Exposure and Health Impact of Pharmaceutical Residue Ingestion via Dietary Sources and Drinking Water

The pharmaceutical industry is a large sector that is essential for humans and animals. Pharmaceuticals (e.g., psychiatric drugs, endocrine-related pharmaceuticals, antibiotics), at levels ranging from nanograms to micrograms, are continuously disseminated into the environment, including surface water, groundwater, drinking water, soils, biota, and sediments, as well as accumulating in animal and plant tissues. Such widespread contamination has increased the potential of exposure of humans and animals via different routes: indirect contact via ingestion (dietary and drinking water) or direct contact via the skin, mucous membranes, and lungs. This raises a major concern about pharmaceutical residues in the environment, which leads to human and animal health problems (e.g., increased risk of developing cancer), reproductive toxicity in aquatic organisms, and antibiotic resistance. In addition, pharmaceutical residues affect the Earth’s natural systems (terrestrial, freshwater, and marine ecosystems), which disrupt the physiology and behavior of organisms, leading to disrupting the environment that may directly or indirectly cause human- and animal-related health risks (e.g., increased prevalence of opportunistic infections and risks of uncommon or low-incidence diseases). These compounds show high interactions with biological systems and could be studied through biomarkers.