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Medicinal footprint of the population of the Rhine basin

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Challenge the future

Delft University of Technology

Medicinal footprint of the population of the

Rhine basin

Rolf Hut, Corine Houtman, Nick van de Giesen

(2)

Rhine Medicine

2

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Rhine Medicine

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(4)

Rhine Medicine

2

(5)

Rhine Medicine

2

Rhine

(6)

Rhine Medicine

2

Rhine

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Rhine Medicine

2

Rhine

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Rhine Medicine

Medicine residue in river

vs

characteristics of upstream population

3

(9)

Rhine Medicine

4

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Rhine Medicine

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Rhine Medicine

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Rhine Medicine

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Rhine Medicine

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Rhine Medicine

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Rhine Medicine

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Rhine Medicine

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Rhine Medicine

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Rhine Medicine

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Metformin Theophyllin Fenazon Naproxen Clofibrate

Diazepam Sulfaquinoxalin Fenofibrinic acid Bezafibrate

Enalapril Oxacillin Losartan Atorvastatin Ibuprofen Clofibrinic

acid Gemfibrosil Diclofenac Hydrochlorothiazide Furosemide

Pravastatin Paracetamol Caffein Primidone Lidocain

Carbamazepin Propanolol Iphosphamide Cyclophosphamide

Atenolol Metoprolol Sotalol Oxazepam Trimethoprim

Temazepam Chloramphenicol Bisoprolol Phenofibrate

Lincomycin Iopromide Ketoprofen Sulfamethoxazole Salicylic

acid

(19)

Rhine Medicine

Data Sources

Measurements (concentrations & GPS locations)

Population data (eurostat)

Digital Elevation Model (Hydrosheds, USGS)

Discharge data

11

(20)

Rhine Medicine

Data Sources

Measurements (concentrations & GPS locations)

Population data (eurostat)

Digital Elevation Model (Hydrosheds, USGS)

Discharge data

11

(21)

Rhine Medicine

Data Sources

Measurements (concentrations & GPS locations)

Population data (eurostat)

Digital Elevation Model (Hydrosheds, USGS)

Discharge data

11

(22)

−200 −100

0

0

100

200

300

400

500

600

700

800

500

1000

1500

2000

2500

Distance from Konstanz in km

concentration in ng/l

analgesic / NSAID

antibiotic

antidepressant / psycholeptic

antidiabetic

antihypertension drug

anti−lipaemic

beta blocker

cytostatic

diuretic

other

0

500

1000

1500

2000

2500

Aare

Neckar

Main Mosel Sieg Ruhr Lippe

Rhine Medicine

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−100

0

100

200

300

400

500

600

700

800

0

10

20

30

40

50

60

70

80

90

100

Distance from Konstanz

concentration in ng/l

Carbamazepin concentrations

compared with model predictions based on

number of male elderly (>65)

measurements

best fit model

Rhine Medicine

13

(24)

Rhine Medicine

Results

14

Female adults (15 < years < 65)

lidocaine

Female Kids (<15 years)

sotalol, oxazepam

Male adults (15 < years < 65)

primidone, losartan

Male Elderly (> 65 years)

carbamazepine, bisoprolol, sulfamethoxazole

Germans (all ages)

temazepam, bezafibrate, hydrochlorothiazide

Swiss (all ages)

atenolol

(25)

−100

0

100

200

300

400

500

600

700

800

0

2

4

6

8

10

12

Distance from Konstanz

concentration in ng/l

Diazepam concentrations

compared with model predictions based on

number of French people in area

measurements

best fit model

Rhine Medicine

15

(26)

Rhine Medicine

Hypothesis

16

Female adults (15 < years < 65)

lidocaine

Female Kids (<15 years)

sotalol, oxazepam

Male adults (15 < years < 65)

primidone, losartan

Male Elderly (> 65 years)

carbamazepine, bisoprolol, sulfamethoxazole

Germans (all ages)

temazepam, bezafibrate, hydrochlorothiazide

Swiss (all ages)

atenolol

(27)

Rhine Medicine

17

(28)

Rhine Medicine

18

(29)

Rhine Medicine

19

(30)

Rhine Medicine

20

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