Drugs in My Drinking Water?
According to the Alliance for the Great Lakes “Recent tests have found very low levels of pharmaceuticals in Lake Michigan at the water intakes for major metropolitan centers like Chicago and Milwaukee. Testing of drinking water outside the Great Lakes region has found similar results. Although at this time there is no known health risk to people at the low levels detected, the presence of pharmaceutical pollution nonetheless represents an emerging concern that should be addressed now to protect public health.
How big is the problem?
Pharmaceutical chemicals are introduced to our water supply through human, as well as agricultural, and veterinary use. Commonly these compounds enter the wastewater system when medicines are either disposed of or excreted by individuals after use. Because municipal wastewater treatment facilities and residential on-lot septic systems were not designed to remove these pollutants, their presence is becoming a growing concern. Both prescription and over-the counter medicines are being produced and consumed in increasing volumes every year. According to the Consumer Healthcare Products Association the retail sales of over-the-counter medicines have grown more than 225% in the ten years leading up to 2013! More than 4.02 billion drug prescriptions were written in the U.S. in 2011 according to the journal ACS Chemical Neuroscience. With the bubble of baby boomers floating up through our population; those numbers are not expected to decrease any time soon.
What do we know?
In short, we do not know as much as we probably should. As is commonly the case, technology has progressed more quickly than our understanding. Recent advances in analytical instrumentation have now made it possible to detect contamination in extremely small concentrations. George Washington University’s Rapid Public Health Policy Response Project states “At current levels, pharmaceutical residues are unlikely to pose an immediate risk to human health, but the long-term consequences of individual chemicals, and combinations of chemicals, are unknown, especially as concentrations rise.”
Some pharmaceuticals are easily broken down and processed by the human body or degrade quickly in the environment, but others are not easily metabolized so they enter the wastewater system. Excretion of biologically unused and unprocessed drugs depends on the formulation of the specific drug and the ability of the individual to break down drugs. This is in turn dependent upon health, age, gender, and other characteristics of the individual. An additional consideration is that some the metabolites, i.e. the digested drugs, are also biologically active.
Wastewater treatment systems are not currently equipped for pharmaceutical removal. A study completed by the United States Geological Survey (USGS) in 30 states in1999 and 2000 looked for 95 organic compounds associated with human and veterinary antibiotics, prescription drugs, steroids and reproductive hormones, caffeine, and chemicals found in plastics, insecticides, fragrances, fire retardants and solvents. Eighty percent of the water samples analyzed contained at least one of the 95 study contaminants. The USGS concluded that current wastewater treatment steps intended to return clean water to American lakes, streams, and rivers did not effectively address pharmaceuticals. According to the USEPA, there are currently no municipal wastewater treatment plants that are engineered specifically for pharmaceutical and personal care product removal or for other unregulated contaminants. Effective removal of these compounds by treatment plants varies based on the type of chemical and on the individual wastewater treatment facilities.
The risks are uncertain. At the concentrations currently found in surface water, the potential effects of pharmaceutical pollution are not well understood. Unlike many other regulated chemical and biological parameters, these compounds are not regularly monitored. Pollution can enter the human body (or the bodies of other terrestrial creatures) through ingestion, surface contact and inhalation of water vapor. Aquatic flora and fauna face constant exposure. Historically, the major concerns have been the resistance to antibiotics and disruption of aquatic endocrine systems by natural and synthetic sex steroids, however, many other compounds and mixtures of pharmaceuticals have unknown consequences.
The number is growing. In addition to antibiotics and steroids, the USEPA reports more than 100 individual pharmaceuticals and personal care products have been identified in environmental samples and drinking water. With thousands of drug compounds currently in existence and more under development and with a recent Mayo Clinic study finding nearly 70% of all Americans are prescribed at least one medication, the potential problem is growing.
Did you flush?
Mothers of young children have been asking this question since Sir John Harrington built the first flush toilet for his godmother Queen Elizabeth I back in the late 1500s. Fast forward several hundred years and the question takes on new meaning; the common practice of disposing of unwanted and expired medications by flushing them down the toilet has become a cause of concern for both environmental regulators and wastewater treatment agencies. As discussed earlier, municipal wastewater treatment plants are not currently designed to remove pharmaceuticals.
What’s a person to do?
The USEPA recommends against flushing as a means of disposing unused/unwanted prescription and over-the-counter drugs unless the label or accompanying patient information specifically instructs the patient to do so. Participation in a drug take-back event is the preferred solution for pharmaceutical disposal. The DEA and local/regional partners sponsor a National Drug Take-Back Day. Call your community or county government to see if an event is available nearby. Take-back events may be scheduled with household hazardous waste collection events so that is also a good time to safely dispose of unwanted lawn and garden chemicals, paint, antifreeze, oil, thermometers and thermostats, batteries and fluorescent bulbs, etc.
Household disposal of pharmaceuticals is a second choice. The following steps are recommended by the Drug Disposal Guidelines issued by the Office of National Drug Control Policy (10/2009). When in doubt about your disposal options, contact your pharmacist.
- Remove the drugs from their original container.
- Mix the drugs with an undesirable substance such as cat litter or used coffee grounds.
- Put this mixture into a disposable lidded container or into a sealable bag.
- Remove or conceal any personal information including prescription numbers on the empty containers.
- Place the sealed container with the drug mixture as well as the empty drug containers in the trash.