Discharge of iodine-containing contrast media into the environment - problem analysis and implementation of measures to reduce discharge by means of separation toilets - experience from a pilot project. / Herausforderung Eintrag jodhaltiger Röntgenkontrastmitteln in die Umwelt ­ Problemanalyse sowie Umsetzung erster Maßnahmen zur Reduktion des Eintrags mittels Trenntoiletten ­ Erfahrungen aus einem Pilotprojekt.

PURPOSE: Environmental aspects and sustainability are becoming increasingly important. In addition to energy consumption, the consumption and environmental discharge of contrast agents pose a particular challenge. Because of their desired stability, X-ray contrast agents (XCAs) are deposited in surface water at a rate of up to 400 tons per year. MATERIALS AND METHODS: In a pilot project, a set of measures (installation of specific separation toilets, the establishment of feedback systems, interviews, questionnaires, and observation) was implemented to sensitize patients and staff to the problem of XCAs during outpatient CT examinations and a retention and recovery system for XCAs was evaluated. RESULTS: In the initial baseline phase, a separation toilet with an additional collection system and a feedback/button system was installed. The built-in feedback system indicated that the separation toilets were used by approx. 16 % of patients without measures. In two subsequent intervention phases, accompanying measures significantly (p < 0.01) increased the use of these separation toilets to 21 % and 25 %, respectively. The measures to reduce the discharge of XCAs were positively assessed by both staff and patients. CONCLUSION: Measures to reduce the discharge of XCAs into the environment have a high acceptance among staff and patients. The subsequent installation of separation toilets is one possibility to achieve on-site retention of XCAs. However, this measure is likely to be of high value only if patients stay on site for a correspondingly long time, as is the case in cardiology, for example. KEY POINTS: · The input of X-ray contrast agents into the environment is relevant in light of the quantity. · Measures to reduce the discharge of X-ray contrast agents into the environment have been investigated in pilot projects. · The (subsequent) installation of separation toilets is possible and allows retention of X-ray contrast agents. · This measure is considered useful by patients and staff. · The financing of these measures needs to be clarified. CITATION FORMAT: · Beer M, Schuler J, Kraus E et al. Discharge of iodine-containing contrast media into the environment - problem analysis and implementation of measures to reduce discharge by means of separation toilets - experience from a pilot project. Fortschr Röntgenstr 2023; 195: 1122 - 1127.

Designing benign molecules: The influence of O-acetylated glucosamine-substituents on the environmental biodegradability of fluoroquinolones.

Antibiotics are detected worldwide in the aquatic environment, with continuously rising concentrations. Antibiotics in the environment have the potential to damage ecosystems and contribute to the development of resistance. Whilst a few antibiotics, such as some ß-lactams, are eliminated by effluent treatment, others, such as fluoroquinolones, are not or just partially removed and enter the environment. Therefore, approaches are needed to tackle those problems at the compound level. Benign by design (BbD), an important part of green pharmacy, has the goal to integrate environmental fate and end-of-use considerations at the very beginning, i.e., into the design of active pharmaceutical ingredients. Hence, pharmaceuticals should be designed to be sufficiently active and stable during storage and usage but should degrade after excretion into the environment, so that they cannot cause any adverse effects. Fluoroquinolones (FQs) are important broad-spectrum antibiotics. They are known to be persistent in the environment and to be neither inactivated nor degraded or even mineralized during sewage treatment. The addition of new substituents via amidation, like glucosamine moieties, at the carboxylic group of FQs, led to better antimicrobial activity compared to its parent compounds against various microorganisms. To investigate if the addition of sugar moieties could improve the overall environmental biodegradability of FQs, eight novel quinolone and fluoroquinolone analogs conjugated with 1,3,4,6-Tetra-O-acetyl-ß-d-glucosamine and 2-deoxy-d-glucopyranose have been investigated regarding their ready biodegradability (OECD 301D/F) and their degradation pathways have been analyzed. According to the OECD 301D test, none of the substances could be classified as readily biodegradable. However, the O-acetyl analogs did undergo a partial degradation of the O-acetyl glucosamine moiety, via stepwise deacetylation and the degradation of the whole glucosamine moiety. The degradation resulted in Fluoroquinolone-3-carboxamide derivatives. Those insights could be further used as input for fragment-based design of benign APIs that will degrade once they reached the environment.