Abstract
The global problem of the presence of human and veterinary pharmaceuticals in the environment is under investigation. Despite the increase in the knowledge of its sources, fates and impacts, the assessment of risks and the derived prevention actions are limited to single cases. The predicted increasing trend in the usage of pharmaceuticals forces the various parties involved to think about comprehensive mitigation actions. There are many areas of daily human life and industrial operations where such actions should take place. Thereby, in the presented review, such actions were summarized and divided into the following groups: A. design, synthesis and production of pharmaceuticals, B. prescription, sales and waste handling, C. control of the sources with advanced technologies. As the total amount of proposed actions was found to be quite high, a ranking according to the term of effects was proposed using the pyramid of needs. The advantages of actions taken in the first steps of the pharmaceutical life cycle (acting on the upstream) over end-of-pipe actions and the application of advanced technologies (the downstream option) were discussed, with reference to expert opinions.