Medicines in the environment: A public health problem. Sistematic Review

Abstract

Overview: With the technology evolution, the presence of medicines has been detected in the environment previously unnoticed by their low concentrations. Different ways these products enter the surface water where wastewater treatment plants are not able to eliminate these drugs and they are causing adverse effects on public health and ecosystems. Objective: Identify through a systematic review the evidence of the possible environmental impact produced by a series of selected medicines and identify corrective measures for environmental sustainability. Method: Through a systematic review based on Campbell Collaboration's systematic review methodology, they have selected papers that show the possible environmental impact of the selected medicines and were identified measures that mitigate the problem. Results: 351 studies were identified, and 15 studies were selected from 10 countries, and developed between 2003 and 2020. The results show that antibiotics are the drugs with the highest number of studies with 40 %, followed by analgesics and NSAIDs with 34 % and hormones with 23 %. A frequency analysis indicates that antibiotics were studied in 87 % of the works, 53 % analgesics- NSAIDs, and 33 % hormones. Conclusion: Little is known about the effect of medicines on the environment, human health, and ecosystems, so more research is needed to manage more effective measures for their elimination or reduction.