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Are the increasing amounts of gadolinium in surface and tap water dangerous?

Since its introduction in the early 1980s, magnetic resonance imaging (MRI) has become an indispensable modality for diagnostic imaging. Gadolinium (Gd)based contrast media have been used in MRI since 1988 and are now administered in 33–50% of examinations. Six of the nine available agents are excreted only via the kidneys and the remaining three agents are also excreted via the hepatocytes into the biliary system (range, 4–50%) so a major proportion of all agents reaches the sewage. Because of their high stability, none of the agents are removed in waste water treatment plants (WWTP) to a significant extent so they are transferred to surface water with the clear water discharge from the WWTP. Teglmann et al. showed that less than 10% of Gd-based contrast media may be removed during current water treatment (1). The contrast media which remain in the water are described as anthropogenic pollutants, meaning that they occur as a result of human activity. The anthropogenic Gd is also transported into groundwater both by natural and by induced bank filtration (2). Twenty years ago, Bau and Dulski (3) described the anthropogenic Gd anomaly in our water and its correlation with the administration of Gd contrast agents, and showed that the amounts of Gd were enriched, i.e. greater in amount relative to the other rare earth elements.