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Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) can cause histopathological changes in the kidney and liver of fish. Still, it isunclear whether exposure to treated municipal wastewater that contains NSAID residues causes similar effects. We thereforeconducted a comprehensive, critical review on claimed histopathological changes in fish exposed either to NSAIDs or to treatedmunicipal wastewater in the laboratory or downstream from treatment plants. A detailed scrutinization questioned the basis forseveral findings. Hepatocellular necrosis, hepatocellular vacuolation, and an increase of developing nephrons/basophilic clusters(DNs/BCs) were overlapping findings, but the lowest observed effect concentrations (LOEC) for the hepatic endpoints werewell above concentrations frequently encountered in treated effluents. An increase of DNs/BCs were reported at lower NSAIDconcentrations, but with some concerns regarding reliability. Hence, there is no clear documentation that histopathological effectscaused by NSAIDs are present in fish exposed to municipal effluents. Study design, including the species studied, exposure regimes,endpoints analyzed, and applied methodology varied widely between studies, all of which could make overlapping effects difficultto detect. In addition, limitations in both experimental design and reporting standards in fish histopathology studies prevent anyfirm conclusions. More comparable study designs in future studies would facilitate comparisons.

Keywords

fish; wastewater treatment plant; sewage; histopathology; NSAID; diclofenac

Published in

Toxicologic Pathology
2026

SLU Authors

UKÄ Subject classification

Pathobiology

Publication identifier

  • DOI: https://doi.org/10.1177/019262332614238

Permanent link to this page (URI)

https://res.slu.se/id/publ/146921