SeweRx: Simulating Baseline Pharmaceutical Concentrations, Mass Loads, and Risk in American Wastewater Across Sewershed Scales

Interventions in waste management may be informed by predicting the concentration of pharmaceuticals entering water resource recovery facilities. This study assembles PharmUse, a database containing consumption data, excretion data, physicochemical properties, fate and transport parameters, and toxicity values for 313 commonly prescribed pharmaceuticals in the United States. PharmUse is used to construct PharmFlush, a model that simulates baseline pharmaceutical concentrations in sewersheds based on sewershed size. PharmFlush predicts pharmaceutical mass loads acceptably for 59% of considered pharmaceuticals, performing comparably to previous models, and additionally predicts trends previously observed in literature. PharmFlush also identifies pharmaceuticals to prioritize based on their concentration and relation to toxicity thresholds. Further analyses postulate the impact of in-sewer processes such as sorption, hydrolysis, and biotransformation, and a simulation demonstrates the utility of SeweRx to wastewater and water reuse operators in a changing regulatory landscape. Overall, SeweRx is an expanding toolbox for operators to enhance pharmaceutical risk management.