Small streams are crucial but vulnerable elements of ecological networks. To better understand the occurrence of phar-
maceutically active compounds (PhACs) in streams, this study focused on the occurrence, distribution, and environ-
mental risk of 111 PhACs and 7 trace elements based on a total of 141 water and sediment samples from small
streams located in the urbanizing region of Budapest, Hungary. Eighty-one PhACs were detected in the aqueous
phase, whereas sixty-two compounds were detected in the sediment. Carbamazepine (CBZ) was the most frequently
identified PhAC in water, and was found in 91.5% of all samples. However, the highest concentrations were measured
for lamotrigine (344.8 μg·L−1
) and caffeine (221.4 μg·L−1
). Lidocaine was the most frequently occurring PhAC in sed-
iment (73.8%), but the maximum concentrations were detected for CBZ (395.9 ng·g−1
) and tiapride (187.7 ng·g−1
). In
both water and sediment, more PhACs were found downstream of the wastewater treatment plants (WWTPs) than in
the samples not affected by treated wastewater, even though no relationship was observed between the total amount of
treated wastewater and the number of detected PhACs. The PhAC concentrations were also independent of the dis-
tance from the WWTP effluents. PhAC-polluted samples were detected upstream of the WWTPs, thereby suggesting the relevance of diffuse emissions in addition to WWTP outlets. The most frequently detected PhACs in the sediment
were usually also present in the water samples collected at the same place and time. The varying concentrations of
PhACs and the fluctuating water–sediment properties resulted in a lack of correlation between the general chemical
properties and the concentrations of PhACs, which makes it difficult to predict PhAC contamination and risks in
urbanized small streams. The environmental risk assessment indicated that diclofenac had the highest risk in the
sampling area