What do we know about the ecotoxicology of pharmaceutical and personal care product mixtures? A critical review

ABSTRACT

No uniform regulation for risk assessment of pharmaceutical and personal care products (PPCP) mixtures is currently available. Hence, a large diversity of strategies can be used for studying cocktail effects of PPCP, which makes difficult the task of incorporating this challenging issue into regulatory frameworks. This review provides an updated state of knowledge on the ecotoxicity of PPCP mixtures, including 194 assessments of the toxicity of mixtures from 65 articles published during 2000–2017. The misunderstandings, deficiencies and data gaps identified from those studies were critically discussed based on the models/tools used to predict/assess the joint effects and the interpretation and presentation of the effect profiles, the experimental designs used, the qualitative and quantitative composition of the PPCP mixtures and the type of bioassays performed regarding test duration, endpoints and levels of biological organization. Possible approaches pointed out in the literature to deal with the identified critical issues were also discussed. Overall, we have identified that further advances in this field of research still lack robust and consistent studies regarding the experimental design and the approaches and terminologies used to calculate, interpret and report the joint effects.

KEYWORDS:

• Experimental designs
• non-additive interaction
• synergism

Conflict of interest

The authors declare that they have no conflict of interest

Acknowledgments

The authors gratefully acknowledge professor Dr. John Sumpter (Brunel University, UK) for his very constructive suggestions for improving the reference dataset and for his kind readiness to revise the English language of this paper.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.