TABLE 1.
Types of pharmaceuticals and concentrations reported in countries worldwide.
| Pharmaceutical type | Pharmaceutical | Max conc (ng/L) | Country | References |
| NSAIDs and analgesics | Naproxen | 4,889 | Mexico | Rivera-Jaimes et al., 2018 |
| NSAIDs and analgesics | Acetaminophen | 4,460 | Mexico | Rivera-Jaimes et al., 2018 |
| NSAIDs and analgesics | Diclofenac | 1,398 | Mexico | Rivera-Jaimes et al., 2018 |
| NSAIDs and analgesics | Diclofenac | 10,221 | Saudi Arabia | Ali et al., 2017 |
| NSAIDs and analgesics | Acetaminophen | 2,346 | Saudi Arabia | Ali et al., 2017 |
| NSAIDs and analgesics | Ibuprofen | 2,094.4 | Brazil | Pereira et al., 2016 |
| NSAIDs and analgesics | Acetaminophen | 34.6 | Brazil | Pereira et al., 2016 |
| NSAIDs and analgesics | Diclofenac | 19.4 | Brazil | Pereira et al., 2016 |
| NSAIDs and analgesics | Acetaminophen | 48.74 | Antartic Peninsula | González-Alonso et al., 2017 |
| NSAIDs and analgesics | Diclofenac | 15.09 | Antartic Peninsula | González-Alonso et al., 2017 |
| NSAIDs and analgesics | Ibuprofen | 10.05 | Antartic Peninsula | González-Alonso et al., 2017 |
| NSAIDs and analgesics | Ibuprofen | 414 | South Korea | Kim et al., 2009 |
| NSAIDs and analgesics | Ibuprofen | 1,850 | Vietnam | Tran et al., 2014 |
| NSAIDs and analgesics | Diclofenac | 1,630 | Vietnam | Tran et al., 2014 |
| NSAIDs and analgesics | Ketoprofen | 1,620 | Vietnam | Tran et al., 2014 |
| NSAIDs and analgesics | Naproxen | 1,110 | Vietnam | Tran et al., 2014 |
| NSAIDs and analgesics | Acetaminophen | 12,430 | Nigeria | Ebele et al., 2020 |
| NSAIDs and analgesics | Ibuprofen | 2,740 | Nigeria | Ebele et al., 2020 |
| NSAIDs and analgesics | Naproxen | 2,120 | Nigeria | Ebele et al., 2020 |
| NSAIDs and analgesics | Diclofenac | 200 | Nigeria | Ebele et al., 2020 |
| NSAIDs and analgesics | Ibuprofen | 121 | Singapore | Wu et al., 2010 |
| NSAIDs and analgesics | Diclofenac | 38 | Singapore | Wu et al., 2010 |
| NSAIDs and analgesics | Naproxen | 30 | Singapore | Wu et al., 2010 |
| NSAIDs and analgesics | Ibuprofen | 34.9 | Baltic Sea/Polish | Borecka et al., 2015 |
| NSAIDs and analgesics | Naproxen | 13,100 | United States/California | Vidal-Dorsch et al., 2012 |
| NSAIDs and analgesics | Ibuprofen | 12,000 | United States/California | Vidal-Dorsch et al., 2012 |
| NSAIDs and analgesics | Acetaminophen | 11,000 | United States/California | Vidal-Dorsch et al., 2012 |
| NSAIDs and analgesics | Diclofenac | 180 | United States/California | Vidal-Dorsch et al., 2012 |
| NSAIDs and analgesics | Diclofenac | 843 | China | Yang et al., 2011 |
| NSAIDs and analgesics | Ibuprofen | 2,200 | Taiwan | Fang et al., 2012 |
| NSAIDs and analgesics | Diclofenac | 185 | Taiwan | Fang et al., 2012 |
| NSAIDs and analgesics | Ketoprofen | 184 | Taiwan | Fang et al., 2012 |
| NSAIDs and analgesics | Ibuprofen | 143,000 | Spain | Santos et al., 2007 |
| NSAIDs and analgesics | Ketoprofen | 2,100 | Spain | Santos et al., 2007 |
| NSAIDs and analgesics | Diclofenac | 280 | Spain | Santos et al., 2007 |
| NSAIDs and analgesics | Ibuprofen | 1,130 | Japan | Nakada et al., 2006 |
| NSAIDs and analgesics | Ketoprofen | 369 | Japan | Nakada et al., 2006 |
| NSAIDs and analgesics | Ibuprofen | 16,500 | Canada | Lishman et al., 2006 |
| NSAIDs and analgesics | Diclofenac | 1,010 | Canada | Lishman et al., 2006 |
| NSAIDs and analgesics | Ketoprofen | 289 | Canada | Lishman et al., 2006 |
| NSAIDs and analgesics | Ibuprofen | 1,900 | United States/Maryland | Yu et al., 2006 |
| NSAIDs and analgesics | Ketoprofen | 1,200 | United States/Maryland | Yu et al., 2006 |
| NSAIDs and analgesics | Diclofenac | 110 | United States/Maryland | Yu et al., 2006 |
| NSAIDs and analgesics | Diclofenac | 4,114 | Austria | Clara et al., 2005 |
| NSAIDs and analgesics | Ibuprofen | 2,679 | Austria | Clara et al., 2005 |
| NSAIDs and analgesics | Ibuprofen | 1,400 | Switzerland | Tixier et al., 2003 |
| NSAIDs and analgesics | Diclofenac | 990 | Switzerland | Tixier et al., 2003 |
| NSAIDs and analgesics | Ketoprofen | 180 | Switzerland | Tixier et al., 2003 |
| NSAIDs and analgesics | Ibuprofen | 3,400 | Germany | Ternes, 1998 |
| NSAIDs and analgesics | Diclofenac | 2,100 | Germany | Ternes, 1998 |
| NSAIDs and analgesics | Ketoprofen | 380 | Germany | Ternes, 1998 |
| NSAIDs and analgesics | Ibuprofen | 4,201 | United Kingdom | Ashton et al., 2004 |
| NSAIDs and analgesics | Diclofenac | 599 | United Kingdom | Ashton et al., 2004 |
| Antibiotic | Azithromycin | 597.5 | Portugal | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ciprofloxacin | 584.9 | Portugal | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clarithromycin | 313,2 | Portugal | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Tetracycline | 231.2 | Portugal | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Trimethoprim | 190.6 | Portugal | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ofloxacin | 184.9 | Portugal | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clindamycin | 86.6 | Portugal | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfapyridine | 48.8 | Portugal | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Cefalexin | 38.4 | Portugal | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfamethoxazole | 30.2 | Portugal | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Pipemidic acid | 20.1 | Portugal | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Azithromycin | 299.5 | Spain | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ciprofloxacin | 200.3 | Spain | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ofloxacin | 142.3 | Spain | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfamethoxazole | 123.4 | Spain | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clarithromycin | 112 | Spain | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Trimethoprim | 102.8 | Spain | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clindamycin | 101.4 | Spain | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Metronidazole | 76.1 | Spain | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Enrofloxacin | 69.4 | Spain | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Cefalexin | 65.2 | Spain | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfapyridine | 63.9 | Spain | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Pipemidic acid | 30.1 | Spain | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ciprofloxacin | 316.8 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ofloxacin | 305.1 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Trimethoprim | 74.2 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfamethoxazole | 68.5 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Cefalexin | 66.3 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfapyridine | 48.7 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Azithromycin | 48 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Tetracycline | 36.9 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clindamycin | 27.8 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Metronidazole | 19.6 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Pipemidic acid | 15.2 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clarithromycin | 11.9 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Orbifloxacin | 6.7 | Cyprus | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Azithromycin | 266.7 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ciprofloxacin | 259.8 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clarithromycin | 204.4 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Tetracycline | 194.2 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Trimethoprim | 141.3 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ampicillin | 99.4 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfapyridine | 95.5 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Metronidazole | 88.6 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Cefalexin | 87.6 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ofloxacin | 65.4 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clindamycin | 59.1 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfamethoxazole | 53 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Nalidixic acid | 50.3 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Pipemidic acid | 18.2 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Oxolinic Acid | 5.3 | Ireland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Azithromycin | 290.4 | Germany | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ciprofloxacin | 230.6 | Germany | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clarithromycin | 123.4 | Germany | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfapyridine | 112 | Germany | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clindamycin | 110.7 | Germany | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Trimethoprim | 105 | Germany | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ofloxacin | 66.5 | Germany | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfamethoxazole | 34.9 | Germany | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Metronidazole | 20.3 | Germany | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Tetracycline | 15.4 | Germany | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Pipemidic acid | 11.8 | Germany | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Cefalexin | 308 | Finland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Trimethoprim | 186.7 | Finland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Azithromycin | 130.7 | Finland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfapyridine | 98.8 | Finland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clindamycin | 94.2 | Finland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Tetracycline | 70.6 | Finland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ciprofloxacin | 43.2 | Finland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Metronidazole | 41.9 | Finland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ofloxacin | 22.8 | Finland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clarithromycin | 4.8 | Finland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Pipemidic acid | 4.8 | Finland | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfapyridine | 184 | Norway | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Tetracycline | 179.2 | Norway | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ciprofloxacin | 159.2 | Norway | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Azithromycin | 149.7 | Norway | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Trimethoprim | 119.7 | Norway | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clindamycin | 97.1 | Norway | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Metronidazole | 93.2 | Norway | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Cefalexin | 60.7 | Norway | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Sulfamethoxazole | 48.6 | Norway | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Ofloxacin | 27.1 | Norway | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Clarithromycin | 20.8 | Norway | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Pipemidic acid | 7,5 | Norway | Rodriguez-Mozaz et al., 2020 |
| Antibiotic | Oxytetracycline | 2,796.6 | China | Wang et al., 2017 |
| Antibiotic | Tetracycline | 1,454.8 | China | Wang et al., 2017 |
| Antibiotic | Chlorotetracycline | 876.2 | China | Wang et al., 2017 |
| Antibiotic | Sulfamethoxazole | 715.3 | China | Wang et al., 2017 |
| Antibiotic | Sulfadiazine | 499.5 | China | Wang et al., 2017 |
| Antibiotic | Sulfamerazine | 329.1 | China | Wang et al., 2017 |
| Antibiotic | Fleroxacin | 309.4 | China | Wang et al., 2017 |
| Antibiotic | Difloxacin | 250.2 | China | Wang et al., 2017 |
| Antibiotic | Sulfanomethioxine | 225.5 | China | Wang et al., 2017 |
| Antibiotic | Ofloxazin | 203.7 | China | Wang et al., 2017 |
| Antibiotic | Sulfadiamidine | 109.9 | China | Wang et al., 2017 |
| Antibiotic | Ciprofloxacin | 106.2 | China | Wang et al., 2017 |
| Antibiotic | Sulfameter | 6 | China | Wang et al., 2017 |
| Antibiotic | Sulfamethoxazole | 2,010 | Mexico | Rivera-Jaimes et al., 2018 |
| Antibiotic | Trimethoprim | 790 | Mexico | Rivera-Jaimes et al., 2018 |
| Antibiotic | Erythromycin | 160 | South Africa | Matongo et al., 2015 |
| Antibiotic | Ciprofloxacin | 14,300 | South Africa | Agunbiade and Moodley, 2016 |
| Antibiotic | Sulfaguanidine | 46,000 | South Africa | Madikizela et al., 2020 |
| Antibiotic | Spiramycin | 38,200 | South Africa | Madikizela et al., 2020 |
| Antibiotic | Fluoroquinolones | 900 | South Africa | Hendricks and Pool, 2012 |
| Antibiotic | Ciprofloxacin | 1,360 | South Africa | Agunbiade and Moodley, 2016 |
| Antibiotic | Erythromycin | 10,600 | Ghana | Azanu et al., 2018 |
| Antibiotic | Sulfamethoxazole | 3,600 | Ghana | Azanu et al., 2018 |
| Antibiotic | Metronidazole | 363 | Ghana | Azanu et al., 2018 |
| Antibiotic | Ciprofloxacin | 15,730 | Ghana | Azanu et al., 2018 |
| Antibiotic | Erythromycin | 16,400 | Tunisia | Tahrani et al., 2017 |
| Antibiotic | Ofloxacin | 175 | Tunisia | Harrabi et al., 2018 |
| Antibiotic | Enrofloxacin | 400 | Tunisia | Harrabi et al., 2018 |
| Antibiotic | Trimethoprim | 7,800 | Tunisia | Tahrani et al., 2017 |
| Antibiotic | Sulfamethoxazole | 53,800 | Mozambique | Branchet et al., 2019 |
| Antibiotic | Trimethoprim | 11,400 | Mozambique | Segura et al., 2015 |
| Antibiotic | Sulfamethoxazole | 23,300 | Kenya | K’oreje et al., 2012 |
| Antibiotic | Sulfadoxin | 1,040 | Kenya | K’oreje et al., 2018 |
| Antibiotic | Doxycycline | 32,200 | Kenya | Kairigo et al., 2020 |
| Antibiotic | Norfloxacin | 26,600 | Kenya | Kairigo et al., 2020 |
| Antibiotic | Trimethoprim | 94,800 | Kenya | K’oreje et al., 2012 |
| Antibiotic | Sulfamethoxazole | 5,600 | Uganda | Nantaba et al., 2020 |
| Antibiotic | Trimethoprim | 89 | Uganda | Nantaba et al., 2020 |
| Antibiotic | Enrofloxacin | 440 | Nigeria | Olaitan et al., 2017 |
| Antibiotic | Oxytetracycline | 26 | Nigeria | Olaitan et al., 2017 |
| Antibiotic | Cefuroxime | 868 | Nigeria | Olaitan et al., 2017 |
| Antibiotic | Amoxicillin | 272,200 | Nigeria | Ebele et al., 2020 |
| Endocrine disruptors | Di-(2-ethylhexyl) phthalate | 589 | Australia | Tan et al., 2007 |
| Endocrine disruptors | nonylphenol | 335 | Australia | Tan et al., 2007 |
| Endocrine disruptors | Dibutyl phthalate | 101 | Australia | Tan et al., 2007 |
| Endocrine disruptors | Bisphenol A | 86.7 | Australia | Tan et al., 2007 |
| Endocrine disruptors | Benzyl butyl phthalate | 75.7 | Australia | Tan et al., 2007 |
| Endocrine disruptors | Diethyl phthalate | 36.9 | Australia | Tan et al., 2007 |
| Endocrine disruptors | 4-tert-octylphenol | 23.5 | Australia | Tan et al., 2007 |
| Endocrine disruptors | 4-cumylphenol | 1.9 | Australia | Tan et al., 2007 |
| Antiretroviral | Efavirenz | 37.3 | South Africa | Mlunguza et al., 2020 |
| Antiretroviral | Emtricitabine | 1.47 | South Africa | Mlunguza et al., 2020 |
| Antiretroviral | Tenofovir disproxil | 0.25 | South Africa | Mlunguza et al., 2020 |
| Antiretroviral | Lamvudine | 118,970 | Zambia | Ngumba et al., 2020 |
| Antiretroviral | Zidovudine | 66,590 | Zambia | Ngumba et al., 2020 |
| Antiretroviral | Nevirapine | 1,720 | Zambia | Ngumba et al., 2020 |
| Antiretroviral | Nevirapine | 33,440 | Kenya | K’oreje et al., 2012 |
| Antiretroviral | Zidovudine | 18,300 | Kenya | K’oreje et al., 2012 |
| Antiretroviral | Lamvudine | 3,150 | Kenya | K’oreje et al., 2012 |
| Antiretroviral | Valacyclovir | 21 | Japan | Azuma et al., 2019 |
| Antiretroviral | Zidovudine | 564 | Germany | Prasse et al., 2010 |
| Antiretroviral | Nevirapine | 32.1 | Germany | Boulard et al., 2018 |
| Antiretroviral | Abacavir | 10 | Germany | Boulard et al., 2018 |
| Antiretroviral | Darunavir | 169 | Poland | Giebułtowicz et al., 2018 |
| Antiretroviral | Zidovudine | 191 | France | Aminot et al., 2015 |
| Antiretroviral | Ritonavir | 155 | France | Aminot et al., 2015 |
| Antiretroviral | Lamivudine | 44 | France | Aminot et al., 2015 |
| Antiretroviral | Nevirapine | 7.7 | France | Aminot et al., 2015 |
| Antiretroviral | Indinavir | 1.5 | France | Aminot et al., 2015 |
| Antiretroviral | Saquinavir | 0.2 | France | Aminot et al., 2015 |
| Antiretroviral | Lamivudine | 507 | Belgium | Vergeynst et al., 2015 |
| Antiretroviral | Ritonavir | 108 | Switzerland | Kovalova et al., 2012 |
| Antiretroviral | Lamivudine | 355 | United States | Masoner et al., 2014 |
| Antiretroviral | Abacavir | 185 | United States | Masoner et al., 2014 |
| Antiretroviral | Nevirapine | 25.2 | United States | Fisher et al., 2016 |
| Anticancer | Capecitabine | 46 | Portugal | Cristóvão et al., 2021 |
| Anticancer | Ifosamide | 44 | Portugal | Cristóvão et al., 2021 |
| Anticancer | Cyclophosphamide | 17 | Portugal | Cristóvão et al., 2021 |
| Anticancer | Tamoxifen | 181 | Spain | Negreira et al., 2014 |
| Anticancer | Cytarabine | 924 | Canada | Vaudreuil et al., 2020 |
| Anticancer | Difluorodeoxyuridine | 300 | Canada | Vaudreuil et al., 2020 |
| Anticancer | Cyclophosphamide | 118 | Canada | Vaudreuil et al., 2020 |
| Anticancer | Methotrexate | 27.3 | Canada | Vaudreuil et al., 2020 |