Lipid regulators

Lipid regulators are ordinarily applied drugs in clinical practice, and they are used to lower the level of cholesterol and regulate the metabolism of lipids. Clara et al. [13] detected a lipid regulator bezafibrate at concentrations up to 7.6 pg L although normally they are found at lower nanograms per liter range [8,18,21,22]. 

Lipid regulators gemfibrozil and bezafibrate frequently detected in wastewaters are reported to be eliminated in WWTPs with 46-69% [51] and 36-54% [13]. On the other side, clofibric acid was reported to be refractory pollutant for municipal WWTPs [22]. 

The results showed that the compounds studied with more frequency in the aquatic environment, and of which, logically, there is more information, are the antibiotics, analgesics and anti-inflammatories (like diclofenac, ibuprofen, naproxen, acetylsalicylic acid, and paracetamol), as well as the p-blocker atenolol. In the category of antibiotics, several families are included, like the macrolides (erythromycin), the fluoroquinolones (ofloxacin and ciprofloxacin), sulfonamides (sulfamethoxazole), penicillins (amoxicillin), the metronidazol, and trimethoprim. Other therapeutic groups also widely studied and frequently found in the environmental waters are the lipid regulators (gemfibrozil and bezafibrat), antiepileptic carbamaze-pine, and antidepressants (diazepam, fluoxetine, paroxetine) (see Table 3). 

Fig. 4 Concentrations (ng L ) of the most ubiquitous analgesics and anti-inflammatories, lipid regulators, psychiatric drugs and [I-blockers detected in (a) wastewater effluents and (b) river water downstream of the three WWTP in the Ebro river basin in relationship to the dilution factor...

The lipid regulator drugs bezafibrate and fenofibrate at initial concentrations of 4.5 and 4.2 ng g-1 in sterile sludge were completely removed after the fungal treatment. The fate of fenofibrate, also present in non-sterile sludge, was the same. Meanwhile, the most abundant atorvastatin, a cholesterol lowering statin, decreased its concentration in 80% and 65% in sterile and non-sterile conditions, respectively. 

Lipid regulator Clofibric acid I. lacteus Cultures were incubated in 10 mg L-1 Low degradation [3]... 

To sum up, it could be concluded, in a general extent, that risks are expected to be higher in areas with lower river flow and that compounds found to induce major hazards coincide with the ones found at the highest concentrations, such as the NSAIDs ibuprofen, diclofenac, naproxen and acetaminophen, lipid regulators, and antibiotics. 

Metabolite of pharmaceutical compound (blood lipid regulator)... 

The reaction of the lipid-regulator gemfibrozil with free chlorine yielded four chlorinated derivatives of this compound [94]. Chlorination of acetaminophen (paracetamol) generated 11 discernible DBFs, including the toxic compounds 1,4-benzoquinone and A-acetyl-p-benzoquinone imine and two ring chlorination products, chloro-4-acetamidophenol and dichloro -acetamidophenol [95]. 

Krkosek WH, Koziar SA, White RL, Gagnon GA (2011) Identification of reaction products from reactions of free chlorine with the lipid-regulator gemfibrozil. Water Res 45 1414-1422... 

Conventional wastewater treatment plants (WWTPs) were not designed for an efficient APIs removal. The sludge retention time (SRT) is one of the crucial parameters, which influence on the design, operation and control of WWTPs. APIs can be divided into three major groups compounds with optimum SRT range for which their removal is the most effective (e.g., antibiotics and antiinflammatories), compounds on which SRT has no impact (e.g., anticonvulsants, p-blockers and hormones), compounds with visible influence of SRT on their removal rate (e.g., lipid regulators) [43]. 

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