Summary

Although they are designed to treat illnesses and disease, exposure to pharmaceuticals present in the environment may be a hazard to human health and could enhance the evolution of antimicrobial resistance. This report is the result of a hazard assessment of pharmaceuticals in wastewater, focusing on one of the most hazardous groups of pharmaceuticals – cytotoxic drugs - which are mainly used to treat cancer. More than 60 different cytotoxic drugs were dispensed annually in New Zealand during 2021 and 2022. Twenty-one of these drugs (the target drugs) had more than 5 kg dispensed annually (by mass not potency), and ten of these have been detected in municipal wastewater internationally. They may therefore be present in wastewater in New Zealand, although this would require further assessment. If detected in NZ wastewater, further studies assessing their presence in surface waters, groundwater and/or drinking water may be warranted.