Human Pharmaceuticals in the Aquatic Environment: A Review of Recent Toxicological Studies and Considerations for Toxicity Testing

Widespread detection of human pharmaceuticals in the environment, ranging between ng/L and mg/L levels in surface waters and effluents and ng/kg to mg/kg levels in aquatic and terrestrial organisms, has caused increased concern of potential ecological effects and hazards to aquatic species and fomented new investigations of potential effects of biosolids and effluents from wastewater treatment plants. Here, we critically review such recent research on the aquatic toxicity of human pharmaceuticals to aquatic organisms. Toxicity testing considerations are examined for differences in sensitivities among aquatic organisms and acute and chronic response thresholds. We further provide perspectives and recommendations, including integration of adverse outcome pathway approaches, during future ecotoxicological studies of human pharmaceuticals in the environment.