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Pharmaceutical pollution of the world's rivers John L. Wilkinson et al. The extent of pharmaceutical pollution of rivers worldwide is unclear. In this study, the authors sampled 1,052 sites along 258 rivers in 104 countries, representing the environmental influence of 471.4 million people. Analyzing 61 active pharmaceutical ingredients, the authors found the highest levels of pharmaceutical pollution in sub-Saharan Africa, southern Asia, and South America. Carbamazepine, metformin, and caffeine, the most frequently detected pharmaceuticals, were found in over half of all monitoring sites. In 25.7% of sites, the concentrations of pharmaceuticals were above the levels considered safe for aquatic life or above thresholds of concern for the development of antibiotic resistance. The results suggest that pharmaceutical pollution in rivers poses a global risk to human and environmental health. Read the award-winning research article: https://www.pnas.org/doi/10.1073/pnas... For more information about the Proceedings of the National Academy of Sciences, visit www.pnas.org.