Influent wastewater analysis to investigate emerging trends of new psychoactive substances use in Europe.

Wastewater-based epidemiology (WBE) can provide objective and timely information on the use of new psychoactive substances (NPS), originally designed as legal alternatives of internationally controlled drugs. NPS have rapidly emerged on the global drug market, posing a challenge to drug policy and constituting a risk to public health. In this study, a WBE approach was applied to monitor the use of more than 300 NPS, together with fentanyl and its main metabolite norfentanyl, in influent wastewater collected from 12 European cities during March-June 2021. Quantitative and qualitative analysis of NPS in composite 24 h influent wastewater samples were based on solid phase extraction and liquid chromatography-mass spectrometry. In-sample stability tests demonstrated the suitability of most investigated biomarkers, except for a few synthetic opioids, synthetic cannabinoids and phenetylamines. Fentanyl, norfentanyl and eight NPS were quantified in influent wastewater and at least three substances were found in each city, demonstrating their use in Europe. N,N-dimethyltryptamine and 3-methylmethcathinone (3-MMC) were the most common NPS found, with the latter having the highest mass loads (up to 24.8 mg/day/1000 inhabitants). Seven additional substances, belonging to five categories of NPS, were identified in different cities. Spatial trends of NPS use were observed between cities and countries, and a changing weekly profile of use was observed for 3-MMC. WBE is a useful tool to rapidly evaluate emerging trends of NPS use, complementing common indicators (i.e. population surveys, seizures) and helping to establish measures for public health protection.

Monitoring Alcohol Consumption in Slovak Cities during the COVID-19 Lockdown by Wastewater-Based Epidemiology.

The consumption of alcohol in a population is usually monitored through individual questionnaires, forensics, and toxicological data. However, consumption estimates have some biases, mainly due to the accumulation of alcohol stocks. This study's objective was to assess alcohol consumption in Slovakia during the COVID-19 pandemic-related lockdown using wastewater-based epidemiology (WBE). Samples of municipal wastewater were collected from three Slovak cities during the lockdown and during a successive period with lifted restrictions in 2020. The study included about 14% of the Slovak population. The urinary alcohol biomarker, ethyl sulfate (EtS), was analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). EtS concentrations were used to estimate the per capita alcohol consumption in each city. The average alcohol consumption in the selected cities in 2020 ranged between 2.1 and 327 L/day/1000 inhabitants and increased during days with weaker restrictions. WBE can provide timely information on alcohol consumption at the community level, complementing epidemiology-based monitoring techniques (e.g., population surveys and sales statistics).

Desorption of pharmaceuticals and illicit drugs from different stabilized sludge types across pH.

Pharmaceutical and illicit drug residues in sewage sludge may present important risks following direct application to agricultural soils, potentially resulting in uptake by plants. Leaching/desorption tests were performed on different types of stabilized sewage sludge originating from multiple treatment technologies in the Slovak Republic. Acid rain and base-rich condition of soil with different pH conditions were simulated to model the effect of widely varying pH (pH 2, 4, 7, 9, and 12) on the leaching/desorption of pharmaceuticals and illicit drugs. Twenty-nine of 93 target analytes were found above the limit of quantification in sludge or associated leachates. Total desorbed amounts of pharmaceuticals and illicit drugs ranged from 810 to 4000 µg/kg, and 110 to 3600 µg/kg of the dry mass of anaerobic and aerobic sludge, respectively. Desorbed fractions were calculated as these values are normalized to initial sludge concentration and, therefore, were more suitable for qualitative description of the behavior of individual compounds. Using principal component analysis, qualitative analysis of the desorbed fraction confirmed the differences among sludge types, pharmaceuticals, and desorption pH. Desorbed fractions could not be related to the octanol/water distribution coefficient. Desorbed fractions also did not reflect the expected ionization of studied molecules unless converted into their relative values. Generally, the lowest mobility was observed within the environmentally relevant pH range of 4-9, and high pH generally resulted in high desorption, especially in anaerobically stabilized sludges.

Searching for the correlations between the use of different groups of pharmaceuticals from wastewaters.

Wastewater contains a wealth of information about the inhabitants of cities. Wastewater-based epidemiology (WBE) has become an effective tool for monitoring public health by analyzing various biomarkers (e.g., chemicals and microorganisms) in wastewater. This way, the estimation of pharmaceuticals' consumption behavior and/or illicit drugs can be calculated. However, monitoring consumption alone is not the only option. If we consider wastewater as a statistical representation of the population's health, medical information can be derived. In this work, we used data from 15 different wastewater treatment plants in Slovak Republic to explore correlations between the use of typical pharmaceuticals and illicit drugs. The analysis was based on the wastewater monitoring data from four years (2016-2019), and 68 different compounds were taken into account. One of the strongest correlations found was between Antihyperlipidemics and Antihypertensives, with Pearson's correlation coefficient of 0.82. This type of analysis within the WBE represents a new potential as an additional source of information for the pharmaceutical, medical and government sectors in assessing health risk factors in the population. Such an evaluation method has even a great potential for artificial intelligence and machine learning for calculating health risk factors together with other sources of data.

Wastewater-based epidemiology to assess the occurrence of new psychoactive substances and alcohol consumption in Slovakia.

Consumption of alcohol and new psychoactive substances (NPS) in a population or during special events (music festivals) is usually monitored through individual questionnaires, forensic and toxicological data, and drug seizures. However, consumption estimates have some biases due mostly to the unknown composition of drug pills for NPS and stockpiling for alcohol. The aim of this study was to evaluate for the first time the real use of alcohol and the occurrence of NPS in Slovakia by wastewater-based epidemiology (WBE). Urban wastewater samples were collected from nine Slovak cities over two years (2017-2018) and during three music festivals. The study included about 20% of the Slovak population and 50 000 festival attendees. The urinary alcohol biomarker ethyl sulfate (EtS) and thirty NPS were analyzed by liquid chromatography tandem mass spectrometry (LC - MS/MS). EtS concentrations were used for estimating the per capita alcohol consumption in each city. The average alcohol consumption in the selected cities and festivals in 2017-2018 ranged between 7 and 126 L/day/1000 inhabitants and increased during the weekends and music festivals. Five NPS belonging to the classes of synthetic cathinones (mephedrone, methcathinone, buphedrone and pentedrone) and phenethylamines (25-iP-NBoMe) were found in the low ng/L range. Methcathinone was the most frequently detected NPS, while the highest normalized mass load corresponded to mephedrone (3.1 mg/day/1000 inhabitants). Wastewater-based epidemiology can provide timely information on alcohol consumption and NPS occurrence at the community level that is complementary to epidemiology-based monitoring techniques (e.g. population surveys, police seizures, sales statistics).

Spatio-temporal assessment of illicit drug use at large scale: evidence from 7 years of international wastewater monitoring.

BACKGROUND AND AIMS: Wastewater-based epidemiology is an additional indicator of drug use that is gaining reliability to complement the current established panel of indicators. The aims of this study were to: (i) assess spatial and temporal trends of population-normalized mass loads of benzoylecgonine, amphetamine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) in raw wastewater over 7 years (2011-17); (ii) address overall drug use by estimating the average number of combined doses consumed per day in each city; and (iii) compare these with existing prevalence and seizure data. DESIGN: Analysis of daily raw wastewater composite samples collected over 1 week per year from 2011 to 2017. SETTING AND PARTICIPANTS: Catchment areas of 143 wastewater treatment plants in 120 cities in 37 countries. MEASUREMENTS: Parent substances (amphetamine, methamphetamine and MDMA) and the metabolites of cocaine (benzoylecgonine) and of Δ9 -tetrahydrocannabinol (11-nor-9-carboxy-Δ9 -tetrahydrocannabinol) were measured in wastewater using liquid chromatography-tandem mass spectrometry. Daily mass loads (mg/day) were normalized to catchment population (mg/1000 people/day) and converted to the number of combined doses consumed per day. Spatial differences were assessed world-wide, and temporal trends were discerned at European level by comparing 2011-13 drug loads versus 2014-17 loads. FINDINGS: Benzoylecgonine was the stimulant metabolite detected at higher loads in southern and western Europe, and amphetamine, MDMA and methamphetamine in East and North-Central Europe. In other continents, methamphetamine showed the highest levels in the United States and Australia and benzoylecgonine in South America. During the reporting period, benzoylecgonine loads increased in general across Europe, amphetamine and methamphetamine levels fluctuated and MDMA underwent an intermittent upsurge. CONCLUSIONS: The analysis of wastewater to quantify drug loads provides near real-time drug use estimates that globally correspond to prevalence and seizure data.

The influence of selected pharmaceuticals on biogas production from laboratory and real anaerobic sludge.

The presented study summarizes laboratory tests results to define the inhibition effect of selected pharmaceuticals on biogas production under anaerobic digestion conditions. Two sets of inhibition tests were realized: (i) with real anaerobic sludge (from municipal wastewater treatment plant (WWTP) where sludge is present and includes a wide spectrum of pharmaceuticals over a long period) and (ii) with laboratory sludge (sludge without pharmaceuticals). Methanogenic tests lasting 20 days were performed with three analgesics (diclofenac, ibuprofen, and tramadol), two antibiotics (amoxicillin and ciprofloxacin), ß-blocker (atenolol), three psychoactive compounds (carbamazepine, caffeine, and cotinine), and a mixture of these compounds. All tests were performed with two concentrations of pharmaceuticals (10 µg/L and 500 µg/L). Results of the methanogenic tests showed the different behaviors of the investigated sludges in the presence of individual pharmaceuticals. Stimulation of anaerobic digestion was mostly detected for laboratory (unadapted) sludge (e.g., the addition of ibuprofen at a concentration of 500 µg/L increased biogas production by 61%). On the other hand, pharmaceuticals inhibited biogas production for real sludge (e.g., the addition of ciprofloxacin 500 µg/L decreased biogas production by 52%).

Music festivals and drugs: Wastewater analysis.

Drug consumption in individual cities, regions, and at various music events and festivals across the EU has generally been monitored via questionnaires, patients' medical data, and police reports. However, an overview of drug consumption obtained from these methods can be negatively affected by various subjective factors. We aimed to investigate an association between levels of target drugs in wastewater, music genres, and festival courses. The occurrence of illicit drugs, their metabolites, and psychoactive compounds was investigated in the influent of six wastewater treatment plants in the Czech and Slovak Republic during seven large-scale music festivals from different music genres: metal, rock, pop, country and folk, ethnic, multi-genre, dance, and trance. The total number of participants included >130,000 active festival attendees. The association between music genre and illicit drug and/or psychoactive pharmaceutical consumptions is discussed on the basis of the results obtained through wastewater analyses. The observed trend was similar to worldwide published data with a specific local phenomenon of methamphetamine prevalence that did not significantly change between music events. Increased specific loads of cocaine (measured as its metabolite benzoylecgonine) and Ecstasy, along with some cannabis, were mainly observed during pop/rock and dance music festivals. However, there was no significant increase observed in the specific loads of all monitored psychoactive pharmaceuticals. This study demonstrates that the abuse of some illicit drugs is closely associated with specific music preferences.

Pharmaceuticals and illicit drugs - A new threat to the application of sewage sludge in agriculture.

The occurrence of 93 pharmaceuticals, illicit drugs and their metabolites has been investigated in stabilized sewage sludge from five municipal wastewater treatment plants (WWTPs) in the Slovak Republic. The total population connected to the tested WWTPs was approximately 600,000 p.e. which represents >20% of the Slovak population connected to public sewer systems. The sludge production from the five tested plants was >8100tons in 2016, which is approximately 15% of the total Slovak sewage sludge production in 2016. The highest total concentration of all pharmaceuticals was found in WWTP Bratislava Devínska Nová Ves (DNV) and Senec - 11,800 and 11,300ng/g dry matter (DM), respectively. Among individual pharmaceuticals, the highest concentrations were recorded for fexofenadine (mean 2340ng/g DM, maximum 5600ng/g DM in Bratislava DNV) and telmisartan (mean 1170ng/g DM, with a maximum of 3370ng/g DM in Senec). A principal component analysis revealed differences between pharmaceutical patterns in aerobically and anaerobically stabilized sludge. The worst-case scenario based on no further degradation of pharmaceuticals between sludge production and field application was used to predict pharmaceutical mass loads in agriculture. For the result, we estimated an annual load to soil in the Slovak Republic of up to several hundred kilograms of pharmaceuticals and drugs, with the maximum for fexofenadine (120kg/year) and verapamil (29kg/year).

Estimation of amount of selected pharmaceuticals sorbed onto digested sludge from wastewater treatment plant Bratislava-Petrzalka.

Antibiotics and antidepressants are among the most successful drugs used for human therapy. Their concentration in influent on WWTP is relative high and there can be removed by biodegradation or sorption. The aim of this study was to define the amounts of sorbed pharmaceuticals on digested sludge from WWTP Bratislava - Petrzalka. The amounts of sorbed pharmaceuticals were calculated from knowing partition coefficients for selected pharmaceuticals and from analytically measured pharmaceutical´s concentrations in sludge liquor. From this calculation were estimated the one-year sorbed amount of pharmaceutical onto sludge from wastewater treatment plant Petrzalka (26,066g/y for ciprofloxacin, 756g/y for azithromycin, 647g/y for clarithromycin, 445g/y for venlafaxine and 148g/y for citalopram).

Occurrence of illicit drugs and selected pharmaceuticals in Slovak municipal wastewater.

We analyzed illicit drugs and their metabolites and pharmaceuticals in wastewater from 15 selected wastewater treatment plants (WWTPs) in Slovakia. Our results indicate that methamphetamine is one of the most commonly used illegal drugs in all the regions of Slovakia monitored in this study. Compared with the international results, the Slovak cities of Dunajská Streda (479 mg/day/1000inh) and Trnava (354 mg/day/1000inh) are among the cities with the largest numbers of methamphetamine users in Europe. These results indicate an increase in the incidence of drugs in big cities and in the satellite cities (Trnava and Dunajská Streda) near Bratislava. These results also confirm the police statistics about production and use of illicit drugs in Slovakia. The highest specific loads of cocaine were found in Bratislava (112 mg/day/1000inh), followed by Petrzalka (74 mg/day/1000inh). Compared with other European cities, Bratislava and the other Slovak cities in this study have a relatively low number of COC consumers. The ecstasy load in wastewater from larger cities also significantly increased over the weekend and during music festivals. The highest 2-year mean concentrations of THC-COOH, a cannabis biomarker, were observed in the sewage from BA-Petrzalka and BA-Central (191 and 171 ng/L, respectively). A first complex monitoring of pharmaceuticals in all therapeutic groups was also realized in selected Slovak WWTPs. Occurrence of wide spectrum of pharmaceuticals with very high concentrations as well as consumptions were observed mainly in small Slovak cities. Considering all 120 monitored pharmaceuticals, Valsartan had the highest concentrations: 6000 ng/L, on average.

Dominant psychoactive drugs in the Central European region: A wastewater study.

The aim of this study was to analyze 26 various illicit drugs, psychopharmaceuticals and metabolites thereof in sewer from 17 selected wastewater treatment plants (WWTPs) in the Slovak and Czech Republics. Urinary bio-markers used were analyzed using liquid chromatography coupled with the tandem mass spectrometry (LC-MS/MS). We then compared our results with data obtained in other parts of Europe and the world. The present study shows that the Slovak and Czech Republics have one of the highest methamphetamine consumption rates in Europe. Within Slovakia, the highest level of methamphetamine consumption was found in Dunajská Streda with the mean specific load of the drug in sewage being up to 479mg/day/1000 inhabitants; the next highest load was detected in Trnava (354mg/day/1000 inhabitants). The methamphetamine, ecstasy and cannabis consumptions in our study were comparable to those found in other European cities, whereas cocaine consumption was lower. Among all of the studied psychopharmaceuticals, tramadol and venlafaxine were represented in the highest concentrations. The highest mean specific load of tramadol was detected in the spa town of Piestany (371mg/day/1000 inhabitants) and Kosice (372mg/day/1000 inhabitants), while the highest mean loads of venlafaxine were recorded for the towns of Trencín (230mg/day/1000 inhabitants) and Piestany (108mg/day/1000 inhabitants).

Zerovalent iron and iron(VI): Effective means for the removal of psychoactive pharmaceuticals and illicit drugs from wastewaters.

Herein we report the analysis of 27 selected psychoactive compounds found in the wastewater of the largest suburb in the eastern part of Central Europe Bratislava­Petrzalka, Slovakia. Thirteen of them (MDMA, methamphetamine, amphetamine, THC-COOH, benzoylecgonine, codeine, tramadol, venlafaxine, oxazepam, citalopram, methadone, EDDP, cocaine) were found in concentrations above 30 ng/L. These compoundswere selected for further monitoring. The possibility of complete degradation of these 13 substances by zerovalent iron and iron(VI) was studied in thewastewater from the Petrzalka treatment plant. During the week the concentration of themajority of the studied compounds inwastewaterwas stable. Concentrations of MDMA, cocaine, tramadol, and oxazepam reached significantly higher levels during the weekend.Only about 10% removal efficiency for tramadol, venlafaxine, oxazepam, MDMA, citalopram, methadone, and EDDP was observed at the treatment plant. In contrast, methamphetamine, amphetamine, and codeine were removed with 68%, 83%, and 53% efficiency, respectively. The degradation of synthetic drugs (methamphetamine, cocaine, MDMA) in wastewater is limited, while cannabis (of natural biological origin) is degradedwith efficiency greater than 90%. After utilization of the Fenton reaction, its modification, and use of ferrate(VI), a high efficiency of eliminating all of these substances to values below the limit of detection was achieved.

Wastewater analysis: the mean of the monitoring of frequently prescribed pharmaceuticals in Slovakia.

The estimation of medication use is based on the statistical data from pharmacies and hospitals. Excessive use or misuse of some compounds, especially psychoactive medications, has not yet been monitored in Slovakia. Wastewater analysis provides useful data about the medication use and misuse in individual regions. This study is focused on the analysis of 23 substances in the wastewaters of Slovakia. The monitoring programme has included stimulants, opioid and morphine derivatives, benzodiazepines, antidepressants, drug precursors and their metabolites. Urinary markers of these compounds were analysed at WWTP influent in seven regions (Bratislava, Kosice, Zvolen, Banská Bystrica, Trencín, Presov a Piestany) using LC-MS/MS technique. The analysis was performed from March to October 2013. The pattern in use of these compounds was also monitored. Tramadol and venlafaxine were found to be the most concentrated compounds among of all studied psychoactive pharmaceuticals. The highest specific loads of tramadol were detected in Piestany (409 mg/day/1000 inhabitants) and Zvolen (366 mg/day/1000 inhabitants). There is a considerable number of spa facilities (hotels) situated in these cities and this fact contributes to a higher occurrence of these psychoactive compounds in respective wastewaters.

Evaluation of different smoking habits during music festivals through wastewater analysis.

Wastewater analysis is a powerful method that can provide useful information about the abuse of legal and illicit drugs. The aim of our study was to determine nicotine consumption during four different music festivals and to find a connection between smoking and preferences for specific music styles using wastewater analysis. The amount of the nicotine metabolite cotinine was monitored in wastewater at the influent of three waste water treatment plants WWTPs in the Czech Republic and Slovakia, where the festivals took place. Urinary bio-markers of nicotine utilization were analyzed by LC-HRMS. More than 80,000 festival participants were monitored during our study from June to September 2014. A significant increase of nicotine consumption was observed in wastewaters during music festivals. The nicotine ingestion level was back-calculated and expressed as mass of pure drug consumed per day and per 1000 inhabitants for selected cities of both countries. The highest differences between typical levels of cotinine in wastewaters and the levels during music festivals were detected in Piestany: 4 g/L/1000 inhabitants during non-festival days compared to 8 g/L/1000 inhabitants during the Topfest pop-rock festival and 6g/L/1000 inhabitants during the Grape dance festival. No significant increase of the amounts of cotinine in wastewater was recorded for the Country and Folk festivals.

Anaerobic digestion of waste biomass from the production of L-cystine in suspended-growth bioreactors.

Waste biomass from the industrial production of the amino acid L-cystine contains above-average concentrations of organic pollutants and significant concentrations of nitrogen and sulfur. The specific biogas production (SBP) of waste biomass was monitored in parallel suspended-growth laboratory anaerobic bioreactors. After severe inhibition was observed, three different procedures were applied to inhibited reactor sludge to counter-attack the inhibitory effects of sulfides, respectively hydrogen sulfide: micro-aeration, dilution with water and precipitation by ferrous iron cations. The performance of bioreactors was weekly monitored. Organic loading rates (as chemical oxygen demand, COD) ranged from 1.07 to 1.97 g L(-1) d(-1). At the end of the experimentation, SBP averaged 217, 300 and 320 l kg(-1) COD with a methane content of 21%, 52% and 54%; specific sludge production averaged 133, 111 and 400 g total solids kg(-1) COD, and inhibition was 49%, 27% and 25%; for the applied procedures of micro-aeration, dilution and precipitation respectively.

National monitoring of nicotine use in Czech and Slovak Republic based on wastewater analysis.

The aim of this study was to compare estimation of nicotine use in Slovakia (SR) and the Czech Republic (CR) based on cotinine analysis in wastewater from seven selected wastewater treatment plants (WWTPs) with conventional estimation based on tobacco product sales. Urinary bio-markers of nicotine use were analyzed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). The study was performed concurrently at all the WWTPs (from 11 to 18 March 2014). Representative 24 h composite samples were analyzed with on line SPE/LC-MS/MS method. Based on the average residence time of wastewater in the sewers and the average time in the sampling device, specific correction coefficients were designed to improve estimation of nicotine consumption. Nicotine ingestion level was back-calculated and expressed as mass of pure drug consumed per day and per 1000 inhabitants for selected cities of both countries (mean, 2.2 g for Piestany and 8.0 g for Nitra, respectively). Consequently, the cigarette consumption results were recalculated for each country separately and compared with the data of both national statistical offices (2362 cigarettes/year/person--SR and 2088 cigarettes/year/person--CR). Our results highly correspond to the data of national statistical offices (up to 99.9% in SR and to 96% in CR). The average amount of money invested in cigarette sales was estimated in the capitals of both countries. It is about 1 million EUR/day for Prague and about 0.3 million EUR/day for Bratislava. The calculation of nicotine consumption, utilizing a specific correction coefficient, is the correct way to obtain more accurate data in drug studies of this kind, thus allowing a better drug abuse assessment.

Status of decentralised wastewater treatment systems and barriers for implementation of nature-based systems in central and eastern Europe.

The aim of this paper is to present a survey on the current status of wastewater treatment systems in 11 central and eastern European (CEE) countries, with a focus on rural areas and on small treatment wetlands for settlements of below 2,000 people. The results indicate that CEE countries have insufficient sanitation systems with different performance efficiencies. These differences stem from the different historical, political and economic developments as well as legislation in the previous five to six decades. CEE settlements with less than 2,000 inhabitants represent almost 30.0 % of the overall number of persons living in CEE countries. These data show that CEE countries have a mainly rural character, but this is slowly decreasing. Over 42 million inhabitants are waiting for proper sanitation systems. This requirement will be ever-growing in the next future, and it is important to know and to prepare appropriate steps for progressive realisation.

National study of illicit drug use in Slovakia based on wastewater analysis.

The aim of this study was to analyze illicit drugs and their metabolites in wastewater from eight selected wastewater treatment plants (WWTPs) in Slovakia. The effect of two of the biggest music festivals in Slovakia on illicit drugs in wastewater was also investigated. Urinary bio-markers of amphetamine, methamphetamine, cocaine, cannabis and ecstasy use were analyzed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). We then compared our results with data obtained in other parts of Europe and the world. This study demonstrates that Slovakia has one of highest methamphetamine consumption rates in Europe. Within Slovakia, the highest level of methamphetamine consumption was found in Petrzalka, where the mean specific load of this drug in sewage was 169 mg/day/1000 inhabitants; the next highest loads were detected in Piestany (128 mg/day/1000 inhabitants) and Bratislava (124 mg/day/1000 inhabitants). Amphetamine, ecstasy and cannabis consumption in our study were comparable to that found in other European cities, whereas cocaine consumption was lower. We also analyzed the pattern of drug consumption over the course of a week. The load of the cocaine metabolite benzoylecgonine in wastewater increased during the weekend. The use of this drug was most common in the capital of Slovakia. Increased consumption was also found during a folk festival in Piestany. The ecstasy load in wastewater from larger cities also significantly increased over the weekend. An increase of drug consumption was also detected during a music festival in Trencín, especially for ecstasy. The specific load of ecstasy during this festival increased from 3mg/day/1000 inhabitants to 29 mg/day/1000 inhabitants. The possible influence of music styles on the consumption of certain drugs was also observed. During a folk festival, methamphetamine and cocaine were more commonly used.

Pilot study of seasonal occurrence and distribution of antibiotics and drug resistant bacteria in wastewater treatment plants in Slovakia.

This work presents environmental and quality-control data from the analyses of 33 antibiotics in influent and effluent water from two waste water treatment plants (WWTPs) in the capital and the biggest city of Slovakia. Seeing that consumption of antibiotics depends on epidemiological season, samples were collected during February and August. Among assessed antibiotics ciprofloxacin and clarithromycin were detected in highest concentrations in influent water. Seasonal changes were observed only in plant A when antibiotic concentrations decreased. On the other hand an increase in some cases was observed in plant B. Insufficient degradation of some macrolides, sulfonamides and trimethoprim was detected according to their higher concentrations in effluent water. Contact of antibiotics in subinhibitory concentrations and sludge bacteria in WWTPs represent the base for the development of significant levels of microbial resistance. Simultaneously, antibiotic resistance of fecal coliforms and fecal streptococci from sewage sludge was evaluated. Majority of coliform bacteria were found to be resistant to ampicillin and gentamicin. A significant seasonal difference was determined only in case of high-level resistance. In summer samples, an increase in the strains resistant to concentrations higher than the resistance breakpoints established by EUCAST and NCCLS was observed. No antibiotic resistance in streptococci was observed. However, as a part of sewage sludge is mixed with compost and utilized in agriculture, better processing of sludge should be considered.