Micropollutants such as pharmaceuticals, ingredients of household chemicals, chemicals used in small businesses or industries, environmental persistent pharmaceutical pollutants (EPPP) or pesticides may not be eliminated in the commonly used sewage treatment processes (primary, secondary and tertiary treatment) and therefore lead to water pollution. Although concentrations of those substances and their decomposition products are quite low, there is still a chance of harming aquatic organisms. For pharmaceuticals, the following substances have been identified as toxicologically relevant: substances with endocrine disrupting effects, genotoxic substances and substances that enhance the development of bacterial resistances. They mainly belong to the group of EPPP. 
Techniques for elimination of micropollutants via a fourth treatment stage during sewage treatment are implemented in Germany, Switzerland, Sweden and the Netherlands and tests are ongoing in several other countries. Such process steps mainly consist of activated carbon filters that adsorb the micropollutants. The combination of advanced oxidation with ozone followed by granular activated carbon (GAC) has been suggested as a cost-effective treatment combination for pharmaceutical residues. For a full reduction of microplasts the combination of ultrafiltration followed by GAC has been suggested. Also the use of enzymes such as laccase secreted by fungi is under investigation. Microbial biofuel cells are investigated for their property to treat organic matter in sewage.
To reduce pharmaceuticals in water bodies, source control measures are also under investigation, such as innovations in drug development or more responsible handling of drugs. In the US, the National Take Back Initiative is a voluntary program with the general public, encouraging people to return excess or expired drugs, and avoid flushing them to the sewage system.