AbstractThis review investigates the occurrence of pharma-ceuticals in the surface waters (including rivers, lakes, oceans, and aquifers) of the USA, discusses various pathways of pharmaceutical contamination from different point sources, assesses the potential risk of pharmaceutical contamination for aquatic organisms, and provides a discussion on the op-portunities for a sustainable management of pharmaceutical contamination. We found a total of 93 pharmaceuticals that have been reported to contaminate the surface water, includ ing: 27 antibiotics; 15 antidepressants; 9 antihypertensives; 7 analgesics; 7 anticonvulsants; 6 antilipidemics; 3 contracep-tives; 3 stimulants; and 2 each of antihistamines, blood thin-ners, disinfectants, antacids, antitussives, anti-anxiety, anti-inflammatory, and diuretic agents. The pharmaceuticals that
are assessed to be at high risk (risk quotient RQ≥1.0) include acetaminophen (analgesic), caffeine (stimulant), sulfadime-thoxine (antibiotic), as well as triclocarban and triclosan (both used in disinfectants). Such drugs require detailed evaluation as to the frequency of their occurrence and the risks for aquatic organisms and humans. Opportunities for sustainable control of pharmaceutical contamination include source control (proper disposal of leftover pharmaceuticals; careful monitor-ing of hospital wastes), and improvements to treatment facil-ities for the efficient removal and safe transformation of pharmaceutical contaminants. Keywords Risk assessment. Surfacewater. Biosolids.
Pharmaceuticals.Review. Antibiotics. Effluents.Fate. Antibiotics. Antidepressants. Contraceptives. Disinfectants.Sustainable. Management