OBJECTIVES:Pharmaceuticals in the environment are of growing public health concern. The main objectives of this study were to develop a new emission estimation model, identify factors critical to reducing emission, and demonstrate the model's applicability for screening and priority setting. METHODS:A new emission estimation model was developed covering the life cycle pathways of pharmaceuticals from supply to discharge into surface water. The emission estimates of the model were assessed by coupling with SimpleBox to give predicted concentrations and by comparing the predicted concentrations with measured concentrations in Korean surface waters for five selected pharmaceuticals (acetaminophen, cephradine, ibuprofen, mefenamic acid, and naproxen). RESULTS:The sensitivity analysis revealed that the biodegradation rate in the sewage treatment plant and the excretion rate of pharmaceuticals were the most important factors influencing the emission rate. The uncertainty of the emission estimate was found to increase with increases in the value of the emission estimate. Once the intrinsic properties of a pharmaceutical (excretion rate, biodegradation rate, and removal rate by sludge separation) were given, the patient behavior parameters, such as participation in a Take-back program and rate of administration, were determined to have a strong influence on the emission estimate. In our study, the predicted and measured concentrations agreed with each other within one order of magnitude. Several management implications were drawn from the analysis of model outcomes. CONCLUSIONS:The model outcomes, alone or in combination with toxicity data, may potentially be used for the purposes of screening, priority setting, and the design of management programs.