A case study to identify priority cytostatic contaminants in hospital effluents A. Olalla a , N. Negreira b, c , M. L  opez de Alda b , D. Barcel  o b, d , Y. Valc  arcel a, e, * a Research Group in Environmental Toxicologyand Risk Assessment (TAyER), Rey Juan Carlos University, Avda Tulip an. s/n, 28933 M ostoles, Madrid, Spain b Water and Soil Quality Research Group, Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA- CSIC), Jordi Girona 18-26, 08034 Barcelona, Spain c International Iberian Nanotechnology Laboratory (INL), Avda, Mestre Jos e Veiga s/n, 4715 Braga, Portugal d Catalan Institute for Water Research (ICRA), H2O Building, Scientific and Technological Park of the University of Girona, Emili Grahit 101,17003 Girona, Spain e Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Immunology and Medical Microbiology, Faculty of Health Sciences, Rey Juan Carlos University, Avda. Atenas, s/n, 28922 Alcorc on, Madrid, Spain highlights  Concentrations of seven of the 17 cytostatic agents analysed, ranging from 25 to 4761 ng/L, were detected.  The highest concentrations corresponded to ifosfamide, methotrexate and cyclophosphamide.  Ifosfamide, imatinib and irinotecan presented the highest HQ values and therefore present the highest environmental risk.  Three substances, namely ifosfamide, irinotecan and imatinib, which should be the focus of environmental monitoring, were identified. article info Article history: Received 26 April 2017 Received in revised form 20 September 2017 Accepted 26 September 2017 Available online 28 September 2017 Handling Editor: Klaus Kümmerer Keywords: Cytostatic agents Priority contaminants Hospital effluents Environmental risk Environmental hazard abstract This study analyses the presence of 17 cytostatic agents from seven different groups, based on their different mechanisms of action, in the effluent from a medium-sized hospital located in eastern Spain. Analysis of the compounds found in the effluents studied involved solidphase extraction (SPE) coupled on-line to a high performance liquid chromatograph tandem mass spectrometer (HPLC-MS/MS). The environmental risk of the compounds studied was then assessed by calculating the hazard quotient (HQ), combining the measured environmental concentrations (MECs) with dose-response data based on the predicted no effect concentrations (PNECs). In addition, the environmental hazard associated was evaluated in accordance with their intrinsic characteristics by calculating the PBT (Persistence Bio- accumulation Toxicity) index. The results of this study showed the presence of seven of the 17 com- pounds analysed in a range of between 25 and 4761 ng/L. The highest concentrations corresponded to ifosfamide (58e4761 ng/L), methotrexate (394e4756 ng/L) and cyclophosphamide (46e3000 ng/L). Assessment of the environmental hazard showed that the three hormonal agents (tamoxifen and its metabolites endoxifen and hydroxytamoxifen) exhibited a maximum PBT value of 9 due to their inherent harm to the environment resulting from their characteristics of persistence, bioaccumulation and toxicity. A combined evaluation of the risk and environmental hazard showed that three of the 17 compounds studied, namely, ifosfamide, imatinib and irinotecan, all of which exhibited HQ values higher than 10 and PBT indices of 6, indicative of a particularly high potential to harm the environment, deserve special attention. © 2017 Published by Elsevier Ltd. 1. Introduction Drugs have been discharged into the environment without re- strictions for many years as wastewater treatment plants (WWTPs) * Corresponding author. Research Group in Environmental Toxicology and Risk Assessment (TAyER), Rey Juan Carlos University, Avda Tulip an. s/n, 28933 M ostoles, Madrid, Spain. E-mail addresses: adrianolalla@gmail.com (A. Olalla), Yolanda.valcarcel@urjc.es (Y. Valc arcel). Contents lists available at ScienceDirect Chemosphere journal homepage: www.elsevier.com/locate/chemosphere https://doi.org/10.1016/j.chemosphere.2017.09.129 0045-6535/© 2017 Published by Elsevier Ltd. Chemosphere 190 (2018) 417e430