Due to a rapidly growing population, increasing water scarcity, and inadequate infrastructure, Indian state/union territories (UT) are forced to divert a significant percentage of domestic human waste untreated to soils, rivers, lakes, and oceans. To determine an initial estimate of the magnitude of this problem, a literature review and subsequent meta-analysis were performed by assessing the mass loadings of pharmaceuticals in human excreta entering Indian watersheds with wastewater and Indian terrestrial environments from open defecation. Publications from 2013- 2017 (<i>n</i> = 11), showed 81 compounds, including antibiotics, analgesics, stimulants, sedatives, and other pharmaceuticals, entering water bodies in 18 cities within 9 Indian states/UT. Integrated of this information with 2011 data on wastewater treatment plant infrastructure and with data from the central pollution control board, we modeled emissions geospatially by region and by mode of human excreta disposal. Preliminary estimates of nationwide loadings to the environment were on the order of several metric tons per day nationwide and ranked in decreasing order from generic pharmaceuticals to antibiotics to stimulant drugs to analgesics and sedatives.  Partially due to differences in both the percentage of open defecation and the percentage wastewater treated, UT Chandigarh (13%; 0%), Lakshadweep (2.2%; ~100%), Daman, Diu and Dadra Nagar Haweli (30%; ~100%) had relatively high loading rates per capita, whereas Maharashtra (47%; 2%), Gujarat (43%; 17%), Sikkim (13%; 66%) and Goa (21%; 50%) had considerably lower ones. Seven of the 35 states and UTs had no wastewater treatment at all (2015 data), and 17 states/UTs had no proposed plan to increase their treatment capacity. Obtained data highlight severe infrastructure needs and can serve to inform estimates of surface water quality; furthermore, they may aid in interpreting geospatial differences in disease prevalence in India as a function of discharges of untreated sewage and the extent of open defecation.<br/>

Meta-analysis of nationwide loadings of pharmaceuticals to Indian aquatic and terrestrial environments from human excreta

2019 Fall National Meeting

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