Occurrence and indicators of pharmaceuticals in Chinese streams: A nationwide study

Pharmaceutically active compounds (PhACs) are excreted by humans and animals and released into the aquatic environment through wastewater, which can have potential negative impacts on ecological systems. To conduct a nationwide investigation of the occurrence of PhACs in water resources in China, an analytical procedure based on solid-phase extraction (SPE) and LC-MS/MS was used to measure 45 PhACs in surface water samples from a network of 29 rivers across 31 provinces in China in 2014 and 2015. PhACs were prevalent in all sampled streams. The concentrations of commonly detected PhACs were comparable to those detected in other countries. High total concentrations (mean > 1 μg L^-1) of all tested PhACs were primarily detected in areas under extreme water stress, specifically northern and eastern coastal areas. Source apportionment based on the profiles of the target compounds found that 54% of the PhACs in China originated from freshly discharged untreated sewage. Metformin (MET) and its biodegradation product, guanylurea (GUL), were used as a pair of indicators to predict PhAC contamination levels and differentiate between biotreated and unbiotreated wastewater. High MET/GUL can be used to indicate untreated wastewater, whereas low MET/GUL values are a strong indicator of treated wastewater. Furthermore, wastewater biotreatment ratios were calculated. We estimated that the biotreatment ratios of most of the provinces in China were less than 50%. We conclude that more attention should be paid to untreated sewage water, especially water in rural areas rather than the existing concentration on urban sewage treatment-oriented management.