Hazard and health risk assessment of exposure to pharmaceutical active compounds via toxicological evaluation by zebrafish

The uncontrolled or continuous release of effluents from wastewater treatment plants leads to the omnipresence of pharmaceutical active compounds (PhACs) in the aquatic media. Today, this is a confirmed problem becoming a main subject of twin public and scientific concerns. However, still little information is available about the long-term impacts of these PhACs on aquatic organisms. In this review, efforts were made to reveal correlation between the occurrence in the environment, ecotoxicological and health risks of different PhACs via toxicological evaluation by zebrafish (Danio rerio). This animal model served as a bioindicator for any health impacts after the exposure to these contaminants and to better understand the responses in relation to human diseases. This review paper focused on the calculation of Risk Quotients (RQs) of 34 PhACs based on environmental and ecotoxicological data available in the literature and prediction from the ECOSAR V2.2 software. To the best of the authors' knowledge, this is the first report on the risk assessment of PhACs by the two different methods as mentioned above. RQs showed greater difference in potential environmental risks of the PhACs. These differences in risk values underline the importance of environmental and experimental factors in exposure conditions and the interpretation of RQ values. While the results showed high risk to Danio rerio of the majority of PhACs, risk qualification of the others varied between moderate to insignifiant. Further research is needed to assess pharmaceutical hazards when present in wastewater before discharge and monitor the effectiveness of treatment processes. The recent new advances in the morphological assessment of toxicant-exposed zebrafish larvae for the determination of test compounds effects on the developmental endpoints were also discussed. This review emphasizes the need for strict regulations on the release of PhACs into environmental media in order to minimize their toxicity to aquatic organisms.

COVID-19: Implications for plastic reduction, with a focus on Personal Protective Equipment (PPE)

With over 190 million cases reported and nearly 4.1 million deaths worldwide, COVID19 has been the center of global attention. This pandemic has changed many aspects of daily life and has, perhaps, indelibly changed the way we live and it is quite likely that there will be no full return to normality. Owing to its impacts across all societal aspects - from micro- and macroeconomics, information management and research, education, to governance, mental health and even territorial integrity and cohesion - the global ecosystem upon which modern society has evolved will have to be redesigned. Many have, indeed, pointed out that the economy will have to be restructured and growth will have to be defined as prosperity - not continuous growth. Perhaps nowhere is this more evident than in the environment.

An integrated approach to investigate the relationship of coupling coordination between social economy and water environment on urban scale - A case study of Kunming

With a rapid economic growth and social development in China, the associated problems of water pollution and shortage of water resources would limit the sustainable and coordinated development of socioeconomic and water environmental systems of urban cities. To investigate the relationship of coupling coordination between social economy and water environment on urban scale, we introduced an integrated approach that enables the dynamic evaluation of coupling coordination degree (CCD), which consists of a system dynamics model and a coupling coordination degree model; and applied it to a case study in Kunming in 2016-2025. The business-as-usual (BAU) scenario and five alternative regulating scenarios are simulated to evaluate the effectiveness exerted by various socioeconomic development patterns and water protection efforts in improving CCD. We found that the improvement of CCD could attribute to both the sufficient water protection efforts and the maintaining sustainable speed and scale of socioeconomic development patterns. Under BAU scenario, Kunming would maintain the current state of barely balanced development with CCD at 0.5-0.8, predominantly due to substantial water consumption and pollution. Through the comparison of dynamic evolutions of system indicators and CCD under five alternative regulating scenarios, it is realistic for Kunming to plan its future development in accordance to M-H scenario (Medium-speed socioeconomic development pattern; High-intensity water protection effort). Following this scenario, Kunming's CCD would conform to a steadily increasing trend in 2016-2025 and remain above 0.8 in 2022-2025, tracing a shift in the development stage of that coupling coordination from "barely balanced development" to "highly balanced development" despite the difficulty to cut NH₃-N emission significantly. The effective and feasible regulatory measures such as reducing productive or domestic water pollutants and consumptions; improving collection and reuse rates of wastewater, should be prioritized when adjusting coordination development during decision-making.

Impact of regulatory measures on antipsychotics drug consumption in Castilla y León, Spain

OBJECTIVES

Antipsychotics are currently used to treat different diseases; even some off-labelled conditions are treated with this medication. Consumption and cost of antipsychotic drugs sharply increased in Spain after second-generation drugs were marketed; several regulatory measures were adopted to curb this trend. The aim of this study was to examine the impact of these measures upon the use and cost of antipsychotics.

STUDY DESIGN

Study of drug use (SDU) from 1995 to 2012. Consumption and cost data were obtained from the CONCYLIA database; this database contains the retail community pharmacies sales of medicinal products reimbursed by the National Health System in Castilla y León (Spain).

METHODS

Data are presented as defined daily doses per 1000 inhabitants per day (DID) and day treatment cost (DTC).

RESULTS

First-generation antipsychotics prescriptions gradually decreased from 3.0 to 1.8 DID; meanwhile, prescriptions for second-generation antipsychotics considerably increased from 0.3 to 9.9 DID. The use of risperidone dropped after the marketing of its structural derivative paliperidone with a similar efficacy but with a substantially higher cost per day. In 2011 and thereafter, patients in Spain began to pay a part of the medications cost, but this did not decrease antipsychotics consumption. Global cost of antipsychotics only began to fall after measures were adopted to lower the price of medicines because of the economic collapse in Spain after May 2010.

CONCLUSION

Several health policy measures have tried to reduce antipsychotics consumption in Spain, special ways of dispensing, marketing of generic drugs and special economic measures for patients. These measures eventually failed to avoid the increase in antipsychotics use. The cost only dropped when lowering prescription drug prices took place.