Pharmaceuticals and personal care products (PPCPs) have adverse effects on aquatic ecosystems, with many compounds bioaccumulating and acting as endocrine disruptors, leading to reproductive issues and ecological imbalances. Wastewater treatment plants are often ineffective at removing these contaminants, causing widespread exposure to aquatic organisms and potential impacts on human health through groundwater contamination. Solutions to mitigate these issues include ozone oxidation and pharmaceutical take back programs for proper disposal.

1. PPCP’s and Their Impact
on Our Environment
By Cori LeBerth

2. Introduction
• North America = Greatest producers and consumers of
Pharmaceuticals and Personal Care Products (PPCPs)
• Some of these products include;
– Prescriptions
– Antibacterial hand soap
– Fragrances
– Shampoo/Conditioner
– Shaving Cream
– Cosmetics
– Insect Repellant

3. Introduction
• Traces of pharmaceuticals in waste water were reportedly found
as far back as the 1960’s and 1970’s
• 50 to 90% of medical substances that people ingest are excreted
through urine and feces.
• Most substances remain unchanged or become metabolites,
which can be even more toxic
• The effects of PPCP’s are not well known in the aquatic
environment
• Waste Water Treatment Plants are unable to remove most PPCP’s

4. Introduction
• St. Lawrence River
– Is one example of an affected aquatic
ecosystem
– Estrogen contaminants can be detected
50km up and down stream of Montreal
– PPCP’s are found as far as 8km down
stream from the WWTP
– Population of nearly 1.8 million people live
in the Basin
• There is still no universally accepted
analysis of PPCP’s in the aquatic
environment

5. Prescription Drugs
• Chemical properties of pharmaceuticals
allow them to bioaccumulate in the aquatic
environment
• Many chemicals act as endocrine
disruptors
• Endocrine disruptors affect reproduction
and development of aquatic organisms
• Metabolites of pharmaceuticals can be
more toxic than the original compound
• Find their way into the ecosystem through
human waste or disposal

6. Endocrine Disruptors
• Endocrine’s regulate normal function of all organ systems
• Disruptors mimic or block the natural endogenous hormones
• Small disruptions to normal endocrine function has lasting
effects
• Effects include
– Disruption of natural hormonal balance
– Masculinization of females/Feminization of males
– Reduction of fertility
– Neurological impairments
– Birth defects
• Many PPCP’s and synthetic chemicals act as endocrine disruptors

7. Antibiotics
• Ciprofloxacin, Sulfamethazole, Trimethoprim, Amoxicillin, etc.
• Found in WWTP effluent due to incomplete metabolization
• Ciprofloxacin
– Second generation Fluoroquinolone
– Negatively affects good bacteria like leaf litter bacteria
– Aquatic invertebrates obtain 20-40% of their carbon from bacteria
– Leaf litter processing is important for carbon cycling in aquatic ecosystems
– Disrupting the food supply of lower trophic levels (i.e. killing bacteria) affects
the functioning of upper trophic levels
• Some scientists worry that overexposure to antibiotics will cause
super immune bacteria
• This is a threat to the whole biosphere

8. Selective Serotonin Reuptake Inhibitors (SSRI’s)
• SSRI’s are commonly known as antidepressants
• Increases serotonin levels by binding to postsynaptic receptors
• Weak affinity as a dopamine transporter
– Dopamine is an amine that acts as a neurotransmitter
– Inadequate levels of dopamine causes neurological disorders including
ADHD, Parkinson’s Disease, and Schizophrenia
• Common SSRI’s include
– Fluoxetine (Prozac)
– Sertraline (Zoloft)
– Venlafaxine (Effexor)
– Citalopram (Celexa)

9. Fluoxetine (Prozac)
• Fluoxetine and its’ cousin Fluvoxamine have
been found in most WWTP effluent
• Specific study has found that Fluoxetine affects
reproduction and development of freshwater
mussels
– Foot enlargement
– Affects spawning rates
• Mussels live in sediment which causes more
bioaccumulation due to longer exposure to
toxins
• 70% of 300 freshwater mussels are threatened
or extinct

10. Venlafaxine (Effexor) and Citalopram (Celexa)
• Impacts aquatic life
– Increases phototaxis/geotaxis in cladocerans which increases their
predation
– Affects reproduction rates of amphipods
– Striped Bass exposed to SSRI’s have reduced ability to capture prey
• Causes Snails to detach from substrate
– Detachment is controlled through dopaminergic neurons
– Mortality by predation, desiccation, transport to unsuitable habitat, and
inability to feed due to detachment from substrate
– Snails have broad geographic distribution therefore there’s a high potential to
affect a large population

11. Venlafaxine (Effexor) and Citalopram (Celexa)
• Found to occur in wastewater at concentrations as much as 10
times greater than fluoxetine
• Lowest effective concentration (LOEC) was 313 pg/L (venlafaxine)
which is 7 thousand times less than the concentration found in
wastewater
• LOEC was 405 pg/L (citalopram) which was five times lower than
the average concentration found in wastewater
• They have the lowest LOEC’s of any SSRI
• Extremely low concentrations of these medications have a huge
impact on the aquatic environment

12. Pharmaceuticals and Personal Care Products
• Compounds from each category have been found in fish blood
and tissue
• Fluoxetine, its’ metabolite norfluoxetine, and sertraline have been
found in fish tissue
• Most sources of PPCP’s are from point sources such as WWTP
effluent
• Aquatic organisms are continuously exposed to these chemicals
from WWTP effluents
– Causes bioaccumulation in organisms due to length of exposure

13. Personal Care Products
• Triclosan (TCS)
– Chemical found in antibacterial soap
– Not completely removed from WWTP
– Stable compound and is readily bioavailable to organisms
– Bioaccumulation depends on concentration and exposure length
– Molecular structure resembles nonsteroidal estrogens
– In tests, TCS reduced testosterone production and disrupts other
steroidogenic processes
– Found to be an endocrine disrupting agent
– Detected in human milk, plasma, and urine indicating bioaccumulation
– Found to result in changes to fin length and masculination of fish fry
– Important to study its affects on the environment due to its extensive use
and occurrence in WWTP effluent

14. Wastewater Treatment Plants (WWTP)
• Unable to remove most PPCP’s
• Most pharmaceutical compounds
are polar and their properties allow
them to escape sedimentation and
biological treatment in WWTP’s
• Not all WWTP’s have a biological
stage which leads to poor
biodegradation of
pharmaceuticals

15. Effects on Ground Water
• Pharmaceuticals from human waste can be found in sewage,
septic systems, and septic leach fields
• Septic effluent can potentially leach into underlying aquifers
depending on soil structure
• 12 of 22 chemicals studied were found in septic effluent in a
Missoula, MT high school
• Some pharmaceuticals were found in unconfined aquifers which
could then be transported by the ground water in measurable
concentrations

16. Potential Solutions
• Ozone (O3) Oxidation
– Found to be an effective disinfectant and powerful oxidizer
– Reacts with organic contaminants through direct reaction or through
formation of free radicals
– Studies have shown that 90% of PPCP’s found in effluent was reduced to an
almost undetectable level
– 2 minutes of Ozone contact time was sufficient to remove the majority of
contaminants
– Viable cost effective option to treat waste water over current methods
– Drawbacks however-most ozone doses do not cause mineralization therefore
by products will be generated
– By-products were found to no longer be estrogenic

17. Ozone Oxidation
Table 11 shows the
effectiveness of
Ozone Oxidation
Treatment

18. Potential Solutions
• Pharmaceutical take back programs
– Allow consumers to dispose of their PPCP’s in an
environmentally friendly way
– Many communities offer this service but mostly
in urban areas
– Possibly have medical clinics offer this service in
order to promote proper disposal in the easiest
way possible for the consumer
– http://dontrushtoflush.org/

19. References
• Bringolf, R.B. et al. 2010. Environmental Occurrence and Reproductive Effects of the Pharmaceutical Fluoxetine in Native
Freshwater Mussels. Environmental Toxicology and Chemistry. 29-6: 1311-1318.
• Fong, P.P. and C.M. Hoy. 2012. Antidepressants (Venlafaxine and Citalopram) cause foot detachment from the substrate
in freshwater snails at environmentally relevant concentrations. Marine and Freshwater Behavior and Physiology.
45-2: 145-153.
• Godfrey, Emily et al. 2007. Pharmaceuticals in On-Site Sewage Effluent and Ground Water, Western Montana. Ground
Water. 45-3: 263-271.
• Maul, J.D. et al. 2006. Effects of the Anitbiotic Ciprofloxacin on Stream Microbial Communities and Detritivorous
Macroinvertebrates. Environmental Toxicology and Chemistry. 25-6: 1598-1606.
• Ramirez, A.J. et al. 2009. Occurrence of Pharmaceuticals and Personal Care Products in Fish: Results of a National
Pilot Study in the United States. Environmental Toxicology and Chemistry. 28-12: 2587-2597.
• Raut, S.A. et al. 2010. Triclosan has Endocrine-Disrupting Effects in Male Western Mosquitofish Gambusia affinis.
Environmental Toxicology and Chemistry. 29-6: 1287-1291.
• Robinson, Isabelle et al. 2007. Trends in the Detection of Pharmaceutical Products and Their Impact and Mitigation in
Water and Wastewater in North America. Analytical and Bioanalytical Chemistry. 387: 1143-1151.
• Snyder, S.A. et al. 2006. Ozone Oxidation of Endocrine Disruptors and Pharmaceuticals in Surface Water and
Wastewater. Ozone: Science and Engineering. 28: 445-460.