**2.2 Health care facilities**

*Environmental Issues and Sustainable Development*

surface, ground and drinking water resources apart from wastewater effluent Globe [2]. However, the removal efficiency is highly variable, and it can be substantially less than 100%. Carballa et al. (2005) suggested that due to their relatively long environmental half-life, many PhACs may be accumulated to the measurable levels in aquatic ecosystems. Concentrations of PhACs were found to be less than one ppb, while the combined concentrations beat ppm ranges [2]. These drugs are highly active and interactive with receptors in humans and animals and are toxic in nature towards health threatening organisms such as bacteria, fungi and parasites. Moreover, human and animal health are affected by various types of organisms and also targeted by PhACs. Therefore, PhACs may have some potential effect on the aquatic and terrestrial organisms [3]. They are usually uncovered as waste for a long time. Therefore, many scientists have started to discover the effects of organisms to various PhACs [4]. Some drugs like an analgesic and anti-inflammatory are universal for their applicability in the medical field and in effluents of WWTPs. They are discharge recipient water at concentrations range of μg/L. For an example, the

*Characteristics of pharmaceutical industry wastewater producing allopathic medicines [2].*

**Parameters Typical values** pH 6.5–7.0 BOD, mg/L 1,200–1,700 COD, mg/L 2,000–3,000 BOD/COD 0.57–0.6 Suspended solids, mg/L 300–400 Volatile acids, mg/L 50–80 Alkalinity as CaCO3, mg/L 50–100 Phenols, mg/L 65–72

concentration of diclofenac is found in WWTP as 1.4 μg/L [5].

industrial effluents is summarized in **Table 1**.

**2.1 Agriculture and agriculture industry**

**2. Sources of PhACs in water and wastewater**

Due to presence of carboxylic moieties (-COOH) and one or two phenolic hydroxyl groups (-OH) most of these types of drugs are acidic in nature. Antibiotics are used generally to prevent bacterial infections and they are used in veterinary applications as food additives at sub-therapeutic doses to treat food efficiency and promote growth [6]. Carballa et al. [7] reported that wide application of antibiotics may lead to bacterial resistances. The occurrence of different drugs in sewage sludge of WWTPs and surface is well reported [8, 9]. Common PhACs present in various

Variety of PhACs made from recombinant proteins potentially has greater efficacy and fewer side effects than small organic molecules [10]. Bacteria or yeast commonly produced the recombinant proteins [11]. However, pharming does not require expensive for the production of proteins or their metabolic products. Also, the production capacity can be rapidly climbed up to meet the demand. It is projected that the expense of producing a recombinant protein via pharming will be less than 60–70% of the current cost [12]. Uses of large amount of water and causes

**356**

**Table 1.**

Varieties of antibiotics have been isolated from urban and hospital wastewater [14]. It has been found that they simply could pass through aquatic environment and be transferred to surface water [15]. Kim and Tanaka [16] suggested that both wastewater treatment processes and the microbial ecology in surface water were disturbed by antibiotics and disinfectants.

Chang et al. [17] found different PhACs including analgesics, beta-blockers, non-steroidal anti-inflammatories, alpha-antidepressants, anti-cancer drugs, antifungal agents, opiates, antibiotics, anti-coagulants, diuretics, anti-anginals, antidiabetics and hypolipidemics are detected by in hospitals effluents. Unregulated disposal of unused and expired medicines is the primary inception of PhACs into the environment from hospitals and health care facilities [17]. Rejection of syringe into the hospital drain off after application on the patient's body also an important source of PhACs is [18].

#### **Figure 1.**

*Pathways for inception of pharmaceuticals and their metabolites in the environment [20].*


#### **Table 2.**

*Concentrations of pharmaceuticals in water and solid wastes [2].*

#### **2.3 Surface water and ground water**

Due to incomplete elimination pharmaceutical products, the residues of these products can enter the aquatic environment [19]. The typical concentration of PhACs in water and solid wastes is summarized in **Table 1**. However, the concentration in untreated industrial wastewater varies from ppb to ppm levels. Different pathways for initiation of pharmaceuticals and their metabolites in the environment are shown in **Figure 1**. The typical values of different parameters of pharmaceutical industry wastewater are shown in **Table 2**.
