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The occurrence of sixty pharmaceutically active compounds (PhACs), twenty metabolites and eight personal care products (PCPs) in the aquatic environment in Spain and their predicted environmental concentrations (PECs) were calculated and compared with measured environmental concentrations (MECs) obtained from relevant published research. The occurrence in the aquatic environment was calculated through a mass balance approach considering the following: the number of pharmaceutical prescriptions issued, the amount of pharmaceutical discharged without consumption, consumption, self-medication, pharmacokinetics, treatment in wastewater facilities and discharged to aquatic environment. The estimation of consumption of active compounds of pharmaceuticals was conducted by at least one of the following methodologies: number of commercial packages sold, data for the number of defined daily …