Assessing the exposure to human and veterinary pharmaceuticals in waterbirds: The use of feathers for monitoring antidepressants and nonsteroidal anti-inflammatory drugs

Ecotoxicological implications of increased antidepressant concentrations in the Laurentian Great Lakes Basin, 2018-2023

Antidepressants are only partially metabolized and then eliminated in urine and feces. Since waste water treatment plants are not designed to remove pharmaceuticals, antidepressants and their metabolites eventually reach the environment. Antidepressants are among the most prescribed drugs in the world, and their prescription rates increased dramatically following the onset of the COVID-19 pandemic. Our aim was to compare their measured environmental concentrations (MECs) in surface water in the three years before and the three years after the pandemic onset. Nearly 1300 samples were collected from 67 sites in the Laurentian Great Lakes Basin, from streams and rivers. We developed a liquid chromatography-tandem mass spectrometry (LC-MS/MS) methodology to measure the MECs of 7 of the most frequently used antidepressants and 3 of their metabolites. Canadian antidepressant use data was also collected via the IQVIA MIDAS® database of estimated sales data for pharmaceutical drugs (2018-2021). We found that the median MECs for 9 of the 10 substances increased between 1.5- and 7.2-fold (p < 0.05). The greatest median increases corresponded to fluvoxamine (4.8-fold) and 10-hydroxyamitriptyline (4.7-fold). Increases were concurrent with rising use rates post-COVID-onset. The highest concentrations corresponded to the metabolite O-desmethylvenlafaxine (3113.98 ng L-1) and its parent drug venlafaxine (699.59 ng L-1) in 2022. We collected and analyzed antidepressant surface water and ecotoxicological data to provide a comprehensive review to contextualize the LC-MS/MS data. We compared maximal MECs to ecotoxicological reference values and theorize a possible ecotoxicological impact when considering the overlap of maximal levels with ecotoxicological reference values cited in the scientific literature. We offer recommendations for next steps.

Environmental behavior, risks, and management of antidepressants in the aquatic environment

Antidepressants are increasingly detected in aquatic environments due to their incomplete removal in wastewater treatment, raising significant concerns about their ecological impacts. This review focuses on the three most widely used classes of antidepressants-tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs). It systematically explores their physicochemical properties and how these properties influence their environmental fate, including sorption, mobility, and bioaccumulation in aquatic ecosystems. The sublethal effects of these antidepressants on aquatic organisms, particularly their impacts on behavior, reproduction, and development, are critically analyzed, highlighting potential threats to biodiversity and ecological stability. Key knowledge gaps are identified, including the long-term impacts of chronic low-dose exposure, the role of bioactive metabolites, and the combined toxicity of antidepressants with other contaminants. The review underscores the importance of advanced wastewater treatment technologies, environmentally mindful prescribing practices, and public awareness campaigns as essential measures to mitigate these risks. By addressing these challenges, this study aims to inform future research and guide sustainable environmental management strategies.

Investigating the environmental fate of active pharmaceutical compounds in a coastal lagoon using a multimedia level III fugacity model

The use of active pharmaceutical ingredients (APIs) has enhanced life quality and longevity but poses significant environmental risks to ecosystems and human health. Evidence-based risk assessments are essential for addressing these issues, requiring detailed data on API presence, behavior, and effects in the environment. In particular, predictive exposure models offer a cost-effective tool to support such investigations. This study focuses on the application of a multimedia level III fugacity model to estimate the predicted environmental concentrations (PECs) and to simulate transport, distribution, and persistence of nine APIs in the Venice Lagoon (Italy), a transitional environment subjected to multiple anthropogenic stressors. Concentrations of the studied APIs in water were estimated within one order of magnitude of measured data, while the model underestimated the concentration of azithromycin and 17-β-estradiol in the sediments due to water half-life overestimation and lack of information about unmonitored emission sources. In detail, the highest levels of APIs in the water were estimated for amoxicillin and clarithromycin, while sediments showed a significant presence of azithromycin and ciprofloxacin. Model results also showed the possibility for sediments to act as sink for azithromycin, ciprofloxacin, erythromycin, estrone, and 17-β-estradiol. For all target APIs, degradation in the water column and adjective outflow were the most important elimination processes, while degradation in the sediments was significant only for erythromycin, ciprofloxacin, and clarithromycin. Monte-Carlo uncertainty and sensitivity analysis showed that degradation in water, affinity to organic matter, and sediment dynamics were the parameters with the strongest influence on model's results. Overall, this work provided valuable information on the environmental fate and behavior of the investigated APIs in a complex transitional waterbody such as the Venice Lagoon and can be useful to support future environmental risk assessments as well as studies to evaluate the effects of emission control measures (e.g., restriction of use, substitution, or implementation of new technologies for wastewater treatment) on APIs environmental exposure.

Pesticides and veterinary pharmaceuticals in neotropical avian carnivores: A scoping review

Organic contaminants have long been known to have negative consequences for wildlife health. For avian carnivores, particular concern surrounds the use of compounds such as pesticides and pharmaceutical drugs, derived from global agricultural and veterinary practices. Previous cases of avian poisoning in North America, Europe and Asia have received great attention, owing to significant declines in avian populations and wider consequences. By contrast, the Neotropics, comprised of Latin America and the Caribbean, has received relatively little attention, despite an extensive agricultural sector and uniquely high avian biodiversity. To evaluate the available evidence on this topic, a scoping review on the effects of agriculturally derived organic contaminants on Neotropical avian carnivores was conducted. Articles from seven databases were screened using exclusion criteria. Of these, 206 primary research articles published since 1965 were identified, investigating 144 compounds in 83 species. Findings indicate substantial knowledge gaps, particularly in observational studies conducted within the Neotropics. Whilst cross-sectional studies were fairly well-represented, with transitions towards less-invasive sampling methods, there were few longitudinal studies, raising concerns of undetected chronic exposure in Neotropical populations. Multiple avian taxonomic families were underrepresented, including globally recognized sentinel species - the osprey and barn owl, as were pharmaceutical drugs in comparison to pesticides. There was a large geographical bias in observational study location, with no research outputs identified from most Neotropical countries. Further research in the Neotropics is required to better understand the pervasiveness of contaminants in native populations, along with improving our understanding of their precise consequences on avian carnivore health.

Factors in the decline of the African penguin: Are contaminants of emerging concern (CECs) a potential new age stressor?

The African penguin is currently experiencing a significant decline, with just over 10,000 breeding pairs left. A substantial body of research reflects the impacts of contaminants of emerging concern (CECs) on the marine environment, with wastewater treatment plants reported as one of the main sources of CEC release. In South Africa, CECs were identified contaminating the marine environment and bioaccumulating in several marine species. Approximately 70 % of all African penguin colonies breed in close proximity to cities and/or harbors in South Africa. Currently, the impact of CECs as a stressor upon the viability of African penguin populations is unknown. Based on the search results there was a clear lack of information on CECs' bioaccumulation and impact on the African penguin. This narrative review will thus focus on the prevalent sources and types of CECs and examine the reported consequences of constant exposure in seabirds, particularly African penguins.

Recent progress in adverse events of carboxylic acid non-steroidal anti-inflammatory drugs (CBA-NSAIDs) and their association with the metabolism: the consequences on mitochondrial dysfunction and oxidative stress, and prevention with natural plant extracts

INTRODUCTION

Carboxylic acid non-steroidal anti-inflammatory drugs (CBA-NSAIDs) are extensively used worldwide due to their antipyretic, analgesic, and anti-inflammatory effects. CBA-NSAIDs have reasonable margin of safety at therapeutic doses, and in the current climate, do not possess addiction potential like opioid drugs. Studies have revealed that various adverse events of CBA-NSAIDs are related mitochondrial dysfunction and oxidative stress.

AREAS COVERED

This review article summarizes adverse events induced by CBA-NSAIDs, mechanisms of mitochondrial damage, oxidative stress, and metabolic interactions. Meanwhile, this review discusses the treatment and prevention of CBA-NSAIDs damage by natural plant extracts based on antioxidant effects.

EXPERT OPINION

CBA-NSAIDs can induce reactive oxygen species (ROS) production, mediate DNA, protein and lipid damage, lead to imbalance of cell antioxidant status, change of mitochondrial membrane potential, activate oxidative stress signal pathway, thus leading to oxidative stress and cell damage. Adverse events caused by CBA-NSAIDs often exhibit dose and time dependence. In order to avoid adverse events caused by CBA-NSAIDs, it is necessary to provide detailed patient consultation and eliminate influencing factors. Moreover, constructive research studies on the organ-specific toxicity and mechanism of natural plant extracts in preventing and treating metabolic abnormalities of CBA-NSAIDs, will provide important value for warning and guidance for use of CBA-NSAIDs.

Toxic effects of environmentally relevant concentrations of naproxen exposure on Daphnia magna including antioxidant system, development, and reproduction

Naproxen (NPX) is one of common non-prescription non-steroidal anti-inflammatory drugs (NSAIDs) which is widely detected in aquatic environments worldwide due to its high usage and low degradation. NPX exerts anti-inflammatory and analgesic pharmacological effects through the inhibition of prostaglandin-endoperoxide synthase (PTGS), also known as cyclooxygenase (COX). Given its evolutionarily relatively conserved biological functions, the potential toxic effects of NPX on non-target aquatic organisms deserve more attention. However, the ecotoxicological studies of NPX mainly focused on its acute toxic effects under higher concentrations while the chronic toxic effects under realistic concentrations exposure, especially for the underlying molecular mechanisms still remain unclear. In the present study, Daphnia magna, being widely distributed in freshwater aquatic environments, was selected to investigate the toxic effects of environmentally relevant concentrations of NPX via determining the response of the Nrf2/Keap1 signaling pathway-mediated antioxidant system in acute exposure, as well as the changes in life-history traits, such as growth, reproduction, and behavior in chronic exposure. The results showed that the short-term exposure to NPX (24 h and 48 h) suppressed ptgs2 expression while activating Nrf2/Keap1 signaling pathway and its downstream antioxidant genes (ho-1, sod, cat and trxr). However, with prolonged exposure to 96 h, the opposite performance was observed, the accumulation of malondialdehyde (MDA) indicated that D. magna suffered from severe oxidative stress. To maintain homeostasis, the exposed organism may trigger ferroptosis and apoptosis processes with the help of Silent mating type information regulation 2 homologs (SIRTs). The long-term chronic exposure to NPX (21 days) caused toxic effects on D. magna at the individual and population levels, including growth, reproduction and behavior, which may be closely related to the oxidative stress induced by the drug. The present study suggested that more attention should be paid to the ecological risk assessment of NSAIDs including NPX on aquatic non-target organisms.

Veterinary pharmaceutical as emerging contaminants in wastewater and surface water: An overview

Veterinary pharmaceuticals have become of interest due to their indiscriminate use. Thus, this paper compiles studies on detection in surface and wastewater, and the treatment applied for their removal. Additionally, a case study was performed to evaluate its commercialization, as the ecological risk assessment for the most relevant compounds. 241 compounds were detected. The highest concentrations were found for antibiotics such as oxytetracycline, amoxicillin, and monensin, with values up to 3732.4 µg/L. Biological treatments have been mainly reported, obtaining removal greater than 80% for sulfadiazine, sulfamethazine, sulfamethoxazole, enrofloxacin, and oxytetracycline. Considering the case study, enrofloxacin and oxytetracycline were widely commercialized. Finally, there was a low risk for the species exposed to enrofloxacin, in contrast, the species exposed to oxytetracycline presented a high risk of long-term mortality. Concluding that veterinary compounds have emerged as a significant concern regarding water source contamination, owing to their potential adverse effects on aquatic biota and even human. This is particularly relevant because many water bodies that receive wastewater are utilized for drinking water purposes. Consequently, the development of comprehensive, full-scale systems for efficient antibiotic removal before their introduction into water sources becomes imperative. Equally important is the need to reconsider their extensive use altogether.

Environmentally relevant concentrations of antidepressant mirtazapine impair the neurodevelopment of zebrafish (Danio rerio)

Mirtazapine is a commonly prescribed antidepressant and has been found widespread in aquatic environments. However, its toxicities to aquatic organisms has rarely been explored. Herein, we conducted a comprehensive study on the developmental effects of mirtazapine on early life stages of zebrafish at environmentally relevant concentrations (3.9 ng/L and 43.5 ng/L). Out of the endpoints measured, spontaneous contraction of embryos at 24 h post fertilization (hpf) and hatching rate and heart rate of embryos at 50 hpf and 56 hpf, respectively, were significantly affected. In light-dark transition behavior test, mirtazapine significantly reduced the swimming frequency and swimming speed of embryos at both concentrations of 3.9 ng/L and 43.5 ng/L. Furthermore, the total swimming distances in dark conditions were also significantly reduced. Transcriptomic analysis was further conducted. It demonstrated that the decreased neural activities in embryos may be associated with altered epinephrine and neuregulin signaling. The present results fill a data gap regarding the exposure of fish to mirtazapine at environmentally relevant concentrations and provide new insights into the neurotoxic mechanisms of mirtazapine exposure.

Neonicotinoids and pharmaceuticals in hair of the Red fox (Vulpes vulpes) from the Cavallino-Treporti peninsula, Italy

Neonicotinoids (NEOs) and active pharmaceuticals ingredients (API) are contaminants widely diffused worldwide, causing increasing concern for potential adverse effects on wildlife. However, research on these contaminants have focused on target and non-target invertebrates, while information on potential effects in terrestrial mammals is lacking. We performed preliminary non-invasive monitoring of NEOs and API in a suburban and agricultural area using hair of the Red fox. The Red fox is a widely diffused mesopredator in Europe, and its plasticity in feeding habits makes it an excellent indicator for assessing exposure to environmental contamination. We observed the presence of NEOs in many Red fox hair samples (n = 11), including imidacloprid (IMI), acetamiprid (ACE), and clothianidin (CLO). The highest quantified concentrations were 6.4 ng g^-1 dry weight (dw), 6.7 ng g^-1 dw, and 0.9 ng g^-1 dw for IMI, ACE, and CLO, respectively. The targeted APIs included non-steroidal anti-inflammatory drugs (NSAIDs) and antidepressants. APIs were less frequently detected than NEOs, and the compounds with the highest prevalence were the NSAID ketoprofen (36%), the antidepressant sertraline (36%), and its active metabolite norsertraline (27%). The presence of human pharmaceuticals such as the NSAID ibuprofen and the antidepressants sertraline, fluoxetine, and their active metabolites norsertraline and norfluoxetine suggest environmental contamination due to untreated and partially treated wastewater discharged in surface waters and soils of the study area. The detection and quantification of ketoprofen and flunixin also suggest the possible use of contaminated manure on farmland. Findings indicate that hair may be used for monitoring environmental exposure to NEOs and provide evidence that hair is a good marker of exposure for antidepressants and certain NSAIDs, including ibuprofen, ketoprofen, and flunixin.

High resolution mass spectrometric suspect screening, wide-scope target analysis of emerging contaminants and determination of legacy pollutants in adult black-tailed godwit Limosa limosa limosa in the Netherlands - A pilot study

The Dutch breeding population of the black-tailed godwit Limosa limosa limosa has declined substantially over recent decades; the role of contaminants is unknown. We analysed liver samples from 11 adult birds found dead on their breeding grounds in SW Friesland 2016-2020, six from extensive, herb-rich grasslands, five from intensive grasslands. We carried out LC and GC wide-scope target analysis of more than 2400 substances, LC suspect screening for more than 60,000 substances, target analysis for Cd, Hg, Ni and Pb, organo-phosphate flame retardants (OPFRs), dechlorane plus compounds and selected polybrominated diphenyl ether flame retardants (PBDEs), and bioassay for polybrominated dibenzo-p-dioxins and dibenzofurans (PBDDs/PDBFs) and dioxin-like polychlorinated biphenyls (dl-PCBs). Residues of 29 emerging contaminants (ECs) were determined through wide-scope target analysis. Another 20 were tentatively identified through suspect screening. These contaminants include industrial chemicals (personal care products, surfactants, PAHs and others), plant protection products (PPPs) and pharmaceuticals and their transformation products. Total contaminant load detected by wide-scope target analysis ranged from c. 155 to c. 1400 ng g^-1 and was generally lower in birds from extensive grasslands. Heatmaps suggest that birds from intensive grasslands have a greater mix and higher residue concentrations of PPPs, while birds from extensive grasslands have a greater mix and higher residue concentrations of per- and polyfluoroalkyl substances (PFAS). All four metals and two OPFRs were detected. All tested PBDEs were below the respective LODs. Bioassay revealed presence of PBDDs, PBDFs and dl-PCBs. Further research is required to elucidate potential health risks to godwits and contaminant sources.

Domestic Waste and Wastewaters as Potential Sources of Pharmaceuticals in Nestling White Storks (Ciconia ciconia)

Information on the exposure of wild birds to pharmaceuticals from wastewater and urban refuse is scarce despite the enormous amount of drugs consumed and discarded by human populations. We tested for the presence of a battery of antibiotics, NSAIDs, and analgesics in the blood of white stork (Ciconia ciconia) nestlings in the vicinity of urban waste dumps and contaminated rivers in Madrid, central Spain. We also carried out a literature review on the occurrence and concentration of the tested compounds in other wild bird species to further evaluate possible shared exposure routes with white storks. The presence of two pharmaceutical drugs (the analgesic acetaminophen and the antibiotic marbofloxacin) out of fourteen analysed in the blood of nestlings was confirmed in 15% of individuals (n = 20) and in 30% of the nests (n = 10). The apparently low occurrence and concentration (acetaminophen: 9.45 ng mL−1; marbofloxacin: 7.21 ng mL−1) in nestlings from different nests suggests the uptake through food acquired in rubbish dumps rather than through contaminated flowing water provided by parents to offspring. As with other synthetic materials, different administration forms (tablets, capsules, and gels) of acetaminophen discarded in household waste could be accidentally ingested when parent storks forage on rubbish to provide meat scraps to their nestlings. The presence of the fluoroquinolone marbofloxacin, exclusively used in veterinary medicine, suggests exposure via consumption of meat residues of treated animals for human consumption found in rubbish dumps, as documented previously at higher concentrations in vultures consuming entire carcasses of large livestock. Control measures and ecopharmacovigilance frameworks are needed to minimize the release of pharmaceutical compounds from the human population into the environment.

Experimental evidence for clothianidin deposition in feathers of house sparrows after ingestion of sublethal doses treated seeds

Bird feathers are commonly used to assess environmental contamination by chemical pollutants. However, although neonicotinoid insecticides are widely applied worldwide, feathers have rarely been used to survey the contamination by neonicotinoids in birds. To investigate whether clothianidin, one compound of the neonicotinoid class, is deposited into birds' feathers, we conducted an experiment with 56 wild male and female house sparrows dispatched in 7 aviaries. During this experiment, house sparrows were fed with certified organic seeds treated with clothianidin at an estimated concentration of 0.25 μg/g BW per day and per individual. We collected blood samples and plucked four tail feathers at the onset of the experiment to confirm that no birds were previously exposed to clothianidin. 35 days later, we collected blood samples and the newly grown feathers. Before exposure, a small number of birds showed very low clothianidin concentrations in plasma and feathers. After exposure, the plasma and the newly grown feathers of all birds contained clothianidin. Clothianidin concentrations in feathers were similar in both sexes, but the plasma of males contained clothianidin at higher concentrations than that of females. Our results confirm that ingested clothianidin transits in the plasma and is deposited in feathers during their growth. They also suggest substantial individual variation in the amounts of clothianidin transiting in the plasma and being deposited in feathers that may reflect variation in metabolism and/or access to food in relation to sex, social hierarchy and group dynamics. Whether increasing levels of exposure translate linearly or non-linearly (e.g. saturation process) into increasing clothianidin concentrations in bird plasma and feathers remains to be investigated. To conclude, these results confirm the relevance of using feathers to biomonitor the presence of neonicotinoids, but the relationship between the level of exposure and the concentrations found in feathers remains to be established.

Environmental exposure to non-steroidal anti-inflammatory drugs and potential contribution to eggshell thinning in birds

Abnormally thin eggshells can reduce avian reproductive success, and have caused rapid population declines. The best known examples of this phenomenon are the widespread population crashes in birds, mostly raptors, fish eating birds, and scavengers, caused by the pesticide DDT and its isomers in the 1960s. A variety of other chemicals have been reported to cause eggshell thinning. Non-steroidal anti-inflammatory drugs (NSAIDs), which are extensively and increasingly used in human and veterinary medicine, may be one particularly concerning group of chemicals that demonstrate an ability to impair eggshell development, based both on laboratory studies and on their known mechanism of action. In this review, we outline environmental and wildlife exposure to NSAIDs, describe the process of eggshell formation, and discuss pathways affected by NSAIDs. We list pharmaceuticals, including NSAIDs, and other compounds demonstrated to reduce eggshell thickness, and highlight their main mechanisms of action. Dosing studies empirically demonstrated that NSAIDs reduce eggshell thickness through cyclooxygenase inhibition, which suppresses prostaglandin synthesis and reduces the calcium available for the mineralization of eggshell. Using the US EPA's CompTox Chemicals Dashboard, we show that NSAIDs are predicted to strongly inhibit cyclooxygenases. NSAIDs have been observed both in the putative diet of scavenging birds, and we report examples of NSAIDs detected in eggs or tissues of wild and captive Old World vultures. We suggest that NSAIDs in the environment represent a hazard that could impair reproduction in wild birds.

Seabirds as Biomonitors of Mercury Bioavailability in the Venice Lagoon

Seabirds accumulate mercury (Hg) due to their long-life span together with their high trophic position. A Hg monitoring in Venice's Lagoon using three seabird species occupying different trophic habitat (Thalasseus sandvicensis, Ichthyaetus melanocephalus, and Chroicocephalus ridibundus) confirmed that fledgelings might effectively be used as sentinels of Hg bioavailability. The significant differences in Hg residues in feathers observed among the species highlighted a possible differential exposure due to different diets, with C. ridibundus accumulating more Hg than the other species. Average residues in feathers were not above the threshold associated with adverse effects on birds (5 mg kg^- 1). Nevertheless, a large part of the C. ridibundus individuals (58%) exceeded the adverse effect level, underlining the need for strengthening Hg monitoring. Seabirds indeed may provide relevant insight on Hg transfer in food webs and a better picture of the hazards to men when bird species forage on species exploited for human consumption.

Risk assessment of selected pharmaceuticals on wildlife with nanomaterials based aptasensors

Pharmaceuticals have improved human and veterinary health tremendously over the years. But the implications of the presence of pharmaceuticals in the environment on terrestrial, avian, and aquatic organisms are still not fully comprehended. The bioaccumulation and biomagnifications of these chemicals through the food chain have long-term effects on the wildlife. The detection and quantification of such pharmaceutical residues in the environment is a tedious process and quicker methods are needed. Aptasensors are one such quick and reliable method for the identification of pharmaceutical residues in the wildlife. Aptasensors are a class of biosensors that work on the principles of biological recognition of elements. The aptamers are unique biological recognition elements with high specificity and affinity to various targets. Their efficiency makes them a very promising candidate for such sensitive research. In this review, the pharmaceutical threats to wildlife and their detection techniques using aptasensors have been discussed.