title: Determination of the psychoactive drugs carbamazepine and diazepam in hospital effluent and identification of their metabolites.
abstract: This study addresses the occurrence of carbamazepine and diazepam and their metabolites in the wastewater of the University Hospital (HUSM) of the Federal University of Santa Maria, RS-Brazil. Samples were collected from three sampling points of the sewage treatment system: point A ('emergency effluent'), point B ('general effluent') and point C ('water course-receptor'). Eight metabolites were identified: carbamazepine-10-11-epoxide, 10-dihydro-carbamazepine, 2-OH-carbamazepine, iminoquinone, acridone, nordiazepam, oxazepam and temazepam. The mean concentrations in the emergency, general effluent and water course-receptor were as follows: 433.0 ± 4.7, 349.0 ± 5.0 and 485.0 ± 5.6 ng L(-1), for carbamazepine and 550.0 ± 4.3, 441.0 ± 7.9 and 586.6 ± 9.3 ng L(-1), for diazepam, respectively. Liquid chromatography with electrospray ionization tandem mass spectrometry (LC-QqLIT-MS) proved to be a method fit-to-purpose. The determination of carbamazepine and diazepam, and the identification of active metabolites showing environmental persistence (carbamazepine-10-11-epoxide, nordiazepam and oxazepam) revealed the need for a more effective treatment of the HUSM effluent. As far as we know, no similar study has been carried out on the wastewater of Brazilian hospitals.
authors.affiliation: Chemistry Department, Federal University of Santa Maria, Santa Maria, RS, Brazil. carlos@lamic.ufsm.br.|Department of Preventive Veterinary Medicine, Federal University of Santa Maria, Santa Maria, RS, Brazil. carlos@lamic.ufsm.br.
authors.forename: Carlos A A
authors.initials: CA
authors.lastname: de Almeida
authors.affiliation: Department of Preventive Veterinary Medicine, Federal University of Santa Maria, Santa Maria, RS, Brazil. mauricioso@lamic.ufsm.br.
authors.forename: Maurício S
authors.initials: MS
authors.lastname: Oliveira
authors.affiliation: Department of Preventive Veterinary Medicine, Federal University of Santa Maria, Santa Maria, RS, Brazil. mallmann@lamic.ufsm.br.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Mallmann
authors.affiliation: Chemistry Department, Federal University of Santa Maria, Santa Maria, RS, Brazil. martins@quimica.ufsm.br.|Departamento de Química, Universidade Federal de Santa Maria, Campus Camobi, CEP 97105-900, Santa Maria, RS, Brazil. martins@quimica.ufsm.br.
authors.forename: Ayrton F
authors.initials: AF
authors.lastname: Martins
mesh_terms: D001938:Brazil; D002220:Carbamazepine / Q000031:analogs & derivatives* / Q000032:analysis / Q000378:metabolism; D002853:Chromatography, Liquid; D003975:Diazepam / Q000032:analysis* / Q000378:metabolism; D006785:Hospitals, University; D008506:Medical Waste / Q000032:analysis; D011619:Psychotropic Drugs / Q000032:analysis*; D012722:Sewage / Q000737:chemistry; D021241:Spectrometry, Mass, Electrospray Ionization; D062065:Wastewater / Q000737:chemistry*; D014874:Water Pollutants, Chemical / Q000032:analysis*
chemical_list: D002220:Carbamazepine; D003975:Diazepam; D008506:Medical Waste; D011619:Psychotropic Drugs; D012722:Sewage; D062065:Wastewater; D014874:Water Pollutants, Chemical; C012227:carbamazepine epoxide
keywords: Carbamazepine; Diazepam; Fragmentation; Hospital effluent; LC-QqLIT-MS; Metabolites