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This study investigated the occurrence of 12 pharmaceuticals (PhCs) in surface water in Central Italy, aiming to improve the estimation of the predicted environmental concentration (PEC) by normalizing the loads to the number of inhabitants of the drainage system in rural, periurban, and urban areas. We performed two sampling campaigns assessing the concentration of PhCs (measured environmental concentration (MEC)) in surface water and in effluent from a wastewater treatment plant. The reliability of PEC calculated by the refined formula was assessed and compared to the ratio obtained by the unrefined formula. MECs of diclofenac, estradiol, estrone, ibuprofen, metformin, naproxen, sulfamethoxazole, atenolol, carbamazepine, and dehydro-erythromycin were significantly higher in urban than in periurban and rural areas, and increases were 12-, 3600-, 256-, 33-, 18-, 120-, 10-, 5-, 2-, and 1-fold, respectively. Refinement of PEC improved estimation of PhC concentrations for all areas, especially for the urban one. The environmental risk was predicted as low for atenolol, carbamazepine, erythromycin, metformin, and naproxen; low/medium for diclofenac and ibuprofen; and high for clarithromycin, estradiol, estrone, and sulfamethoxazole. Overall, the highest risk was posed by PhCs in effluent, while a progressively decreasing risk was estimated for urban, periurban, and rural areas.

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Predicted and Measured Concentration of Pharmaceuticals in Surface Water of Areas with Increasing Anthropic Pressure: A Case Study in the Coastal Area of Central Italy