Body burden and health risk of pharmaceuticals in elderly population: A multi-site biomonitoring study in China

中国老年人群药物的身体负担与健康风险：一项多站点生物监测研究

Authors：Fangting Hu, Yi Liu, Xiaoting Liu, Sheng Wang, Liang Ruan, Xuechun Liu, Qi Zhong, Xinsheng Qin, Panzhu Qin, Hanyu Xuan, Fangbiao Tao, Kaiyong Liu

Source：Ecotoxicology And Environmental Safety

PMID: 40480131

DOI: 10.1016/j.ecoenv.2025.118468

Abstract

Evidence suggests that pharmaceuticals (PhACs) are widespread in the environment and may pose a threat to human health. However, limited health risk assessments are available for PhAC exposure in large and multi-site populations, especially among vulnerable populations. To address this gap, we conducted biomonitoring of 46 representative PhACs in urine samples from 3096 older adults. PhAC concentrations, adjusted for urine specific gravity, were used to calculate the estimated daily intake (EDI) and assess associated health risks. All individuals had at least one PhAC detected in their urine, with the detection rates of sulfameter, acetaminophen, metformin, and sulfamonomethoxine exceeding 70%. Median PhAC concentrations ranged from below the limit of detection to 29.79 ng/mL. The EDI values were generally low, with the exception of those of nine PhACs, whose EDI values exceeded 1000 µg/kg/day at the 99th percentile. Total antibiotic exposure posed a health risk in 13.9% of all individuals. Amoxicillin, florfenicol, and ciprofloxacin were major contributors to the potential health risk of gut microbiota disruption. Among the non-antibiotic PhACs, acetaminophen, amantadine, and metformin posed potential health risks to 2.2%, 1.9%, and 0.9% of all individuals, respectively. Overall, this study sheds light on PhAC exposure in older adults across different regions and provides valuable insights that can help with safeguarding their health.

Keywords: Elderly; Health risk assessment; Human biomonitoring; Pharmaceuticals.

摘要：

研究表明，药品（PhACs）在环境中广泛存在，可能对人类健康构成威胁。然而，针对大型多地点人群（尤其是脆弱人群）的PhAC暴露健康风险评估尚不充分。为填补这一空白，我们对3096名老年人的尿液样本进行了46种代表性PhAC的生物监测。调整尿液比重后，使用PhAC浓度计算估计每日摄入量（EDI）并评估相关健康风险。所有受试者尿液中均检测到至少一种PhAC，其中磺胺甲噁唑、对乙酰氨基酚、二甲双胍和磺胺甲噁唑的检出率超过70%。PhAC浓度中位数范围从低于检测限到29.79 ng/mL。EDI值总体较低，但有9种PhAC的EDI值在第99百分位数时超过1000 µg/kg/天。总抗生素暴露对13.9%的受试者构成健康风险。阿莫西林、氟苯尼考和环丙沙星是肠道微生物群紊乱潜在健康风险的主要贡献者。在非抗生素类PhAC中，对乙酰氨基酚、金刚烷胺和二甲双胍分别对2.2%、1.9%和0.9%的个体构成潜在健康风险。总体而言，本研究揭示了不同地区老年人PhAC暴露情况，并提供了有助于保障其健康的宝贵见解。

关键词：老年人；健康风险评估；人体生物监测；药品。