This  report  of  MORPHEUS  Project  Partners  documents  the  outcome  of  WP3  –  consumption patterns.   Herein,   the   project   aims   to   identify   and   quantify   the   emission   of   selected pharmaceuticals   especially   discharged   via   wastewater   of   WWTP.   A   comprehensive   data research was performed and prioritized pharmaceutical consumption loads have been calculated for the model areas in Lithuania, Poland, Sweden and Germany. The outcome of this report can be summarized in the following key facts:

1.    Consumption data is based on either sales data of wholesalers/pharmacies or data from health care institutions. The unit of consumption is number of reimbursed packages andDDD, respectively.

2.    The resolution and  data coverage (only partly including OTC, hospital etc.) is  country- specific:  The  best  time-resolution  was  found  in  Poland  (monthly),  the  best  spatial resolution in Lithuania (population group <3000).

3.    Country-specific  consumption  was  comparable  by  a  developed  value  intake  load  per inhabitant per year.

4.    For   Swedish   and   German   data,   a   comparison   of   different   distributing   sites   of pharmaceuticals   was   possible   (over   the   counter   sales,   application   in   hospitals, prescriptions/pharmacies).

5.    For Lithuanian data, the high spatial resolution enabled a potential correlation with the local demographic data in regard of consumption of beta blocking pharmaceuticals.

6.    For Polish data, a seasonal variation can be clearly shown for antibiotics.

7.    For  German  data,  an  accumulation  within  the  river  catchment  shows  that  a  complete picture   of   the   whole   system   is   essential   to   understand   the   actual   burden   of pharmaceuticals in the environment.

8.    Comparing the model areas, all results have been in the same order of magnitude more or  less  depending  on  consumption  and  doses.  Metformin  and  diverse  analgesics revealed high intake loads.  In general, mostly German intake loads exceed the  others which  may  lies  in  the  fact  that  the  selection  of  pharmaceuticals  is  mostly  based  on German literature and statistics  due to availability/accessibility.  An  adjustment to  each country-specific list may lead to other results.

9.    Some  substances  remain  unclear:  Contrast  media  and  hormones  are  still  a  matter  of burden  to  the  environment  but  caused  some  difficulties  during  data  collection  andresearch.