title: Implementing ecopharmacovigilance (EPV) from a pharmacy perspective: A focus on non-steroidal anti-inflammatory drugs.
abstract: Environmental experts have made great efforts to control pharmaceutical pollution. However, the control of emerged environmental problems caused by medicines should draw more attention of pharmacy and pharmacovigilance researchers. Ecopharmacovigilance (EPV) as a kind of pharmacovigilance for the environment is recognized worldwide as crucial to minimize the environmental risk of pharmaceutical pollutants. But continuing to treat the pollution of pharmaceuticals as a group of substances instead of targeting individual pharmaceuticals on a prioritized basis will lead to a significant waste of resources. Considering vulture population decline caused by non-steroidal anti-inflammatory drugs (NSAIDs) residues, we presented a global-scale analysis of 139 reports of NSAIDs occurrence across 29 countries, in order to provide a specific context for implementing EPV. We found a heavy regional bias toward research in Europe, Asia and America. The top 5 most frequently studied NSAIDs included ibuprofen, diclofenac, naproxen, acetaminophen and ketoprofen. The profile of NSAIDs was dominated by acetaminophen in wastewater influents and effluents. Ibuprofen was the most abundant NSAID in surface water. Only 9 NSAIDs were reported in groundwater samples. And majority of NSAIDs were detected in solid matrices at below 1μg/g except for ketoprofen, diclofenac and ibuprofen. From a pharmacy perspective, we get some implication and propose some management practice options for EPV implementation. These include: Further popularizing and applying the concept of EPV, together with developing relevant regulatory guidance, is necessary; More attention should be paid to how to implement EPV for the pollution control of older established drugs; Triggering "a dynamic watch-list mechanism" in conjunction with "source control"; Implementing targeted sewage treatment technologies and strengthening multidisciplinary collaboration; Pharmaceutical levels in aquatic organisms as biological indicators for monitoring pharmaceutical pollution within the water environment; Upgrading drinking water treatment plants with the aim of removing pharmaceutical residues; Paying more attention to EPV for pharmaceuticals in solid matrices.
authors.affiliation: Department of Pharmacy, College of Medicine, Wuhan University of Science and Technology, Wuhan 430065, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Hubei Woman and Child Hospital, Wuhan 430070, China. Electronic address: hbs102626@163.com.
authors.forename: Bingshu
authors.initials: B
authors.lastname: He
authors.affiliation: Department of Pharmacy, College of Medicine, Wuhan University of Science and Technology, Wuhan 430065, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Yan
authors.affiliation: Department of Pharmacy, College of Medicine, Wuhan University of Science and Technology, Wuhan 430065, China.
authors.forename: Xiamin
authors.initials: X
authors.lastname: Hu
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000032:analysis* / Q000633:toxicity; D001717:Birds; D004784:Environmental Monitoring; D060735:Pharmacovigilance; D014874:Water Pollutants, Chemical / Q000032:analysis* / Q000633:toxicity
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D014874:Water Pollutants, Chemical
keywords: Ecopharmacovigilance; Environment; Non-steroidal anti-inflammatory drugs; Pharmaceutical residues