<div dir="ltr"><p class=""><span style="font-size:14pt;font-family:Arial,sans-serif">To:
Diane Buxbaum, MPH</span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif">Environmental Scientist</span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif">U.S. Environmental Protection
Agency,</span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif">Region 2</span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif">Division of Enforcement and
Compliance Assistance</span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif"> </span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif">From:
Ronald E. Ney, Jr.,PhD</span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif"> </span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif">Subject:
Pharmwaste Digest, Vol 98, Issue 6</span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif"> </span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif">Dear
Ms. Buxbaum:</span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif"> </span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif">There
are other questions that concern wastewater and the many unknowns for pharmaceuticals
and other chemicals being discharged and they are;</span></p>
<p class="" style="margin-left:0.5in"><span style="font-size:14pt;font-family:Arial,sans-serif">1.<span style="font-size:7pt;font-family:'Times New Roman'">
</span></span><span style="font-size:14pt;font-family:Arial,sans-serif">Does
EPA require residue data (residue data meaning parent and degradation products)
on reclaimed or recycle wastewater which can contain not only pharmaceutical
waste but thousands of other chemicals including metals, pesticides, dioxins,
etc.?</span></p>
<p class="" style="margin-left:0.75in"><span style="font-size:14pt;font-family:Symbol">·<span style="font-size:7pt;font-family:'Times New Roman'">
</span></span><span style="font-size:14pt;font-family:Arial,sans-serif">What
EPA Regulations would regulate the chemicals in treated wastewater and would
that include water for watering home owner’s lawns?</span></p>
<p class="" style="margin-left:0.5in"><span style="font-size:14pt;font-family:Arial,sans-serif">2.<span style="font-size:7pt;font-family:'Times New Roman'">
</span></span><span style="font-size:14pt;font-family:Arial,sans-serif">Will
these chemicals in treated wastewater or recycle wastewater be a hazard to
children, adults, persons with immune disorders and pets if the water is used
to water lawns?</span></p>
<p class="" style="margin-left:0.75in"><span style="font-size:14pt;font-family:Symbol">·<span style="font-size:7pt;font-family:'Times New Roman'">
</span></span><span style="font-size:14pt;font-family:Arial,sans-serif">Are
there any EPA regulations to protect these from chemicals in wastewater?</span></p>
<p class="" style="margin-left:0.75in"><span style="font-size:14pt;font-family:Symbol">·<span style="font-size:7pt;font-family:'Times New Roman'">
</span></span><span style="font-size:14pt;font-family:Arial,sans-serif">If
a home owner has a food garden will these be taken-up by the food plants and if
so, does EPA have any data on parent and degradates?</span></p>
<p class="" style="margin-left:0.5in"><span style="font-size:14pt;font-family:Arial,sans-serif">3.<span style="font-size:7pt;font-family:'Times New Roman'">
</span></span><span style="font-size:14pt;font-family:Arial,sans-serif">Does
EPA know if any of the chemicals in wastewater can be bound to organic matter
in soil, suspended sediment and sediment?</span></p>
<p class="" style="margin-left:0.5in"><span style="font-size:14pt;font-family:Symbol">·<span style="font-size:7pt;font-family:'Times New Roman'"> </span></span><span style="font-size:14pt;font-family:Arial,sans-serif">Can these bound
residues be released by standard extraction methods and if so is there a
material balance of the parent chemical to prove such?</span></p>
<p class="" style="margin-left:0.5in"><span style="font-size:14pt;font-family:Arial,sans-serif">4.<span style="font-size:7pt;font-family:'Times New Roman'">
</span></span><span style="font-size:14pt;font-family:Arial,sans-serif">Does
EPA know what the breakdown products from pharmaceuticals are and have methods
to extract and determine them?</span></p>
<p class="" style="margin-left:0.5in"><span style="font-size:14pt;font-family:Arial,sans-serif">5.<span style="font-size:7pt;font-family:'Times New Roman'">
</span></span><span style="font-size:14pt;font-family:Arial,sans-serif">Does
EPA know the fate and transport of these pharmaceuticals in air, water, soil,
plants and animals and other chemicals that can be in wastewater?</span></p>
<p class="" style="margin-left:0.5in"><span style="font-size:14pt;font-family:Arial,sans-serif">6.<span style="font-size:7pt;font-family:'Times New Roman'">
</span></span><span style="font-size:14pt;font-family:Arial,sans-serif">Does
EPA have analytes to discern recovery of these chemicals from air, water, soil,
plants and animals?</span></p>
<p class="" style="margin-left:0.5in"><span style="font-size:14pt;font-family:Arial,sans-serif">7.<span style="font-size:7pt;font-family:'Times New Roman'">
</span></span><span style="font-size:14pt;font-family:Arial,sans-serif">What
Federal Government Agency is protecting us and under what regulation?</span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif">Respectfully,</span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif"> </span></p>
<p class=""><span style="font-size:14pt;font-family:Arial,sans-serif">Dr.
Ron Ney</span></p></div><div class="gmail_extra"><br><br><div class="gmail_quote">On Fri, Dec 6, 2013 at 8:00 AM, <span dir="ltr"><<a href="mailto:pharmwaste-request@lists.dep.state.fl.us" target="_blank">pharmwaste-request@lists.dep.state.fl.us</a>></span> wrote:<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">Send Pharmwaste mailing list submissions to<br>
<a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a><br>
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When replying, please edit your Subject line so it is more specific<br>
than "Re: Contents of Pharmwaste digest..."<br>
<br>Today's Topics:<br>
<br>
1. RE: Concentrations of prioritized pharmaceuticals ineffluents<br>
from 50 large wastewater treatment plants in the US<br>
andimplications for risk estimation (Jim Mullowney)<br>
<br><br>---------- Forwarded message ----------<br>From: "Jim Mullowney" <<a href="mailto:jmullowney@pharma-cycle.com">jmullowney@pharma-cycle.com</a>><br>To: "'Ed Gottlieb'" <<a href="mailto:egottlieb@cityofithaca.org">egottlieb@cityofithaca.org</a>>, "'Buxbaum, Diane'" <<a href="mailto:Buxbaum.Diane@epa.gov">Buxbaum.Diane@epa.gov</a>>, "'DeBiasi, Deborah \(DEQ\)'" <<a href="mailto:Deborah.DeBiasi@deq.virginia.gov">Deborah.DeBiasi@deq.virginia.gov</a>>, "'Zimmer, Catherine'" <<a href="mailto:zenllc@usfamily.net">zenllc@usfamily.net</a>>, <<a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a>><br>
Cc: <a href="mailto:abuxbaum@downtownwomen.com">abuxbaum@downtownwomen.com</a>, <a href="mailto:ATL-LEADERS@LISTS.SIERRACLUB.ORG">ATL-LEADERS@LISTS.SIERRACLUB.ORG</a>, <a href="mailto:cbuxbaum@sandiaprep.org">cbuxbaum@sandiaprep.org</a><br>
Date: Fri, 6 Dec 2013 10:59:32 -0500<br>Subject: RE: [Pharmwaste] Concentrations of prioritized pharmaceuticals ineffluents from 50 large wastewater treatment plants in the US andimplications for risk estimation<br><u></u><u></u><div lang="EN-US" link="blue" vlink="purple" style="margin-left:3.0pt;margin-top:3.0pt;margin-right:3.0pt;margin-bottom:.75pt">
<div><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Hi Ed and Diane, <u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">I would like to add to Catherine’s List.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">In August The World Health Organization published a Handbook on health care waste management and highlighted a group of Pharmaceuticals called Genotoxic and stated<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p><p class="MsoNormal" style="text-indent:.5in"><span style="font-size:16.0pt;background:yellow">Any discharge of genotoxic waste into the environment could have disastrous ecological consequences</span><span style="font-size:16.0pt">.</span><span style="font-size:16.0pt;color:red"><u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Most Genotoxic drugs are used in cancer treatment and 27 of them are excreted heavily in the patients urine, feces and vomit for 48 hours after treatment. The WHO states that it is the responsibility of the Pharmacist to control Genotoxic waste including the human waste and it is the responsibility of those involved in paying for the treatment cover the cost. We are the United States of America, we put a car on the moon, we can collect pee in a cup.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">I am attaching a list of the 27 bad actors.<u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Jim Mullowney<u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="mailto:jmullowney@pharma-cycle.com" target="_blank">jmullowney@pharma-cycle.com</a> <u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p><div><div style="border:none;border-top:solid #b5c4df 1.0pt;padding:3.0pt 0in 0in 0in">
<p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext"> <a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us" target="_blank">pharmwaste-bounces@lists.dep.state.fl.us</a> [mailto:<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us" target="_blank">pharmwaste-bounces@lists.dep.state.fl.us</a>] <b>On Behalf Of </b>Ed Gottlieb<br>
<b>Sent:</b> Friday, December 06, 2013 8:44 AM<br><b>To:</b> Buxbaum, Diane; DeBiasi, Deborah (DEQ); Zimmer, Catherine; <a href="mailto:pharmwaste@lists.dep.state.fl.us" target="_blank">pharmwaste@lists.dep.state.fl.us</a><br>
<b>Cc:</b> <a href="mailto:abuxbaum@downtownwomen.com" target="_blank">abuxbaum@downtownwomen.com</a>; <a href="mailto:ATL-LEADERS@LISTS.SIERRACLUB.ORG" target="_blank">ATL-LEADERS@LISTS.SIERRACLUB.ORG</a>; <a href="mailto:cbuxbaum@sandiaprep.org" target="_blank">cbuxbaum@sandiaprep.org</a><br>
<b>Subject:</b> Re: [Pharmwaste] Concentrations of prioritized pharmaceuticals ineffluents from 50 large wastewater treatment plants in the US andimplications for risk estimation<u></u><u></u></span></p></div></div><p class="MsoNormal">
<u></u> <u></u></p><div><p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext">Hi Diane,<u></u><u></u></span></p></div><div><p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext"> <u></u><u></u></span></p>
</div><div><p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext">I would add to Catherine's list: <u></u><u></u></span></p></div><div><p class="MsoNormal">
<span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext">Change prescribing guidelines (based on inventory data from take-back events) to help reduce the amount of waste medications generated.<u></u><u></u></span></p>
</div><div><p class="MsoNormal" style="margin-right:0in;margin-bottom:5.0pt;margin-left:0in"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">Ed Gottlieb<br>Chair, Coalition for Safe Medication Disposal <br>
Industrial Pretreatment Coordinator <br>Ithaca Area Wastewater Treatment Facility<br>525 3<sup>rd</sup> Street<br>Ithaca, NY 14850<br><a href="tel:%28607%29%20273-8381" value="+16072738381" target="_blank">(607) 273-8381</a><br>
fax: <a href="tel:%28607%29%20273-8433" value="+16072738433" target="_blank">(607) 273-8433</a><u></u><u></u></span></p></div><div><p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext"><br>
>>> "Catherine Zimmer" <<a href="mailto:zenllc@usfamily.net" target="_blank">zenllc@usfamily.net</a>> 12/5/2013 4:03 PM >>><u></u><u></u></span></p></div><div><div><div><p class="MsoNormal">
<span style="font-size:10.0pt;font-family:"Calibri","sans-serif"">Hi Diane,<u></u><u></u></span></p></div><div><p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Calibri","sans-serif""> <u></u><u></u></span></p>
</div><div><p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Calibri","sans-serif"">From everything I’ve read it would take a multitude of treatment regimens to address the plethora of pharmaceuticals (and other contaminants) in our wastewater systems. And, if we got breakdown, what would those breakdown products look like? Would they be biologically active? What kind of pollutants would they be? <u></u><u></u></span></p>
</div><div><p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Calibri","sans-serif""> <u></u><u></u></span></p></div><div><p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Calibri","sans-serif"">I hate to sound like a broken record, but a better strategy is to reduce and eliminate these things at the source. First, we stop using our surface waters as dumps. Industry has to re-use their own water, they can’t dump into rivers, lakes, oceans. WWTP, also re-use water. Households get educated on health improvements that don’t use drugs and MD support alternative treatments and less toxic/persistent pharmaceuticals when necessary. Individual households treat their sewage to remove rx. While this is a large undertaking, it seems ultimately a better outcome than trying to treat everything being dumped into the water. <u></u><u></u></span></p>
</div><div><p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Calibri","sans-serif""> <u></u><u></u></span></p></div><div><p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Calibri","sans-serif"">Very truly yours,<br>
<br>Catherine Zimmer, MS, BSMT<br>Principal<br>Zimmer Environmental Improvement LLC<br>Ph: <a href="tel:651.645.7509" value="+16516457509" target="_blank">651.645.7509</a><u></u><u></u></span></p></div><div><div><div><p class="MsoNormal">
<span style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> <u></u><u></u></span></p></div><div><div><p class="MsoNormal" style="background:whitesmoke"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> <a href="mailto:Buxbaum.Diane@epa.gov" title="Buxbaum.Diane@epa.gov" target="_blank">Buxbaum, Diane</a> <u></u><u></u></span></p>
</div><div><p class="MsoNormal" style="background:whitesmoke"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">Sent:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> Tuesday, December 03, 2013 2:44 PM<u></u><u></u></span></p>
</div><div><p class="MsoNormal" style="background:whitesmoke"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">To:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> <a href="mailto:Deborah.DeBiasi@deq.virginia.gov" title="Deborah.DeBiasi@deq.virginia.gov" target="_blank">DeBiasi, Deborah (DEQ)</a> ; <a href="mailto:pharmwaste@lists.dep.state.fl.us" title="pharmwaste@lists.dep.state.fl.us" target="_blank">pharmwaste@lists.dep.state.fl.us</a> <u></u><u></u></span></p>
</div><div><p class="MsoNormal" style="background:whitesmoke"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">Cc:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> <a href="mailto:abuxbaum@downtownwomen.com" title="abuxbaum@downtownwomen.com" target="_blank">abuxbaum@downtownwomen.com</a> ; <a href="mailto:cbuxbaum@sandiaprep.org" title="cbuxbaum@sandiaprep.org" target="_blank">cbuxbaum@sandiaprep.org</a> ; <a href="mailto:ATL-LEADERS@LISTS.SIERRACLUB.ORG" title="ATL-LEADERS@LISTS.SIERRACLUB.ORG" target="_blank">ATL-LEADERS@LISTS.SIERRACLUB.ORG</a> <u></u><u></u></span></p>
</div><div><p class="MsoNormal" style="background:whitesmoke"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">Subject:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> RE: [Pharmwaste] Concentrations of prioritized pharmaceuticals ineffluents from 50 large wastewater treatment plants in the US andimplications for risk estimation<u></u><u></u></span></p>
</div></div></div><div><p class="MsoNormal"><span style="font-family:"Calibri","sans-serif""> <u></u><u></u></span></p></div></div><div><p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#0f243e">I am ccing some nongovernmental environmental activists on this email Wow, how depressing. Were most or all of these plants secondary plants? Were any tertiary? Are there any ideas of nonprohibitive methods for reducing or eliminating the discharge of these pharmaceuticals into the receiving bodies? Would, in areas where there is the land, exposure to sunlight and ponds allow for the breakdown of these drugs (and how dangerous might those products be)? Probably not possible in most urban areas and even where possible very costly. <u></u><u></u></span></p>
<p class="MsoNormal"> <span style="font-family:"Calibri","sans-serif";color:#0f243e"><u></u><u></u></span></p><div><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#0f243e">Diane D. Buxbaum, MPH<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#0f243e">Environmental Scientist<u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#0f243e">U.S. Environmental Protection Agency,<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#0f243e">Region 2<u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#0f243e">Division of Enforcement and Compliance Assistance<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#0f243e">290 Broadway (21 East)<u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#0f243e">New York, NY 10007<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#0f243e"><a href="mailto:buxbaum.diane@epa.gov" target="_blank">buxbaum.diane@epa.gov</a><u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#0f243e">Phone <a href="tel:212-637-3919" value="+12126373919" target="_blank">212-637-3919</a><u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#0f243e">Fax <a href="tel:212-637-4086" value="+12126374086" target="_blank">212-637-4086</a><u></u><u></u></span></p>
</div><p class="MsoNormal"> <span style="font-family:"Calibri","sans-serif";color:#0f243e"><u></u><u></u></span></p><div><div style="border:none;border-top:solid #b5c4df 1.0pt;padding:3.0pt 0in 0in 0in">
<p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext"> <a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us" target="_blank">pharmwaste-bounces@lists.dep.state.fl.us</a> [<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us" target="_blank">mailto:pharmwaste-bounces@lists.dep.state.fl.us</a>] <b>On Behalf Of </b>DeBiasi, Deborah (DEQ)<br>
<b>Sent:</b> Tuesday, December 03, 2013 3:21 PM<br><b>To:</b> <a href="mailto:pharmwaste@lists.dep.state.fl.us" target="_blank">pharmwaste@lists.dep.state.fl.us</a><br><b>Subject:</b> [Pharmwaste] Concentrations of prioritized pharmaceuticals in effluents from 50 large wastewater treatment plants in the US and implications for risk estimation<u></u><u></u></span></p>
</div></div><p class="MsoNormal"> <u></u><u></u></p><p class="MsoNormal"> <u></u><u></u></p><table border="0" cellspacing="0" cellpadding="0" style="border-collapse:collapse"><tbody><tr style="height:95.6pt"><td width="615" valign="top" style="width:461.3pt;padding:0in 0in 0in 0in;height:95.6pt">
<p class="MsoNormal" style="margin-right:12.6pt;line-height:16.7pt;vertical-align:baseline"><span style="font-size:15.5pt">Concentrations of prioritized pharmaceuticals in ef</span><span style="font-size:14.5pt;font-family:"Arial","sans-serif"">fl</span><span style="font-size:15.5pt">uents from 50 large wastewater treatment plants in the US and implications for risk estimation<u></u><u></u></span></p>
<p class="MsoNormal" style="margin-top:9.2pt;line-height:12.8pt;vertical-align:baseline"><span style>Mitchell S. Kostich</span><sup><span style="font-family:"Arial","sans-serif"">*</span></sup><span style>, Angela L. Batt, James M. Lazorchak<u></u><u></u></span></p>
<p class="MsoNormal" style="margin-right:19.8pt;margin-bottom:.95pt;margin-left:0in;line-height:8.4pt;vertical-align:baseline"><b><i><span style="font-size:7.0pt">Ecological Exposure Research Division, National Exposure Research Laboratory, U.S. Environmental Protection Agency, 26 W. Martin Luther King Drive, Cincinnati, OH 45268, USA<u></u><u></u></span></i></b></p>
</td><td width="83" valign="top" style="width:62.15pt;padding:0in 0in 0in 0in;height:95.6pt"></td></tr></tbody></table><p class="MsoNormal"> <u></u><u></u></p><p class="MsoNormal"> <u></u><u></u></p><p class="MsoNormal" style="margin-right:0in;margin-bottom:7.4pt;margin-left:0in;line-height:8.4pt;vertical-align:baseline">
<b><span style="letter-spacing:3.0pt">ABSTRACT<u></u><u></u></span></b></p><p class="MsoNormal" style="text-align:justify;line-height:9.5pt;vertical-align:baseline"><img border="0" width="477" height="2" src="cid:image001.png@01CEF270.40DC6E50"><span style="letter-spacing:-.3pt">We measured concentrations of 56 active pharmaceutical ingredients (APIs) in effluent samples from 50 large wastewater treatment plants across the US. Hydrochlorothiazide was found in every sample. Metoprolol, atenolol, and carbamazepine were found in over 90% of the samples. Valsartan had the highest concentration (5300 ng/L), and also had the highest average concentration (1600 ng/L) across all 50 samples. Estimates of potential risks to healthy human adults were greatest for six anti-hypertensive APIs (lisinopril, hydrochlorothiazide, valsartan, atenolol, enalaprilat, and metoprolol), but nevertheless suggest risks of exposure to individual APIs as well as their mixtures are generally very low. Estimates of potential risks to aquatic life were also low for most APIs, but suggest more detailed study of potential ecological impacts from four analytes (sertraline, propranolol, desmethylsertraline, and valsartan).<u></u><u></u></span></p>
<p class="MsoNormal" style="text-align:justify;line-height:9.5pt;vertical-align:baseline"> <span style="letter-spacing:-.3pt"><u></u><u></u></span></p><p class="MsoNormal"><span style="letter-spacing:-.4pt">Published by Elsevier Ltd.</span><u></u><u></u></p>
<p class="MsoNormal"> <u></u><u></u></p><p class="MsoNormal"> <u></u><u></u></p><p class="MsoNormal"> <u></u><u></u></p><p class="MsoNormal"> <u></u><u></u></p><p class="MsoNormal"><span style="font-size:10.0pt;color:navy">Deborah L. DeBiasi</span><span style="font-size:11.0pt;color:navy"><br>
</span><b><span style="font-size:10.0pt;color:navy">Email: <a href="mailto:Deborah.DeBiasi@deq.virginia.gov" target="_blank">Deborah.DeBiasi@deq.virginia.gov</a></span></b><b><i><span style="font-size:10.0pt;color:red"><br>
</span></i></b><span style="font-size:10.0pt;color:navy">WEB site address: <a href="http://www.deq.virginia.gov/" target="_blank">www.deq.virginia.gov</a></span><span style="font-size:11.0pt;color:navy"><br></span><span style="font-size:10.0pt;color:navy">Virginia Department of Environmental Quality</span><span style="font-size:11.0pt;color:navy"><br>
</span><span style="font-size:10.0pt;color:navy">Office of Water Permits </span><span style="font-size:11.0pt;color:navy"><br></span><span style="font-size:10.0pt;color:navy">Industrial Pretreatment/Whole Effluent Toxicity (WET) Program</span><span style="font-size:11.0pt;color:navy"><br>
</span><span style="font-size:10.0pt;color:navy">PPCPs, EDCs, and Microconstituents<u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;color:navy"><a href="http://www.deq.virginia.gov/Programs/Water/PermittingCompliance/PollutionDischargeElimination/Microconstituents.aspx" target="_blank">http://www.deq.virginia.gov/Programs/Water/PermittingCompliance/PollutionDischargeElimination/Microconstituents.aspx</a></span><span style="font-size:10.0pt;color:navy"><u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;color:navy">Mail: P.O. Box 1105, Richmond, VA 23218</span><span style="font-size:11.0pt;color:navy"><br></span><span style="font-size:10.0pt;color:navy">Location: 629 E. Main Street, Richmond, VA 23219</span><span style="font-size:11.0pt;color:navy"><br>
</span><span style="font-size:10.0pt;color:navy">PH: <a href="tel:804-698-4028" value="+18046984028" target="_blank">804-698-4028</a> FAX: <a href="tel:804-698-4032" value="+18046984032" target="_blank">804-698-4032</a><u></u><u></u></span></p>
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