Pharmaceuticals are a subset of micropollutants, present in the environment in trace concentrations. Because of their persistent nature, these chemicals are of particular concern. Little is known about how mixtures of pharmaceutical residues, found in WWTP effluents, affect the environment or public health. Yet, numerous studies show negative outcomes for both aquatic and terrestrial organisms, suggesting that they are given both to bioaccumulation and uptake in plants. Israel leads the world in effluent reuse (86%), almost exclusively utilized for purposes of agricultural irrigation. Pharmaceuticals, however, are not included in Israel’s water regulatory oversight or management, essentially creating an epidemiological experiment among its citizens and environment. Globally, these compounds also are not commonly subject to monitoring or regulation. This study reviews and analyzes water policies and regulation worldwide that address the presence of pharmaceuticals in water resources, with a particular focus on Australia, Singapore, Switzerland, and the USA. Furthermore, the study investigates the reasons why these chemicals are not yet regulated in Israel. Based on a comprehensive evaluation of the data and analysis of the regulatory rationale in other countries, a list of recommended pharmaceutical standards that should be measured and monitored in Israel’s wastewater treatment system is proposed. The suggested prioritization criteria should be at the heart of a new regulatory agenda for controlling pharmaceutical contamination in wastewater.
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