Avaliação de risco ambiental de fármacos

Abstract

Drugs are inserted into the aquatic environment after excretion by patients and may persist in the environment due to their difficult removal in sewage treatment plants (STP). In Brazil, the problem is aggravated because most health services do not carry out pre-treatment on their effluents, launching the evictions in the STP influents or in the surface waters. Improving sanitation indicators and access to health services is part of the United Nations Sustainable Development Goals (SDGs), however one consequence of economic and social development is the increased insertion of organic micro-pollutants such as drugs into the aquatic environment. The objectives of this study are: contextualize the impact of medicines consumption on the aquatic environment within the scope of the SDGs; make a preliminary environmental risk assessment of cancer drugs in a Brazilian municipality following the provisions of an international guideline; evaluate the adequacy of these standards to the Brazilian reality and other municipalities by the potential of drug insertion in the aquatic environment. The study uses information on socioeconomic activities and demographic and sanitation aspects, as well as drug consumption, ecotoxicology and physicochemical properties. Results indicated that drugs constitute a class of emerging pollutants that compromise the reach of the ODS. Of the twenty drugs evaluated, ten have the possibility of removal by sewage treatment, demonstrating that sanitation is important to mitigate its effects on the environment. Preliminary estimation of the potential for contamination of the aquatic environment by cancer drugs in 142 Brazilian municipalities showed that the less populous municipalities with low rates of sewage treatment and whose health services perform more antineoplastic chemotherapy procedures, are more likely to contaminate their water resources by residues of these drugs.