Occurrence and detection of selected pharmaceuticals of emerging concern: potential risks for aquatic ecosystems and human health

The rising global demand for pharmaceuticals, especially during and after the COVID-19 pandemic, has intensified their presence in aquatic environments. These substances, often inadequately removed by conventional wastewater treatment processes, pose serious risks to aquatic ecosystems and human health due to their persistence, potential for bioaccumulation, and ability to induce antimicrobial resistance. While commonly used pharmaceuticals such as paracetamol and ciprofloxacin have been extensively studied, critical knowledge gaps remain for compounds like azithromycin, dexamethasone, and prednisone, despite their wide therapeutic use. This study presents a comprehensive review of the occurrence, detection techniques, and ecological risks of these three pharmaceuticals of emerging concern. Using literature sourced from peer-reviewed databases including Scopus, Web of Science, and Google Scholar, the review identifies significant gaps in current research, particularly regarding environmental monitoring in aqueous environments, transformation products, and long-term ecotoxicity. The review also discusses the limitations of existing analytical methods in detecting trace levels of these compounds. The scientific value of this work lies in its focus on understudied but environmentally relevant pharmaceuticals, providing a consolidated synthesis of fragmented data, and highlighting the urgent need for improved monitoring strategies. The study underscores the importance of expanding pharmaceutical surveillance to include these compounds and promoting the development of advanced detection technologies. Addressing these gaps is critical for protecting aquatic life, preventing the spread of resistant pathogens, ensuring water quality for human use, and fostering sustainable and resilient environmental management practices.