Flows of Active Pharmaceutical Ingredients Originating from Health Care Practices on a Local, Regional, and Nationwide Level in Germany—Is Hospital Effluent Treatment an Effective Approach for Risk Reduction?

Alder, A. C., McArdell, C. S., Golet, E. M., Kohler, H.-P. E., Molnar, E., Ngoc Anh Pham, T., et al. (2004). Environmental exposure of antibiotics in wastewaters, sewage sludges and surface waters in Switzerland. In K. Kümmerer (Ed.), Pharmaceuticals in the environment: Sources, fate, effects and risks (2nd ed., pp. 55–65). Heidelberg: Springer.

Alexy, R., Sommer, A., Lange, F. T., & Kümmerer, K. (2006). Local use of antibiotics and their input and fate in a small sewage treatment plant—Significance of balancing and analysis on a local scale vs. nationwide scale. Acta Hydrochimica et Hydrobiologica, 34, 587–592.

Bager, F., & Emborg, H.-D. (2001). DANMAP 2000. Consumption of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from food animals, foods and humans in Denmark. Copenhagen.

Calamari, D., Zuccato, E., Castiglioni, S., Bagnati, R., & Fanelli, R. (2003). Strategic survey of therapeutic drugs in the rivers Po and Lambro in northern Italy. Environmental Science & Technology, 37, 1241–1248.

Castiglioni, S., Fanelli, R., Calamari, D., Bagnati, R., & Zuccato, E. (2004a). Methodological approaches for studying pharmaceuticals in the environment by comparing predicted and measured concentrations in River Po, Italy. Regulatory Toxicology and Pharmacology, 39, 25–32.

Castiglioni, S., Zuccato, E., & Calamari, D. (2004b). Comparison of the concentrations of pharmaceuticals in STPs and rivers in Italy as a tool for investigating their environmental distribution and fate. Paper presented at the SETAC Europe 14th Annual Meeting, Prague.

European Federation of Animal Health (FEDESA) (2001). Antibiotic use in farm animals does not threaten human health. FEDESA/FEFANA Press release Brussels, 13 July 2001.

Goossens, H., Ferech, M., Coenen, S., & Stephens, P. (2005). European surveillance of antimicrobial consumption project group. Comparison of outpatient systemic antibacterial use in 2004 in the United States and 27 European countries. Clinical Infectious Diseases, 44, 1091–1095.

Götz, K., & Keil, F. (2007). Medikamentenentsorgung in privaten Haushalten: Ein Faktor bei der Gewässerbelastung mit Arzneimittelwirkstoffen? UWSF, 19, 180–188.

Guardabassi, L., & Dalsgaard, A. (2001). Occurrence and fate of antibiotic resistant bacteria in sewage. Environmental Project No. 722002 Miljøprojekt. Danish Environmental Protection Agency.

Günther, J., Kern, W. V., Nink, K., Schröder, H., & de With, K. (2003). Solange sie noch wirken. Kommentare und Analysen zum Antibiotikaverbrauch in Deutschland. Bonn and Freiburg: Wissenschaftliches Institut der AOK (WldO) and Universitätsklinikum Freiburg.

Hädrich, C. (2006). Thesis, Universität Freiburg.

Haiß, A. (2001). Thesis, Humboldt Universität Berlin.

Heberer, T. (2002). Occurrence, fate, and removal of pharmaceutical residues in the aquatic environment: a review of recent research data. Toxicology Letters, 131, 5–17.

Heberer, T., & Feldmann, D. (2005). Contribution of effluents from hospitals and private households to the total loads of diclofenac and carbamazepine in municipal sewage effluents—Modeling versus measurements. Journal of Hazardous Materials, 122(3), 211–218.

Heinzmann, B., Schwarz, R.-J., & Pineau, C. (2006). Getrennte Erfassung von jodorganischen Röntgenkontrastmitteln in Berliner Krankenhäusern und deren Transformation. Paper presented at the Workshop: Getrennte Erfassung von jodorganischen Röntgenkontrastmitteln in Berliner Krankenhäusern und deren Transformation, Berlin, March.

Henninger, A., & Kümmerer, K. (2003). Promoting resistance by the emission of antibiotics from hospitals and households into effluent. Clinical Microbiology and Infection, 9, 1203–1214.

Kolpin, D., Furlong, E. T., Meyer, M. T., Thurman, E. M., Zaugg, S. D., & Barber, L. B. (2002). Pharmaceuticals, hormones, and other organic wastewater contaminants in U.S. streams, 1999–2000: A national reconnaissance. Environmental Science & Technology, 36, 1202–1211.

Kümmerer, K. (2001). Drugs, diagnostic agents and disinfectants in waste water and water—A review. Chemosphere, 45, 957–969.

Kümmerer, K. (2007). Sustainable from the very beginning: rational design of molecules by life cycle engineering as an important approach for green pharmacy and green chemistry. Green Chemistry, 9, 899–907.

Kümmerer, K. (Ed.) (2008). Pharmaceuticals in the environment: sources, fate, effects and risks (3rd ed.). Heidelberg: Springer.

Kümmerer, K., & Helmers, E. (2000). Hospital effluents as a source of gadolinium in the aquatic environment. Environmental Science & Technology, 34, 573–577.

Kümmerer, K., & Hofmeister, S. (2008). Sustainability, substance flow management and time. Part I Temporal analysis of substance flows. Journal of Environmental Management 88(4), 1333–1342.

Kümmerer, K., Steger-Hartmann, T., & Meyer, M. (1997). Biodegradability of the anti-tumour agents ifosfamide and its occurrence in hospital effluents and communal sewage. Water Research, 31, 2705–2710.

Miao, X.-S., Bishay, F., Chen, M., & Metcalfe, C. D. (2004). Occurrence of antimicrobials in the final effluents of waste water treatment plants in Canada. Environmental Science & Technology, 38, 3533–3541.

Ministerie van Verkeer en Waterstaat (Ed.) (2003). Humane en veterinaire geneesmiddelen in Nederlands oppervlaktewater en afvalwater. RIZA rapport 023, Leylstadt.

Nikolaou, A., Meric, S., & Fatta, D. (2007). Occurrence patterns of pharmaceuticals in water and wastewater environments. Analytical and Bioanalytical Chemistry, 387, 1225–1234.

Ongerth, J. E., & Khan, S. (2004). Drug residuals: How xenobiotics can affect water supply sources. Journal of AWWA, 98, 94–101.

Rönnefahrt, I. (2005). Verbrauchsmengen in der Bewertung des Umweltrisikos von Humanarzneimitteln, In: Umweltbundesamt (Hrsg.). Arzneimittel in der Umwelt – Zu Risiken und Nebenwirkungen fragen Sie das Umweltbundesamt. Dessau, UBA-Texte 29/05.

Sacher, F., & Stoks, P. G. (2003). Pharmaceutical Residues in Waters in the Netherlands. Results of a monitoring programme for RIWA. Nieuwegein.

Sattelberger, S. (1999). Arzneimittelrückstände in der Umwelt, Bestandsaufnahme und Problemstellung. Report des Umweltbundesamtes Österreich, Wien.

Schulte-Oehlmann, U., Oehlmann, J., & Püttmann, W. (2007). Arzneimittelwirkstoffe in der Umwelt – Einträge, Vorkommen und der Versuch einer Bestandsaufnahme. UWSF, 19, 168–179.

Schuster, A., & Kümmerer, K. (2008). Umweltrisikobewertung von Zytostatika. Unpublished report, Freiburg 2008.

Schwabe, U., & Paffrath, D. (2006). Arzneiverordnungs-Report 2006. In U. Schwabe, & D. Paffrath (Eds.), Aktuelle Daten, Kosten, Trends und Kommentare. Heidelberg: Springer.

Union of Concerned Scientists (2001). 70 percent of all antibiotics given to healthy lifestock. Press Release, 8 January. Cambridge, MA.

Verbrugh, H. A., & de Neeling, A. J. (Eds.) (2003). Consumption of antimicrobial agents and antimicrobial resistance among medically important bacteria in the Netherlands. SWAB NETHMAP.

Wise, R. (2002). Antimicrobial resistance: Priorities for action. Journal of Antimicrobial Chemotherapy, 49, 585–586.

Zuccato, E., Calamari, D., Natangelo, M., & Fanelli, R. (2000). Presence of therapeutic drugs in the environment. Lancet, 355, 1789–1790.