| Abstract [eng] |
Macrolide group antibiotics Azithromycin, Clarithromycin and Erythromycin due to their excessive use are considered to be one of misused pharmaceuticals worldwide. As high risk substances these antibiotics have been included in the monitoring watch list of Regulation 2018/840 / EU. The main objective of the research was to perform flow analysis and environmental impact risk assessment of the investigated substances and to provide recommendations on how to accurately reduce pollution and leakage of these substances in Lithuania. For the flow analysis the newest information from 2015-2018 period were used.The main processes defined were: consumption, disposal and distribution of pharmaceutical substances in the environment. In 2018 antibiotic usage increased by 11.4%. Over 4 years period clarithromycin consumption increased by 18 %. Pharmaceuticals consumption DDD/1000/per day in Lithuania were lower than lower than the European Union average. The largest amounts of pharmaceuticals came from households (91 %), followed by health facilities and hospitals (9 %). Most unused pharmaceuticals are incorrectly disposed. The main task should be to raise environmental awareness, to educate the public about the correct handling of pharmaceutical substances. Analysis of material flows shows that wastewater treatment plants account for the largest share of pharmaceuticals (72 %) Concentration of pharmaceutical substances in wastewater of Klaipėda, Palanga, Kretinga and Nida WWTPs were assessed using the data of the Morpheaus project. The PEC / PNEC> 1 for the substances azithromycin and clarithromycin indicates that these substances may pose a significant risk. The chosen assessment methodology for influent and effluent wastewater wastewater in Klaipėda is acceptable, significantly overestimated in Palanga, and greatly overestimated in Kretinga and Nida. Taking in to account the deviations in the results, this methodology could be used to measure the concentrations of pharmaceuticals or other pollutants. An environmental management system has been developed for the test substances azithromycin, clarithromycin and erythromycin with the aim to reduce their pollution in the aquatic environment. Following the application of the technological parameters of the developed control system to reduce the concentration of test substances in the environment, the expected efficiency and effectiveness should reach up to 50 %. Currently, wastewater treatment plants are a key factor in reducing the concentrations of pharmaceuticals in wastewater and at the same time in the environment. |
