{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:46:32Z","timestamp":1791837992858,"version":"4.3.4"},"reference-count":47,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NPO \u201cSystemic Risk Institute\u201d","award":["LX22NPO5101"],"award-info":[{"award-number":["LX22NPO5101"]}]},{"name":"European Union\u2014Next Generation EU (Ministry of Education, Youth and Sports. NPO: EXCELES)","award":["LX22NPO5101"],"award-info":[{"award-number":["LX22NPO5101"]}]},{"name":"Grant Agency of Charles University","award":["LX22NPO5101"],"award-info":[{"award-number":["LX22NPO5101"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Molecules"],"abstract":"<jats:p>A multi-residue UHPLC\u2013MS\/MS analytical method, previously developed for monitoring 52 pharmaceuticals in drinking water, was used to analyse these pharmaceuticals in wastewater originating from healthcare facilities in the Czech Republic. Furthermore, the methodology was expanded to include the evaluation of the effectiveness of drug removal in Czech wastewater treatment plants (WWTPs). Of the 18 wastewater samples analysed by the validated UHPLC-MS\/MS, each sample contained at least one quantifiable analyte. This study reveals the prevalence of several different drugs; mean concentrations of 702 \u03bcg L\u22121 of iomeprol, 48.8 \u03bcg L\u22121 of iopromide, 29.9 \u03bcg L\u22121 of gabapentin, 42.0 \u03bcg L\u22121 of caffeine and 82.5 \u03bcg L\u22121 of paracetamol were present. An analysis of 20 samples from ten WWTPs revealed different removal efficiencies for different analytes. Paracetamol was present in the inflow samples of all ten WWTPs and its removal efficiency was 100%. Analytes such as caffeine, ketoprofen, naproxen or atenolol showed high removal efficiencies exceeding 80%. On the other hand, pharmaceuticals like furosemide, metoprolol, iomeprol, zolpidem and tramadol showed lower removal efficiencies. Four pharmaceuticals exhibited higher concentrations in WWTP effluents than in the influents, resulting in negative removal efficiencies: warfarin at \u22129.5%, indomethacin at \u221253%, trimethoprim at \u221254% and metronidazole at \u2212110%. These comprehensive findings contribute valuable insights to the pharmaceutical landscape of wastewater from healthcare facilities and the varied removal efficiencies of Czech WWTPs, which together with the already published literature, gives a more complete picture of the burden on the aquatic environment.<\/jats:p>","DOI":"10.3390\/molecules29071480","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T12:41:57Z","timestamp":1711543317000},"page":"1480","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Monitoring Pharmaceuticals and Personal Care Products in Healthcare Effluent Wastewater Samples and the Effectiveness of Drug Removal in Wastewater Treatment Plants Using the UHPLC-MS\/MS Method"],"prefix":"10.3390","volume":"29","author":[{"given":"Lucia","family":"Molnarova","sequence":"first","affiliation":[{"name":"Department of Analytical Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 43 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatana","family":"Halesova","sequence":"additional","affiliation":[{"name":"ALS Czech Republic, Na Harfe 223\/9, 190 00 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Tomesova","sequence":"additional","affiliation":[{"name":"ALS Czech Republic, Na Harfe 223\/9, 190 00 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Vaclavikova","sequence":"additional","affiliation":[{"name":"ALS Czech Republic, Na Harfe 223\/9, 190 00 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8483-5739","authenticated-orcid":false,"given":"Zuzana","family":"Bosakova","sequence":"additional","affiliation":[{"name":"Department of Analytical Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 43 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101848","DOI":"10.1016\/j.eclinm.2023.101848","article-title":"Global Antibiotic Use during the COVID-19 Pandemic: Analysis of Pharmaceutical Sales Data from 71 Countries, 2020\u20132022","volume":"57","author":"Nandi","year":"2023","journal-title":"EClinicalMedicine"},{"key":"ref_2","first-page":"S72","article-title":"Temporal Monitoring of Pharmaceutical Consumption Using a Wastewater-Based Epidemiologic Approach","volume":"34","author":"Quireyns","year":"2022","journal-title":"Toxicol. Anal. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"153329","DOI":"10.1016\/j.scitotenv.2022.153329","article-title":"Persistence, Environmental Hazards, and Mitigation of Pharmaceutically Active Residual Contaminants from Water Matrices","volume":"821","author":"Sharma","year":"2022","journal-title":"Sci. Total Environ."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1016\/j.watres.2018.08.034","article-title":"Distribution and Fate of Pharmaceuticals and Their Metabolite Conjugates in a Municipal Wastewater Treatment Plant","volume":"144","author":"Brown","year":"2018","journal-title":"Water Res."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Silva, B., Costa, F., Neves, I.C., and Tavares, T. (2015). Psychiatric Pharmaceuticals as Emerging Contaminants in Wastewater, Springer.","DOI":"10.1007\/978-3-319-20493-2"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.watres.2017.12.029","article-title":"Occurrence and Fate of Emerging Contaminants in Municipal Wastewater Treatment Plants from Different Geographical Regions-a Review","volume":"133","author":"Tran","year":"2018","journal-title":"Water Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/j.envpol.2019.05.091","article-title":"Occurrences, Levels and Risk Assessment Studies of Emerging Pollutants (Pharmaceuticals, Perfluoroalkyl and Endocrine Disrupting Compounds) in Fish Samples from Kalk Bay Harbour, South Africa","volume":"252","author":"Ojemaye","year":"2019","journal-title":"Environ. Pollut."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.scitotenv.2019.01.303","article-title":"Veterinary Pharmaceutical Residues in Water Resources and Tap Water in an Intensive Husbandry Area in France","volume":"664","author":"Charuaud","year":"2019","journal-title":"Sci. Total Environ."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.watres.2017.09.019","article-title":"Negative Environmental Impacts of Antibiotic-Contaminated Effluents from Pharmaceutical Industries","volume":"126","author":"Bielen","year":"2017","journal-title":"Water Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"394","DOI":"10.2134\/jeq2015.07.0336","article-title":"Antibiotics and Antibiotic Resistance in Agroecosystems: State of the Science","volume":"45","author":"Sallach","year":"2016","journal-title":"J. Environ. Qual."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.coesh.2019.11.005","article-title":"Antibiotics Traces in the Aquatic Environment: Persistence and Adverse Environmental Impact","volume":"13","author":"Bilal","year":"2020","journal-title":"Curr. Opin. Environ. Sci. Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"136192","DOI":"10.1016\/j.scitotenv.2019.136192","article-title":"Occurrence, Ecotoxicological Risks of Sulfonamides and Their Acetylated Metabolites in the Typical Wastewater Treatment Plants and Receiving Rivers at the Pearl River Delta","volume":"709","author":"Cui","year":"2020","journal-title":"Sci. Total Environ."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/j.scitotenv.2018.10.417","article-title":"Trace Determination of Sulfonamide Antibiotics and Their Acetylated Metabolites via SPE-LC-MS\/MS in Wastewater and Insights from Their Occurrence in a Municipal Wastewater Treatment Plant","volume":"653","author":"Yuan","year":"2019","journal-title":"Sci. Total Environ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.chroma.2017.05.053","article-title":"Fast Determination of Pesticides and Other Contaminants of Emerging Concern in Treated Wastewater Using Direct Injection Coupled to Highly Sensitive Ultra-High Performance Liquid Chromatography-Tandem Mass Spectrometry","volume":"1507","author":"Malato","year":"2017","journal-title":"J. Chromatogr. A"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"8979","DOI":"10.1007\/s00216-015-9063-x","article-title":"Screening of Pharmaceuticals and Illicit Drugs in Wastewater and Surface Waters of Spain and Italy by High Resolution Mass Spectrometry Using UHPLC-QTOF MS and LC-LTQ-Orbitrap MS","volume":"407","author":"Bade","year":"2015","journal-title":"Anal. Bioanal. Chem."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.chroma.2016.04.009","article-title":"Simple and Quick Determination of Analgesics and Other Contaminants of Emerging Concern in Environmental Waters by On-Line Solid Phase Extraction Coupled to Liquid Chromatography\u2013Tandem Mass Spectrometry","volume":"1446","author":"Vidal","year":"2016","journal-title":"J. Chromatogr. A"},{"key":"ref_17","first-page":"934","article-title":"Occurrence and Environmental Impact of Pharmaceutical Residues from Conventional and Natural Wastewater Treatment Plants in Gran Canaria (Spain)","volume":"599\u2013600","year":"2017","journal-title":"Sci. Total Environ."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jpba.2019.02.016","article-title":"Analysis of 44 Pharmaceuticals Consumed by Elderly Using Liquid Chromatography Coupled to Tandem Mass Spectrometry","volume":"168","author":"Pueyo","year":"2019","journal-title":"J. Pharm. Biomed. Anal."},{"key":"ref_19","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_20","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.chroma.2015.12.036","article-title":"Multi-Residue Analysis of 90 Emerging Contaminants in Liquid and Solid Environmental Matrices by Ultra-High-Performance Liquid Chromatography Tandem Mass Spectrometry","volume":"1431","author":"Petrie","year":"2016","journal-title":"J. Chromatogr. A"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.scitotenv.2014.12.034","article-title":"Pharmaceuticals in the Freshwater Invertebrate, Gammarus Pulex, Determined Using Pulverised Liquid Extraction, Solid Phase Extraction and Liquid Chromatography\u2013Tandem Mass Spectrometry","volume":"511","author":"Miller","year":"2015","journal-title":"Sci. Total Environ."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jpba.2016.11.008","article-title":"Determination of Pharmaceutical Residues in Wastewater Using High Performance Liquid Chromatography Coupled to Quadrupole-Orbitrap Mass Spectrometry","volume":"133","author":"Pugajeva","year":"2017","journal-title":"J. Pharm. Biomed. Anal."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.aca.2016.01.056","article-title":"Target and Suspect Screening of Psychoactive Substances in Sewage-Based Samples by UHPLC-QTOF","volume":"914","author":"Reid","year":"2016","journal-title":"Anal. Chim. Acta"},{"key":"ref_24","unstructured":"Gwenzi, W., Kanda, A., Danha, C., Muisa-Zikali, N., and Chaukura, N. (2023). Applied Water Science Volume 1: Fundamentals and Applications, Wiley Online Library."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"146275","DOI":"10.1016\/j.scitotenv.2021.146275","article-title":"Ecotoxicological Risk Assessment of Contaminants of Emerging Concern Identified by \u201cSuspect Screening\u201d from Urban Wastewater Treatment Plant Effluents at a Territorial Scale","volume":"778","author":"Gosset","year":"2021","journal-title":"Sci. Total Environ."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"100071","DOI":"10.1016\/j.envadv.2021.100071","article-title":"Fungi for the Bioremediation of Pharmaceutical-Derived Pollutants: A Bioengineering Approach to Water Treatment","volume":"4","year":"2021","journal-title":"Environ. Adv."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.envpol.2017.11.060","article-title":"Removal of Pharmaceutical Compounds in Water and Wastewater Using Fungal Oxidoreductase Enzymes","volume":"234","author":"Naghdi","year":"2018","journal-title":"Environ. Pollut."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.jhazmat.2012.03.013","article-title":"Comparison of COD Removal from Pharmaceutical Wastewater by Electrocoagulation, Photoelectrocoagulation, Peroxi-Electrocoagulation and Peroxi-Photoelectrocoagulation Processes","volume":"219\u2013220","author":"Farhadi","year":"2012","journal-title":"J. Hazard. Mater."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Ensano, B.M.B., Borea, L., Naddeo, V., Belgiorno, V., De Luna, M.D.G., and Ballesteros Jr, F.C. (2017). Removal of Pharmaceuticals from Wastewater by Intermittent Electrocoagulation. Water, 9.","DOI":"10.3390\/w9020085"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/j.biortech.2016.05.124","article-title":"Biotransformation of Trace Organic Compounds by Activated Sludge from a Biological Nutrient Removal Treatment System","volume":"216","author":"Inyang","year":"2016","journal-title":"Bioresour. Technol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Pandis, P.K., Kalogirou, C., Kanellou, E., Vaitsis, C., Savvidou, M.G., Sourkouni, G., Zorpas, A.A., and Argirusis, C. (2022). Key Points of Advanced Oxidation Processes (AOPs) for Wastewater, Organic Pollutants and Pharmaceutical Waste Treatment: A Mini Review. ChemEngineering, 6.","DOI":"10.3390\/chemengineering6010008"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"112760","DOI":"10.1016\/j.jenvman.2021.112760","article-title":"The Influence of UV Irradiation on PAHs in Wastewater","volume":"293","year":"2021","journal-title":"J. Environ. Manag."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Mashuri, S.I.S., Ibrahim, M.L., Kasim, M.F., Mastuli, M.S., Rashid, U., Abdullah, A.H., Islam, A., Asikin-Mijan, N., Tan, Y.H., and Mansir, N. (2020). Photocatalysis for Organic Wastewater Treatment: From the Basis to Current Challenges for Society. Catalysts, 10.","DOI":"10.3390\/catal10111260"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"171260","DOI":"10.1016\/j.scitotenv.2024.171260","article-title":"Review on Ultrasonic Technology Enhanced Biological Treatment of Wastewater","volume":"925","author":"Wen","year":"2024","journal-title":"Sci. Total Environ."},{"key":"ref_35","unstructured":"(2024, March 20). Commission Implementing Decision (EU) 2022\/1307 of 22July 2022 Establishing a Watch List of Substances for Union-Wide Monitoring in the Field of Water Policy Pursuant to Directive 2008\/105\/EC of the European Parliament and of the Council (Notified under Document C(2022) 5098) (Text with EEA Relevance), C\/2022\/5098. Available online: https:\/\/op.europa.eu\/en\/publication-detail\/-\/publication\/3887fb7f-0c86-11ed-b11c-01aa75ed71a1\/language-en."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Molnarova, L., Halesova, T., Vaclavikova, M., and Bosakova, Z. (2023). Monitoring Pharmaceuticals and Personal Care Products in Drinking Water Samples by the LC-MS\/MS Method to Estimate Their Potential Health Risk. Molecules, 28.","DOI":"10.3390\/molecules28155899"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"157353","DOI":"10.1016\/j.scitotenv.2022.157353","article-title":"Pharmaceutical Pollution of Hospital Effluents and Municipal Wastewaters of Eastern Canada","volume":"846","author":"Vaudreuil","year":"2022","journal-title":"Sci. Total Environ."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.scitotenv.2018.11.433","article-title":"Environmental Fate of Pharmaceutical Compounds and Antimicrobial-Resistant Bacteria in Hospital Effluents, and Contributions to Pollutant Loads in the Surface Waters in Japan","volume":"657","author":"Azuma","year":"2019","journal-title":"Sci. Total Environ."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1007\/s10661-018-7097-1","article-title":"Identification and Quantification of 19 Pharmaceutical Active Compounds and Metabolites in Hospital Wastewater in Cameroon Using LC\/QQQ and LC\/Q-TOF","volume":"190","author":"Mayoudom","year":"2018","journal-title":"Environ. Monit. Assess."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/j.ecoleng.2016.08.010","article-title":"Occurrence and Removal of Pharmaceuticals in Four Full-Scale Constructed Wetlands in the Czech Republic\u2014The First Year of Monitoring","volume":"98","author":"Vymazal","year":"2017","journal-title":"Ecol. Eng."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"108957","DOI":"10.1016\/j.vacuum.2019.108957","article-title":"Boron Doped Diamond Electrode\u2014The Elimination of Psychoactive Drugs and Resistant Bacteria from Wastewater","volume":"171","author":"Grabic","year":"2020","journal-title":"Vacuum"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.scitotenv.2019.04.160","article-title":"Emerging Contaminants in Wastewater, Stormwater Runoff, and Surface Water: Application as Chemical Markers for Diffuse Sources","volume":"676","author":"Tran","year":"2019","journal-title":"Sci. Total Environ."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"163284","DOI":"10.1016\/j.scitotenv.2023.163284","article-title":"Assessment of Selected Pharmaceuticals in Riyadh Wastewater Treatment Plants, Saudi Arabia: Mass Loadings, Seasonal Variations, Removal Efficiency and Environmental Risk","volume":"882","author":"Alharbi","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"146554","DOI":"10.1016\/j.scitotenv.2021.146554","article-title":"A Review of the Adsorption-Biological Hybrid Processes for the Abatement of Emerging Pollutants: Removal Efficiencies, Physicochemical Analysis, and Economic Evaluation","volume":"780","year":"2021","journal-title":"Sci. Total Environ."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"124413","DOI":"10.1016\/j.jhazmat.2020.124413","article-title":"A Review on Effective Removal of Emerging Contaminants from Aquatic Systems: Current Trends and Scope for Further Research","volume":"409","author":"Rathi","year":"2021","journal-title":"J. Hazard. Mater."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1016\/j.envpol.2017.08.032","article-title":"Occurrence, Fate and Transformation of Emerging Contaminants in Water: An Overarching Review of the Field","volume":"231","author":"Wilkinson","year":"2017","journal-title":"Environ. Pollut."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1002\/etc.3339","article-title":"Pharmaceuticals in the Environment\u2014Global Occurrences and Perspectives","volume":"35","author":"Weber","year":"2016","journal-title":"Environ. Toxicol. Chem."}],"container-title":["Molecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1420-3049\/29\/7\/1480\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:19:11Z","timestamp":1760105951000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1420-3049\/29\/7\/1480"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,27]]},"references-count":47,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["molecules29071480"],"URL":"https:\/\/doi.org\/10.3390\/molecules29071480","relation":{},"ISSN":["1420-3049"],"issn-type":[{"value":"1420-3049","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,27]]}}}