Pan-European insights on pharmaceutical use and removal patterns based on wastewater analysis for more than 400 compounds
Abstract
Pharmaceuticals and their human metabolites are widely detected in municipal wastewater, serving as indicators of both population-level use and wastewater treatment performance. Within the PARC project, a coordinated pan-European wastewater monitoring campaign was conducted at 30 wastewater treatment plants (WWTPs) in 15 countries, integrating multi-laboratory targeted analysis of >400 pharmaceuticals and metabolites, covering a broad range of relevant compounds. Influent pharmaceutical load profiles indicate that regional prescribing practices contribute substantially to pharmaceutical patterns in municipal wastewater, whereas seasonal variability contributes only modestly, and sewer catchment size has little influence. These patterns were driven by complex mixtures of pharmaceuticals across multiple therapeutic classes rather than individual compounds. Comparison with national prescription statistics highlighted substantial limitations in the comparability of pharmaceutical use data across Europe, underscoring the value of wastewater-based epidemiology as an independent and complementary data source. Case studies demonstrated the interpretative power of wastewater data: Sacubitrilat was detected in all 30 WWTPs, enabling the first quantitative pan-European assessment of its increasing use and widespread occurrence across 15 countries, including its loads and removal. In contrast, sartan profiles varied markedly between countries, reflecting national prescribing preferences and demonstrating that indicators based solely on defined daily doses can misrepresent environmental relevance. For the sartan case study, wastewater-derived consumption estimates based on the summed loads of seven sartans agreed well with reported national statistics, generally within a factor of three across the investigated countries despite uncertainties inherent to wastewater-based back-calculation. Across treatment technologies, mean pharmaceutical removal efficiencies were comparable (41-53%). However, pronounced variability among WWTPs suggests that treatment performance may be influenced by site-specific operational factors (e.g., process configuration, hydraulic retention time, and sludge age), although these effects could not be robustly disentangled from differences in treatment technology and other site-level characteristics in the present dataset. Overall, this study represents one of the largest multi-compound and multi-country wastewater monitoring efforts to date and demonstrates that harmonized wastewater monitoring can provide reliable, actionable insights into pharmaceutical use and fate across Europe, supporting both epidemiological surveillance and identifying pharmaceuticals that may warrant further environmental risk assessment.
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BibTeX
@article{meyer2026paneuropean,
title = {{Pan-European insights on pharmaceutical use and removal patterns based on wastewater analysis for more than 400 compounds}},
author = {Corina Meyer and Eva-Maria Braxmaier and Saskia Finckh and Angela Maria Castro Velazco and Martin Krauss and Werner Brack and Carolin Huber and Harry Elliss and Ben Faill and Barbara Kasprzyk-Hordern and Herbert Oberacher and Selina Tisler and Jan H Christensen and Noelia Salgueiro-Gonzalez and Sara Castiglioni and Branislav Vrana and Azziz Assoumani and Nina Huynh and Iker Alvarez-Mora and Maddi Salvoch and Tim Boogaerts and Adrian Covaci and Anna Białk-Bielińska and Joanna Dołżonek and Juliane Hollender},
journal = {Water Research},
year = {2026},
month = sep,
doi = {10.1016/j.watres.2026.127008},
url = {https://hal.science/hal-05790042v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Pan-European insights on pharmaceutical use and removal patterns based on wastewater analysis for more than 400 compounds
AU - Corina Meyer
AU - Eva-Maria Braxmaier
AU - Saskia Finckh
AU - Angela Maria Castro Velazco
AU - Martin Krauss
AU - Werner Brack
AU - Carolin Huber
AU - Harry Elliss
AU - Ben Faill
AU - Barbara Kasprzyk-Hordern
AU - Herbert Oberacher
AU - Selina Tisler
AU - Jan H Christensen
AU - Noelia Salgueiro-Gonzalez
AU - Sara Castiglioni
AU - Branislav Vrana
AU - Azziz Assoumani
AU - Nina Huynh
AU - Iker Alvarez-Mora
AU - Maddi Salvoch
AU - Tim Boogaerts
AU - Adrian Covaci
AU - Anna Białk-Bielińska
AU - Joanna Dołżonek
AU - Juliane Hollender
PY - 2026
DA - 2026/09/26
JO - Water Research
DO - 10.1016/j.watres.2026.127008
UR - https://hal.science/hal-05790042v1
AB - Pharmaceuticals and their human metabolites are widely detected in municipal wastewater, serving as indicators of both population-level use and wastewater treatment performance. Within the PARC project, a coordinated pan-European wastewater monitoring campaign was conducted at 30 wastewater treatment plants (WWTPs) in 15 countries, integrating multi-laboratory targeted analysis of >400 pharmaceuticals and metabolites, covering a broad range of relevant compounds. Influent pharmaceutical load profiles indicate that regional prescribing practices contribute substantially to pharmaceutical patterns in municipal wastewater, whereas seasonal variability contributes only modestly, and sewer catchment size has little influence. These patterns were driven by complex mixtures of pharmaceuticals across multiple therapeutic classes rather than individual compounds. Comparison with national prescription statistics highlighted substantial limitations in the comparability of pharmaceutical use data across Europe, underscoring the value of wastewater-based epidemiology as an independent and complementary data source. Case studies demonstrated the interpretative power of wastewater data: Sacubitrilat was detected in all 30 WWTPs, enabling the first quantitative pan-European assessment of its increasing use and widespread occurrence across 15 countries, including its loads and removal. In contrast, sartan profiles varied markedly between countries, reflecting national prescribing preferences and demonstrating that indicators based solely on defined daily doses can misrepresent environmental relevance. For the sartan case study, wastewater-derived consumption estimates based on the summed loads of seven sartans agreed well with reported national statistics, generally within a factor of three across the investigated countries despite uncertainties inherent to wastewater-based back-calculation. Across treatment technologies, mean pharmaceutical removal efficiencies were comparable (41-53%). However, pronounced variability among WWTPs suggests that treatment performance may be influenced by site-specific operational factors (e.g., process configuration, hydraulic retention time, and sludge age), although these effects could not be robustly disentangled from differences in treatment technology and other site-level characteristics in the present dataset. Overall, this study represents one of the largest multi-compound and multi-country wastewater monitoring efforts to date and demonstrates that harmonized wastewater monitoring can provide reliable, actionable insights into pharmaceutical use and fate across Europe, supporting both epidemiological surveillance and identifying pharmaceuticals that may warrant further environmental risk assessment.
SN - 0043-1354
SN - 1879-2448
ER -