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Paltiel, 2016 Human Exposure to Wastewater-Derived Pharmaceuticals in Fresh Produce: A Randomized Controlled Trial Focusing on Carbamazepine

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Personal commentary: This study raises an alarm due to the growing problems with how the world is getting water not only for drinking, but also for crop irrigation. I took carbamazepine (Tegretol) as a mood stabilizer for over a decade and was taken off with a rapid taper after my white blood cell count suddenly dropped dangerously low. This is not a benign side effect and having any amount of this type of toxic drug in our food and water supply should not be taken lightly.


Environ Sci Technol. 2016 Apr 19;50(8):4476-82. doi: 10.1021/acs.est.5b06256. Epub 2016 Apr 7

Human Exposure to Wastewater-Derived Pharmaceuticals in Fresh Produce: A Randomized Controlled Trial Focusing on Carbamazepine

Paltiel O1,2,3, Fedorova G3,4, Tadmor G1,3,4, Kleinstern G1,3, Maor Y3, Chefetz B3,4.


Abstract at: http://www.ncbi.nlm.nih.gov/pubmed/?term=Human+Exposure+to+Wastewater-Derived+Pharmaceuticals+in+Fresh+Produce%3A+A+Randomized+Controlled+Trial+Focusing+on+Carbamazepine


Fresh water scarcity has led to increased use of reclaimed wastewater as an alternative and reliable source for crop irrigation. Beyond microbiological safety, concerns have been raised regarding contamination of reclaimed wastewater by xenobiotics including pharmaceuticals. This study focuses on carbamazepine, an anticonvulsant drug which is ubiquitously detected in reclaimed wastewater, highly persistent in soil, and taken up by crops. In a randomized controlled trial we demonstrate that healthy individuals consuming reclaimed wastewater-irrigated produce excreted carbamazepine and its metabolites in their urine, while subjects consuming fresh water-irrigated produce excreted undetectable or significantly lower levels of carbamazepine. We also report that the carbamazepine metabolite pattern at this low exposure level differed from that observed at therapeutic doses. This "proof of concept" study demonstrates that human exposure to xenobiotics occurs through ingestion of reclaimed wastewater-irrigated produce, providing real world data which could guide risk assessments and policy designed to ensure the safe use of wastewater for crop irrigation.

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