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Pharmaceuticals in the Environment

The Quick Facts: The use of pharmaceuticals in the United States is common and widespread. Unfortunately, people tend to improperly dispose of unused pharmaceuticals by putting them in the trash or by flushing them down the toilet. These disposal methods may be causing environmental and human health hazards such as disrupting reproductive systems, neurological problems in children, and increased incidence of some cancers. No national standards exist for how much of any pharmaceutical is too much in waterways or in drinking water. You can help to protect the health of humans, wildlife, and the environment by properly disposing of unused, unwanted, or expired pharmaceuticals in these ways.

A Medicated Environment
According to the United States Environmental Protection Agency (EPA), pharmaceuticals comprise a large and varied group of chemicals, including human and veterinary medicines.

The EPA has found trace components of pharmaceuticals in the environment, specifically in aquifers, discharges from sewage treatment plants, and rivers in several areas of Europe, and recently in the United States (U.S.). The drugs found by the EPA include cholesterol-lowering drugs, antibiotics, analgesics, antiseptics and beta-blockers.

Other contaminants that have been documented in the environment include hormones created in the human body, synthetic hormones (such as those manufactured for birth control or menopausal supplement), and industrial/commercial compounds which can have some hormonal function (such as pesticides, alkylphenols, and phthalates).

A study by the University of York warns that even though the reported concentrations of pharmaceuticals in the environment are generally low, the substances have been observed across a wide variety of hydrological, climatic, and land-use settings, and many of the substances have been detected throughout the year. This information suggests pharmaceuticals in the environment are widespread and persistent.

What are the Sources?
The U.S. Geological Survey (USGS) says the source of pharmaceuticals in the environment is primarily through the release of human and animal wastes to the environment. Overall, during manufacture and use, human and veterinary pharmaceuticals may be released to the environment by a number of routes.

Human Waste
People contribute pharmaceuticals to the environment unintentionally when medication is consumed and medication residues pass out of the body and into sewer & septic systems. Also, externally-applied drugs and personal care products wash down the shower drain and into wastewater treatment systems.

The USGS found that the concentration of many of the pharmaceuticals found in the environment, such as sulfamethoxazole (an antibiotic used to treat a wide range of bacterial infections), triclosan (an antimicrobial agent commonly used in soaps), and caffeine, increased dramatically downstream from the first major wastewater treatment plant. In the U.S., many municipal and private wastewater treatment facilities, as well as septic systems, discharge into a waterway or underground water supply. Unfortunately, many of the wastewater treatment plants in the U.S. are not designed to remove pharmaceuticals through the treatment of sewage.

Unused or expired medications also reach the environment when they are placed in the trash. Medications placed in the trash end-up in landfills where they leach out into groundwater and surface water supplies.

Animal Waste
In the U.S., animals are injected with many medicines, especially antibiotics. The large number of animals in livestock operations creates a proportionately large volume of animal waste and associated pharmaceuticals, including veterinary antibiotics. Not surprisingly, feeding operations are contributing veterinary pharmaceuticals to the environment due to medicated feed. Data from studies demonstrate that veterinary pharmaceuticals are excreted and frequently occur at detectable levels in liquid and solid waste. This waste washes into nearby waterways, or is sometimes used in fertilizers applied on land.

Aquaculture is also a source of the pharmaceutical waste stream. Research documenting the presence of antibiotics in fish hatchery water shows the occurrence and persistence of antibiotics in medicated feed used in fish hatcheries.

Biosolid Fertilizers Used on Land
The land application of sludge or “biosolids” that result from the treatment of wastewater is another potential source of pharmaceuticals to the environment. According to USGS, wastewater treatment plants in the U.S. generate approximately 7 million dry tons of sludge each year. Sludge is frequently applied to soils to fertilize plants and to improve the quality of soil. These biosolids and composts are used widely in both residential and commercial landscaping and in agriculture, and may be a widespread source of pharmaceuticals to surface and ground water. Preliminary results of ongoing research suggest pharmaceuticals can accumulate in soils.

Wastewater Irrigation
Arid areas of the U.S. often irrigate with treated wastewater. USGS scientists found that soil samples from Colorado land irrigated with wastewater contained pharmaceuticals, including erythromycin (an antibiotic), carbamazepine (a drug used to prevent and control seizures), fluoxetine (an antidepressant), and diphenhydramine (a common non-prescription antihistamine). Another study found pharmaceuticals in water samples collected from Lake Mead on the Colorado River and Las Vegas Wash, a waterway used to transport treated wastewater from the Las Vegas metropolitan area to Lake Mead. Some of the pharmaceuticals detected were caffeine, carbamazepine (used to treat epilepsy), cotinine (a metabolite of nicotine), dehydronifedipine (a metabolite of a commonly used antianginal), antibiotics (clarithromycin, erythromycin, sulfamethoxazole, and trimethoprim), acetaminophen (an analgesic and anti-inflammatory), cimetidine (used to treat ulcers), codeine (a narcotic and analgesic), diltiazem (an antihypertensive), and 1,7-dimethylxanthine (a metabolite of caffeine).

Harmful Effects of Pharmaceuticals on Environmental & Human Health
There is increasing concern that the pharmaceuticals in surface and ground waters and the environment, in general, are impacting the environment, animals, and people. Some of these impacts may include: contributing to antibiotic resistance; feminization by estrogens; the effects on environmental organisms; the presence of anti-depressants in drinking water; the effects on wildlife of veterinary drugs such as pain killers. Two serious consequences of pharmaceutical contamination of the environment are increased antibiotic resistance and disruption of human and animal endocrine (or reproductive) systems.

Effects on the Environment
Unfortunately, the USGS says, “Our ability to measure contaminants currently exceeds our understanding of their potential environmental effects.” For most of the pharmaceuticals found in the environment, there is currently little information regarding their potential toxicological significance in ecosystems—particularly effects from long-term, low-level environmental exposure.

However, according to the USGS’s study, “Emerging Contaminants in the Environment,” low-level exposure to some contaminants can disrupt animal reproduction and development by modulating, mimicking, or interfering with normal hormonal function. These types of contaminants are called endocrine disrupting chemicals. Specifically, native fish populations have been found to exhibit endocrine disruption, showing low male-to-female sex ratio and fish having both female and male reproductive organs. Studies have also shown that compounds are bio-accumulating in animal tissue and being passed up the food chain.

Effects on Human Health
The impacts of pharmaceuticals in the environment on human health are even lesser known, but still in question. Federal officials in the U.S. are beginning to study the human health effects that could be caused by endocrine disrupting chemicals found in water, resulting from pharmaceutical contamination. Studies are being conducted to research the possible links to neurological problems in children and increased incidence of some cancers. Researchers also suggest that estrogen from birth control pills, which contaminates drinking water supplies, is potentially contributing to early puberty in young girls.

In a recent study conducted in Italy, pharmaceuticals slowed growth when tested on human kidney cells. This preliminary study suggested the potential impacts of pharmaceutical water contamination to humans, and raised more concerns about the impacts on the very young, old, or sick. Also, a recent study commissioned by the Associated Press in the U.S. revealed that recent laboratory research has found that small amounts of medications found in the environment affect human embryonic kidney cells, human blood cells, and human breast cancer cells. The cancer cells proliferated too quickly; the kidney cells grew too slowly; and the blood cells showed biological activity associated with inflammation.

According to the University of York, there are still many questions that need to be addressed before knowing the threat to human (and environmental) health:

Overall, until these questions are answered, it is recommended by scientists that we should strive to refine the ways in which we use and handle and treat medicines in order to minimize releases to the environment.

What are the Government and Pharmaceutical Companies Doing?
Unfortunately, there is no national strategy to deal with pharmaceutical pollution in our environment. There are no effective mandates to test, treat, limit, or even advise the public. No national standards exist for how much of any pharmaceutical is too much in waterways or in drinking water. Wastewater treatment plants are not required to test for pharmaceuticals in the treated effluent that is released into nearby waters. In addition, while the U.S. Food and Drug Administration can review the environmental impact of new drugs, it has never rejected one on this basis.

The EPA is working with state and local partners to research, collect information, and develop new ways to monitor and detect pharmaceuticals in the environment. In the meantime, the EPA is also helping to fund various stewardship activities, such as educating the public about proper pharmaceutical disposal (see below), and funding pharmaceutical acceptance programs.

Pharmaceutical companies are responding with statements and by conducting their own studies. Companies say that public interest in this topic has grown due to advancements in analytical capabilities in detecting these chemicals in the environment.

What Can You Do?
To help protect the health of humans, wildlife, and the environment, you can properly dispose of unused, unwanted, or expired pharmaceuticals in these ways:

Related Real Mama Articles:
Chemicals in Cosmetics (Fall 2005 Issue)
Tuna Fish: Is it Mercury in a Can? (Spring 2006 Issue)

Information used in this article was found at the following sources, which you can visit if you want to find out more about this topic:

http://www.safecosmetics.org/ (Campaign for Safe Cosmetics is a coalition of women’s, public health, labor, environmental health and consumer-rights groups with the goal to protect the health of consumers and workers by requiring the health and beauty industry to phase out the use of chemicals linked to cancer, birth defects and other health problems, and replace them with safer alternatives.)

http://earth911.org/blog/2007/11/05/why-are-pharmaceuticals-hazardous/ (Earth 911 website, “Why are Pharmaceuticals Hazardous?” by Mark Rappaport on November 5, 2007)

http://www.astrazeneca.com/article/511608.aspx (Astra Zeneca, a drug company, “Pharmaceuticals in the Environment”)

http://www.gsk.com/investors/reps03/EHS03/GSKehs-35.htm (GlaxoSmithKline, a drug company, “Pharmaceuticals in the Environment”)

http://toxics.usgs.gov/regional/emc/ (United States Geological Survey (USGS), “Emerging Contaminants in the Environment,” The major goal of the Emerging Contaminants Project is to provide information on compounds for evaluation of their potential threat to environmental and human health. Sept. 6, 2007)

http://www.chbr.noaa.gov/peiar/default.aspx (National Oceanic & Atmospheric Administration, National Centers for Coastal Ocean Science, Center for Coastal Environmental Health and Biomolecular Research, “The Pharmaceuticals in the Environment, Information for Assessing Risk,” a database of available information on the general chemistry and toxicology of potential environmental levels of pharmaceuticals; updated November 24, 2006)

http://www.lcgceurope.com/lcgceurope/Pharmaceutical/Extraction-of-Pharmaceuticals-from-Environmental-W/ArticleStandard/Article/detail/409914 (LC/GC Europe, a business-to-business publication, “Extraction of Pharmaceuticals from Environmental Water Samples,” March 2, 2007)

http://www2.chem.ku.edu/Lunte_Grp/projects/investigation_of_pharmaceuticals.htm (Craig Lunte Research Group at the University of Kansas Chemistry Department, “Investigation of Pharmaceuticals in Environmental Samples Using CE-MS and LC-MS”)

http://goliath.ecnext.com/coms2/summary_0199-498519_ITM&referid=2090 (Bulletin of the World Health Organization, “Potential impact of pharmaceuticals on environmental health,” Author: Jones, Oliver A.H.; Voulvoulis, Nick; Lester, John N., October 1, 2003)

http://pubs.acs.org/hotartcl/est/es011055j_rev.html (American Chemical Society, reprint of Pharmaceuticals, “Hormones, and Other Organic Wastewater Contaminants in U.S. Streams, 1999-2000: A National Reconnaissance”, Dana W. Kolpin, Edward T. Furlong, Michael T. Meyer, E. Michael Thurman, Steven D. Zaugg, Larry B. Barber, and Herbert T. Buxton, Environmental Science & Technology, March 15, 2002)

http://www.epa.gov/ppcp/ (EPA website on pharmaceuticals in the environment, 2/15/08)

http://www.york.ac.uk/depts/eeem/gsp/esm/issues/pharma.htm (University of York, Environment Department, “Pharmaceuticals in the Environment,” article and diagram of routes of release of human and veterinary pharmaceuticals to the environment, August 12, 2006)

http://www.alternet.org/environment/59305/?page=entire (E Magazine, Pharmaceuticals in Our Water Supply Are Causing Bizarre Mutations to Wildlife, by Greg Peterson. Posted August 9, 2007)

http://www.teleosis.org (The Journal of Ecologically Sustainable Medicine, Health News: Pharmaceutical Pollution, Spring/Summer 2007)

http://www.msnbc.msn.com/id/23558785/ (“How meds in water could impact human cells,” Associated Press, MSNBC, March 10, 2008)

http://www.startribune.com/nation/16430656.html (“Investigation finds drugs in drinking water,” By Jeff Donn, Martha Mendoza, and Justin Pritchard, Associated Press, March 10, 2008)

http://www.epa.gov/waterscience/guide/pharm/guidance/ (United States Environmental Protection Agency, “Effluent Guidelines: Pharmaceuticals Manufacturing Point Source Category,” updated January 2, 2008)

http://www.wcbs880.com/pages/1808876.php?contentType=4&contentId=1706190" (WCBS NewsRadio, “No Regulations to Keep Pharmaceuticals Out of Drinking Water—Part 3/3 in an AP Special Investigation,” by Jeff Donn, Martha Mendoza, and Justin Pritchard, Associated Press Writers, March 12, 2008)


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