The Status report on pharmaceuticals in the Baltic Sea region (PDF) was published by UNESCO and HELCOM in 2017. The report was developed jointly by the Baltic Marine Environment Protection Commission (Helsinki Commission, HELCOM) and Policy Area Hazards of the European Union Strategy for the Baltic Sea Region (EUSBSR). It serves as a case study within the framework of UNESCO Emerging Pollutants in Water Series under UNESCO-IHP’s International Initiative on Water Quality (IIWQ) Project on ‘Emerging Pollutants in Wastewater Reuse in Developing Countries’.
Pharmaceuticals included in the report belong to eight therapeutic groups. The available data indicate that the most frequently measured substances in the Baltic Sea marine environment belong to the therapeutic groups of anti-inflammatory and analgesics, cardiovascular agents, and central nervous system agents. Ninety-one percent of the measured pharmaceuticals were detected inMunicipal Waste Water Treatment Plants (MWWTPs), 52% in freshwater and 44% in marine environment.
The main pathway of pharmaceuticals into the freshwater and marine environments, according to the collected data, is via the discharges of MWWTPs effluents. Only nine out of 118 assessed pharmaceuticals were removed from wastewater during the treatment processes with an efficiency over 95%, and nearly half of the compounds were removed with an efficiency of less than 50%. Sixteen compounds were found in higher concentrations in effluents from MWWTP than in influents.
The report includes data on 167 pharmaceutical substances sampled in the marine environment, 111 in surface freshwater systems, and 156 pharmaceutical substances and 2 metabolites in influents, effluents and sludge from municipal wastewater treatment plants. Data were reported by Denmark, Estonia, Finland, Germany, Poland, Russia (St. Petersburg), and Sweden. The data presented in the report cover the period 2003–2014 and include 47,600 individual samples on pharmaceuticals in MWWTPs and freshwater as well as 4,600 individual samples in the coastal, open sea and transitional areas of the Baltic Sea marine environment.
In order to follow up the findings of the Status report, HELCOM decided to establish an expert group (CG Pharma) to provide scientific background for the regional environmental policy regarding pharmaceuticals in the environment and to serve as a platform for regional dialogue for various environmental issues related to pharmaceuticals.
The HELCOM group will cooperate with the Pharmaceuticals in the environment (PIE) – A Baltic Sea Region cooperation platform, launched by Policy Area Hazards of the EU Strategy for the Baltic Sea Region. The cooperation platform is intended to support the implementation of projects and other activities aiming to reduce the emission of pharmaceuticals to the Baltic environment, as well as to support regional policy development and stakeholder cooperation.
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 Anti-inflammatory and analgesics; antimicrobials and antidotes; cardiovascular agents; central nervous system agents; chemotherapeutic agents and x-ray contrast media; dermatological agents; hormones and hormone antagonists and metabolic; gastrointestinal agents.