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Quantification, phase distribution, and persistence of antiretroviral drugs in wastewater treatment systems and their ecotoxicological impacts in aquatic environments

Thesis (PhD)--Stellenbosch University, 2026.

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Main Author: Volschenk, Mercia
Other Authors: Wolfaardt, Gideon M.
Format: Thesis
Language:English
Published: Stellenbosch : Stellenbosch University 2026
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access_status_str Open Access
author Volschenk, Mercia
author2 Wolfaardt, Gideon M.
author_browse Volschenk, Mercia
Wolfaardt, Gideon M.
author_facet Wolfaardt, Gideon M.
Volschenk, Mercia
author_sort Volschenk, Mercia
collection Thesis
dc_rights_str_mv Stellenbosch University
description Thesis (PhD)--Stellenbosch University, 2026.
format Thesis
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institution Stellenbosch University (South Africa)
language English
last_indexed 2026-06-10T12:41:26.849Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository
publishDate 2026
publishDateRange 2026
publishDateSort 2026
publisher Stellenbosch : Stellenbosch University
publisherStr Stellenbosch : Stellenbosch University
record_format dspace
source_str SUNScholar — Stellenbosch University Repository
spelling oai:scholar.sun.ac.za:10019.1/135591 Quantification, phase distribution, and persistence of antiretroviral drugs in wastewater treatment systems and their ecotoxicological impacts in aquatic environments Volschenk, Mercia Wolfaardt, Gideon M. Archer, Elize Surujlal-Naicker, Swastika Stellenbosch University. Faculty of Science. Dept. of Microbiology. Thesis (PhD)--Stellenbosch University, 2026. Volschenk, M. 2026. Quantification, phase distribution, and persistence of antiretroviral drugs in wastewater treatment systems and their ecotoxicological impacts in aquatic environments. Unpublished doctoral dissertation. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/1ab03b88-bd51-4ddf-a140-f2c62b6a71e1 South Africa has the world’s largest antiretroviral therapy (ART) programme, treating more than 5.5 million people, which has resulted in high levels of antiretroviral drugs (ARVs) in wastewater and environmental waters. Despite this scale, the occurrence, fate, and ecological effects of ARVs in wastewater treatment plants (WWTPs) and receiving waters remain poorly understood. This study investigated three widely prescribed ARVs, efavirenz (EFZ), emtricitabine (EMT) and nevirapine (NVP), examining their behaviour in conventional activated sludge (CAS) WWTPs and their potential effects on aquatic organisms. Seasonal monitoring of two WWTPs over two years showed consistent detection of all three ARVs in influent and effluent. EMT occurred at the highest concentrations, followed by EFZ and NVP. Reduction efficiencies varied between plants and seasons, with EMT showing the most consistent removal, while EFZ and NVP frequently displayed low or negative values. Multivariate analysis revealed clear seasonal structuring and associations with routine water quality determinants, such as manganese, lead, magnesium, etc., indicating that operational and environmental factors influence ARV behaviour during treatment. Process-level investigations revealed compound-specific phase distributions driven by physicochemical properties: emtricitabine, characterised by high polarity and low sorption affinity, remained predominantly in the aqueous phase, efavirenz exhibited strong sorption to solids, and nevirapine, with intermediate polarity and ionisation behaviour, partitioned between aqueous and solid phases. Pharmaceuticals were not consistently reduced across treatment stages or over time, with negative stage-specific reduction efficiencies reflecting dynamic phase exchanges, including desorption and microbial deconjugation, rather than simple degradation. Ecotoxicological testing using a battery of bioassays revealed variable endocrine responses in yeast-based assays (YES, YAS, YAES and YAAS), low bacterial and algal sensitivity (Aliivibrio fischeri bioluminescence inhibition and Raphidocelis subcapitata algal growth inhibition assays), and stronger effects at higher trophic levels (Daphnia magna immobilisation and Danio rerio fish embryo toxicity tests). Behavioural endpoints, such as changes in zebrafish larval activity, were the most sensitive indicators of ARV impact, identifying effects at concentrations below the detection threshold of standard ecotoxicity assays. These effects were observed at concentrations comparable to those measured in South African surface waters, while conventional mortality and morphological endpoints did not indicate any effects at these levels. The combined findings demonstrate that ARVs persist throughout CAS treatment systems, exhibit compound-specific behaviour, and can exert sub-lethal biological effects at environmentally relevant concentrations. This highlights the limitations of existing treatment infrastructure and the reliance on routine chemical monitoring alone. This research provides evidence-based recommendations for integrating effect-based tools such as behavioural bioassays with chemical monitoring and for applying compound-specific treatment strategies. Although this work was conducted within a South African context, its insights extend to other high-burden regions facing similar challenges. These findings support the development of more effective and proactive approaches to managing pharmaceutical contamination in aquatic environments. Doctoral 2026-04-02T07:21:15Z 2026-04-02T07:21:15Z 2026-03 Thesis https://scholar.sun.ac.za/handle/10019.1/135591 en Stellenbosch University 131 pages application/pdf Stellenbosch : Stellenbosch University
spellingShingle Volschenk, Mercia
Quantification, phase distribution, and persistence of antiretroviral drugs in wastewater treatment systems and their ecotoxicological impacts in aquatic environments
title Quantification, phase distribution, and persistence of antiretroviral drugs in wastewater treatment systems and their ecotoxicological impacts in aquatic environments
title_full Quantification, phase distribution, and persistence of antiretroviral drugs in wastewater treatment systems and their ecotoxicological impacts in aquatic environments
title_fullStr Quantification, phase distribution, and persistence of antiretroviral drugs in wastewater treatment systems and their ecotoxicological impacts in aquatic environments
title_full_unstemmed Quantification, phase distribution, and persistence of antiretroviral drugs in wastewater treatment systems and their ecotoxicological impacts in aquatic environments
title_short Quantification, phase distribution, and persistence of antiretroviral drugs in wastewater treatment systems and their ecotoxicological impacts in aquatic environments
title_sort quantification phase distribution and persistence of antiretroviral drugs in wastewater treatment systems and their ecotoxicological impacts in aquatic environments
url https://scholar.sun.ac.za/handle/10019.1/135591
work_keys_str_mv AT volschenkmercia quantificationphasedistributionandpersistenceofantiretroviraldrugsinwastewatertreatmentsystemsandtheirecotoxicologicalimpactsinaquaticenvironments