Pharmaceuticals and personal care
products (PPCPs) garner increasing
attention globally for both their usefulness as indicators of human
waste and their potency as emerging organic toxicants. Three decades
of rapid increase in PPCP study combined with an increasing number
of PPCPs on the global market have created an opportunity (1) to review
trends in diversity of compounds, sewage treatment techniques (STTs),
and ecosystems investigated as well as (2) to identify knowledge gaps
in the literature. We conducted a quantitative evidence synthesis
of 6517 abstracts from primary articles in the environmental PPCP
literature by examining relative abundance of specific PPCP classes,
STTs, and ecosystem types. Our results demonstrate that non-prescription
drugs and antibiotics dominated PPCP abstracts, appearing in 51% and
39% of reviewed abstracts, respectively, in comparison to hormones
(18%), prescription drugs (18%), fragrances (0.3%), and antioxidants
(0.0%), which can all elicit physiological and ecological responses
even at low concentrations. References to centralized STTs (e.g.,
activated sludge, 37%) were more frequent than decentralized STTs
(e.g., septic, 2%), despite decentralized STTs being common and frequently
high impact sources of sewage pollution worldwide. Freshwater lotic
systems (63%) were more prevalent than freshwater lentic (24%) and
terrestrial (20%) systems. This discrepancy is notable because the
longer residence times of lentic and terrestrial systems may enable
PPCPs to concentrate and thus increase risk of biological consequences.
These results highlight distinct opportunities to address knowledge
gaps in the environmental PPCP literature, including underrepresented
compounds (e.g., fragrances), sewage treatment techniques (e.g., septic
systems), and ecosystem types (e.g., lakes).