The objectives of this project are to:
1. Identify all relevant studies, in the published and grey literature, that investigate pharmaceutical concentrations in raw or treated water or factors affecting those concentrations.
2. Assess broadly the quality of the studies identified, in terms of the scope of the study and the performance of the analytical methods used.
3. Summarise the findings of the studies, their relevance to England and Wales and identify any factors that may lead to high concentrations.
4. Devise a systematic evaluation of the potential for all pharmaceutical and recreational drugs used in England and Wales to reach raw and treated water.
5. Group together compounds with similar properties, where possible, based on mode of action or chemical functionality.
6. Obtain relevant usage data for each pharmaceutical or group of pharmaceuticals and, based on knowledge of the properties, estimate degradation/dilution for each group or individual compound through each stage from use of the compound to water treatment.
7. Consider at least four scenarios: two where there are significant inputs of treated sewage effluent into the water sources (one with more “advanced” treatment and one with conventional treatment), plus two more scenarios where inputs are lower but with different levels of treatment. All scenarios will be based on real sites in England or Wales.
8. Consider the potential unusually high inputs from, for example, inappropriate disposal of old pharmaceuticals and from normal discharges from areas of potential high use such as hospitals or old people homes.
9. Conclude on the likely levels in raw and treated water and comment, in broad terms, on the health significance of the estimated levels.
10. Where appropriate, recommend areas for future research.