Occurrence and distribution of pharmaceuticals in wastewater from households, livestock farms, hospitals and pharmaceutical manufactures

Twenty-four pharmaceuticals were measured in wastewater from 12 municipal wastewater treatment plants (M-WWTPs), four livestock WWTPs (L-WWTPs), four hospital WWTPs (H-WWTPs) and four pharmaceutical manufacture WWTPs (P-WWTPs). The total concentration of pharmaceuticals in the influent samples was highest in the L-WWTPs followed by the P-WWTPs, H-WWTPs and M-WWTPs. The effluents had different patterns of pharmaceuticals than their corresponding influents because of the different fate of each compound in the WWTPs. Non-steroidal anti-inflammatory drugs (NSAIDs) were the most dominant in the influents from the M-WWTPs and P-WWTPs, while antibiotics were dominantly detected in the L-WWTP. In the H-WWTP influents, NSAIDs, caffeine and carbamazepine were dominant. In the P-WWTPs, the distribution of pharmaceuticals in the effluents varied with sampling sites and periods. The M-WWTP influents had the highest daily loads, while the effluents showed somewhat similar levels in all source types.     

Perfluoroalkyl compounds in municipal WWTPs in Tianjin, China—concentrations, distribution and mass flow

BACKGROUNDS: Perfluorinated compounds (PFCs) have drawn much attention due to their environmental persistence, ubiquitous existence, and bioaccumulation potential. Wastewater treatment plants (WWTPs) are fundamental utilities in cities, playing an important role in preventing water pollution by lowering pollution load in waste waters. However, some of the emerging organic pollutants, like PFCs cannot be efficiently removed by traditional biological technologies in WWTPs, and some even increase in effluents compared to influents due to the incomplete degradation of precursors. Hence, WWTPs are considered to be a main point source in cities for PFCs that enter the aquatic environment. However, the mass flow of PFCs from WWTPs has seldom been analyzed for a whole city. Hence, in the present study, 11 PFCs including series of perfluoroalkyl carboxylic acids (PFCAs, C4-C12) and two perfluoroalkyl sulfonates (PFASs, C6 and C8) were measured in WWTP influents and effluents and sludge samples from six municipal WWTPs in Tianjin, China. Generation and dissipation of the target PFCs during wastewater treatment process and their mass flow in effluents were discussed. RESULTS: All the target PFCs were detected in the six WWTPs, and the total PFC concentration in different WWTPs was highly influenced by the population density and commercial activities of the corresponding catchments. Perfluorooctanoic acid (PFOA) was the predominant PFC in water phase, with concentrations ranging from 20 to 170 ng/L in influents and from 30 to 145 ng/L in effluents. Concentrations of perfluoroalkyl sulfonates decreased substantially in the effluent compared to the influent, which could be attributed to the sorption onto sludge, whereas concentrations of PFOA and some other PFCAs increased in the effluent in some WWTPs due to their weaker sorption onto solids and the incomplete degradation of precursors. Perfluorooctane sulfonic acid (PFOS) was the predominant PFC in sludge samples followed by PFOA, and their concentrations ranged from 42 to 169 g/kg and from 12 to 68 g/kg, respectively. Sludge-wastewater distribution coefficients (log K(d)) ranged from 0.62 to 3.87 L/kg, increasing with carbon chain length of the homologues. The mass flow of some PFCs in the effluent was calculated, and the total mass flow from all the six municipal WWTPs in Tianjin was 26, 47, and 3.5 kg/year for perfluorohexanoic acid, PFOA, and PFOS, respectively.     

Polycyclic aromatic hydrocarbons in wastewater, WWTPs effluents and in the recipient waters of Beijing, China

In this study, surface water samples from the Wenyu River and the North Canal, effluent from major wastewater treatment plants (WWTPs) in Beijing, and wastewater from open sewers that discharge directly into the river system were collected and analyzed for 16 priority USEPA polycyclic aromatic hydrocarbons (PAHs). Concentrations of these 16 PAHs ranged from 193 to 1790 ng/L in river surface waters, 245 to 404 ng/L in WWTP effluents, and 431 to 2860 ng/L in the wastewater from the small sewers. The WWTP effluent was the main contributor of dissolved PAHs to the river, while wastewater from the small sewers contributed both dissolved and suspended particulate matter-associated PAH to the river as indicated by the high dissolved organic carbon and suspended particulate matter contents in the wastewater. Although the flow from each open sewer was small, a PAH discharge as high as 44 kg/year could occur into the river from these types of sewers. This amount was equivalent to about 22 % of the PAH loads discharged into the North Canal downstream from Beijing, whereas the remainder was mainly released by the major WWTPs in Beijing.     

Distribution,fate, and risk assessment of antibiotics in five wastewater treatment plants in Shanghai,China

The project studied the occurrence, fate, and seasonal variation of 14 antibiotics, from five wastewater treatment plants (WWTPs) in Shanghai. The results indicated that ofloxacin, sulfamethoxazole, and oxytetracycline were the predominant antibiotics, with maximum concentrations of 1208.20, 959.13, and 564.30 ng/L in influents, while 916.88, 106.60, and 337.81 ng/L in effluents, respectively. The level of antibiotics in WWTPs obviously varied with seasonal changes, and higher detectable frequencies and concentrations were found in winter. The daily mass loads per capita of amoxicillin, enrofloxacin, and oxytetracycline in the study were all higher than those in other regions/countries, such as Hong Kong, Australia, and Italy. The elimination of antibiotics through these WWTPs was incomplete, and a wide range of removal efficiencies during the different treatment process and seasons were observed (?500.56 to 100 % in winter and ?124.24 to 94.21 % in summer). Sulfonamides were relatively easy to be removed in WWTPs and the ultraviolet (UV) process can effectively improve the removal efficiency. Risk assessment of antibiotics in effluents was estimated. Only AMOX’s hazard quotient (HQ) was higher than 0.01. Even though the environmental risks in the study were estimated to be low, the potential negative effects on aquatic ecosystems should call our attention as continually discharge in the long term.     

Fate of pharmaceuticals and personal care products in wastewater treatment plants - Conception of a database and first results

We created a database in order to quantitatively assess the occurrence and removal efficiency of pharmaceuticals and personal care products (PPCPs) in wastewater treatment plants (WWTPs). From 117 scientific publications, we compiled 6641 data covering 184 PPCPs. Data included the concentrations of PPCPs in WWTP influents and effluents, their removal efficiency and their loads to the aquatic environment. The first outputs of our database allowed to identify the most investigated PPCPs in WWTPs and the most persistent ones, and to obtain reliable and quantitative values on their concentrations, frequency of detection and removal efficiency in WWTPs. We were also able to compare various processes and pointed out activated sludge with nitrogen treatment and membrane bioreactor as the most efficient ones.     

Occurrence and ecological hazard assessment of selected veterinary medicines in livestock wastewater treatment plants

The occurrence of some veterinary medicines in the livestock wastewater plants (WWTPs) was investigated. This investigation represented the occurrence of veterinary medicines to treat in the livestock WWTPs or be discharged into the water system in Korea since the sampling sites were widely distributed across the nation and samples were collected from the 11 livestock WWTPs. Nine antibiotics, two analgesics, and two disinfectants occurred in the livestock wastewater plants (WWTPs). From 11 livestock WWTP influents, chlortetracycline, oxytetracycline, acetylsalicylic acid, and disinfectants frequently occurred with the high concentrations. Meanwhile, sulfamethoxazole, erythromycin-H₂O, and trimethoprim did not occur during sampling periods. The values for log Kow of each chemical showed a high correlation with the number of hydrogen bonding acceptors and were important parameters to estimate and understand the biodegradability and toxicity of a compound in the environment. The biodegradability of each compound was proportional to the hydrophilicity of each compound and the toxicity was proportional to the number of hydrogen bonding acceptors of each compound. The expected introductory concentration (EIC), predicted exposure concentration (PEC), and hazard quotient showed that the livestock WWTP effluents were hazardous to ecosystems.     

Occurrence of estrogenic effects in sewage and industrial wastewaters in Beijing, China

Estrogenic potencies of the effluents or water samples from wastewater treatment plants (WWTPs), industries and hospitals and some receiving rivers in Beijing city were estimated by using a human estrogen receptor recombinant yeast assay. Estrogenic activity of industrial wastewaters was found to range from 0.1 to 13.3 ng EEQ/L and decreased to the range of 0.03-1.6 ng EEQ/L after treatment. Estrogenic activity in WWTP influent ranged from 0.3 to 1.7 ng EEQ/L and decreased to the range of 0.05-0.5 ng EEQ/L after treatment. In the receiving river waters, the estrogenic effect range was 0.1-4.7 ng EEQ/L. These data suggest that treated industrial effluents and WWTP effluents of concern are not the only source of estrogenic pollution in surface waters in Beijing city. EEQ levels in Beijing river water are likely attributable to untreated municipal and industrial wastewaters discharged directly into the river.     

Spatial distribution and sources of perfluorochemicals in the NW Mediterranean coastal waters (Catalonia, Spain)

This study provides the first evidence of the sources and loads of perfluorochemicals (PFCs) to the NW Mediterranean Sea. Five PFCs were analyzed in 45 seawater samples collected along the Catalan coast. Total PFCs ranged from 0.07 to 13.0 ng/l, being the levels higher in ports than in coastal waters. To determine the sources of PFCs, 8 wastewater treatment plants (WWTPs) effluents and 6 rivers discharging to the sea were also analyzed. WWTP effluents contained total PFCs levels ranging from 3.47 to 132 ng/l but due to the relatively low discharge flows, they contributed to 34.7 g/d to the sea. Total PFCs in rivers ranged from 2.24 to 21.9 ng/l and were the principal PFCs contributors to the sea. Overall, a total load of 190 g/d of PFCs are discharged to the NW Mediterranean coast. The effects and risk of PFCs discharges to the Mediterranean basin are discussed.     

Identification of relevant micropollutants in Austrian municipal wastewater and their behaviour during wastewater treatment

The European Union has defined environmental quality standards (EQSs) for surface waters for priority substances and several other pollutants. Furthermore national EQSs for several chemicals are valid in Austria. The study investigated the occurrence of these compounds in municipal wastewater treatment plant (WWTP) effluents. In a first screening of 15 WWTPs relevant substances were identified, which subsequently were monitored in 9 WWTPs over 1 year (every 2 months). Out of 77 substances or groups of substances (including more than 90 substances) 13 were identified as potentially relevant in respect to water pollution and subjected to the monitoring, whereas most other compounds were detected in concentrations far below the respective EQS for surface waters and therefore not further considered. The preselected 13 compounds for monitoring were cadmium (Cd), nickel (Ni), copper (Cu), selenium (Se), zinc (Zn), diuron, polybrominated diphenyl ethers (PBDEs), di(ethyl-hydroxyl)phthalate (DEHP), tributyltin compounds (TBT), nonylphenoles (NP), adsorbable organic halogens (AOX) and the complexing agents ethylenediaminetetraacetic acid (EDTA) as well as nitrilotriacetic acid (NTA). In the effluents of WWTPs the concentrations of the priority substances Cd, NP, TBT and diuron frequently exceeded the respective EQS, whereas the concentrations for DEHP and Ni were below the respective EQS. The effluent concentrations for AOX, EDTA, NTA, Cu, Se and Zn frequently are in the range or above the Austrian EQS for surface waters. Besides diuron and EDTA all compounds are removed at least partially during wastewater treatment and for most substances the removal via the excess sludge is the major removal pathway. For the 13 compounds which were monitored in WWTP effluents population equivalent specific discharges were calculated. Since for many compounds no or only few information is available, these population equivalent specific discharges can be used to assess emissions from municipal WWTPs to surface waters as well as to make a first assessment of the impact of a discharge on surface waters chemical status. Comparing discharges and river pollution on a load basis, the influence of diffuse sources becomes obvious and therefore should also be taken into consideration in river management.     

International cross-validation of a BOD5 surrogate

BOD5 dates back to 1912 when the Royal Commission decided to use the mean residence time of water in the rivers of England, 5 days, as a standard to measure the biochemical oxygen demand. Initially designed to protect the quality of river waters from extensive sewage discharge, the use of BOD5 has been quickly extended to waste water treatment plants (WWTPs) to monitor their efficiency on a daily basis. The measurement has been automatized but remains a tedious, time- and resource-consuming analysis. We have cross-validated a surrogate BOD5 method on two sites in France and in the USA with a total of 109 samples. This method uses a fluorescent redox indicator on a 96-well microplate to measure microbial catabolic activity for a large number of samples simultaneously. Three statistical tests were used to compare surrogate and reference methods and showed robust equivalence.     

Perfluorooctane surfactants in waste waters, the major source of river pollution

Perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) are persistent and widely distributed in the environment. Recently, the discharge of municipal waste water has been shown to be an important route of such perfluoroalkyl surfactants into the aquatic environment. The aim of this study was to assess the mass flow of PFOA and PFOS from typical waste water treatment plants (WWTPs) into surface waters. Samples were collected at different stages of treatment of four WWTPs in Northern Bavaria, Germany, and from the rivers receiving the treated waste waters (WW). The outflow of PFOA from the WWTPs to the rivers was 20-fold higher than the inflow to the plants; about a tenth was removed with the sludge. For PFOS, the increase from inlet to outlet was about 3-fold; almost half of it was retained in the sludge. Both surfactants were released into river water from the WWTP of a medium-sized city with domestic, industrial and commercial waste waters; in domestic waste waters the surfactants were found at much lower levels.     

Occurrence and distribution of selected pharmaceuticals and personal care products in aquatic environments: a comparative study of regions in China with different urbanization levels

Purpose

We analyzed and compared the distributions of 13 target pharmaceuticals in different water samples from the Hangzhou metropolitan area and Linan County, Southeast China.

Methods

Sampling was conducted in five hospitals, two wastewater treatment plants (WWTPs), and Qiantang River. Samples were concentrated by solid-phase extraction and PPCP concentrations were determined by UPLC-MS/MS.

Results and discussion

Trimethoprim, erythromycin A dihydrate, norfloxacin, ofloxacin, diclofenac sodium, and atenolol were the most frequently detected pharmaceuticals in hospital effluents. Most of the pharmaceutical concentrations in hospital effluents were higher than those in the WWTP influents. Although both WWTPs adopt the anaerobic?Caerobic?Canoxic treatment process, the removal rates for pharmaceuticals, such as trimethoprim and diclofenac sodium, were completely different. Meanwhile, erythromycin A dihydrate, ofloxacin, penicillin-G, cephalexin, cefazolin, ibuprofen, and diclofenac sodium were detected in Qiantang River.

Conclusions

These results indicate that hospitals are more concentrated sources of pharmaceuticals than WWTPs, and the WWTPs are not the only route of entry of pharmaceuticals into aquatic environments in these two regions.     

The fate and risk of selected pharmaceutical and personal care products in wastewater treatment plants and a pilot-scale multistage constructed wetland system

The removal of 12 pharmaceuticals and personal care products (PPCPs) in two full-scale wastewater treatment plants (WWTPs) and a tertiary treatment system was studied. The ecological risks of effluents from both secondary and tertiary treatment systems as well as excess sludge were evaluated. Primary treatment and ultraviolet light disinfection showed limited ability to remove most selected PPCPs. The combination of an anaerobic process and triple-oxidation ditches can eliminate DEET better than the anaerobic/anoxic/oxic process. Adsorption to sludge played a key role in the removal of triclocarban. Multistage constructed wetlands as a tertiary treatment efficiently removed caffeine and ibuprofen from wastewater and could decrease the risk of partial selected PPCPs. Selected PPCPs residues in excess sludge generally produced higher risks to the ecological environment than effluents from WWTPs.     

Carbamazepine and diclofenac: removal in wastewater treatment plants and occurrence in water bodies

In the aquatic environment, pharmaceuticals have been widely found. Among them, carbamazepine and diclofenac were detected at the highest frequency. To evaluate the worldwide environmental impacts of both drugs, their global consumption volumes are estimated, based on the dose per capita. The metabolites of these pharmaceuticals are also of environmental concerns, especially trans-10,11-dihydro-10,11- dihydroxycarbamazepine (CBZ-diol) which probably has a similar concentration in water bodies to that of its parent drug. The removal efficiencies and mechanisms of both drugs in the wastewater treatment plants (WWTPs) are discussed with the actual state of knowledge. The occurrences of both drugs are examined in various water bodies including WWTP effluents, surface waters, groundwater and drinking water. Their chemical, physical and pharmacological properties are also addressed in context, which can largely influence their environmental behaviors. The ecotoxicological studies of both drugs imply that they do not easily cause acute toxic effects at their environmental concentrations. However their chronic effects need cautious attention.     

Mass flows of endocrine disruptors in the Glatt River during varying weather conditions

This study focused on the occurrence and behaviour in wastewater and surface waters of several phenolic endocrine disrupting compounds (EDCs) including parabens, alkylphenolic compounds, phenylphenol (PhP) and bisphenol A (BPA). Analytical procedures using solid-phase-extraction and LC-MS/MS techniques were applied to samples of influents and effluents of wastewater treatment plants (WWTPs) discharging into the Glatt River (Switzerland) as well as to river water samples. A mass flow analysis provided insight into the main sources and the fate of these contaminants during different weather conditions. Concentrations in influents were in the low μg/L range for most analytes. Removal of parabens in the WWTPs was mostly above 99%. Nonylphenol polyethoxylates (A₉PEO) removal amounted to 98%, but in some cases nonylphenoxy acetic acid (A₉PEC) or nonylphenols (NP) were formed. In effluents, concentrations were highest for the A₉PEC, A₉PEO and NP. Concentrations in river water were in the high ng/L range for alkylphenolic compounds and in the low ng/L range for BPA, PhP and the parabens. During the sampling period, in which several rain events occurred, both water flows and mass flows varied strongly. Mass flows in WWTP effluents and in the river increased with increasing water flows for most compounds indicating that higher water flows do not lead necessarily to a proportional dilution of the pollutants. Throughout the low water flow period, mass flows predicted from the known inputs were similar to the actual mass flows at the end of the river for most analytes. For none of the EDCs, significant in-stream removal could be observed. In the periods with high water flows, mass flows in the river were much higher than can be explained by the initially defined sources. Discharge of untreated wastewater influent into the river was assessed as an additional source. Adding this source improved the mass balance for some, but not all of the analytes.     

Effects of an industrial effluent on plant colonization and on the germination and post-germinative growth of seeds of terrestrial and aquatic plant species

Major oil sands industrial companies are located in the Athabasca Oil Sands Deposit in northeastern Alberta, Canada. During the process used to extract light crude oil (via hot water digestion and flotation), gypsum is usually added to produce consolidated tails (CT) and CT release water. The vast volumes of process-treated waters (effluent) are held within large dyked tailings ponds. Toward testing viable options for reclamation, various hummock-wetlands systems have been constructed; in addition, natural wetlands (inhabited by obligate wetland plant species) have become established as a result of seeping of the effluents held within the large dyked ponds. Vegetation surveys conducted on and around the industrial site revealed that the constructed wetlands associated with the dyke drainage (effluent treated with phosphorous) and consolidated tails (CT; effluent treated with gypsum) had low biodiversity and were not invaded by many aquatic plants. Although the natural wetland was also not invaded by many aquatic species, it was found to be as diverse as the reference wetlands (i.e. off-site wetlands not exposed to the effluents). Exposure to oil sands effluents had an inhibitory effect on the germination (percent and/or rate) of several plant species (tomato, clover, wheat, rye, pea, reed canary grass, loblolly pine); clover and tomato seed germination were most affected. Two treatments in particular (effluents from the natural on-site wetland and the CT constructed wetland), delayed germination, and also led to reduced fresh weight of seedlings of tomato, wheat, clover and loblolly pine. The osmolarities of the effluents associated with the natural on-site wetland and CT constructed wetland were 712 and 728 mOs/kg, respectively; substituting these effluents with solutions of polyethylene glycol of the same osmotic potentials had a greater inhibitory effect on germination rate. The negative effects of the effluents on seed germination may account for the paucity of aquatic species that invaded the oil sands impacted wetlands. This factor will also be critical in determining the long-term feasibility of hummock-wetland systems.     

Occurrence,elimination, and risk of anticoagulant rodenticides and drugs during wastewater treatment

Anticoagulants are biocides widely used as pest control agents in agriculture, urban infrastructures, and domestic applications for the control of rodents. Other anticoagulants such as warfarin and acenocoumarol are also used as drugs against thrombosis. After use, anticoagulants are discharged to sewage grids and enter wastewater treatment plants (WWTPs). Our hypothesis is that WWTP effluents can be a source of anticoagulants to receiving waters and that these can affect aquatic organisms and other nontarget species. Therefore, the objective of the present study was to determine the occurrence of 11 anticoagulants in WWTPs receiving urban and agricultural wastewaters. Warfarin was the most ubiquitous compound detected in influent waters and was partially eliminated during the activated sludge treatment, and low nanograms per liter concentration were found in the effluents. Other detected compounds were coumatetralyl, ferulenol, acenocoumarol, flocoumafen, brodifacoum, bromadiolone, and difenacoum at concentrations of 0.86–87.0 ng L^?1. Considering water volumes of each WWTP, daily emissions were estimated to be 0.02 to 21.8 g day^?1, and thus, WWTPs contribute to the loads of anticoagulants to receiving waters. However, low aquatic toxicity was observed using Daphnia magna as a model aquatic organism.     

Contamination of nonylphenolic compounds in creek water, wastewater treatment plant effluents, and sediments from Lake Shihwa and vicinity, Korea: comparison with fecal pollution

Nonylphenolic compounds (NPs), coprostanol (COP), and cholestanol, major contaminants in industrial and domestic wastewaters, were analyzed in creek water, wastewater treatment plant (WWTP) effluent, and sediment samples from artificial Lake Shihwa and its vicinity, one of the most industrialized regions in Korea. We also determined mass discharge of NPs and COP, a fecal sterol, into the lake, to understand the linkage between discharge and sediment contamination. Total NP (the sum of nonylphenol, and nonylphenol mono- and di-ethoxylates) were 0.32-875 μg L⁻¹ in creeks, 0.61-87.0 μg L⁻¹ in WWTP effluents, and 29.3-230 μg g⁻¹ TOC in sediments. Concentrations of COP were 0.09-19.0 μg L⁻¹ in creeks, 0.11-44.0 μg L⁻¹ in WWTP effluents, and 2.51-438 μg g⁻¹ TOC in sediments. The spatial distributions of NPs in creeks and sediments from the inshore region were different from those of COP, suggesting that Lake Shihwa contamination patterns from industrial effluents differ from those from domestic effluents. The mass discharge from the combined outfall of the WWTPs, located in the offshore region, was 2.27 kg d⁻¹ for NPs and 1.00 kg d⁻¹ for COP, accounting for 91% and 95% of the total discharge into Lake Shihwa, respectively. The highest concentrations of NPs and COP in sediments were found in samples at sites near the submarine outfall of the WWTPs, indicating that the submarine outfall is an important point source of wastewater pollution in Lake Shihwa.     

Spatial and seasonal distribution of selected antibiotics in surface waters of the Pearl Rivers, China

The distribution and occurrence of 15 antibiotics in surface water of the Pearl River System (Liuxi River, Shijing River and Zhujiang River) and effluents of four wastewater treatment plants (WWTPs) were investigated in two sampling events representing wet season and dry season by using rapid resolution liquid chromatography-electrospray tandem mass spectrometry (RRLC-MS/MS) in positive ionization mode. Only eight antibiotics (sulfadiazine, sulfapyridine, sulfamethazine, sulfamethoxazole, trimethoprim, roxithromycin, erythromycin-H?O and norfloxacin) were detected in the water samples of the three rivers and the effluents. The detection frequencies and levels of antibiotics in the dry season were higher than those in the wet season. This could be attributed to the dilution effects in the wet season and relatively lower temperature in the dry season under which antibiotics could persist for a longer period. The levels of the detected antibiotics in different sites are generally in a decreasing order as follows: Shijing River ≥WWTP effluent ≥Zhujiang River ≥ Liuxi River. Risk assessment based on the calculated risk quotients showed that only erythromycin-H?O and roxithromycin detected in the Pearl Rivers might have adverse effects on aquatic organisms.     

The occurrence of illicit and therapeutic pharmaceuticals in wastewater effluent and surface waters in Nebraska

The occurrence and estimated concentration of twenty illicit and therapeutic pharmaceuticals and metabolites in surface waters influenced by wastewater treatment plant (WWTP) discharge and in wastewater effluents in Nebraska were determined using Polar Organic Chemical Integrative Samplers (POCIS). Samplers were installed in rivers upstream and downstream of treated WWTP discharge at four sites and in a discharge canal at a fifth location. Based on differences in estimated concentrations determined from pharmaceuticals recovered from POCIS, WWTP effluent was found to be a significant source of pharmaceutical loading to the receiving waters. Effluents from WWTPs with trickling filters or trickling filters in parallel with activated sludge resulted in the highest observed in-stream pharmaceutical concentrations. Azithromycin, caffeine, 1,7-dimethylzanthine, carbamazepine, cotinine, DEET, diphenhydramine, and sulfamethazine were detected at all locations. Methamphetamine, an illicit pharmaceutical, was detected at all but one of the sampling locations, representing only the second report of methamphetamine detected in WWTP effluent and in streams impacted by WWTP effluent.