Wastewater-based epidemiology (WBE) is considered as an effective tool for monitoring drug consumption, which is often obtained by back-calculation using the influent concentration and other parameters of wastewater treatment plants . Lack of information on the transformation of drugs in municipal wastewater and sewers may lead to inaccurate consumption estimation. Fourteen prescription drugs in four major categories of diseases (cardiovascular, diabetes, depression, and asthma) were selected to study their adsorption and biodegradation in wastewater and biofilm sewers under different temperatures, pH and biofilms conditions. The result demonstrated that the decay percentage of drugs in wastewater is increased with temperature. Within 72 h, eleven of these 14 drugs, such as metformin, metoprolol, bezafibrate, etc., have decay percentages below 20% in wastewater, which are considered as stable drugs; and the decay percentages of the other three, monluster, paroxetine, and sertraline, are greater than 20%, which are the most unstable drugs. In lab-scale aerobic and anaerobic sewers, the decay percentages of metformin, glipizide, metoprolol, gemfibrozil, and atorvastatin are less than 20% within 24 h. The decay percentages of venlafaxine, citalopram, fluoxetine, salmeterol, and salbutamol within 24 h are 20%–60% and paroxetine and sertraline are close to or even exceed 80% within 6 h. Biodegradation of drugs in sewers with aerobic or anaerobic biofilms is higher than that in wastewater systems without biofilms. The results showed that when the per capita consumption of drugs is estimated by using the WBE method, the stability of drugs in wastewater and different types of sewers will significantly affect their residual concentrations.
Identifying the attenuation characteristics of drugs in sewage and sewers is one of the important factors to improve the accuracy of wastewater-based epidemiology (WBE) application. In this study, 28 drugs including antidepressants, cardiovascular drugs, antihistamines, anticonvulsants and some of their human metabolites were chosen as the targets to study the hydrolysis , adsorption, and biodegradation at different temperatures in sewage and sewers. The interaction between drugs degradation and community structure of biofilm was also investigated. In the simulated sewers, the removal percentages of 12 parent or drug metabolites are 0–20%, such as demethylvenlafaxine, fluvoxamine, etc., which are highly stable chemicals and suitable to be chosen as biomarkers for WBE back-calculation under appropriate circumstances. Fourteen drugs including venlafaxine and citalopram have removal percentages of 20–60%. While paroxetine and sertraline, with removal percentage of 100%, are the most unstable and cannot be used as biomarkers. Among the 28 drugs, there are 25 drugs that have a higher loss rate in the aerobic sewer than that in the anaerobic sewer in this study. During drug exposure in anaerobic biofilms, species abundance first decreased and then increased. Species abundance and diversity in aerobic biofilm generally showed a decreasing trend. In addition, Proteobacteria and Spirochaetota were the dominant phyla in both sewers.