Supplementary data 2 Model parameters

Term / Description / Value or equation /
AR.inpt / Administration rate of inpatient (%) / 100 a
AR.outpt / Administration rate of outpatient (%) / 39.1~100.0 b
BR.leach / Biodegradation rate in leachate treatment plant (%) / Pharmaceutical specific value
BR.stp / Biodegradation rate in sewage treatment plant (%) / Pharmaceutical specific value
DIS.h / Disuse of hospitals (kg/yr) / TS.hospital•DISR.hospital/100
DIS.p / Disuse of pharmacies (kg/yr) / TS.pharmacy•DISR.pharmacy/100
DIS.ts / Disuse of total supplies (kg/yr) / TS•DISR.ts/100
DIS.w / Disuse of wholesalers (kg/yr) / S.wholesaler•DISR.wholesaler /100
DISR.hospital / Disuse inventory ratio in hospitals (%) / 0.0~10.0 c
DISR.pharmacy / Disuse inventory ratio in pharmacies (%) / 0.0~10.0 c
DISR.ts / Disuse inventory ratio in total supplies (%) / 0.0~10.0 c
DISR.wholesaler / Disuse inventory ratio in wholesalers (%) / 0.0~10.0 c
E.leach / Emission to surface water from leachate treatment plant (kg/yr) / LEACH.in•(100-BR.leach-SLR.leach-VLR.leach)/100
E.stp / Emission to surface water from sewage treatment plant (kg/yr) / STP.in•(100-BR.stp-SLR.stp-VLR.stp)/100
ER / Excretion rate (%) / Pharmaceutical specific value
INCN.in / Inflow of pharmaceuticals to incineration plant (kg/yr) / DIS.ts+DIS.w+DIS.h+DIS.p+TB
L.incn_stp / Inflow of pharmaceuticals in linked treatment of incineration plant to sewage treatment plant (kg/yr) / RE.incn•(100-LFR.incn)/100
L.niso_stp / Inflow of pharmaceuticals in linked treatment of nightsoil treatment plant to sewage treatment plant (kg/yr) / NISO.in•(100-SLR.niso)/100
L.setp_stp / Inflow of pharmaceuticals in linked treatment of septic tank to sewage treatment plant (kg/yr) / SEPT.in•(100-LR.sept_niso)/100
LEACH.in / Inflow of pharmaceuticals to leachate treatment plant (kg/yr) / W.wb+RE.incn•LFR.incn/100
LEACHSL.incn / Incinerated pharmaceuticals in leachate treatment plant sludge (kg/yr) / SL.leach•LEACHSLR.incn/100
LEACHSL.rec / Recycled pharmaceuticals in leachate treatment plant sludge (kg/yr) / SL.leach•LEACHSLR.rec/100
LEACHSL.sea / Ocean-disposed pharmaceuticals in leachate treatment plant sludge (kg/yr) / SL.leach•LEACHSLR.sea/100
LEACHSL.soil / Landfilled pharmaceuticals in leachate treatment plant sludge (kg/yr) / SL.leach•LEACHSLR.soil/100
LEACHSLR.incn / Ratio of incinerated sludge from leachate treatment plant (%) / 13.0 d
LEACHSLR.rec / Ratio of recycled sludge from leachate treatment plant (%) / 25.0 d
LEACHSLR.sea / Ratio of ocean-disposed sludge from leachate treatment plant (%) / 47.0 d
LEACHSLR.soil / Ratio of landfilled sludge from leachate treatment plant (%) / 15.0 d
LFR.incn / Landfill rate out of incineration residue (%) / 0.0 e
LR.sept_niso / Linked treatment rate of septic tank to nighsoil treatment plant (%) / 73.6 d
NISO.in / Inflow of pharmaceuticals to nightsoil treatment plant (kg/yr) / SEPT.in•LR.sept_niso/100
NISOSL.incn / Incinerated pharmaceuticals in nightsoil treatment plant sludge (kg/yr) / SL.niso•NISOSLR.incn/100
NISOSL.rec / Recycled pharmaceuticals in nightsoil treatment plant sludge (kg/yr) / SL.niso•NISOSLR.rec/100
NISOSL.sea / Ocean-disposed pharmaceuticals in nightsoil treatment plant sludge (kg/yr) / SL.niso•NISOSLR.sea/100
NISOSL.soil / Landfilled pharmaceuticals in nightsoil treatment plant sludge (kg/yr) / SL.niso•NISOSLR.soil/100
NISOSLR.incn / Ratio of incinerated sludge from nightsoil treatment plant (%) / 1.0 d
NISOSLR.rec / Ratio of recycled sludge from nightsoil treatment plant (%) / 35.0 d
NISOSLR.sea / Ratio of ocean-disposed sludge from nightsoil treatment plant (%) / 59.0 d
NISOSLR.soil / Ratio of landfilled sludge from nightsoil treatment plant (%) / 5.0 d
NS / Net supply (kg/yr) / TS-DIS.ts
RE.incn / Residue after incineration plant (kg/yr) / INCN.in•(100-RR.incn)/100
RR.incn / Removal rate in incineration plant (%) / 100 f
S.exp / Supply to exporter (kg/yr) / NS•SR.exp/100
S.wholesaler / Supply to wholesaler (kg/yr) / NS•SR.wholesaler/100
SEPT.in / Inflow of pharmaceuticals to septic tank (kg/yr) / TA.excretion+W.toilet
SL.leach / Residue in sludge from leachate treatment plant (kg/yr) / LEACH.in•SLR.leach/100
SL.niso / Residue in sludge from nightsoil treatment plant (kg/yr) / NISO.in•SLR.niso/100
SL.stp / Residue in sludge from sewage treatment plant (kg/yr) / STP.in•SLR.stp/100
SL.tot / Total residue in sludge from water treatment plants (kg/yr) / SL.stp+SL.leach+SL.niso
SLR.leach / Removal rate by sludge separation in leachate treatment plant (%) / Pharmaceutical specific value
SLR.niso / Removal rate by sludge separation in nightsoil treatment plant (%) / Pharmaceutical specific value
SLR.stp / Removal rate by sludge separation in sewage treatment plant (%) / Pharmaceutical specific value
SR.company / Supply rate to pharmaceutical company (%) / 9.0 g
SR.etc / Supply rate to others (%) / 3.6 g
SR.exp / Supply rate to exporter (%) / 7.0 g
SR.hospital / Supply rate to hospital (%) / 25.5 g
SR.pharmacy / Supply rate to pharmacy (%) / 18.1 g
SR.w_h / Supply rate from wholesaler to hospital (%) / 23.0 g
SR.w_p / Supply rate from wholesaler to pharmacy (%) / 63.3 g
SR.wholesaler / Supply rate to wholesaler (%) / 36.8 g
STP.in / Inflow of pharmaceuticals to sewage treatment plant (kg/yr) / W.sink+L.setp_stp+L.niso_stp+L.incn_stp
STPSL.incn / Incinerated pharmaceuticals in sewage treatment plant sludge (kg/yr) / SL.stp•STPSLR.incn/100
STPSL.rec / Recycled pharmaceuticals in sewage treatment plant sludge (kg/yr) / SL.stp•STPSLR.rec/100
STPSL.sea / Ocean-disposed pharmaceuticals in sewage treatment plant sludge (kg/yr) / SL.stp•STPSLR.sea/100
STPSL.soil / Landfilled pharmaceuticals in sewage treatment plant sludge (kg/yr) / SL.stp•STPSLR.soil/100
STPSLR.incn / Ratio of incinerated sludge from sewage treatment plant (%) / 13.0 d
STPSLR.rec / Ratio of recycled sludge from sewage treatment plant (%) / 25.0 d
STPSLR.sea / Ratio of ocean-disposed sludge from sewage treatment plant (%) / 47.0 d
STPSLR.soil / Ratio of landfilled sludge from sewage treatment plant (%) / 15.0 d
TA.admin / Total amount of administration (kg/yr) / (TS.inpt•AR.inpt/100)+(TS.outpt•AR.outpt/100)
TA.excretion / Total amount of excretion (kg/yr) / TA.admin•ER/100
TA.imp / Total amount of import (kg/yr) / Pharmaceutical specific value
TA.prod / Total amount of production (kg/yr) / Pharmaceutical specific value
TA.waste / Total amount of waste (kg/yr) / TS.outpt• (100-AR.outpt)/100
TB / Returned amount in Take-back program (kg/yr) / TA.waste•TBR/100
TBR / Return rate to Take-back program (%) / 0~100
TE.water / Total emission to surface water (kg/yr) / E.stp+E.leach
TS / Total supply to region (kg/yr) / TA.prod+TA.imp
TS.hnp / Total supply to hospital and pharmacy (kg/yr) / NS-S.exp-DIS.w
TS.hospital / Total supply to hospital (kg/yr) / TS.hnp•TSR.hospital/100
TS.inpt / Total supply to inpatient (kg/yr) / TS.hospital-DIS.h
TS.outpt / Total supply to outpatient (kg/yr) / TS.pharmacy-DIS.p
TS.pharmacy / Total supply to pharmacy (kg/yr) / TS.hnp•TSR.pharmacy/100
TSD.incn / Total incinerated pharmaceuticals in sludges (kg/yr) / STPSL.incn+LEACHSL.incn+NISOSL.incn
TSD.rec / Total recycled pharmaceuticals in sludges (kg/yr) / STPSL.rec+LEACHSL.rec+NISOSL.rec
TSD.sea / Total ocean-disposed pharmaceuticals in sludges (kg/yr) / STPSL.sea+LEACHSL.sea+NISOSL.sea
TSD.soil / Total landfilled pharmaceuticals in sludges (kg/yr) / STPSL.soil+LEACHSL.soil+NISOSL.soil
TSR.hospital / Total supply rate to hospital (%) / (SR.hospital+SR.wholesaler•SR.w_h/100) /((SR.pharmacy+SR.wholesaler•SR.w_p/100)+(SR.hospital+SR.wholesaler•SR.w_h/100))*100
TSR.pharmacy / Total supply rate to pharmacy (%) / (SR.pharmacy+SR.wholesaler•SR.w_p/100) /((SR.pharmacy+SR.wholesaler•SR.w_p/100)+(SR.hospital+SR.wholesaler•SR.w_h/100))*100
VL.leach / Volatilization loss from leachate treatment plant (kg/yr) / LEACH.in•VLR.leach/100
VL.stp / Volatilization loss from sewage treatment plant (kg/yr) / STP.in•VLR.stp/100
VL.tot / Volatilization loss from water treatment plants (kg/yr) / VL.stp+VL.leach
VLR.leach / Volatilization loss rate from leachate treatment plant (%) / Pharmaceutical specific value
VLR.stp / Volatilization loss rate from sewage treatment plant (%) / Pharmaceutical specific value
W.sink / Waste into sink (kg/yr) / TA.waste•WR.sink/100
W.toilet / Waste into toilet (kg/yr) / TA.waste•WR.toilet/100
W.wb / Waste into waste bin (kg/yr) / TA.waste•WR.wb/100
WR.sink / Waste rate into sink (%) / (100-TBR) •0.07 h
WR.toilet / Waste rate into toilet (%) / (100-TBR) •0.07 h
WR.wb / Waste rate into waste bin (%) / (100-TBR) •0.86 h

a Inpatients hardly have chances to waste prescribed medications.

b The minimum value of 39.1% for AR.outpt was taken from the rate of people who take all the medications they purchase in a survey performed in 2009 [26].

c According to a survey performed in 2009 [30], these rates were reported to be below 10%.

d 2009 data from Sewerage of Korea statistics [29].

e Assumed to be negligible.

f Assumed to be complete.

g 2009 data from Korean pharmaceutical industry statistics [28].

h The ratio of 86: 7: 7 was taken from a survey in 2009 [26].