Occurrence and\nRemoval Efficiency of Active Pharmaceutical\nIngredients (APIs) in Wastewater Treatment Plants: A Systematic Review\nfrom Southeast Asia

Active Pharmaceutical Ingredients\n(APIs) in the aquatic\nenvironment\nhave become a growing concern due to their potential health and environmental\nimpacts. The review aims to examine the occurrence and removal efficiency\nof APIs in the influent and effluent of wastewater treatment plants\n(WWTPs) in Southeast Asian countries, including Thailand, Singapore,\nMalaysia, Indonesia, Vietnam, and the Philippines. The review covers\nfive classes of APIs, i.e., nonsteroidal anti-inflammatory drugs (NSAIDs),\nantibiotics, anticonvulsants, antihypertensives, and stimulants. We\nsystematically scoured Scopus-indexed articles published from 2011\nto 2022 from Google Scholar, PubMed, and Dimensions and extracted\nmeasured concentrations of APIs detected in WWTPs. The wastewater\ninfluent contained the following APIs from each class in the highest\nmean or median concentrations: paracetamol (mean: 26,000 ng/L), ciprofloxacin\n(mean: 567.4 ng/L), gabapentin (median: up to 3609 ng/L), atenolol\n(median: up to 4124 ng/L), and caffeine (mean: 38,000 ng/L). Moreover,\nstudies in Singapore have recorded the highest treatment efficiency\non various APIs compared to those recorded in Malaysia, Thailand,\nor Vietnam. This study underscores the importance of implementing\nstandardized monitoring techniques, enhancing wastewater infrastructure,\nand raising awareness among parties involved to address the environmental\nhazards linked to pharmaceutical pollution effectively.