Pharmaceuticals and illicit drugs in environmental waters: A systematic review and quantitative analysis of global trends 2004-2021. Part 1.

Pharmaceuticals and illicit drugs are increasingly recognised as hazardous environmental contaminants, yet global-scale temporal analyses remain limited. This systematic review and quantitative analysis of research published between 2008 and 2021, examines the occurrence of substances across wastewaters and impacted surface waters across six continents and whether temporal patterns coincided with anthropogenic activities and major global events. Significant temporal variations were observed, particularly in Europe and Asia, with notably fluctuations in antibiotics, anti-inflammatories, cardiovascular system medications, cocaine and derivatives, painkillers, and anti-depressants and psychiatric drugs. Higher concentrations of anti-depressants and cardiovascular medications occurred during periods associated with the 2008 Global Financial Crisis, whilst increases in antibiotics and anti-depressants coincided with the SARS-CoV-2 pandemic period. These findings highlight associations between environmental substance occurrence and periods of socioeconomic and public-health disruption and support continuous, geographically inclusive monitoring to improve understanding of long-term temporal patterns.