{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T16:46:01Z","timestamp":1793033161584,"version":"4.5.0"},"reference-count":134,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,27]],"date-time":"2022-11-27T00:00:00Z","timestamp":1669507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The negative effect of the pharmaceuticals presence (persistence?) in various components of the environment is a global problem today. These compounds are released into the environment as a result of, inter alia, their use and improper disposal. Therefore, it is important to reduce excessive drug consumption and to develop a system for the collection of unused\/expired pharmaceuticals. The effectiveness of actions in this area is inextricably linked with the need to educate society on how to deal properly with unwanted medications. The aim of the study was to show that the inappropriate handling of unused\/expired drugs by society is an important problem in waste management systems, and it impacts the state of the environment. Forty-eight scientific articles published between 2012 and 2021 were taken into account that discussed the systems in various countries for the collection of unused\/expired pharmaceuticals. This literature review shows that the main method of disposing of unused\/expired medications, according to respondents from different countries, is either by disposing of them in household waste or flushing them into the sewage system. This is also the case in countries with systems or programs for the return of redundant drugs, which indicates that these systems are not sufficiently effective. This may be influenced by many factors, including the lack or ineffective education of the society.<\/jats:p>","DOI":"10.3390\/ijerph192315798","type":"journal-article","created":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T03:28:49Z","timestamp":1669606129000},"page":"15798","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":165,"title":["Household Pharmaceutical Waste Disposal as a Global Problem\u2014A Review"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5556-3658","authenticated-orcid":false,"given":"Justyna","family":"Rogowska","sequence":"first","affiliation":[{"name":"Division of Medical and Pharmacy Law, Department of Social Medicine, Faculty of Health Sciences, Medical University of Gda\u0144sk, Tuwima Str. 15, 80-210 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8757-5311","authenticated-orcid":false,"given":"Agnieszka","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Division of Medical and Pharmacy Law, Department of Social Medicine, Faculty of Health Sciences, Medical University of Gda\u0144sk, Tuwima Str. 15, 80-210 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,27]]},"reference":[{"key":"ref_1","unstructured":"(2021, October 10). WHO. Available online: https:\/\/www.who.int\/data\/gho\/data\/indicators\/indicator-details\/GHO\/life-expectancy-at-birth-(years)."},{"key":"ref_2","unstructured":"Roser, M., Ortiz-Ospina, E., and Ritchie, H. (2021, October 10). Life Expectancy. Our World in Data. Available online: https:\/\/ourworldindata.org\/life-expectancy."},{"key":"ref_3","unstructured":"OECD Indicators (2019). Health at a Glance 2019, OECD Publishing."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"227","DOI":"10.31024\/ajpp.2018.4.2.21","article-title":"Knowledge, attitude and practices of Over the Counter (OTC) medicines among rural population-A cross sectional study","volume":"4","author":"Goyal","year":"2018","journal-title":"Asian J. Pharm. Pharmacol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/ijpp.12457","article-title":"Attitudes towards sales and use of over-the-counter drugs in Sweden in a reregulated pharmacy market: A population-based study","volume":"27","author":"Hedenrud","year":"2019","journal-title":"Int. J. Pharm. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"112106","DOI":"10.1016\/j.jenvman.2021.112106","article-title":"Pharmaceutical pollution sources and solutions: Survey of human and veterinary medication purchasing, use, and disposal","volume":"285","author":"Vatovec","year":"2021","journal-title":"J. Environ. Manag."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Barrenberg, E., Knopf, H., and Garbe, E. (2018). Over-the-counter (OTC) drug consumption among adults living in Germany: Results from the German Health Interview and Examination Survey for Adults 2008\u20132011 (DEGS1). Pharmacy, 6.","DOI":"10.3390\/pharmacy6020052"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s00267-019-01174-7","article-title":"Pharmaceutical household waste practices: Preliminary findings from a case study in Poland","volume":"64","author":"Rogowska","year":"2019","journal-title":"Environ. Manag."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"26725","DOI":"10.1007\/s11356-017-9551-y","article-title":"Disposal of household pharmaceuticals in insular communities: Social attitude, behavior evaluation and prevention activities","volume":"25","author":"Zorpas","year":"2018","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1007\/s40267-020-00785-z","article-title":"Self-medication during COVID-19 pandemic: Challenges and opportunities","volume":"36","author":"Malik","year":"2020","journal-title":"Drugs Ther. Perspect."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jsps.2020.12.001","article-title":"Self-medication practices during the COVID-19 pandemic among the adult population in Peru: A cross-sectional survey","volume":"29","author":"Manrique","year":"2021","journal-title":"Saudi Pharm. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"126351","DOI":"10.1016\/j.chemosphere.2020.126351","article-title":"Occurrence and toxicity of antibiotics in the aquatic environment: A review","volume":"251","author":"Kovalakova","year":"2020","journal-title":"Chemosphere"},{"key":"ref_13","unstructured":"(2021, October 10). The State of the World\u2019s Antibiotics 2021, a Global Analysis of Antimicrobial Resistance and Its Drivers, the Center for Disease Dynamics, Economics & Policy. Available online: https:\/\/cddep.org\/wp-content\/uploads\/2021\/02\/The-State-of-the-Worlds-Antibiotics-in-2021.pdf."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1080\/07388551.2018.1471038","article-title":"Research progress on distribution, migration, transformation of antibiotics and antibiotic resistance genes (ARGs) in aquatic environment","volume":"38","author":"Shao","year":"2018","journal-title":"Crit. Rev. Biotechnol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"108","DOI":"10.3109\/03009734.2014.896438","article-title":"Antibiotics in the environment","volume":"119","author":"Larsson","year":"2014","journal-title":"Upsala J. Med. Sci."},{"key":"ref_16","unstructured":"Vieno, N., Hallgren, P., Wallberg, P., Pyh\u00e4l\u00e4, M., and Zandaryaa, S. (2017). Baltic Marine Environment Protection Commission. Pharmaceuticals in the Aquatic Environment of the Baltic Sea Region: A Status Report, UNESCO Publishing. CCB Report: Pharmaceutical Pollution in the Baltic Sea Region."},{"key":"ref_17","unstructured":"(2017). One Health Action Plan. Communication from the Commission to the Council and the European Parliament a European One Health Action Plan against Antimicrobial Resistance (AMR) (Standard No. COM\/2017\/0339)."},{"key":"ref_18","unstructured":"(2019). Strategic Approach to Pharmaceuticals in the Environment. Communication from the Commission to the European Parliament, the Council and the European Economic and Social Committee, European Union Strategic Approach to Pharmaceuticals in the Environment, Brussels (Standard No. 11.3.2019, COM(2019) 128 Final)."},{"key":"ref_19","unstructured":"(2022, March 22). Baltic Sea Action Plan (BSAP) Update 2021, Baltic Marine Environment Protection Commission, October 2021. Available online: https:\/\/helcom.fi\/media\/publications\/Baltic-Sea-Action-Plan-2021-update.pdf."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Pires, A., Martinho, G., Rodrigues, S., and Gomes, M.I. (2019). Prevention and reuse: Waste hierarchy steps before waste collection. Sustainable Solid Waste Collection and Management, Springer.","DOI":"10.1007\/978-3-319-93200-2"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1108\/JGR-03-2014-0009","article-title":"The global public health issue of pharmaceutical waste: What role for pharmacists?","volume":"5","author":"Singleton","year":"2014","journal-title":"J. Glob. Responsib."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1177\/0734242X11423286","article-title":"Assessment of pharmaceutical waste management at selected hospitals and homes in Ghana","volume":"30","author":"Sasu","year":"2012","journal-title":"Waste Manag. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s40545-018-0155-9","article-title":"Assessment of knowledge, attitude and practice towards disposal of unused and expired pharmaceuticals among community in Harar city, Eastern Ethiopia","volume":"11","author":"Ayele","year":"2018","journal-title":"J. Pharm. Policy Pract."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/jphs.12333","article-title":"Knowledge, attitude and disposing practice of unused and expired medicines among the general public in Malaysia","volume":"11","author":"Ong","year":"2020","journal-title":"J. Pharm. Health Serv. Res."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Hassali, A.M., and Shakeel, S. (2020). Unused and Expired Medications Disposal Practices among the General Public in Selangor, Malaysia. Pharmacy, 8.","DOI":"10.3390\/pharmacy8040196"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Marwa, K.J., Mcharo, G., Mwita, S., Katabalo, D., Ruganuza, D., and Kapesa, A. (2021). Disposal practices of expired and unused medications among households in Mwanza, Tanzania. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0246418"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e04551","DOI":"10.1016\/j.heliyon.2020.e04551","article-title":"Improper disposal practice of unused and expired pharmaceutical products in Indonesian households","volume":"6","author":"Insani","year":"2020","journal-title":"Heliyon"},{"key":"ref_28","first-page":"S955","article-title":"A survey on medicine disposal practice among households in Yogyakarta","volume":"12","author":"Kristina","year":"2018","journal-title":"Asian J. Pharm."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.jenvman.2017.04.101","article-title":"Investigating sources of pharmaceutical pollution: Survey of over-the-counter and prescription medication purchasing, use, and disposal practices among university students","volume":"198","author":"Vatovec","year":"2017","journal-title":"J. Environ. Manag."},{"key":"ref_30","first-page":"3","article-title":"Pharmaceutical waste management an overview","volume":"9","author":"Kadam","year":"2016","journal-title":"Indian J. Pharm. Pract."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s00267-019-01199-y","article-title":"Household pharmaceutical waste disposal in Selangor, Malaysia\u2014Policy, public perception, and current practices","volume":"64","author":"Ariffin","year":"2019","journal-title":"Environ. Manag."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1002\/tqem.21744","article-title":"Disposal of unused antibiotics as household waste: A social driver of antimicrobial resistance","volume":"30","author":"Sharma","year":"2021","journal-title":"Environ. Qual. Manag."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Aquino, S., Antonio Spina, G., Leit\u00e3o Zajac, M.A., and Luiz Lopes, E. (2018). Reverse logistics of postconsumer medicines: The roles and knowledge of pharmacists in the municipality of S\u00e3o Paulo, Brazil. Sustainability, 10.","DOI":"10.3390\/su10114134"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"61","DOI":"10.3390\/jox11020005","article-title":"Pharmaceutical pollution and disposal of expired, unused, and unwanted medicines in the Brazilian context","volume":"11","author":"Freitas","year":"2021","journal-title":"J. Xenobiot."},{"key":"ref_35","unstructured":"(2021, October 10). Decree 10.388 of 2020, Available online: https:\/\/www.in.gov.br\/web\/dou\/-\/decreto-n-10.388-de-5-de-junho-de-2020-260391756."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.jsps.2012.04.001","article-title":"Practice, awareness and opinion of pharmacists toward disposal of unwanted medications in Kuwait","volume":"20","author":"Abahussain","year":"2012","journal-title":"Saudi Pharm. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.cptl.2020.08.004","article-title":"Pharmacy students\u2019 knowledge and practices concerning the storing and disposal of household medication in Saudi Arabia","volume":"13","author":"Abahussain","year":"2021","journal-title":"Curr. Pharm. Teach. Learn."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Alghadeer, S., and Al-Arifi, M.N. (2021). Community pharmacists\u2019 practice, awareness, and beliefs about drug disposal in Saudi Arabia. Healthcare, 9.","DOI":"10.3390\/healthcare9070823"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s13584-016-0108-1","article-title":"Household medical waste disposal policy in Israel","volume":"5","author":"Berman","year":"2016","journal-title":"Israel J. Health Policy Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1007\/s11096-014-9936-7","article-title":"Issues around household pharmaceutical waste disposal through community pharmacies in Croatia","volume":"36","author":"Vitale","year":"2014","journal-title":"Int. J. Clin. Pharm."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1007\/s11096-012-9652-0","article-title":"Storage and disposal of unused medications: Knowledge, behavior, and attitudes among Serbian people","volume":"34","author":"Kusturica","year":"2012","journal-title":"Int. J. Clin. Pharm."},{"key":"ref_42","unstructured":"Thane, G. (2022, November 12). A Call to Action: An Evidence Review on Pharmaceutical Disposal in the Context of Antimicrobial Resistance in Canada, NCCID. Available online: https:\/\/nccid.ca\/wp-content\/uploads\/sites\/2\/2021\/03\/A-Call-to-Action-An-Evidence-Review-on-Pharmaceutical-Disposal-in-the-Context-of-Antimicrobial-Resistance-in-Canada.pdf."},{"key":"ref_43","unstructured":"(2021, October 10). Cyclamed. Available online: https:\/\/www.cyclamed.org\/english."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"182","DOI":"10.31925\/farmacia.2021.1.25","article-title":"Regulations on green pharmacy in European countries\u2013a comparative study","volume":"62","author":"Toma","year":"2021","journal-title":"Farmacia"},{"key":"ref_45","unstructured":"EU (2021, October 10). Commission Notice Separate Collection of Household Hazardous Waste (2020\/C 375\/01) (OJ EU C375\/1 6.11.2020). Available online: https:\/\/eur-lex.europa.eu\/legal-content\/EN\/TXT\/PDF\/?uri=CELEX:52020XC1106&rid=2."},{"key":"ref_46","first-page":"1425","article-title":"Disposal of unused medicines resulting from home treatment in Romania","volume":"17","author":"Tit","year":"2016","journal-title":"J. Environ. Prot. Ecol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Bungau, S., Tit, D.M., Fodor, K., Cioca, G., Agop, M., Iovan, C., Cseppento, D.C., Bumbu, A., and Bustea, C. (2018). Aspects regarding the pharmaceutical waste management in Romania. Sustainability, 10.","DOI":"10.3390\/su10082788"},{"key":"ref_48","first-page":"1093","article-title":"Procedures regarding expired medicinal products: Selected legal issues","volume":"20","author":"Zimmermann","year":"2011","journal-title":"Pol. J. Environ. Stud."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1177\/0734242X16639388","article-title":"Practices of pharmaceutical waste generation and discarding in households across Portugal","volume":"34","author":"Valente","year":"2016","journal-title":"Waste Manag. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1007\/s11096-007-9177-0","article-title":"Returned medicines in community pharmacies of Barcelona, Spain","volume":"30","author":"Coma","year":"2008","journal-title":"Pharm. World Sci."},{"key":"ref_51","unstructured":"(2021, October 10). Sigre. Available online: https:\/\/www.sigre.es\/en\/wp-content\/uploads\/2019\/09\/SIGRE_Sustainability_Report-2018_Executive_Summary.pdf."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1345\/aph.1R706","article-title":"Behind closed doors: Medication storage and disposal in the home","volume":"47","author":"Wieczorkiewicz","year":"2013","journal-title":"Ann. Pharmacother."},{"key":"ref_53","unstructured":"(2021, October 10). DEA, Available online: https:\/\/www.dea.gov\/press-releases\/2014\/09\/08\/dea-releases-new-rules-create-convenient-safe-and-secure-prescription."},{"key":"ref_54","first-page":"1","article-title":"Overview of Pharmaceutical Disposal Methods: Addressed to the General Assembly of Illinois","volume":"17","author":"Chintam","year":"2020","journal-title":"J. Sci. Pol. Gov."},{"key":"ref_55","unstructured":"(2021, February 04). EPA, Available online: https:\/\/www.epa.gov\/hwgenerators\/collecting-and-disposing-unwanted-medicines."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Ocan, M., Bbosa, G.S., Waako, P., Ogwal-Okeng, J., and Obua, C. (2014). Factors predicting home storage of medicines in Northern Uganda. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-650"},{"key":"ref_57","first-page":"2175","article-title":"What happens to unused, expired and unwanted medications? A survey of a community-based medication disposal practices","volume":"3","author":"Abruquah","year":"2014","journal-title":"Int. J. Dev. Sustain."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Lam, Y., McCrindle, R., Hui, T., Sherratt, R., and Donyai, P. (2021). The Effect of Quality Indicators on Beliefs about Medicines Reuse: An Experimental Study. Pharmacy, 9.","DOI":"10.3390\/pharmacy9030128"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.sapharm.2014.10.003","article-title":"Taking stock of medication wastage: Unused medications in US households","volume":"11","author":"Law","year":"2015","journal-title":"Res. Social Adm. Pharm."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e214101119021","DOI":"10.33448\/rsd-v10i11.19021","article-title":"Disposal of pharmaceuticals wastes by the population of an outcrop area of the Guarani Aquifer System in Southern Brazil","volume":"10","author":"Brati","year":"2021","journal-title":"Res. Soc. Dev."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Udofia, E.A., Gulis, G., and Fobil, J. (2017). Solid medical waste: A cross sectional study of household disposal practices and reported harm in Southern Ghana. BMC Public Health, 17.","DOI":"10.1186\/s12889-017-4366-9"},{"key":"ref_62","first-page":"1","article-title":"Household knowledge and perceptions on disposal practices of unused medicines in Kenya","volume":"4","author":"Bukachi","year":"2016","journal-title":"J. Anthropol. Archaeol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s40545-019-0174-1","article-title":"Assessment of disposal practices of expired and unused medications among community pharmacies in Anambra State southeast Nigeria: A mixed study design","volume":"12","author":"Michael","year":"2019","journal-title":"J. Pharm. Policy Pract."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"774","DOI":"10.18203\/2319-2003.ijbcp20212371","article-title":"Knowledge, attitude, and practices on disposal methods of expired and unused medicines among students in public academic institutions in Lusaka, Zambia","volume":"10","author":"Kampamba","year":"2021","journal-title":"Int. J. Basic Clin. Pharmacol."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Bashaar, M., Thawani, V., Hassali, M.A., and Saleem, F. (2017). Disposal practices of unused and expired pharmaceuticals among general public in Kabul. BMC Public Health, 17.","DOI":"10.1186\/s12889-016-3975-z"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.resconrec.2018.09.024","article-title":"Identifying household pharmaceutical waste characteristics and population behaviors in one of the most densely populated global cities","volume":"140","author":"Chung","year":"2019","journal-title":"Resour. Conserv. Recycl."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Yu, X., Hu, X., Li, S., Zhang, M., and Wang, J. (2019). Attitudes and practice regarding disposal for unwanted medications among young adults and elderly people in China from an ecopharmacovigilance perspective. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16081463"},{"key":"ref_68","first-page":"2476","article-title":"Safe medication disposal: Need to sensitize undergraduate students","volume":"4","author":"Aditya","year":"2013","journal-title":"Int. J. Pharm. Life Sci."},{"key":"ref_69","first-page":"101","article-title":"Disposal practice for unused medications among the students of the International Islamic University Malaysia","volume":"2","author":"Azad","year":"2012","journal-title":"J. Appl. Pharm. Sci."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"793","DOI":"10.2147\/RMHP.S291025","article-title":"Knowledge and Practice on Ecopharmacovigilance and Medicine Storage Amongst Medical and Dental Students in Lalitpur, Nepal","volume":"14","author":"Jha","year":"2021","journal-title":"Risk Manage. Health. Policy"},{"key":"ref_71","first-page":"13","article-title":"A Threat to the Environment from Practice of Drug Disposal in Thailand","volume":"7","author":"Arkaravichien","year":"2014","journal-title":"Environ. Asia"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e13822","DOI":"10.1111\/ijcp.13822","article-title":"Medications disposal and medications storage in Jordan: A cross-sectional study","volume":"75","author":"Naser","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1007\/s00267-016-0666-6","article-title":"Assessment of household disposal of pharmaceuticals in Lebanon: Management options to protect water quality and public health","volume":"57","author":"Massoud","year":"2016","journal-title":"Environ. Manag."},{"key":"ref_74","first-page":"17","article-title":"Safe disposal of medicines in Palestine","volume":"4","author":"Assali","year":"2016","journal-title":"J. Pharm. Pharmacol. Palestina."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1007\/s11096-016-0287-4","article-title":"Investigating the disposal of expired and unused medication in Riyadh, Saudi Arabia: A cross-sectional study","volume":"38","author":"Alqahtani","year":"2016","journal-title":"Int. J. Clin. Pharm."},{"key":"ref_76","first-page":"8516741","article-title":"Patients\u2019 knowledge and attitude toward the disposal of medications","volume":"2017","author":"AlAzmi","year":"2017","journal-title":"J. Pharm."},{"key":"ref_77","first-page":"3","article-title":"Environmental contamination by pharmaceutical waste: Assessing patterns of disposing unwanted medications and investigating the factors influencing personal disposal choices","volume":"1","author":"Shaaban","year":"2018","journal-title":"J. Pharmacol. Pharm. Res."},{"key":"ref_78","first-page":"8","article-title":"Drug consumers behaviors toward the disposal of unused and expired medicines in Qassim Province\/Saudi Arabia","volume":"8","author":"Abdullah","year":"2018","journal-title":"J. Pharm. Biomed. Sci."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"316","DOI":"10.4236\/pp.2020.1111026","article-title":"Household Disposal and Recycling of Medication in Saudi Arabia: A Call for Introducing Drug Take-Back Programs","volume":"11","author":"Alqurshi","year":"2020","journal-title":"Pharmacol. Pharm."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jsps.2017.11.006","article-title":"Assessment of the association between drug disposal practices and drug use and storage behaviors","volume":"26","author":"Akici","year":"2018","journal-title":"Saudi Pharm. J."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.scitotenv.2014.01.085","article-title":"Public practice regarding disposal of unused medicines in Ireland","volume":"478","author":"Vellinga","year":"2014","journal-title":"Sci. Total Environ."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1515\/sjph-2016-0025","article-title":"Analysis of expired medications in Serbian households","volume":"55","author":"Kusturica","year":"2016","journal-title":"Slov. J. Public Health"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1071\/AH16296","article-title":"When is a medicine unwanted, how is it disposed, and how might safe disposal be promoted? Insights from the Australian population","volume":"42","author":"Bettington","year":"2018","journal-title":"Aust. Health Rev."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1634\/theoncologist.2014-0071","article-title":"Patterns of storage, use, and disposal of opioids among cancer outpatients","volume":"19","author":"Reddy","year":"2014","journal-title":"Oncologist"},{"key":"ref_85","first-page":"1","article-title":"Role of pharmacist in pharmaceutical waste management","volume":"6","author":"Dubey","year":"2017","journal-title":"World"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1111\/jep.12511","article-title":"Prediction of pharmacist intention to provide medication disposal education using the theory of planned behavior","volume":"22","author":"Tai","year":"2016","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.puhe.2016.04.001","article-title":"Impact of an intervention programme on knowledge, attitude and practice of healthcare staff regarding pharmaceutical waste management, Gaza, Palestine","volume":"138","author":"Tabash","year":"2016","journal-title":"Public Health"},{"key":"ref_88","unstructured":"FIP (2021, October 10). Green Pharmacy Practice: Taking Responsibility for the Environmental Impact of Medicines. International Pharmaceutical Federation (FIP)., Available online: https:\/\/www.fip.org\/files\/fip\/publications\/2015-12-Green-Pharmacy-Practice.pdf."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"78","DOI":"10.18773\/austprescr.2018.015","article-title":"Returning unwanted medicines to pharmacies: Prescribing to reduce waste","volume":"41","author":"Wheeler","year":"2018","journal-title":"Aust. Prescr."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s40545-017-0126-6","article-title":"Evaluation of the National Return of unwanted medicines (RUM) program in Australia: A study protocol","volume":"10","author":"Wheeler","year":"2017","journal-title":"J. Pharm. Policy Pract."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Kelly, F., McMillan, S., Spinks, J., Bettington, E., and Wheeler, A.J. (2018). \u2018You don\u2019t throw these things out:\u2019an exploration of medicines retention and disposal practices in Australian homes. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5753-6"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1590\/S1984-82502012000300018","article-title":"Critical analysis of the regulations regarding the disposal of medication waste","volume":"48","author":"Bellan","year":"2012","journal-title":"Braz. J. Pharm. Sci."},{"key":"ref_93","unstructured":"(2021, October 10). HPSA. Available online: https:\/\/healthsteward.ca."},{"key":"ref_94","unstructured":"(2022, November 22). Households and the Environment 2011, The Statistics Canada. Available online: https:\/\/www150.statcan.gc.ca\/n1\/en\/pub\/11-526-x\/11-526-x2013001-eng.pdf?st=xX3JEKJg."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1007\/s00267-017-0834-3","article-title":"Investigating research gaps of pharmaceutical take back Events: An analysis of take back program participants\u2019 socioeconomic, demographic, and geographic characteristics and the public health benefits of take back programs","volume":"59","author":"Stoddard","year":"2017","journal-title":"Environ. Manag."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1080\/14659891.2017.1337821","article-title":"Multi-state medication take back initiative: Controlled substances collected from 2011 to 2015","volume":"23","author":"Stewart","year":"2018","journal-title":"J. Subst. Use"},{"key":"ref_97","unstructured":"(2021, October 10). DEA, Available online: https:\/\/takebackday.dea.gov."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s42834-019-0042-3","article-title":"Factors determining the public receptivity regarding waste sorting: A case study in Surabaya city, Indonesia","volume":"30","author":"Setiawan","year":"2020","journal-title":"Sustain. Environ. Res."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.jclepro.2016.05.064","article-title":"Assessing the intention-behavior gap in electronic waste recycling: The case of Brazil","volume":"142","author":"Echegaray","year":"2017","journal-title":"J. Clean. Prod."},{"key":"ref_100","first-page":"354","article-title":"Attitudes and opinions towards public littering in the Kingdom of Bahrain","volume":"26","author":"Freije","year":"2019","journal-title":"Arab J. Basic Appl. Sci."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.microc.2017.11.008","article-title":"Occurrence, removal, mass loading and environmental risk assessment of emerging organic contaminants in leachates, groundwaters and wastewaters","volume":"137","author":"Kapelewska","year":"2018","journal-title":"Microchem. J."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"4470","DOI":"10.1016\/j.watres.2011.05.033","article-title":"Determination of sorption of seventy-five pharmaceuticals in sewage sludge","volume":"45","author":"Ledin","year":"2011","journal-title":"Water Res."},{"key":"ref_103","doi-asserted-by":"crossref","unstructured":"Pereira, A., Silva, L., Laranjeiro, C., Lino, C., and Pena, A. (2020). Selected pharmaceuticals in different aquatic compartments: Part I\u2014Source, fate and occurrence. Molecules, 25.","DOI":"10.3390\/molecules25051026"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"111565","DOI":"10.1016\/j.jenvman.2020.111565","article-title":"Occurrence and fate of pharmaceuticals in a wastewater treatment plant from southeast of Spain and risk assessment","volume":"279","author":"Lahora","year":"2021","journal-title":"J. Environ. Manag."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s13280-019-01219-5","article-title":"Micropollutants in treated wastewater","volume":"49","author":"Rogowska","year":"2020","journal-title":"AMBIO"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"109741","DOI":"10.1016\/j.jenvman.2019.109741","article-title":"Analysis, occurrence, and removal of pharmaceuticals in African water resources: A current status","volume":"253","author":"Madikizela","year":"2020","journal-title":"J. Environ. Manag."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.jenvman.2017.02.022","article-title":"Status of pharmaceuticals in African water bodies: Occurrence, removal and analytical methods","volume":"193","author":"Madikizela","year":"2017","journal-title":"J. Environ. Manag."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.wasman.2016.03.029","article-title":"Occurrence and treatment efficiency of pharmaceuticals in landfill leachates","volume":"55","author":"Lu","year":"2016","journal-title":"Waste Manag."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.chemosphere.2015.02.030","article-title":"Investigating landfill leachate as a source of trace organic pollutants","volume":"127","author":"Clarke","year":"2015","journal-title":"Chemosphere"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"111030","DOI":"10.1016\/j.jenvman.2020.111030","article-title":"Fate and toxicity of pharmaceuticals in water environment: An insight on their occurrence in South Asia","volume":"271","author":"Khan","year":"2020","journal-title":"J. Environ. Manag."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1007\/s10646-014-1293-8","article-title":"Ecotoxicity and environmental risk assessment of pharmaceuticals and personal care products in aquatic environments and wastewater treatment plants","volume":"23","author":"Pinto","year":"2014","journal-title":"Ecotoxicology"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"4992","DOI":"10.1007\/s11356-014-3662-5","article-title":"Toxicities of 48 pharmaceuticals and their freshwater and marine environmental assessment in northwestern France","volume":"23","author":"Minguez","year":"2016","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1039\/C9GC03265G","article-title":"Ecotoxicological assessment of pharmaceuticals and personal care products using predictive toxicology approaches","volume":"22","author":"Kar","year":"2020","journal-title":"Green Chem."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1080\/02508060.2021.1889867","article-title":"A source-to-sea approach to emerging pollutants in freshwater and oceans: Pharmaceuticals in the Baltic Sea region","volume":"46","author":"Zandaryaa","year":"2021","journal-title":"Water Inter."},{"key":"ref_115","unstructured":"OECD (2019). Pharmaceutical Residues in Freshwater: Hazards and Policy Responses, OECD Studies on Water, OECD Publishing."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"172813","DOI":"10.1016\/j.ejphar.2019.172813","article-title":"Antimicrobial pharmaceuticals in the aquatic environment-occurrence and environmental implications","volume":"866","author":"Felis","year":"2020","journal-title":"Eur. J. Pharmacol."},{"key":"ref_117","doi-asserted-by":"crossref","unstructured":"Giebu\u0142towicz, J., Na\u0142\u0119cz-Jawecki, G., Harnisz, M., Kucharski, D., Korzeniewska, E., and P\u0142aza, G. (2020). Environmental risk and risk of resistance selection due to antimicrobials\u2019 occurrence in two Polish wastewater treatment plants and receiving surface water. Molecules, 25.","DOI":"10.3390\/molecules25061470"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/j.scitotenv.2019.03.162","article-title":"Antibiotic resistance in drinking water systems: Occurrence, removal, and human health risks","volume":"669","author":"Sanganyado","year":"2019","journal-title":"Sci. Total Environ."},{"key":"ref_119","unstructured":"\u017durman, T., Erker, A., and Levstek, M. (2022, February 06). EU Level Policy and Legislative Framework on Circular Water Use. Interreg. Available online: https:\/\/www.interreg-central.eu\/Content.Node\/D.T1.2.1.-EU-LEVEL-POLICY-AND-LEGISLATIVE-FRAMEWORK-2.pdf."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.envpol.2012.11.022","article-title":"Occurrence of 95 pharmaceuticals and transformation products in urban groundwaters underlying the metropolis of Barcelona, Spain","volume":"174","author":"Jurado","year":"2013","journal-title":"Environ. Pollut."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.jenvman.2018.10.051","article-title":"Diverse and abundant antibiotics and antibiotic resistance genes in an urban water system","volume":"231","author":"Huang","year":"2019","journal-title":"J. Environ. Manag."},{"key":"ref_122","unstructured":"GAP (2022, November 22). Global Action Plan for Antimicrobial Resistance. World Health Organization. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241509763."},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"Anand, U., Adelodun, B., Cabreros, C., Kumar, P., Suresh, S., Dey, A., and Bontempi, E. (2022). Occurrence, transformation, bioaccumulation, risk and analysis of pharmaceutical and personal care products from wastewater: A review. Environ. Chem. Lett., 1\u201322.","DOI":"10.1007\/s10311-022-01498-7"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"153756","DOI":"10.1016\/j.scitotenv.2022.153756","article-title":"Suspect screening of wastewaters to trace anti-COVID-19 drugs: Potential adverse effects on aquatic environment","volume":"824","author":"Cappelli","year":"2022","journal-title":"Sci Total Environ."},{"key":"ref_125","first-page":"152691","article-title":"Pharmaceutical compounds used in the COVID-19 pandemic: A review of their presence in water and treatment techniques for their elimination","volume":"814","year":"2021","journal-title":"Sci. Total Environ."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1007\/s40199-020-00358-5","article-title":"Short and long term impacts of COVID-19 on the pharmaceutical sector","volume":"28","author":"Ayati","year":"2020","journal-title":"DARU J. Pharm. Sci."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"2312","DOI":"10.1002\/hec.4378","article-title":"Income gradient of pharmaceutical panic buying at the outbreak of the COVID-19 pandemic","volume":"30","author":"Elek","year":"2021","journal-title":"Health Econ."},{"key":"ref_128","doi-asserted-by":"crossref","unstructured":"Han, J., He, S., and Lichtfouse, E. (2022). Waves of pharmaceutical waste. Environ. Chem. Lett.","DOI":"10.1007\/s10311-022-01491-0"},{"key":"ref_129","unstructured":"(2022, November 22). DEA, Available online: https:\/\/www.dea.gov\/press-releases\/2020\/03\/27\/national-prescription-drug-take-back-day-postponed."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"e024767","DOI":"10.1136\/bmjopen-2018-024767","article-title":"Willingness of patients to use unused medication returned to the pharmacy by another patient: A cross-sectional survey","volume":"9","author":"Bekker","year":"2019","journal-title":"BMJ Open"},{"key":"ref_131","doi-asserted-by":"crossref","unstructured":"Alhamad, H., and Donyai, P. (2020). Intentions to \u201cReuse\u201d Medication in the Future Modelled and Measured Using the Theory of Planned Behavior. Pharmacy, 8.","DOI":"10.3390\/pharmacy8040213"},{"key":"ref_132","doi-asserted-by":"crossref","unstructured":"Oluwole, A.O., Omotola, E.O., and Olatunji, O.S. (2020). Pharmaceuticals and personal care products in water and wastewater: A review of treatment processes and use of photocatalyst immobilized on functionalized carbon in AOP degradation. BMC Chem., 14.","DOI":"10.1186\/s13065-020-00714-1"},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"155346","DOI":"10.1016\/j.apsusc.2022.155346","article-title":"A novel organic\/inorganic S-scheme heterostructure of TCPP\/Bi12O17Cl2 for boosting photodegradation of tetracycline hydrochloride: Kinetic, degradation mechanism, and toxic assessment","volume":"610","author":"Wang","year":"2022","journal-title":"Appl. Surf. Sci."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"100073","DOI":"10.1016\/j.apmate.2022.100073","article-title":"Constructing Cd0.5Zn0.5S\/Bi2WO6 S-scheme heterojunction for boosted photocatalytic antibiotic oxidation and Cr (VI) reduction","volume":"2","author":"Li","year":"2022","journal-title":"Adv. Powder Mater."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/23\/15798\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:28:00Z","timestamp":1760146080000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/23\/15798"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,27]]},"references-count":134,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["ijerph192315798"],"URL":"https:\/\/doi.org\/10.3390\/ijerph192315798","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,27]]}}}