Estimating daily and diurnal variations of illicit drug use in Hong Kong: a pilot study of using wastewater analysis in an Asian metropolitan city.

The measurement of illicit drug metabolites in raw wastewater is increasingly being adopted as an approach to objectively monitor population-level drug use, and is an effective complement to traditional epidemiological methods. As such, it has been widely applied in western countries. In this study, we utilised this approach to assess drug use patterns over nine days during April 2011 in Hong Kong. Raw wastewater samples were collected from the largest wastewater treatment plant serving a community of approximately 3.5 million people and analysed for excreted drug residues including cocaine, ketamine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA) and key metabolites using liquid chromatography coupled with tandem mass spectrometry. The overall drug use pattern determined by wastewater analysis was consistent with that have seen amongst people coming into contact with services in relation to substance use; among our target drugs, ketamine (estimated consumption: 1400-1600 mg/day/1000 people) was the predominant drug followed by methamphetamine (180-200 mg/day/1000 people), cocaine (160-180 mg/day/1000 people) and MDMA (not detected). The levels of these drugs were relatively steady throughout the monitoring period. Analysing samples at higher temporal resolution provided data on diurnal variations of drug residue loads. Elevated ratios of cocaine to benzoylecgonine were identified unexpectedly in three samples during the evening and night, providing evidence for potential dumping events of cocaine. This study provides the first application of wastewater analysis to quantitatively evaluate daily drug use in an Asian metropolitan community. Our data reinforces the benefit of wastewater monitoring to health and law enforcement authorities for strategic planning and evaluation of drug intervention strategies.

Pharmaceuticals in tap water: human health risk assessment and proposed monitoring framework in China.

BACKGROUND: Pharmaceuticals are known to contaminate tap water worldwide, but the relevant human health risks have not been assessed in China. OBJECTIVES: We monitored 32 pharmaceuticals in Chinese tap water and evaluated the life-long human health risks of exposure in order to provide information for future prioritization and risk management. METHODS: We analyzed samples (n = 113) from 13 cities and compared detected concentrations with existing or newly-derived safety levels for assessing risk quotients (RQs) at different life stages, excluding the prenatal stage. RESULTS: We detected 17 pharmaceuticals in 89% of samples, with most detectable concentrations (92%) at < 50 ng/L. Caffeine (median-maximum, nanograms per liter: 24.4-564), metronidazole (1.8-19.3), salicylic acid (16.6-41.2), clofibric acid (1.2-3.3), carbamazepine (1.3-6.7), and dimetridazole (6.9-14.7) were found in ≥ 20% of samples. Cities within the Yangtze River region and Guangzhou were regarded as contamination hot spots because of elevated levels and frequent positive detections. Of the 17 pharmaceuticals detected, 13 showed very low risk levels, but 4 (i.e., dimetridazole, thiamphenicol, sulfamethazine, and clarithromycin) were found to have at least one life-stage RQ ≥ 0.01, especially for the infant and child life stages, and should be considered of high priority for management. We propose an indicator-based monitoring framework for providing information for source identification, water treatment effectiveness, and water safety management in China. CONCLUSION: Chinese tap water is an additional route of human exposure to pharmaceuticals, particularly for dimetridazole, although the risk to human health is low based on current toxicity data. Pharmaceutical detection and application of the proposed monitoring framework can be used for water source protection and risk management in China and elsewhere.

Antibiotics in the Hong Kong metropolitan area: Ubiquitous distribution and fate in Victoria Harbour.

We investigated the presence and fate of 16 antibiotics belonging to seven groups (beta-lactams, fluoroquinolones, macrolides, sulfonamides, tetracyclines, trimethoprim and amphenicols) in effluents of sewage plants and receiving waters in Hong Kong. Cefalexin, amoxicillin, ofloxacin and erythromycin-H(2)O were ubiquitous in sea water throughout Victoria Harbour, indicating continuous discharge to the environment. This is one of the few studies reporting the frequent occurrence of cefalexin and amoxicillin in sewage effluents and sea water (170-5070 and 64-1670 ng/L in sewage; 6.1-493 and 0.64-76 ng/L in sea water, respectively). Mass flows from seven sewage plants discharged an estimated total of 14.4 kg/day to the Harbour. Typhoon shelters also appeared to play an important role as sources of antibiotics, as evidenced by elevated concentrations within their boundaries. Mass balance estimations suggested significant quantities of antibiotics are discharged to the Harbour without passage through treatment plants.