Concentrations and mass loadings of cardiovascular pharmaceuticals in healthcare facility wastewaters.

Healthcare facilities are an under-characterized source of pharmaceuticals to municipal wastewaters. In this study, the composition and magnitude of sixteen cardiovascular active pharmaceutical ingredients (APIs) and two cardiovascular API metabolites in wastewater effluents from a hospital, nursing care, assisted living, and independent living facility are presented. Each cardiovascular API was detected in at least one facility's wastewater. The hospital's wastewater had the most detected cardiovascular APIs with thirteen of the eighteen measured compounds positively confirmed and quantified. Maximum mean analyte concentrations within each healthcare facility's wastewater were: 11.3 µg L(-1) atenolol for the independent living facility; 8.7 µg L(-1) valsartan for the assisted living facility; 2.7 µg L(-1) diltiazem for the nursing home facility; and 14.6 µg L(-1) valsartan for hospital facility. Daily wastewater flow was combined with individual concentrations to estimate the cardiovascular API mass loadings leaving each facility through wastewater discharges to the municipal sewer system. The estimated daily mass loading of all measured cardiovascular APIs ranged from 0.87 g per day at the assisted living facility to 12.5 g per day at the hospital. The combined loading for all four facilities was 16.2 g per day. This presented research informs the risk management process by providing source characterization data for healthcare facility wastewaters containing commonly prescribed cardiovascular APIs.