Tabla de Contenidos:
  • 1. Environmental Contaminants and Health Care: An Introduction / Rai S. Kookana
  • 2. Environmental Contamination From Health-Care Facilities / Tiago S. Oliveira
  • Introduction
  • PPCPs in Health Care Facilities Effluents
  • PPCPs in WWTPs
  • Municipal WWTPs
  • Hospital Effluent
  • Other Treatment Options
  • PPCPs Emission and Ecological Risks
  • Conclusion
  • References
  • 3. Fate and Behavior of Environmental Contaminants Arising From Health-Care Provision / Rai S. Kookana
  • Introduction
  • Environmental Fate Processes
  • Physicochemical Properties of Healthcare Contaminants
  • Receiving Environments
  • Aquatic Environment
  • Fate Processes Impacting Wastewater Treatment
  • Fate in the Aquatic Ecosystem
  • Terrestrial Environment
  • Fate in the Terrestrial Ecosystem
  • Wastewater and Biosolids Application on Land
  • Atmosphere
  • Disposal of Poorly Treated Healthcare Waste
  • Conclusions
  • References
  • 4. Ecotoxicological Perspectives on Health Care and the Environment / W. Baylor Steele
  • Health care and the Environment: Pharmaceuticals are Indicators of Urbanization
  • Historical Bioaccumulation and Ecotoxicology Tools: Inadequate for Pharmaceuticals?
  • Ecotoxicology During Retrospective Studies of Water Quality
  • Bioaccumulation During Prospective Studies of Chemicals
  • Ecotoxicity during Prospective Studies of Chemicals
  • Emerging Ecotoxicology Approaches for Studying Health-care Impacts
  • Biological Read-Across, Fish Plasma Modeling and Behavioral Ecotoxicology
  • Ecotoxicology and Bioaccumulation Approaches to Study Medicines in the Environment
  • Ecotoxicology Outlook for Medicines: Opportunities to Advance Sustainability Science?
  • Acknowledgments
  • References
  • Further Reading
  • 5. Terrestrial Ecotoxicity / Chad A. Kinney
  • Introduction of Health-Care Products into Terrestrial Environments
  • Regulatory and Technical Aspects of Health-Care Products in the Terrestrial Environment
  • Soil Invertebrate (Earthworm) Toxicity
  • Plant Toxicity
  • Outlook and Future Research Needs
  • References
  • 6. Environmental Contaminants of Health-Care Origin: Exposure and Potential Effects in Wildlife / Barnett A. Rattner
  • Introduction
  • Sources of Health-care Contaminants and Exposure Pathways for Wildlife
  • Aquatic Environment
  • Terrestrial Environment
  • Current Knowledge of Exposure, Hazard and Risks of Contaminants of Health-care Origin
  • Mammals
  • Birds
  • Reptiles and Amphibians
  • Approaches for Characterizing Exposure, Hazard and Risk Posed by Contaminants From Health care to Wildlife
  • Exposure Assessment
  • Hazard Assessment: Empirical Data and the Use of Read-Across From Preclinical and Clinical Drug Trials
  • Risk
  • Future Priorities
  • Exposure Assessment
  • Hazard Assessments
  • Exposure and Risk of APIs to Wildlife in Developing Countries
  • Novel Ideas and Thinking Outside of the Box
  • Do Wildlife Act as Vectors for the Transfer of Antimicrobial Resistance?
  • Conclusions
  • Acknowledgments
  • References
  • 7. Pharmaceuticals in the Environment and Human Health / Alistair B.A. Boxall
  • Introduction
  • Routes of Human Exposure to Pharmaceuticals in the Environment
  • Toxicological Risks of Pharmaceutical Residues in the Environment
  • Potential Indirect Effects of Pharmaceutical Residues on Human Health and Well-being
  • Research Needs
  • References
  • Further Reading
  • 8. Antibiotics and Antibiotic Resistance: Closing the Loop Between Hospitals and the Environment / Amy Pruden
  • What are Antibiotics?
  • What is Antibiotic Resistance?
  • How to Combat Antibiotic Resistance
  • Antibiotic Resistance Genes as Environmental "Contaminants"
  • Opportunities to Mitigate the Spread of Antibiotic Resistance via the Water Cycle
  • "Hot-Spot" Treatment at Hospitals
  • Wastewater Treatment Plants and Recycled Water
  • Agricultural Practices
  • Aquaculture
  • Antibiotic Manufacturing
  • Closing Thoughts
  • References
  • Further Reading
  • 9. Antimicrobial Use and Ecotoxicological Risks from Pandemics and Epidemics / Andrew C. Singer
  • Introduction
  • Case Study: Influenza Pandemic 2009
  • Secondary Bacterial Infections
  • Environmental Relevance of Medical Response
  • Preparing for the Next Pandemic
  • Special Cases of Mosquito Transmission
  • Known and Unknown Unknowns
  • Pandemics of Chronic Diseases
  • Conclusion
  • References
  • 10. Management of Waste from the Health-Care Sector / Amy Wolff
  • Need for Healthcare Waste Management
  • Defining "Healthcare" Waste
  • UK Definition of Healthcare Waste
  • Healthcare Waste Management in Economically Less Developed Countries
  • Basics of Healthcare Waste Management
  • Options for Healthcare Waste Treatment and Disposal
  • Landfill
  • Destruction Processes
  • Low Temperature Sterilization Processes
  • Legislative Framework of the Healthcare Waste Sector in the United Kingdom
  • Global Dimension
  • How European Legislation Works in the United Kingdom and Implications for Brexit
  • UK Regulatory Authorities
  • Applying the Waste Hierarchy in the Healthcare Sector
  • Circular Economy Approach
  • "Duty of Care" Principle
  • Classifying a Waste Using the European Waste Catalogue
  • Color Coding of Waste Containers
  • Research and Laboratory Wastes
  • Environmental Permitting and Waste Management Licensing
  • Conclusions
  • Legislation Shaping and Creating a Healthier Healthcare Waste Sector
  • References
  • Further Reading
  • 11. Stewardship Approaches to Reducing Health-Care Contaminants / Karin P.M. Helwig
  • Introduction
  • Environmental Stewardship
  • Medicinal Product Chain
  • Legislative Context of Healthcare Contaminants
  • Current Legislation
  • Stewardship at Regulatory Level
  • Stewardship Approaches along the Medicinal Product Chain
  • Product Design and Production
  • Manufacturing
  • Healthcare Sector
  • Wasted Pharmaceuticals
  • Source Segregation of Urine
  • Wastewater Treatment
  • Discussion
  • Conclusion
  • References
  • 12. Management of Environmental Contaminants From Health Care: Sustainable Pharmacy / Klaus Kummerer
  • Introduction
  • Sustainable Chemistry and Pharmacy
  • End of the Pipe's End
  • New Business Models
  • Stakeholders
  • Benign by Design
  • References
  • Further Reading
  • 13. Policy, Regulations, and Risk Assessment / David Taylor
  • Introduction
  • Pharmaceutical Manufacturing
  • Pharmaceutical Use
  • Regulatory Frameworks
  • Regulatory ERA and EA Approaches
  • Risk Management
  • Environmental Legislation
  • Relationship Between Medicines and Environmental Legislation
  • Unused and Life Expired Medicines
  • References
  • Further Reading.