.e. pharmaceuticals used in amount higher than 37.5 kg/year might cause a risk to the environment.
PEC / PNEC • Availability of toxicity data • PNEC calculated for 37 substances • Only 3 pharmaceuticals exceed the PEC/PNEC ratio of 1: • amoxicillin, • ciprofloxacin • spiramycin.
PEC / PNEC • Availability of toxicity data • PNEC calculated for 37 substances • Only 3 pharmaceuticals exceed the PEC/PNEC ratio of 1: • amoxicillin, • ciprofloxacin • spiramycin.
PEC / PNEC • Availability of toxicity data • PNEC calculated for 37 substances • Only 3 pharmaceuticals exceed the PEC/PNEC ratio of 1: • amoxicillin, • ciprofloxacin • spiramycin.
Taking into account metabolism • Even 60-70% of amoxicillin is excreted unchanged in urine. • ~ 35% of ciprofloxacine is excreted in urine as unchanged drug • Spiramycin is mainly excreted by non renal processes. Urinary excretion accounts for ~14% of an administered dose
Taking into account metabolism • Even 60-70% of amoxicillin is excreted unchanged in urine. • ~ 35% of ciprofloxacine is excreted in urine as unchanged drug • Spiramycin is mainly excreted by non renal processes. Urinary excretion accounts for ~14% of an administered dose
Taking into account metabolism • Even 60-70% of amoxicillin is excreted unchanged in urine. • ~ 35% of ciprofloxacine is excreted in urine as unchanged drug • Spiramycin is mainly excreted by non renal processes. Urinary excretion accounts for ~14% of an administered dose
Taking into account treatment in WWTP - About 80% of effluents in Lithuania undergo biological treatment - No biological treatment in Kaunas yet • 60% sorption onto sewage sludge is reported for amoxicillin • 65% of ciprofloxacin was eliminated by sorption, and 30% was detected in the effluent
Taking into account treatment in WWTP - About 80% of effluents in Lithuania undergo biological treatment - No biological treatment in Kaunas yet • 60% sorption onto sewage sludge is reported for amoxicillin • 65% of ciprofloxacin was eliminated by sorption, and 30% was detected in the effluent
Taking into account treatment in WWTP - About 80% of effluents in Lithuania undergo biological treatment - No biological treatment in Kaunas yet • 60% sorption onto sewage sludge is reported for amoxicillin • 65% of ciprofloxacin was eliminated by sorption, and 30% was detected in the effluent