LEPABE - Laboratory for Process, Environmental, Biotechnology and Energy Engineering, Faculty of Engineering, University of Porto, R. Dr. Roberto Frias, 4200-465 Porto, Portugal; ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.
ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal; LSRE-LCM - Laboratory of Separation and Reaction Engineering - Laboratory of Catalysis and Materials, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.
Sci Total Environ. 2022 Dec 20;853:158559. doi: 10.1016/j.scitotenv.2022.158559. Epub 2022 Sep 8.
Cytostatic drugs are pharmaceuticals administered to cancer patients under chemotherapy. Their occurrence in surface waters has been reported worldwide, increasing environmental and human health concerns. This work addresses a question of worldwide interest: are these hazardous pharmaceuticals in surface waters a potential threat? For the first time, this study brings information on the presence of cytostatic drugs in Portuguese rivers. Furthermore, cutting-edge data on the occurrence of two cytostatic drugs is provided; up to the authors' best knowledge, flutamide and mycophenolate mofetil have never been monitored in worldwide surface waters. Nine out of thirteen cytostatic drugs were detected in Portuguese rivers. Despite bicalutamide being the cytostatic most frequently detected, the highest concentration was recorded for cyproterone (19 ± 3 ng/L). Three different scenarios were considered to estimate the risks from the exposure of humans to cytostatic drugs via surface waters. Two scenarios are associated with bathing practices in rivers, particularly in the spring and summer seasons (river beaches): (i) the exposure to cytostatic drugs by dermal contact with contaminated water and (ii) the exposure by accidental ingestion of contaminated water, which is less likely but also occurs. The third exposure scenario is related to (iii) the long-life consumption of drinking water produced from river water capture, under worst-case conditions, i.e. negligible degradation of cytostatic drugs at drinking water treatment plants. It was concluded that the third exposure context to cytostatics could represent a risk to children, if the highest concentration ever reported in the literature for cyclophosphamide in surface waters is considered. Still, attending to the carcinogenicity of some of these compounds (e.g., cyclophosphamide, chlorambucil, etoposide and tamoxifen), health risks might always be expected, regardless of the contamination level. Furthermore, health risks associated with synergic effects and/or long-term exposures cannot be ruled out, even for the remaining cytostatics/exposure contexts.
细胞抑制剂是在化疗中给癌症患者使用的药物。它们在世界范围内的地表水已经有报道，增加了对环境和人类健康的关注。这项工作解决了一个全球性的问题：这些有害的药物在地表水中是否构成潜在威胁？这是首次提供有关葡萄牙河流中存在细胞抑制剂的信息。此外，还提供了关于两种细胞抑制剂的最新发生数据；据作者所知，氟他胺和霉酚酸酯在世界范围内的地表水从未被监测到过。在葡萄牙河流中检测到了 13 种细胞抑制剂中的 9 种。尽管比卡鲁胺是最常检测到的细胞抑制剂，但记录到的最高浓度是环丙孕酮（19 ± 3ng/L）。考虑了三种不同的情况来估计人类通过地表水接触细胞抑制剂的风险：（i）通过与受污染的水接触皮肤来暴露于细胞抑制剂，（ii）意外摄入受污染的水，这种情况不太可能发生，但也会发生，（iii）通过长期饮用从河流取水的饮用水来暴露于细胞抑制剂，在最糟糕的情况下，即在饮用水处理厂几乎没有降解细胞抑制剂的情况下。研究得出的结论是，如果考虑到文献中地表水环磷酰胺的最高浓度，第三种接触细胞抑制剂的情况可能对儿童构成风险。然而，由于这些化合物中的一些（例如环磷酰胺、苯丁酸氮芥、依托泊苷和他莫昔芬）具有致癌性，无论污染水平如何，都可能会存在健康风险。此外，即使对于剩余的细胞抑制剂/暴露情况，也不能排除协同作用和/或长期暴露相关的健康风险。
