Occurrence and risk assessment of pharmaceuticals in surface waters of the Middle East and North Africa: A review

• Published in: The Science of the total environment 2022-12, Vol.851, p.158302-158302, Article 158302
• Main Authors: Mheidli, Nourhan, Malli, Ali, Mansour, Fatima, Al-Hindi, Mahmoud
• Format: Article
• Language: English
• Subjects: Measured environmental concentrations; Pharmaceuticals; Risk assessment; Surface water
• ISSN: 0048-9697; 1879-1026
• DOI: 10.1016/j.scitotenv.2022.158302

Pharmaceutical compounds in surface water are perceived as contaminants of emerging concern due to their impacts on the aquatic environment and human health. The risk associated with these compounds has not been quantified in the Middle East and North Africa (MENA). This review identified that 210 pharmaceutical compounds have been analyzed in MENA water compartments between 2008 and 2022. In fact, 151 of these substances were detected in at least one of 13 MENA countries where occurrence studies had been conducted. Antibiotics claimed the highest number of pharmaceuticals detected with concentrations ranging between 0.03 and 66,400 ng/L (for Thiamphenicol and Spiramycin respectively). To investigate whether any of these compounds exert an ecological, human health, or antibiotic resistance risk, a screening-level risk assessment was performed in surface water matrices using maximum, median, and minimum concentrations. 39 and 8 detected pharmaceuticals in MENA surface waters posed a possible risk on aquatic ecosystems and human health respectively. Extremely high risk quotients (>1000) for six pharmaceuticals (17β estradiol, spiramycin, diclofenac, metoprolol, ethinylestradiol, and carbamazepine) were enumerated based on maximal concentrations implying an alarming risk on aquatic toxicity. Moreover, hormones posed the highest possible risk on human health whether ingested through drinking water or fish (e.g., 17β-estradiol had a health risk quotient of 2880 for children). Spiramycin showed a high risk of antibiotic resistance with a risk quotient of 133. This review serves as a basis for future prioritization studies and regulatory guidelines in the MENA region to minimize the risks of the identified compounds. [Display omitted] •151 out of 210 analyzed compounds were detected in MENA water matrices.•26 % of the detected pharmaceuticals in MENA waters posed a risk on aquatic life.•Antibiotics posed the highest risk on the aquatic environment.•5 % of the detected pharmaceuticals in MENA waters posed a risk on human health.•Hormones posed the highest risk on human health.