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Presence of Pharmaceuticals in Treated Wastewater Effluent and Surface Water
Supply Systems, Metropolitan Atlanta, Georgia, July–September 1999
Deborah M. Moll, Ph.D.1; Elizabeth A. Frick2; Alden K. Henderson, Ph.D., M.P.H.1; Edward T. Furlong, Ph.D. 3; Michael T. Meyer, Ph.D.4 1Centers for Disease Control and Prevention, National Center for Environmental Health, Atlanta, GA;2U.S. Geological Survey, Atlanta, GA; 3U.S. Geological Survey, Denver Federal Center, Denver, CO; Abstract
Human and veterinary pharmaceutical compounds are a source of increasing environmental concern because thecompounds are used in large quantities and the physical and chemical properties of the compounds make themlikely to be transported into hydrologic systems. Effects on human health and aquatic ecosystems from thepresence of small concentrations of pharmaceuticals in streams and rivers are generally unknown. Severalpharmaceuticals have recently been detected in the US and Europe in surface waters that receive sewageeffluent. Because Federal and state agencies do not routinely monitor these compounds, almost no data exist onthe occurrence and distribution in US water supplies.
The Centers for Disease Control and Prevention (CDC) and the U.S. Geological Survey (USGS) initiated astudy in 1999 to determine the occurrence of pharmaceuticals in treated effluent discharged from waterpollution control plants (WPCPs), and in raw and finished drinking water at three drinking-water treatmentplants in the Chattahoochee River watershed in Metropolitan Atlanta. Grab samples of water were collected atfive effluent discharge points, and raw and finished water samples were collected at three drinking-watertreatment plants downstream of the effluent discharges. Samples were collected once per month during low-flow conditions from July through September 1999. Two research analytical methods recently developed by theUSGS Toxics Hydrology Program were used to quantify prescription and nonprescription pharmaceuticals,including antibiotics, at parts per billion (ppb) concentrations in filtered water samples.
Sixteen pharmaceuticals were detected in wastewater samples, 10 were detected in raw drinking-water samples,and three were detected in finished drinking-water samples. The prescription pharmaceuticals detected includeddiltiazem and dehydronifedipine (cardiac medications), metformin (anti-diabetic medication), and gemfibrozil(cholesterol-lowering agent). The nonprescription pharmaceuticals detected included caffeine (stimulant), 1,7-dimethyl xanthine (caffeine metabolite), cotinine (nicotine metabolite), cimetidine (gastrointestinal and ulcermedication), and acetominophen (analgesic). The antibiotics detected represent four groups includingsulfonamides (trimethoprim, sulfamethazine, sulfamethoxazole, and sulfadimethoxine), macrolides(erythromycin-H2O and roxithromycin), lincosamides (lincomycin), and fluoroquinolones (enrofloxacin). Anadditional seven prescription and nonprescription pharmaceuticals and fourteen antibiotics that were analyzedfor were not detected.
One to three prescription pharmaceuticals were detected in 13 of 15 treated WPCP effluent samples.
Concentrations ranged from low parts per trillion (ppt) to low ppb. Diltiazem was the only prescriptionpharmaceutical detected in raw drinking-water samples–detected at low ppt concentrations. No prescriptionpharmaceuticals were detected in finished drinking-water samples (minimum reporting levels (MRLs) rangedfrom 0.007–0.028 ppb). One to four nonprescription pharmaceuticals were detected in 11 of 15 treated WPCPeffluent samples at low ppt to low ppb levels. Detection of nonprescription pharmaceuticals in the nine rawdrinking-water samples ranged from no detections for cimetidine to nine detections for caffeine. The only threepharmaceuticals detected in finished drinking-water samples—caffeine, cotinine, and acetominophen—arewidely used nonprescription pharmaceuticals. These compounds were detected in low ppb concentrations in twoto eight of the nine finished drinking-water samples. One to five antibiotics were detected in 14 of 15 treatedWPCP effluent samples at low ppt to low ppb levels, and in seven of 15 raw drinking-water samples at low ppblevels. No antibiotics were detected in finished drinking-water samples (MRLs ranged from 0.03-0.10 ppb).
Detection of antibiotics in raw drinking water is of particular concern because the presence of these chemicalsin the environment may lead to the development of resistant bacterial strains, thus diminishing the therapeuticeffectiveness of antibiotics. Detection of numerous prescription and nonprescription pharmaceutical compoundsin treated WPCP effluent, and raw and finished drinking water; together with the absence of pharmaceutical manufacturing facilities in the study area, suggests that human use of pharmaceuticals is one source of thesecompounds in water resources within the upper Chattahoochee River watershed.
Biographical Sketches
Deborah M. Moll, Ph.D., has worked as an Environmental Health Scientist in the Health Studies Branch of
CDC’s National Center for Environmental Health since 1998, focusing on exposure to contaminants through
drinking water. She received her PhD from the Department of Civil and Environmental Engineering, University
of Cincinnati in 1998 with a focus in drinking water quality and treatment. She is a member of the American
Water Works Association and the International Water Association.
Centers for Disease Control and Prevention, National Center for Environmental Health, 1600 Clifton Rd, NE,M.S. E-23, Atlanta, GA 30333.
phone: 404-639-2581, fax: 404-639-2565, email: Elizabeth A. Frick, has been a hydrologist for the USGS since 1983. Her Masters degree is in Hydrology from
the University of Nevada, Reno. Her recent work is focused on water-quality issues in the Chattahoochee River
associated with the USGS NAWQA program, a microbial contamination study in conjunction with the NPS,
and emerging contaminants study in conjunction with CDC.
U.S. Geological Survey, 3039 Amwiler Road, Atlanta, GA 30360-2824.
phone: 770-903-9158, fax: 770-903-9199, email: Alden K. Henderson, PhD., MPH, is a toxicologist at the Centers for Disease Control and Prevention in
Atlanta, GA. He received his Ph.D. in toxicology from the University of Arizona and his Masters of Public
Health in epidemiology from the University of Hawaii. His projects deal with documenting exposures to
environmental agents and determining the human health effects of these exposures.
Centers for Disease Control and Prevention, National Center for Environmental Health, 1600 Clifton Rd, NE,M.S. E-23, Atlanta, GA 30333.
phone: 404-639-2530, fax: 404-639-2565, email: Edward T. Furlong, PhD., received a PhD degree in Chemical Oceanography from the University of
Washington, and joined the U.S. Geological Survey in 1987 as part of the Methods Research and Development
Program of the National Water Quality Laboratory. His research interests are focused on the application of mass
spectrometry techniques to the analysis of trace organic compounds of environmental interest. Current research
includes development of HPLC/MS and HPLC/MS/MS methods for the determination of pharmaceuticals and
their degradation products in environmental samples by HPLC/MS and GC/MS.
U.S. Geological Survey, National Water Quality Laboratory, Denver Federal Center, Building 95, MS 407,Lakewood, CO 80225-0046.
phone: 303-236-3941, fax: 303-236-3499, email: Michael T. Meyer, Ph.D., has worked as an Organic Geochemist for the U.S. Geological Survey (USGS) since
1988. He received his Ph.D. in Geology from the University of Kansas in 1994. His research has focused on the
development of methods for the analysis of emerging organic contaminants (e.g. herbicide metabolites and
pharmaceuticals) and determining their occurrence, fate, and geochemical transport in the environment.
Currently he is the Supervisory Research Geochemist of the USGS, Florida District, Ocala Water Quality and
Research Laboratory.
U.S. Geological Survey, 4500 SW 40th Avenue, Ocala, FL 34474-5731.
phone: 352-237-5514 x202, fax: 352-237-7081, email:


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