Evidence map›Paper›PMID 42481907›Full record

SynthesisDrug safety2026

Presence of Benzodiazepines in Aquatic Environments: A Systematic Review of the Literature.

Jacopo Grisotto, Irene Cristini, Salvatore Crisafulli, Francesco Ciccimarra, Francesca Patuzzi, Federica Soardo, Elisabetta Mariavittoria Giunco, Giovanna Paolone, Gianluca Trifirò

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Drug safety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jacopo Grisotto *Department of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 10, 37124, Verona, Italy.
Irene Cristini *Department of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 10, 37124, Verona, Italy.
Salvatore CrisafulliDepartment of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 10, 37124, Verona, Italy.
Francesco CiccimarraDepartment of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 10, 37124, Verona, Italy.
Francesca PatuzziDepartment of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 10, 37124, Verona, Italy.
Federica SoardoDepartment of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 10, 37124, Verona, Italy.
Elisabetta Mariavittoria GiuncoDepartment of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 10, 37124, Verona, Italy.
Giovanna Paolone *Department of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 10, 37124, Verona, Italy.
Gianluca Trifirò *Department of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 10, 37124, Verona, Italy. gianluca.trifiro@univr.it.ORCID http://orcid.org/0000-0003-1147-7296

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPharmaceuticals in aquatic environments are a growing environmental concern. Because of their widespread use and poor removal by conventional wastewater treatment, benzodiazepines are frequently detected in treated effluents.

objectiveTo synthesise global evidence on the occurrence and distribution of benzodiazepines and their metabolites across the urban water cycle.

methodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in performing this systematic review. Bibliographic databases PubMed (including PubMed Central and Medline), Embase and Scopus were searched, from the inception date to July 26th, 2024, using query terms related to benzodiazepines (BDZs) and water pollution. Titles, abstracts and full text of the articles were independently evaluated by six review authors.

resultsOf 1973 records identified, 119 studies published between 2001 and 2024 met the inclusion criteria. Most research (N = 102) was conducted in European countries, followed by Asia (N = 29), America (N = 16), Africa (N = 5) and Australia (N = 2). Reported BDZ concentrations varied widely across the included studies, ranging from below analytical detection limits to several thousand ng/L, depending on the specific compound, sampling strategy, analytical technique, and environmental matrix. Most of the included studies searched BDZs in surface water (N = 61), followed by wastewater treatment plants (WWTP) effluents (N = 47) and WWTP influents (N = 40). Diazepam (N = 64 studies), oxazepam (N = 58 studies), lorazepam (N = 45 studies), temazepam (N = 31 studies) and alprazolam (N = 29 studies) were the most frequently detected compounds.

conclusionGlobal data highlight the need for standardised monitoring frameworks, targeted sources mitigation, and advanced water treatment technologies capable of efficiently removing chemically stable pharmaceutical compounds. Strengthening these approaches is essential to reduce ecological risks, minimise human exposure, and safeguard the long-term integrity of aquatic ecosystems.

Identifiers

PMID42481907

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.