Pharmaceuticals and personal care products in the environment: what are the big questions?
BACKGROUND
Over the past 10-15 years, a substantial amount of work has been done by the scientific, regulatory, and business communities to elucidate the effects and risks of pharmaceuticals and personal care products (PPCPs) in the environment.


OBJECTIVE
This review was undertaken to identify key outstanding issues regarding the effects of PPCPs on human and ecological health in order to ensure that future resources will be focused on the most important areas.


METHODS
To better understand and manage the risks of PPCPs in the environment, we used the "key question" approach to identify the principle issues that need to be addressed. Initially, questions were solicited from academic, government, and business communities around the world. A list of 101 questions was then discussed at an international expert workshop, and a top-20 list was developed. Following the workshop, workshop attendees ranked the 20 questions by importance.


RESULTS
The top 20 priority questions fell into seven categories: a) prioritization of substances for assessment, b) pathways of exposure, c) bioavailability and uptake, d) effects characterization, e) risk and relative risk, f ) antibiotic resistance, and g) risk management.


CONCLUSIONS
A large body of information is now available on PPCPs in the environment. This exercise prioritized the most critical questions to aid in development of future research programs on the topic.
Environment Department, University of York, Heslington, York, United Kingdom.
Alistair B A
AB
Boxall
Murray A
MA
Rudd
Bryan W
BW
Brooks
Daniel J
DJ
Caldwell
Kyungho
K
Choi
Silke
S
Hickmann
Elizabeth
E
Innes
Kim
K
Ostapyk
Jane P
JP
Staveley
Tim
T
Verslycke
Gerald T
GT
Ankley
Karen F
KF
Beazley
Scott E
SE
Belanger
Jason P
JP
Berninger
Pedro
P
Carriquiriborde
Anja
A
Coors
Paul C
PC
Deleo
Scott D
SD
Dyer
Jon F
JF
Ericson
François
F
Gagné
John P
JP
Giesy
Todd
T
Gouin
Lars
L
Hallstrom
Maja V
MV
Karlsson
D G Joakim
DG
Larsson
James M
JM
Lazorchak
Frank
F
Mastrocco
Alison
A
McLaughlin
Mark E
ME
McMaster
Roger D
RD
Meyerhoff
Roberta
R
Moore
Joanne L
JL
Parrott
Jason R
JR
Snape
Richard
R
Murray-Smith
Mark R
MR
Servos
Paul K
PK
Sibley
Jürg Oliver
JO
Straub
Nora D
ND
Szabo
Edward
E
Topp
Gerald R
GR
Tetreault
Vance L
VL
Trudeau
Glen
G
Van Der Kraak
D004352:Drug Resistance, Microbial / Q000187:drug effects; D064420:Drug-Related Side Effects and Adverse Reactions; D004781:Environmental Exposure; D004784:Environmental Monitoring; D006795:Household Products / Q000032:analysis* / Q000633:toxicity*; D006801:Humans; D004364:Pharmaceutical Preparations / Q000032:analysis / Q000378:metabolism*; D012106:Research / Q000458:organization & administration*; D018570:Risk Assessment
D004364:Pharmaceutical Preparations