Reducing micropollutants with source control: substance flow analysis of 212 pharmaceuticals in faeces and urine

Pharmaceuticals in the aquatic environment are raising concern. It is expected that many anthropogenic pharmaceuticals are largely excreted via urine; a popular argument for introducing urine source separation. However, to date, this assumption lacks verification. We close this gap with quantitative screening of official pharmaceutical data. We analysed the excretion pathways of 212 pharmaceuticals' active ingredients (AI), equalling 1,409 products. On average, 64% (±27%) of each AI was excreted via urine, and 35% (±26%) via faeces. In urine, 42% (±28%) of each AI was excreted as metabolites. However, these numbers need cautious interpretation. We found an extreme variability (1) between different therapeutic groups, (2) within some groups and (3) sometimes even between products of the same AI. We discuss various therapeutic groups and include Swiss sales' quantities. For instance, urine source separation could very effectively remove the highly sold and non-degradable x-ray contrast media: 94% (±4%) are excreted via urine. However, for different pharmaceuticals belonging to cytostatics, excretion via urine was 6–98%. Because of such large variability we advise caution to introduce the still imperfect urine separation technology solely because of pharmaceuticals. Nonetheless, together with other good arguments for this innovation, removal of pharmaceuticals is a welcome side effect.