Pharmaceuticals in the environment: lessons learned for reducing uncertainties in environmental risk assessment.

Pharmaceuticals in the environment are often present at trace levels (e.g., ng/L) in surface waters and effluents of developed countries, yet represent contaminants of emerging concern. Attributes of many of these substances, such as potency, chirality, and ionization, present challenges to historical environmental risk assessment and management paradigms. In this chapter, we critically examine several important aspects of pharmaceuticals, specifically highlighting some of the lessons we have learned from studying these substances in the environment over the past 15 years. We submit that incorporating such "lessons learned" during environmental risk assessments promises to reduce uncertainties and support more sustainable management efforts.