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[背景]在世界范围内,已知药品会污染自来水,但是在中国尚无相关的人类健康风险评估。[目的]监测中国自来水中的32种药品,并评估暴露的终身人类健康风险,以便为未来的优先级管理和风险管理提供信息。[方法]作者分析来自13个城市的样本(n=113),并将检测到的浓度与现有或新得出的安全水平进行比较,以评估除产前期以外不同生命阶段的风险商数(RQs)。[结果]在89%的样本中检测到17种药品,大多数(92%)检出浓度<50ng/L。在≥20%的样本中检测到咖啡因(中等～最大浓度,24.4～564ng/L)、甲硝唑(1.8～19.3ng/L)、水杨酸(16.6～41.2ng/L)、氯贝酸(1.2～3.3ng/L)、卡马咪嗪(1.3～6.7ng/L)、二甲硝咪唑(6.9～14.7ng/L)。由于自来水中检测到药品水平及阳性频率均高,长江中下游地区城市和广州被视为受药品污染的重点区域。在检测到的17种药品中,13种为极低风险水平,但4种药品(二甲硝咪唑、甲砜霉素、磺胺二甲基嘧啶和克拉霉素)至少在一个生命阶段的RQ≥0.01,尤其是婴幼儿和儿童阶段,应被视为管理的高度优先级。本文提出了一个基于指标的监测框架,为中国的药品来源识别、水处理效果及水安全管理提供信息。[结论]中国的自来水是人体药品暴露另外的一个路径,特别是二甲硝咪唑,尽管基于当前的毒性数据,它对人体健康是低风险的。药品检测和监测建议框架可用于在中国和其他地方的水源保护和风险管理。
[Background] There are known pharmaceuticals that pollute tap water worldwide, but there is no relevant human health risk assessment in China. [Purpose] To monitor 32 drugs in tap water in China and assess the lifetime lifetime human health risks of exposure in order to provide information for future priority management and risk management. [Method] The authors analyzed samples from 13 cities (n = 113) and compared the detected concentrations with existing or newly established safety levels to assess risk quotient at different life stages except during prenatal period RQs). [Results] Seventeen drugs were detected in 89% of the samples, most of which (92%) detected concentrations <50ng / L. Caffeine (median to maximum concentration, 24.4 to 564 ng / L), metronidazole (1.8 to 19.3 ng / L), salicylic acid (16.6 to 41.2 ng / L) Acid (1.2 ~ 3.3ng / L), carbamazine (1.3 ~ 6.7ng / L) and dimetridazole (6.9 ~ 14.7ng / L). Due to the high level of drugs detected in tap water and the positive frequency, the cities in the middle and lower reaches of the Yangtze River and Guangzhou are considered as key areas for drug contamination. Thirteen of the 17 drugs tested were at very low risk, but the RQ of the four drugs (metronidazole, thiamphenicol, sulfamethoxazole and clarithromycin) were at least in one life stage 0.01, especially for infants and children, should be considered as a high priority for management. This article presents an indicator-based monitoring framework that provides information on drug source identification, water treatment effectiveness and water safety management in China. [Conclusions] Tap water in China is an additional route to human drug exposure, especially metronidazole, although it is low risk to human health based on current toxicity data. The proposed framework for drug testing and monitoring can be used for water conservation and risk management in China and elsewhere.