Pharmaceuticals in water: a bibliometric review of removal technologies, research trends, and socioeconomic factors (2000-2025)

REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 1 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. Pharmaceuticals in water: a bibliometric review of removal technologies, research trends, and socioeconomic factors (2000-2025) Fármacos na água: uma revisão bibliométrica de tecnologias de remoção, tendências de pesquisa e fatores socioeconômicos (2000-2025) Productos farmacéuticos en el agua: una revisión bibliométrica de tecnologías de eliminación, tendencias de investigación y factores socioeconómicos (2000-2025) DOI: 10.54033/cadpedv22n8-183 Originals received: 5/16/2025 Acceptance for publication: 6/11/2025 Daiane Francisca do N. Silva Master in Energy and Nuclear Technologies Institution: Universidade Federal de Pernambuco (UFPE) Address: Recife, Pernambuco, Brazil E-mail: [email protected] Jean Firmino Cardoso Bachelor in Civil Engineering Institution: Universidade Federal de Pernambuco (UFPE) Address: Recife, Pernambuco, Brazil E-mail: [email protected] Daniel Milian Pérez Doctor in Energy and Nuclear Technologies Institution: Universidade Federal de Pernambuco (UFPE) Address: Recife, Pernambuco, Brazil E-mail: [email protected] Abel Gámez Rodríguez Doctor in Energy and Nuclear Technologies Institution: Universidade Federal de Pernambuco (UFPE) Address: Recife, Pernambuco, Brazil E-mail: [email protected] REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 2 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. Yaicel Ge Proenza Doctor in Chemistry Institution: Universidade Federal de Pernambuco (UFPE) Address: Recife, Pernambuco, Brazil E-mail: [email protected] Antonio Celso Dantas Antonino Doctor in Soil Physics Institution: Universidade Federal de Pernambuco (UFPE) Address: Recife, Pernambuco, Brazil E-mail: [email protected] ABSTRACT Pharmaceutical contamination in aquatic environments is a growing global concern due to its ecological and public health implications. These compounds, often resistant to conventional treatments, originate from domestic, hospital, and industrial effluents and persist in water bodies. This study presents a bibliometric review of scientific publications from 2000 to 2025, aiming to examine the relationship between pharmaceutical pollution, socioeconomic conditions, and remediation technologies. Data were collected from Scopus and Web of Science using the keywords “removal AND pharmaceuticals AND water”. Duplicate records were removed, and the final dataset was processed using a custom Python script to generate bibliometric visualizations. A three-stage filtering process was applied to identify relevant studies, characterize methodologies, and select articles for full reading. Results show a consistent increase in scientific output over the years, with a notable concentration of research in China, the United States, and Brazil. Adsorption was identified as the most explored technique, often employing activated carbon, biochar, and nanomaterials. Funding trends peaked in 2024, with a slight drop in 2025 due to incomplete data. The findings indicate increasing global engagement with pharmaceutical removal, emphasizing the role of research in addressing both environmental and social inequalities. This review highlights the need for scalable, efficient, and context-sensitive treatment solutions. Keywords: Water Contamination. Pharmaceutical Pollution. Socioeconomic Conditions. Removal Technologies. Bibliometric Analysis. Adsorption. RESUMO A contaminação por fármacos em ambientes aquáticos é uma preocupação crescente devido aos riscos que representa à saúde pública e ao equilíbrio ecológico. Esses compostos, frequentemente recalcitrantes aos tratamentos convencionais, são introduzidos nas águas por esgotos domésticos, hospitalares e industriais. Este estudo apresenta uma revisão bibliométrica da produção científica entre 2000 e 2025, com o objetivo de investigar a relação entre a poluição por fármacos, as condições socioeconômicas e as tecnologias de remediação empregadas. Foram utilizados dados das bases Scopus e Web of Science com os termos “removal AND pharmaceuticals AND water”. Após a remoção de REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 3 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. duplicatas, os dados foram processados por meio de um script desenvolvido em Python. A análise foi conduzida em três etapas: elegibilidade, caracterização e leitura completa. Os resultados revelam crescimento consistente da produção científica, com destaque para China, Estados Unidos e Brasil. A adsorção foi a técnica mais estudada, com uso recorrente de carvão ativado, biocarvão e nanomateriais. O financiamento à pesquisa apresentou pico em 2024, com queda aparente em 2025 devido a dados ainda parciais. Conclui-se que há um engajamento crescente na busca por soluções eficazes, escaláveis e adaptadas aos diferentes contextos socioeconômicos, reforçando o papel da ciência na mitigação de desigualdades ambientais. Palavras-chave: Contaminação da Água. Poluição por Fármacos. Condições Socioeconômicas. Tecnologias de Remoção. Análise Bibliométrica. Adsorção. RESUMEN La contaminación por fármacos en entornos acuáticos representa un problema ambiental y sanitario en expansión. Estos compuestos, difíciles de eliminar mediante tratamientos convencionales, provienen de descargas domésticas, hospitalarias e industriales, permaneciendo en cuerpos de agua. Este estudio ofrece una revisión bibliométrica de publicaciones científicas entre 2000 y 2025, con el objetivo de analizar la relación entre la contaminación farmacéutica, las condiciones socioeconómicas y las tecnologías de remediación utilizadas. Se recolectaron datos de las bases Scopus y Web of Science mediante la búsqueda “removal AND pharmaceuticals AND water”. Tras eliminar duplicados, los datos fueron procesados mediante un script personalizado em Python. La selección de artículos se realizó en tres fases: análisis de elegibilidad, caracterización y lectura completa. Los resultados muestran un crecimiento constante en la producción científica, destacando China, Estados Unidos y Brasil como principales productores. La técnica más investigada fue la adsorción, utilizando carbón activado, biochar y nanomateriales. La financiación alcanzó su punto máximo en 2024, con un descenso en 2025 atribuible a datos incompletos. El estudio revela un compromiso creciente con la remediación de contaminantes farmacéuticos, subrayando la importancia de desarrollar soluciones efectivas, accesibles y adaptadas a distintas realidades sociales. Palabras clave: Contaminación del Agua. Polución Farmacéutica. Condiciones Socioeconómicas. Tecnologías de Eliminación. Análisis Bibliométrico. Adsorción. 1 INTRODUCTION The contamination of water resources by pharmaceutical compounds, classified as part of the broader group of emerging contaminants, has become a pressing global concern due to its potential impacts on both environmental REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 4 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. integrity and public health. These substances, commonly referred to as pharmaceutical and personal care products (PPCPs), include a wide range of bioactive molecules such as antibiotics, analgesics, hormones, and antidepressants (LETSOALO et al., 2023). Their release into aquatic ecosystems occurs through several pathways, including discharges from Wastewater Treatment Plants (WWTPs), effluents from chemical and pharmaceutical industries (CPI), inappropriate product usage and disposal, domestic and industrial activities, surface runoff and leaching, as well as illegal discharges and human activities (Anliker et al., 2022; Cangola; Abagale; Cobbina, 2024; Delgado et al., 2023; Ślósarczyk; Wolny; Witkowski, 2025). Pharmaceuticals are particularly problematic because they are often designed to be biologically active and persistent. Their physicochemical properties—such as high solubility and resistance to biodegradation—facilitate their mobility and persistence in aquatic environments (Battaglin et al., 2018). Studies have shown that even low concentrations of pharmaceuticals can induce a variety of adverse effects on aquatic organisms, including behavioral changes, endocrine disruption, oxidative stress, and alterations in reproductive and physiological processes (Anliker et al., 2022; Battaglin et al., 2018; Delgado et al., 2023). The presence of antibiotics in water bodies contributes to the emergence and spread of antibiotic-resistant bacteria, which poses a severe threat to global public health (Battaglin et al., 2018; Cangola; Abagale; Cobbina, 2024; Ślósarczyk; Wolny; Witkowski, 2025). In addition, some pharmaceuticals can bioaccumulate in aquatic organisms and, through the food chain, reach higher concentrations in predators, including humans (Battaglin et al., 2018; Delgado et al., 2023; Letsoalo et al., 2023). Given the limitations of conventional wastewater treatment processes in effectively removing these micropollutants, the need for advanced remediation technologies has become increasingly evident. In recent years, significant scientific efforts have been directed toward identifying innovative materials and methods capable of mitigating the risks associated with pharmaceutical contamination in water (Ahmad et al., 2025; Borah et al., 2025; Choudhury et al., 2025; Dong et al., 2025; Issaka; Danso-Boateng; Baffoe, 2024; Silva et al., 2018; REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 5 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. Sirés; Brillas, 2012). However, despite the growing body of research on this topic, gaps remain regarding the relationship between the geographic distribution of contamination, local socioeconomic conditions, and the adoption of specific remediation technologies. Understanding these dynamics is crucial for developing strategies that are not only technically effective but also socially and economically viable (Delgado et al., 2023; Cangola; Abagale; Cobbina, 2024; Vinther et al., 2025). In response to these gaps, this study presents a bibliometric review of publications from 2000 to 2025 that address the removal of pharmaceuticals from water, with a specific focus on identifying trends in research output, leading countries and institutions, most studied contaminants, frequently used reactive materials, and the interplay between scientific productivity and socioeconomic indicators. 2 THEORETICAL FRAMEWORK Water contamination by synthetic organic compounds presents numerous challenges for environmental protection and public health. Among these compounds are industrial chemicals, pesticides, and pharmaceutical residues, many of which are not efficiently removed by conventional WWTPs. The underestimation of industrial pollution, especially from synthetic organic compounds, and the urgent need for innovative treatment solutions as alternatives to energy-inefficient wastewater incineration underscore the gravity of the problem. Technologies such as fluorescence spectroscopy still face difficulties in quantifying contaminants due to interference from fluorescent organic matter (Anliker et al., 2022; Vinther et al., 2025). Additionally, promising methods like the use of BioMnOx for micropollutant removal still require thorough investigation at realistic concentrations and under in situ conditions (Furgal; Meyer; Bester, 2014). Significant knowledge gaps persist, including the lack of a centralized database of contaminant absorbance and fluorescence properties (Vinther et al., 2025). Among emerging contaminants, pharmaceuticals have received increasing attention in recent years. Beyond their environmental REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 6 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. occurrence and effects—already discussed in the introduction—attention has shifted toward improving detection and treatment technologies specific to these compounds. Recent innovations in the identification of pharmaceuticals in water encompass advanced analytical techniques and the development of highsensitivity biosensors. Untargeted High-Resolution Mass Spectrometry (HRMS) enables the identification of unforeseen compounds, while fluorescence spectroscopy offers a cost-effective alternative for characterizing dissolved organic matter (Anliker et al., 2022; Vinther et al., 2025). Furthermore, electrochemical and optical biosensors, utilizing aptamers and metallic nanoparticles, facilitate the selective detection of various pharmaceuticals at low concentrations (Letsoalo et al., 2023). Beyond detection, technological hurdles persist in the development of effective treatment methods for pharmaceutical contaminants. Nanocellulose faces problems with self-aggregation and difficulties in its large-scale manufacturing and modification (Nordin et al., 2024), while nanofiltration membranes and nanomaterials are still under development and exhibit limitations such as fouling and high costs (Letsoalo et al., 2023). Modeling photocatalysis and optimizing low-cost adsorbents, like powdered activated carbon (PAC), also require further investigation (Campinas et al., 2021; Durán-Álvarez et al., 2024; Mueses et al., 2021). Among the available technologies for the removal of pharmaceutical compounds from water, adsorption has gained prominence, offering simplicity, sustainability, and cost-effectiveness. It allows for the use of diverse materials such as activated carbon, biochar, nano-adsorbents, zeolites, and other low-cost options (Letsoalo et al., 2023; Nordin et al., 2024; Priyan V; Narayanasamy, 2022). While other techniques like membranes, advanced oxidation processes, biological and chemical treatments, and piezocatalysis are also employed, adsorption's versatility and efficacy make it one of the most promising approaches for remediating emerging contaminants (Abdullah et al., 2024; Delgado et al., 2023; Demiti et al., 2025; Mueses et al., 2021). Current research emphasizes the need for alternative remediation techniques with high selectivity REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 7 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. and adsorption affinity, aiming to overcome the limitations of conventional technologies (Letsoalo et al., 2023). Key areas of focus include the application of nanoadsorbents and the mathematical modeling of solar photocatalytic reactors to optimize large-scale treatment (Mueses et al., 2021; Priyan V; Narayanasamy, 2022). Focusing specifically on the removal of pharmaceuticals from water, adsorption proves to be an efficient technique, with increasing attention on nanocellulose-based adsorbents and other nanomaterials (Furgal; Meyer; Bester, 2014; Letsoalo et al., 2023; Mueses et al., 2021). Carbon nanotubes, graphene oxide, and magnetic nanocomposites are also being explored, despite ongoing challenges related to their cost and potential toxicity (Letsoalo et al., 2023). Additionally, Advanced Oxidation Processes (AOPs), membrane technologies, biotransformations, and heterogeneous photocatalysis are employed to optimize the removal of these persistent organic pollutants (Demiti et al., 2025; Durán-Álvarez et al., 2024; Letsoalo et al., 2023). Although considerable scientific progress has been made, several critical aspects remain understudied. Comprehensive data on the occurrence and risks of PPCPs in aquatic systems are still limited (Cangola; Abagale; Cobbina, 2024). The concentrations and impacts of veterinary pharmaceuticals, in particular, are poorly understood, highlighting a crucial area for future investigation (Delgado et al., 2023). This theoretical overview highlights the complexity of pharmaceutical contamination in water matrices and frames the rationale for conducting a bibliometric review. This study aims to explore trends in remediation technologies and analyze the influence of socioeconomic conditions on scientific output between 2000 and 2025. 3 METHODOLOGY This bibliometric review investigates the interrelation between pharmaceutical contamination in water resources, the adoption of remediation technologies, and local socioeconomic conditions. Specifically, it investigates (i) the most prevalent pharmaceuticals in aquatic environments, (ii) the reactive materials most REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 8 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. employed for their removal, (iii) the evolution of research output and recent technological advances, and (iv) the geographic and institutional distribution of scientific contributions. Furthermore, it seeks to understand how local socioeconomic conditions relate to the development and application of remediation strategies. The research encompassed works published between the years 2000 and March 2025, covering virtually the entire development concerning the application of reactive materials in the removal of contaminants from water resources. The inclusion of data up to March 2025 ensures a current overview of recent trends, although readers should note that the 2025 dataset is partial and may not represent the full year's output. Scientific data were collected from the Scopus and Web of Science platforms using the combined search terms: “removal AND pharmaceuticals AND water”. The query was unrestricted with respect to language or document type, ensuring broad coverage. Basic information including titles, publication years, authors, abstracts, keywords, citations, and affiliations were exported from the databases and processed using Python. A Python script was developed to perform the bibliometric analysis, covering the entire workflow from data cleaning to results export. Essential libraries such as pandas and matplotlib were employed for data manipulation and visualization. This stage included removal of duplicate entries, chronological organization, data preprocessing, analysis of geographical affiliations, funding sources, and temporal trends. The script generated word clouds, distribution charts, and semantic networks, with results exported in formats like PNG and Excel for enhanced interpretability. Subsequently, the documents were analyzed in three stages: (1) titles and abstracts were read to determine whether each work met the eligibility criteria. In this stage, a bibliometric analysis was also performed on the retrieved documents to identify research trends and the countries most engaged with the subject. This analysis further allowed an exploration of the economic implications associated with concerns over the preservation and remediation of water resources; (2) titles, abstracts, keywords, and methodology sections were examined to characterize each document in terms of contaminant removal strategy, country of study, type of study, and the specific water matrix analyzed; (3) finally, a selection of REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 9 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. documents was chosen for full reading. This selection included only those studies that addressed strategies for removing pharmaceuticals from water resources using reactive materials. Figure 1 presents the flowchart outlining this process, along with the eligibility criteria applied in the research. Figure 1. Flow diagram illustrating the sequential selection process of the documents analyzed. Source: Prepared by the authors. Following the general bibliometric analysis, a more targeted filtering process was conducted to select articles whose titles contained keywords semantically aligned with the structure “pharmaceutical + water + removal”. Consequently, from the initial pool of 3,387 articles encompassed within the bibliometric review, 95 were selected for full-text analysis aimed at constructing a timeline of key technological and methodological developments. 4 RESULTS AND DISCUSSION This section presents and discusses the main findings of the bibliometric review, organized into two complementary parts. First, we examine the evolution of scientific production over the 2000–2025 period, highlighting geographic distribution, funding sources, institutional engagement, and keyword dynamics. This quantitative overview provides insight into the global research landscape and its driving forces. In the second part, we synthesize the key advances in contaminant identification and pharmaceutical removal strategies, establishing a timeline of REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 16 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. remediation of emerging contaminants, with a specific focus on pharmaceuticals in water resources. The aim is to map the evolution of treatment strategies, technological innovations, and research priorities from 2000 to 2025, highlighting key milestones and transitions in scientific approaches to pharmaceutical pollution. The review is organized into subperiods that reflect distinct stages in the field’s development: from early detection and problem recognition (2000– 2005), through the emergence of advanced technologies and source control initiatives (2006–2010), to the consolidation of multi-barrier strategies and nanotechnologies (2011–2015), the diversification of materials and processes (2016–2020), and, finally, the recent trend towards integrated, multifunctional treatment systems (2021–2025). Between 2000 and 2005, significant progress was made in understanding the occurrence, fate, and treatment of emerging contaminants, with particular emphasis on pharmaceuticals in water sources (O. A. H. Jones et al., 2005; Lopez et al., 2003; Ternes et al., 2002; Matamoros et al., 2005). Numerous reviews and studies documented the widespread detection of these substances and underscored the limited efficacy of conventional wastewater treatment processes (Gross et al., 2004; Lam et al., 2004; Rooklidge et al., 2005). Persistent contaminants such as iodinated radiocontrast media were found in both U.S. and German treatment facilities, showing resistance to conventional degradation pathways (Drewes et al., 2001; Ternes et al., 2002; O. A. H. Jones et al., 2005). Investigations into antibiotic biodegradability and resistance highlighted concerns related to urban effluents (Bound & Voulvoulis, 2005; Young et al., 2014), while studies on filter systems reported varying removal efficiencies for compounds such as sulfamethoxazole, trimethoprim, and lincomycin (Rooklidge et al., 2005). Other contaminants of interest included triclosan, fluoroquinolones, APEMs, and estrogens (Gross et al., 2004; Ternes et al., 2002; Matamoros et al., 2005). Pharmaceuticals like carbamazepine, diclofenac, ibuprofen, and clofibric acid were frequently studied due to their persistence in aquatic systems and resistance to removal (Bound & Voulvoulis, 2005; O. A. H. Jones et al., 2005; Lam REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 17 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. et al., 2004; Ternes et al., 2002). Caffeine was recognized as an anthropogenic indicator of contamination (Ternes et al., 2002; O. A. H. Jones et al., 2005). Slow sand and roughing filters showed compound-specific performance, with adsorption to filter media playing a key role in removal mechanisms (Rooklidge et al., 2005). As conventional treatments proved inadequate for many compounds, attention shifted to advanced technologies. Membrane processes such as nanofiltration and reverse osmosis demonstrated high removal efficiencies for pharmaceuticals and radiocontrast agents (Vedavyasan, 2000; Drewes et al., 2001). UVbased oxidation processes (e.g., UV/H₂O₂) showed promise for degrading pharmaceutical intermediates, especially in waters with low turbidity (Lopez et al., 2003; Lam et al., 2004). Granular activated carbon adsorption also proved effective, particularly for compounds like bezafibrate, carbamazepine, and diclofenac (Ternes et al., 2002; Young et al., 2014). Natural attenuation processes were extensively evaluated. Studies of riverine transport, artificial recharge, and constructed wetlands revealed partial removal and transformation of various contaminants, dependent on redox conditions and compound characteristics (Gross et al., 2004; Drewes et al., 2001; Matamoros et al., 2005). Riverbank filtration and reclaimed water irrigation were explored as mitigation strategies (O. A. H. Jones et al., 2005; Young et al., 2014). From the years 2006 to 2010, the evolution from detection-focused studies to advanced treatment development and source control initiatives reflects a growing understanding of the complexity of micropollutant removal. A holistic, integrated approach remains essential for addressing these persistent environmental challenges. Growing awareness of micropollutants such as pharmaceuticals, endocrine disruptors, and PPCPs in aquatic environments has led to increased research efforts (Broséus et al., 2009; Chelliapan et al., 2006; Cuerda-Correa et al., 2010; Gros et al., 2007; Heberer et al., 2008; Püttmann et al., 2008; Whelehan et al., 2010). Initial studies primarily addressed their occurrence and quantification in wastewater and surface waters, revealing the limited removal capacity of conventional WWTPs (Gros et al., 2007). Although acute toxicity to aquatic REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 18 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. organisms was generally low, concerns about chronic toxicity and mixture effects persisted (Gros et al., 2007). Subsequent research focused on evaluating treatment technologies. Biological processes such as activated sludge showed substance-specific removal efficiencies, often improved by increasing sludge retention time (SRT), though compounds like carbamazepine remained resistant (Püttmann et al., 2008; White et al., 2006; Gros et al., 2007). Membrane bioreactors (MBRs) offered improved operational control but did not consistently outperform conventional treatments for most micropollutants (Püttmann et al., 2008; Dordio et al., 2009). Anaerobic treatment was also explored under various operational conditions (Chelliapan et al., 2006). Among physicochemical methods, adsorption using activated carbon proved particularly effective and has been implemented in both wastewater and drinking water contexts (Püttmann et al., 2008; White et al., 2006). Powdered activated carbon (PAC) reduced pharmaceutical loads by up to 80%, albeit with higher operational costs and potential impacts on sludge management (Püttmann et al., 2008). Alternative adsorbents such as carbon black have been assessed for NSAIDs under different pH and temperature conditions (Cuerda-Correa et al., 2010). Oxidation techniques, especially ozonation and AOPs, demonstrated high degradation efficiency for various PPCPs but were limited by high costs and the risk of by-product formation (Broséus et al., 2009; Kim et al., 2009; Püttmann et al., 2008; Wintgens et al., 2008). Membrane technologies, including nanofiltration (NF) and reverse osmosis (RO), showed high rejection rates for a wide spectrum of emerging contaminants (White et al., 2006; Wintgens et al., 2008). Natural and semi-natural systems such as bank filtration and constructed wetlands also showed selective effectiveness, particularly in removing antimicrobial residues and specific metabolites like clofibric acid (Heberer et al., 2008; Dordio et al., 2009). Around the year 2008, a consensus had formed around the necessity of multi-barrier strategies combining different treatment technologies to ensure effective removal of diverse micropollutants (Püttmann et al., 2008; Wintgens et al., REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 19 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. 2008). In drinking water treatment, the integration of activated carbon and ozonation is often recommended, especially when source waters are vulnerable to contamination (Püttmann et al., 2008). Additionally, source control measures have been proposed to reduce contaminant input at its origin. These include substance flow separation (e.g., wastewater from hospitals), localized treatment systems, and decentralized sanitation concepts such as “No-Mix-Toilets” for segregating different wastewater streams (Püttmann et al., 2008). Such strategies may offer more sustainable and cost-effective solutions for managing high-risk compounds than end-of-pipe treatments alone. From 2011 onwards, the field saw a shift from conventional methods to advanced oxidation, adsorption, biological, and membrane-based technologies for more effective PPCPs removal. Studies explored electrochemical methods like electrocoagulation, anodic oxidation (using BDD anodes), and electro-Fenton for effective degradation of pharmaceuticals (Sirés & Brillas, 2012). Sulfate radical-based AOTs using PMS and persulfate were also developed as alternatives to hydroxyl radical-based processes (Nfodzo & Choi, 2011). Reverse osmosis showed high removal efficiency (Boleda et al., 2011). Emerging contaminants such as PPCPs in surface and groundwater have raised increasing concern due to their persistence and the limited efficacy of conventional treatment methods (Dolar et al., 2012; Ibáñez et al., 2013; Moreira et al., 2015; Nfodzo & Choi, 2011; Quesada-Peñate et al., 2012). Biodegradation plays a critical role in preventing their accumulation (Kruglova et al., 2014). By 2012, catalytic wet air oxidation (CWAO) with activated carbon was proposed for paracetamol removal in a hybrid adsorption–oxidation system (Quesada-Peñate et al., 2012). MBR–RO systems achieved >99% removal for many micropollutants (Dolar et al., 2012; Nielsen et al., 2013). AOPs, including ozonation and H2O2/UV, were studied further, as were adsorption and methods like ultrasound, photocatalysis, and Fenton (Nasuhoglu et al., 2012; Quesada-Peñate et al., 2012). Pilot-scale studies in 2013 evaluated ozone-based AOPs for removing up to 60 contaminants (Ibáñez et al., 2013). Polishing steps post-MBR included O3, O3+H2O2, PAC, and ClO2, with PAC REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 20 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. showing strong performance (Nielsen et al., 2013). Resin-based adsorption was also noted (Grimmett, 2013). In 2014, biodegradation of pharmaceuticals in nitrifying sludge was investigated at low temperatures (Kruglova et al., 2014), and removal efficiency was compared across treatment systems like MTP, STS, and wetlands (Du et al., 2014). Later studies reviewed MOFs as promising adsorbents (Hasan & Jhung, 2015), and nanomaterials (ZnO, TiO2, Ag NPs, ZVI-modified biochar) were proposed for microbial control (Inyang & Dickenson, 2015). Aerobic Granular Sludge (AGS) proved effective for fluoxetine removal through adsorption/desorption mechanisms (Moreira et al., 2015). A broad review of 168 micropollutants showed variable removal in conventional plants, with some compounds like caffeine being well removed, while others like carbamazepine persisted. Post-treatment with ozonation and sand filtration was recommended (Margot et al., 2015). The literature from 2016–2020 reflects a growing focus on diverse removal strategies for emerging contaminants, combining adsorption, AOPs, biological treatments, and nanotechnology. The reviewed sources focus on removing emerging contaminants—including PPCPs, EDCs, and pesticides—such as antibiotics (e.g., amoxicillin, ciprofloxacin), analgesics (e.g., diclofenac, ibuprofen), and others like carbamazepine and triclosan (Ahmed et al., 2017; Guo et al., 2020; Mojiri et al., 2020; Rasheed et al., 2019; Silva et al., 2018a, 2018b; Sophia A. & Lima, 2018; Ushavipinachandran et al., 2020; Weng et al., 2018; Zhang et al., 2017). Adsorption is widely studied using materials like activated carbon, biochar, MOFs, and magnetic or modified adsorbents (Rocha et al., 2020; Silva et al., 2018b; Sophia A. & Lima, 2018; Thiebault, 2020). Studies explore interactions, kinetics, and mechanisms such as electrostatic attraction (Rocha et al., 2020). AOPs—Fenton, photo-Fenton, ozonation, photocatalysis, ultrasound—are frequently cited for degrading pharmaceuticals (Ahmed et al., 2017; Mirzaei et al., 2017; Monteoliva-García et al., 2019; Tasca et al., 2020; Tolboom et al., 2019; REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 21 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. Zhu et al., 2019). Ferrate(VI) and electrochemical methods are also discussed (Ahmed et al., 2017; Feng et al., 2018). Biological treatments include constructed wetlands and membrane bioreactors (Santos et al., 2019; Thiebault, 2020; Zaied et al., 2020), along with anaerobic digestion (Ghattas et al., 2017; Mojiri et al., 2020). Other techniques include membrane filtration (Ahmed et al., 2017; Monteoliva-García et al., 2019), electrocoagulation (Tasca et al., 2020; Zaied et al., 2020), algae-based removal (Tolboom et al., 2019), and nanomaterials like magnetic nanoparticles and supported Fe/Ni (Guo et al., 2020; Rocha et al., 2020; Ushavipinachandran et al., 2020; Weng et al., 2018). In recent years (2021 onwards), emerging contaminants, particularly PPCPs, have been increasingly detected in the environment due to inadequate disposal from sources such as hospital sewage, domestic waste, and pharmaceutical effluents (Abbasi et al., 2021). These compounds pose risks to human health, ecosystems, and can induce antibiotic resistance (Adeoye et al., 2024; Fallah et al., n.d.; Denora et al., 2024; Masinga et al., 2024; Moreno-Bermedo et al., 2025). A wide range of materials have been explored for emerging contaminants adsorption, including granular activated carbon, biochars, carbon nanotubes, metal oxides, and nanocomposites (Fallah et al., n.d.; Ajiboye et al., 2024; Adeoye et al., 2024; Ahmad & Ejaz, 2023; Gautam et al., 2024; Moreno-Bermedo et al., 2025). Notably, BiFeO₃ nanoparticles and chitosan-based composites have shown high efficiency for drug removal (Abbasi et al., 2021; Aminzai et al., 2023). Functionalized and magnetic carbon materials have also demonstrated promising reuse potential (Adeoye et al., 2024; Adel Naji & Tark Abd Ali, 2023). Biological techniques include fungal and bacterial bioremediation, MBRs, sequencing batch reactors, and constructed wetlands (Chandran et al., 2023; Alazaiza et al., 2022; Bodle et al., 2022; Hdidou et al., 2022; Salvi-Taga et al., 2024). Integration of adsorption with biological systems has improved the removal of various drugs (Chandran et al., 2023). AOPs, including Fenton, Photo-Fenton, and Electro-Fenton, have been extensively investigated for PPCPs and dye degradation (Abramov et al., 2022; REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 22 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. Smułek et al., 2021; Al-howri et al., 2024; Adeoye et al., 2024; Moreno-Bermedo et al., 2025). Ozonation and photocatalysis are often coupled with other methods for enhanced efficiency (Hom-Diaz et al., 2022; Ponce-Robles et al., 2023). Electrode materials, such as modified biochar, have improved degradation rates in Electro-Fenton systems (Moreno-Bermedo et al., 2025). Additional treatment approaches include coagulation/flocculation with natural coagulants, membrane filtration, and integrated AOP-biological processes for comprehensive contaminant removal (Alazaiza et al., 2022; Miladi et al., 2024; Pachaiappan et al., 2022). In closing, the chronological synthesis outlined in this section helps contextualize how scientific approaches to pharmaceutical pollution have advanced over time, offering a foundation for future innovation and policy development. 5 CONCLUSION Pharmaceutical contamination in aquatic environments is intrinsically linked to local socioeconomic conditions. In regions with limited sanitation infrastructure, ineffective wastewater treatment systems, and inadequate regulatory frameworks, pharmaceuticals are more likely to persist in water sources. Research output in this field has grown significantly from 2000 to 2025, reflecting increased international collaboration, greater funding availability, and heightened awareness of the environmental and health implications of pharmaceutical pollutants. Funding agencies in China and Europe have dominated the financial landscape, with Brazilian institutions also playing a relevant role, indicating a strong geographical commitment to addressing this global issue. While high-income countries such as the United States and Germany lead in publication volume, developing economies like India and Brazil have also contributed substantially to the literature—often driven by internal policy incentives and the urgent need to ensure water quality for their populations. From the full-text analysis of key publications, several recurring patterns and technological preferences were identified. The most common pharmaceutical pollutants include analgesics, anticonvulsants, antibiotics, and hormone-related compounds—many of which persist through conventional treatment. In response, REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 23 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. adsorption has emerged as the most widely studied approach, particularly using materials like activated carbon, biochar, carbon nanotubes, and metal oxides. Complementary strategies such as AOPs, membrane filtration, and biological systems (e.g., membrane bioreactors, constructed wetlands) have also gained traction. Recent advances point to a trend toward integration: combining treatment methods, employing nanomaterials, and applying modeling tools to enhance performance and scalability. These innovations reflect the field’s interdisciplinary nature and underscore the need for efficient, adaptable solutions, especially in vulnerable regions where the health and environmental stakes are highest. ACKNOWLEDGEMENTS This research was partially supported by the Research Support Foundation of the State of Pernambuco (FACEPE), project numbers: IBPG-1064-3.09/22 and BFP0146-3.09/23 and the National Council for Scientific and Technological Development (CNPq), project number: 465764/2014-2 - Observatório Nacional da Dinâmica da Água e de Carbono no Bioma Caatinga (ONDACBC). Additionally, the authors acknowledge funding from the Human Resources Training Program of the Brazilian National Agency for Petroleum, Natural Gas, and Biofuels (PRHANP) via PRH 48.1/UFPE (ANP/FINEP Grants No. 48610.201019/2019-38 and FAPESP Grants No. 2024/10544-2 and 2024/12259-3), supported by resources from oil companies qualified under Clause P (Research, Development, and Innovation) of ANP Resolution No. 50/2015. REVISTA CADERNO PEDAGÓGICO – Studies Publicações Ltda. ISSN: 1983-0882 Page 24 REVISTA CADERNO PEDAGÓGICO – Studies Publicações e Editora Ltda., Curitiba, v.22, n.8, p. 01-33. 2025. 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