{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:13:16Z","timestamp":1792177996368,"version":"4.4.0"},"reference-count":27,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Pharmaceuticals are invaluable allies in human and veterinary medicine, but their indiscriminate use can transform them into formidable pollutants\u2014a threat that remains largely underestimated. The growth of the pharmaceutical market has increased the environmental presence of drugs, both as original compounds during production and as metabolites following administration. Particularly concerning is the presence of antibiotics in wastewater, which contributes to the development and spread of bacterial resistance. This review analyzes the primary causes of environmental pharmaceutical pollution and its impact on ecosystems. We describe the most significant results obtained from analyzing wastewater, primarily in Italy, but also in other European countries, and examine the official positions of environmental protection organizations.<\/jats:p>","DOI":"10.3390\/life15091341","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T08:53:46Z","timestamp":1756112026000},"page":"1341","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Environmental Pollution from Pharmaceuticals"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6322-817X","authenticated-orcid":false,"given":"Stefania","family":"Zampelli","sequence":"first","affiliation":[{"name":"Research and Training Center for Health and Social Issues, University Guglielmo Marconi, Via Plinio, 44, 00193 Roma, Italy"},{"name":"Academy for Health and Clinical Research, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1869-3912","authenticated-orcid":false,"given":"Roberto","family":"Verna","sequence":"additional","affiliation":[{"name":"Research and Training Center for Health and Social Issues, University Guglielmo Marconi, Via Plinio, 44, 00193 Roma, Italy"},{"name":"Academy for Health and Clinical Research, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.chemosphere.2018.01.148","article-title":"Long-term exposure of Mytilus galloprovincialis to diclofenac, ibuprofen and ketoprofen: Insights into bioavailability, biomarkers and transcriptomic changes","volume":"198","author":"Mezzelani","year":"2018","journal-title":"Chemosphere"},{"key":"ref_2","unstructured":"European Commission (2019). 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, European Commission."},{"key":"ref_3","unstructured":"Mudgal, S., De Toni, A., Lockwood, S., Sal\u00e8s, K., Backhaus, T., and Sorensen, B.H. (2013). Study on the Environmental Risks of Medical Products, Final Report, Executive Agency for Health and Consumers."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1146\/annurev-marine-040821-075606","article-title":"The biological effects of pharmaceuticals in the marine environment","volume":"3","author":"Mezzelani","year":"2022","journal-title":"Ann. Rev. Mar. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.scitotenv.2018.03.076","article-title":"Effects of waterborne antidepressants on non-target animals living in the aquatic environment: A review","volume":"631\u2013632","author":"Sehonova","year":"2018","journal-title":"Sci. Total. Environ."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1039\/C9EM00020H","article-title":"Emerging investigator series: Towards a framework for establishing the impacts of pharmaceuticals in wastewater irrigation systems on agro-ecosystems and human health","volume":"21","author":"Carter","year":"2019","journal-title":"Environ. Sci. Process. Impacts"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Jesus, F., and Tremblay, L.A. (2022). Key challenges to the effective management of pollutants in water and sediment. Toxics, 27.","DOI":"10.3390\/toxics10050219"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1038\/sj.embor.7400307","article-title":"The environmental side effects of medication","volume":"5","author":"Boxall","year":"2004","journal-title":"EMBO Rep."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Mutuku, C., Gazdag, Z., and Melegh, S. (2022). Occurrence of antibiotics and bacterial resistance genes in wastewater: Resistance mechanisms and antimicrobial resistance control approaches. World J. Microbiol. Biotechnol., 38.","DOI":"10.1007\/s11274-022-03334-0"},{"key":"ref_10","unstructured":"European Union (2013). Directive 2013\/39\/EU of 12 August 2013 amending Directives 2000\/60\/EC and 2008\/105\/EC as regards priority substances in the field of water policy. Off. J. Eur. Union, 226, 1\u201317."},{"key":"#cr-split#-ref_11.1","unstructured":"European Union (2018). Implementing Decision of 5 June 2018, No 2018\/840\/EU establishing a watch list of substances to be monitored at Union level in the field of water policy pursuant to Directive 2008\/105\/EC of the European Parliament and of the Council and repealing Commission Implementing Decision"},{"key":"#cr-split#-ref_11.2","unstructured":"(EU) 2015\/495. Off. J. Eur. Union, 141, 9-12."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(00)02270-4","article-title":"Presence of therapeutic drugs in the environment","volume":"355","author":"Zuccato","year":"2000","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1021\/es020158e","article-title":"A strategic survey of therapeutic drugs in the rivers Po and Lambro in Northern Italy","volume":"37","author":"Calamari","year":"2003","journal-title":"Environ. Sci. Technol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"5864","DOI":"10.1007\/s11356-014-3765-z","article-title":"Occurrence of selected pharmaceuticals in the principal sewage treatment plants in Rome (Italy) and in the receiving surface waters","volume":"22","author":"Patrolecco","year":"2015","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1021\/es050991m","article-title":"Removal of pharmaceuticals in sewage treatment plants in Italy","volume":"40","author":"Castiglioni","year":"2006","journal-title":"Environ. Sci. Technol."},{"key":"ref_16","first-page":"5399","article-title":"Source, occurrence and fate of antibiotics in the Italian aquatic environment","volume":"39","author":"Zuccato","year":"2005","journal-title":"Environ. Sci. Technol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.watres.2017.12.047","article-title":"Mass balance of emerging contaminants in the water cycle of a highly urbanized and industrialized area of Italy","volume":"131","author":"Castiglioni","year":"2018","journal-title":"Water Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jhazmat.2018.07.099","article-title":"Risk assessment of a mixture of emerging contaminants in surface water in a highly urbanized area in Italy","volume":"361","author":"Riva","year":"2019","journal-title":"J. Hazard. Mater."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.ijheh.2018.01.008","article-title":"Monitoring emerging contaminants in the drinking water of Milan and assessment of the human risk","volume":"221","author":"Riva","year":"2018","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1038\/nature02317","article-title":"Diclofenac residues as the cause of vulture population decline in Pakistan","volume":"427","author":"Oaks","year":"2004","journal-title":"Nature"},{"key":"ref_21","unstructured":"European Commission (2020). Communication COM\/2020\/667: Chemicals Strategy for Sustainability Towards a Toxic-Free Environment, European Commission."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Dos Santos, C.R., Lebron, Y.A.R., Moreira, V.R., Koch, K., and Amaral, M.C.S. (2022). Biodegradability, environmental risk assessment and ecological footprint in wastewater technologies for pharmaceutically active compounds removal. Bioresour. Technol., 343.","DOI":"10.1016\/j.biortech.2021.126150"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"547","DOI":"10.4103\/0253-7613.100363","article-title":"Ecopharmacovigilance: An issue urgently to be addressed","volume":"44","author":"Medhi","year":"2012","journal-title":"Indian J. Pharmacol."},{"key":"#cr-split#-ref_24.1","unstructured":"European Union (2019). Regulation"},{"key":"#cr-split#-ref_24.2","unstructured":"(EU) 2019\/6 of the European Parliament and of the Council of 11 December 2018 on veterinary medicinal products, and repealing Directive 2001\/82\/EC. Off. J. Eur. Union, 4, 43-165."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"783","DOI":"10.2166\/wst.2012.243","article-title":"Occurrence and reduction of pharmaceuticals in the water phase at Swedish wastewater treatment plants","volume":"66","author":"Andersen","year":"2012","journal-title":"Water Sci. Technol."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/9\/1341\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:35:37Z","timestamp":1760034937000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/9\/1341"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,25]]},"references-count":27,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["life15091341"],"URL":"https:\/\/doi.org\/10.3390\/life15091341","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,25]]}}}