Health risk-based prioritization approaches of pharmaceuticals in the Upper Citarum River Basin

Abstract Two methods were developed to prioritize human health risks of pharmaceuticals based on defined daily doses (DDDs) obtained from the WHO and acute toxicity data on pharmaceuticals (TDLo) obtained from the PubChem database. A major advantage of these methods is that it requires no acceptable daily intake (ADI), reference dose (RfD), or tolerable daily intake (TDI) values, which are often unavailable or difficult to obtain for pharmaceuticals group. Both methods were applied to prioritize 16 pharmaceuticals detected by passive samplers in the water source of Ciwalengke Village, a peri-urban area in the Upper Citarum River Basin. Ten out of 16 pharmaceuticals could be prioritized by using both methods. The risk indicator values (RIhum) showed good agreement between the two approaches, especially for Caffeine and Trimethoprim. The priority ranking of Caffeine and Lidocaine were always in the top 3 highest human health risks. The ranking comparison showed considerable consistency, indicating that both prioritization methods are reasonably in line with each other. The pharmaceutical intake through the exposure of contaminated river water was expected to pose negligible human health risks (i.e. RIhum < 1) but can be refined more by conducting supplementary effects studies for other individual pharmaceuticals or pharmaceuticals mixtures.