Exposure and ecotoxicological risk assessment of mixtures of top prescribed pharmaceuticals in Swedish freshwaters.

Surface water concentrations of 54 pharmaceuticals were predicted for seven major Swedish rivers and the Stockholm City area basins using the STREAM-EU model. These surface water concentrations were used to predict the ecotoxicological impact resulting from the exposure of aquatic organisms to this mixture of 54 pharmaceuticals. STREAM-EU model results indicated that <10 substances were present at median annual water concentrations greater than 10 ng/L with highest concentrations occurring mostly in the more densely populated area of the capital city, Stockholm. There was considerable spatial and temporal variability in the model predictions (1-3 orders of magnitude) due to natural variability (e.g. hydrology, temperature), variations in emissions and uncertainty sources. Local mixture ecotoxicological pressures based on acute EC50 data as well as on chronic NOEC data, expressed as multi-substance potentially affected fraction of species (msPAF), were quantified in 114 separate locations in the waterbodies. It was estimated that 5% of the exposed aquatic species would experience exposure at or above their acute EC50 concentrations (so-called acute hazardous concentration for 5% of species, or aHC5) at only 7% of the locations analyzed (8 out of 114 locations). For the evaluation based on chronic NOEC concentrations, the chronic HC5 (cHC5) is exceeded at 27% of the locations. The acute mixture toxic pressure was estimated to be predominantly caused by only three substances in all waterbodies: Furosemide, Tramadol and Ibuprofen. A similar evaluation of chronic toxic pressure evaluation logically demonstrates that more substances play a significant role in causing a higher chronic toxic pressure at more sites as compared to the acute toxic pressure evaluation. In addition to the three substances contributing most to acute effects, the chronic effects are predominantly caused by another five substances: paracetamol, diclofenac, ethinylestradiol, erythromycin and ciprofloxacin. This study provides regulatory authorities and companies responsible for water quality valuable information for targeting remediation measures and monitoring on a substance and location basis.