The prioritization of active pharmaceutical ingredients (APIs) for monitoring programmes and/or environmental risk assessment (ERA) purposes is based on several criteria, including environmental occurrence data. However, data on API occurrence in Brazilian surface freshwaters are still scarce. The Brazilian Unified Health System (SUS) provides several medicines free-of-charge, including medications that have bezafibrate, fluoxetine and levothyroxine as the API. Thus, our objective was to investigate the occurrence of bezafibrate, fluoxetine and levothyroxine in samples collected at sampling sites included in the surface freshwater monitoring program of the São Paulo State Environmental Agency (CETESB); caffeine was also included in the analysis because it is commonly used as an anthropogenic marker of aquatic environment contamination. Monitoring results showed that levothyroxine was not found in any of the analysed samples. Caffeine was ubiquitous in the analysed samples, thus indicating anthropic contamination in the studied water bodies. Caffeine and bezafibrate presented risk quotient (RQ) < 1 for all the sampling sites and periods evaluated in this study. For fluoxetine, RQs > 1 were found in all water samples in which this API was found, indicating a potential risk for freshwater pelagic biota. Thus, fluoxetine should be regulated in São Paulo State in order to protect the aquatic biota. Additional occurrence studies in other Brazilian states are still needed to evaluate if fluoxetine is a nationwide pollutant.
Keywords: Active pharmaceutical ingredients; Contaminants of emerging interest; Liquid chromatography-tandem mass spectrometry; Pelagic biota; Risk quotient.