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Human Exposure to Wastewater-Derived Pharmaceuticals in Fresh Produce: A Randomized Controlled Trial Focusing on Carbamazepine

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† Braun School of Public Health and Community Medicine, Hadassah-Hebrew University of Jerusalem, Jerusalem 9112001, Israel
‡ Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel
§ The Hebrew University Center of Excellence in Agriculture and Environmental Health
∥ Department of Soil and Water Sciences, Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel
*E-mail: [email protected]
Cite this: Environ. Sci. Technol. 2016, 50, 8, 4476–4482
Publication Date (Web):March 29, 2016
https://doi.org/10.1021/acs.est.5b06256
Copyright © 2016 American Chemical Society
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    Fresh water scarcity has led to increased use of reclaimed wastewater as an alternative and reliable source for crop irrigation. Beyond microbiological safety, concerns have been raised regarding contamination of reclaimed wastewater by xenobiotics including pharmaceuticals. This study focuses on carbamazepine, an anticonvulsant drug which is ubiquitously detected in reclaimed wastewater, highly persistent in soil, and taken up by crops. In a randomized controlled trial we demonstrate that healthy individuals consuming reclaimed wastewater-irrigated produce excreted carbamazepine and its metabolites in their urine, while subjects consuming fresh water-irrigated produce excreted undetectable or significantly lower levels of carbamazepine. We also report that the carbamazepine metabolite pattern at this low exposure level differed from that observed at therapeutic doses. This “proof of concept” study demonstrates that human exposure to xenobiotics occurs through ingestion of reclaimed wastewater-irrigated produce, providing real world data which could guide risk assessments and policy designed to ensure the safe use of wastewater for crop irrigation.

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    • Recovery values for the analytes for different plants (Figure S1); concentrations of carbamazepine and metabolites in produce samples irrigated with reclaimed wastewater (Figure S2); urinary carbamazepine levels in all participants throughout the trial (Figure S3); study population characteristics (Table S1); and water content in produce (Table S2) (PDF)

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