Department of Environmental Science, Institute for Water & Wetland Research, Radboud University Nijmegen, Nijmegen, The Netherlands.
Department of Global Health-Amsterdam, Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Integr Environ Assess Manag. 2022 Nov;18(6):1639-1654. doi: 10.1002/ieam.4588. Epub 2022 Feb 28.
Active pharmaceutical ingredients (APIs) can reach surface waters used for drinking water extraction and recreational activities, such as swimming and fishing. The aim of the present study was to systematically assess the lifetime human health risks posed by 15 individual APIs and their mixtures occurring in the German-Dutch transboundary Vecht River. An exposure model was developed and used to assess the combined risks of oral and dermal exposure under a variety of exposure conditions. A total of 4500 API uptake values and 165 lifetime risk values were estimated for 15 and 11 APIs, respectively. Overall, the lifetime human health risks posed by the APIs and their mixtures based on modeling results were deemed acceptable under typical exposure conditions. Under very extreme environmental conditions and human behavior, API mixture risks were of potential concern while the risks of individual APIs were negligible, with a few exceptions. The antibiotic doxycycline and analgesic phenazone showed the highest and lowest risks, respectively. The study did not evaluate the potential risks caused by metabolite compounds. Recommendations for water managers are provided to help improve the accuracy and utility of human health risk assessments of pharmaceuticals. Integr Environ Assess Manag 2022;18:1639-1654. © 2022 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).
活性药物成分 (API) 可能会进入用于饮用水提取和娱乐活动（如游泳和钓鱼）的地表水。本研究的目的是系统评估在德国-荷兰跨界 Vecht 河存在的 15 种单独 API 及其混合物对人类终生健康造成的风险。开发了一种暴露模型，并用于评估在各种暴露条件下口服和皮肤暴露的综合风险。分别为 15 种和 11 种 API 估算了 4500 个 API 摄取值和 165 个终生风险值。总体而言，基于建模结果，在典型暴露条件下，API 和其混合物对人类健康造成的终生风险被认为是可以接受的。在非常极端的环境条件和人类行为下，API 混合物的风险可能受到关注，而个别 API 的风险可以忽略不计，但也有例外。抗生素强力霉素和止痛药非那宗分别显示出最高和最低的风险。本研究没有评估代谢物化合物可能造成的潜在风险。为了帮助提高药物的人类健康风险评估的准确性和实用性，为水管理者提供了建议。2022 年《综合环境评估与管理》，第 18 卷，第 1639-1654 页。© 2022 作者。综合环境评估与管理由 Wiley 期刊 LLC 代表环境毒理与化学学会（SETAC）出版。
