SYSTEMATIC LITERATURE REVIEW OF HOUSEHOLD PHARMACEUTICAL WASTE IN THE SOUTHEAST ASIAN AQUATIC ENVIRONMENT IN DPSIR PERSPECTIVE

• Main Author: Dwi Astuti, Yolanda
• Format: Theses
• Language: Indonesia
• Subjects: Teknik saniter dan perkotaan; teknik perlindungan lingkungan
• Online Access: https://digilib.itb.ac.id/gdl/view/70696
• Institution: Institut Teknologi Bandung

This systematic literature review provides a critical understanding of the entry route of pharmaceutical wastes into the aquatic environment in Southeast Asia, including its occurance and abundance as well as the ecological risks with a focus on the aquatic environment. Technological aspect related to efforts to reduce the impact of pharmaceutical waste disposal and pharmaceutical waste management policies are also recorded and analyzed. This SLR is done with DPSIR (Drivers, Pressure, State, Impact, Response) framework to synthesize the current knowledge on household pharmaceutical waste in aquatic environment in Southeast Asian. Knowledge, attitudes and practices of the Southeast Asian population regarding the use of antibiotics and the disposal of pharmaceutical waste were at a moderate level (61.9% forknowledge proportion and 55.2% for attitude and practice proportion). The pathways of household pharmaceuticals entering the aquatic environments in Southeast Asia are through WWTPs (Wastewater Treatment Plants)/STPs (Sewage Treatment Plants) outlet, septic tank leakages, municipal sewage, urban run-off, urban canals, urban drainage, and landfill leachate. This study identified concentrations of Active Pharmaceutical Ingredients (APIs) in surface water and groundwater and also from WWTP’s effluent. The highest concentration of APIs in surface waters was reported from caffeine compound at 114,179 ng L-1, followed by erythromycin and acetaminophen at 48,517 and 45,882 ng L-1, respectively. Meanwhile in groundwater, the highest concentration of APIs was reported from caffeine at 16,249 ng L-1 followed by acetaminophen at 4689 ng L-1. Gabapentin and sulpiride, from anticonvulsant class, were reported in WWTP’s effluent in Singapore with the highest concentration of 8855 ng L-1. Erythromycin, amoxicillin and clarithromycin, from antibiotic class, were reported to have the highest ecological risk in Southwast Asian aquatic environment. Overall, the proportion of ecological risk from pharmaceutical waste in the waters of the Southeast Asia Region was at high (29.5%), medium (14.5%), low (13.4%) level. Pharmaceutical waste treatment in Southeast Asia was reported using secondary treatment technologies, including Conventional Active Sludge (CAS), Membrane Bio-Reactor (MBR), Aerated Ponds (AP), Active Sludge (AS), Oxidation Ponds (OP), Oxidation Ditch (OD), Sequencing Batch Reactor (SBR). CAS and MBR provided better average removal effeciencies for antibiotics than AS. EPV (Ecopharmacovigilance) review suggests the need for policies related to the management of household pharmaceutical waste, including regulations on proper antibiotic prescribing as well as restrictions on pharmaceutical waste that can enter the aquatic environment. Government also need to enhance public knowledge on the impacts of improper medication waste disposal on the environment, and also facilitating collection points (dropbox) that become accessible for anyone.