Are the increasing amounts of gadolinium in surface and tap water dangerous?

Thomsen, Henrik S.

doi:10.1177/0284185116666419

Cited by 51 publications

(24 citation statements)

References 27 publications

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“…London, and Prague [Thomsen 2017]), sediments, soil, and even living organisms. The determined concentration of Gd ant in surface water and tap water was fairly low (highest levels of 200-1100 and 30 ng/L, respectively).…”

Section: Discussionmentioning

confidence: 99%

Gadolinium as a new emerging contaminant of aquatic environments

Rogowska

Olkowska²,

Ratajczyk³

et al. 2018

Enviro Toxic and Chemistry

165

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Since the 1980s, gadolinium (Gd)-based contrast agents (GBCAs) have been routinely used in magnetic resonance imaging as stable chelates of the Gd ion, without toxic effects. Generally, GBCAs are considered some of the safest contrast agents. However, it has been observed that they can accumulate in patient tissue, bone, and probably brain (causing nephrogenic systemic fibrosis in patients with kidney failure or insufficiency and disturbance of calcium homeostasis in the organism). The GBCAs are predominantly removed renally without metabolization. Subsequently, they do not undergo degradation processes in wastewater-treatment plants and are emitted into the aquatic ecosystem. Their occurrence was confirmed in surface waters (up to 1100 ng/L), sediments (up to 90.5 μg/g), and living organisms. Based on a literature review, there is a need to investigate the contamination of different ecosystems and to ascertain the environmental fate of Gd. Long-term ecotoxicological data, degradation, metabolism, bioaccumulation processes, and biochemical effects of the Gd complexes should be explored. These data can be used to assess detailed environmental risks because currently only hotspots with high levels of Gd can be marked as dangerous for aquatic environments according to environmental risk assessments. Environ Toxicol Chem 2018;37:1523-1534. © 2018 SETAC.

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Section: Discussionmentioning

confidence: 99%

Gadolinium as a new emerging contaminant of aquatic environments

Rogowska

Olkowska²,

Ratajczyk³

et al. 2018

Enviro Toxic and Chemistry

165

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“…The figures for patients who undergo MRI exams and the global administration of Gd-CAs will continue to grow because of the increasing number of available MRI scanners worldwide. Therefore, a large and continuously increasing amount of Gd enters the aqueous environment and enriches Gd over LAs more and more [93]. However, there is no standard for Gd-CAs that regulates their concentrations in sewage effluents or receiving water bodies, partly because of the insufficient knowledge about the ecological effects of LAs [1].…”

Section: Anthropogenic Gd (Gd Anth )mentioning

confidence: 99%

“…In addition, Gd 3+ regularly binds with a higher affinity than Ca 2+ and competes with Ca 2+ in physiological processes [165], resulting in a decrease of neuromuscular transmission, and interference in both intracellular enzymes and cell membrane processes through the transmetalation process [166,167]. Human beings would not survive 0.1 mmol/kg free Gd (e.g., GdCl 2 ) being injected into circulation [93].…”

Section: Human Health Risks Of Gd Anthmentioning

confidence: 99%

Gadolinium as an Emerging Microcontaminant in Water Resources: Threats and Opportunities

Ebrahimi

Barbieri

2019

Geosciences

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As a result of high doses of paramagnetic gadolinium (Gd) chelates administered in magnetic resonance imaging (MRI) exams, their unmetabolized excretion, and insufficient removal in wastewater treatment plants (WWTPs), large amounts of anthropogenic Gd (Gdanth) are released into surface water. The upward trend of gadolinium-based contrast agent (Gd-CA) administrations is expected to continue growing and consequently higher and higher anthropogenic Gd concentrations are annually recorded in water resources, which can pose a great threat to aquatic organisms and human beings. In addition, the feasibility of Gd retention in patients administered with Gd-CAs repeatedly, and even potentially fatal diseases, including nephrogenic systemic fibrosis (NSF), due to trace amounts of Gd have recently arisen severe health concerns. Thus, there is a need to investigate probable adverse health effects of currently marketed Gd-CAs meticulously and to modify the actual approach in using Gd contrast media in daily practice in order to minimize unknown possible health risks. Furthermore, the employment of enhanced wastewater treatment processes that are capable of removing the stable contrast agents, and the evaluation of the ecotoxicity of Gd chelates and human exposure to these emerging contaminants through dermal and ingestion pathways deserve more attention. On the other hand, point source releases of anthropogenic Gd into the aquatic environment presents the opportunity to assess surface water—groundwater interactions and trace the fate of wastewater plume as a proxy for the potential presence of other microcontaminants associated with treated wastewater in freshwater and marine systems.

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“…The anthropogenic Gd found is dominated by highly stable, water-soluble complexes, specifically GBCAs administered for MR imaging and subsequently found in waste water (ultimately passing through sewage treatments plants into surface water). 44 In evaluating the potential for adverse effects with human exposure to gadolinium in tap water, it should be noted that the systemic bioavailability after oral exposure is minimal. There is no evidence to date for substantial systematic exposure of humans to Gd on the basis of uptake from the environment.…”

Section: Gadolinium In the Environmentmentioning

confidence: 99%

Critical Questions Regarding Gadolinium Deposition in the Brain and Body After Injections of the Gadolinium-Based Contrast Agents, Safety, and Clinical Recommendations in Consideration of the EMA's Pharmacovigilance and Risk Assessment Committee Recommendation for Suspension of the Marketing Authorizations for 4 Linear Agents

2017

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For magnetic resonance, the established class of intravenous contrast media is the gadolinium-based contrast agents. In the 3 decades since initial approval, these have proven in general to be very safe for human administration. However, in 2006, a devastating late adverse reaction to administration of the less stable gadolinium-based contrast agents was identified, nephrogenic systemic fibrosis. The result of actions taken by the European Medicines Agency and the US Food and Drug Administration, stratifying the agents by risk and contraindicating specific agents in severe renal dysfunction, has led to no new cases being identified in North America or Europe. Subsequently, in 2014, long-term deposition in the brain of gadolinium was first shown, after administration of 2 nonionic linear chelates, gadodiamide, and gadopentetate dimeglumine. This has led to an intense focus on the question of in vivo distribution, possible dechelation, and subsequent deposition of gadolinium, together with substantial clarification of the phenomenon as well as stratification of the agents on this basis. This review focuses on 8 critical questions regarding gadolinium deposition in the brain and body, with the answers and discussion therein important for future regulatory decisions and clinical practice. It is now clear that dechelation of gadolinium occurs in vivo with the linear agents and is responsible for this phenomenon, with key experts in the field recommending, except where there is no suitable alternative, a shift in clinical practice from the linear to macrocyclic agents. In addition, on March 10, 2017, the Pharmacovigilance and Risk Assessment Committee of the European Medicines Agency recommended suspension of the marketing authorization for 4 linear gadolinium contrast agents-specifically Omniscan, Optimark, Magnevist, and MultiHance (gadodiamide, gadoversetamide, gadopentetate dimeglumine, and gadobenate dimeglumine)-for intravenous injection. Cited in the report was convincing evidence of gadolinium deposition in the brain months after injection of these linear agents. Primovist/Eovist (gadoxetic acid disodium) will remain available, being used at a lower dose for liver imaging, because it meets an important diagnostic need. In addition, a formulation of Magnevist for intra-articular injection will remain available because of its very low gadolinium concentration.

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Are the increasing amounts of gadolinium in surface and tap water dangerous?

Cited by 51 publications

References 27 publications

Gadolinium as a new emerging contaminant of aquatic environments

Gadolinium as a new emerging contaminant of aquatic environments

Gadolinium as an Emerging Microcontaminant in Water Resources: Threats and Opportunities

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