Drug pollution
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Drug pollution or pharmaceutical pollution is
pollution Pollution is the introduction of contaminants into the natural environment that cause adverse change. Pollution can take the form of any substance (solid, liquid, or gas) or energy (such as radioactivity, heat, sound, or light). Pollutants, the ...
of the environment with
pharmaceutical drug A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field an ...
s and their metabolites, which reach the aquatic environment (
groundwater Groundwater is the water present beneath Earth's surface in rock and soil pore spaces and in the fractures of rock formations. About 30 percent of all readily available freshwater in the world is groundwater. A unit of rock or an unconsolidated ...
,
river A river is a natural flowing watercourse, usually freshwater, flowing towards an ocean, sea, lake or another river. In some cases, a river flows into the ground and becomes dry at the end of its course without reaching another body of w ...
s,
lake A lake is an area filled with water, localized in a basin, surrounded by land, and distinct from any river or other outlet that serves to feed or drain the lake. Lakes lie on land and are not part of the ocean, although, like the much large ...
s, and
ocean The ocean (also the sea or the world ocean) is the body of salt water that covers approximately 70.8% of the surface of Earth and contains 97% of Earth's water. An ocean can also refer to any of the large bodies of water into which the wo ...
s) through
wastewater Wastewater is water generated after the use of freshwater, raw water, drinking water or saline water in a variety of deliberate applications or processes. Another definition of wastewater is "Used water from any combination of domestic, industrial ...
. Drug pollution is therefore mainly a form of
water pollution Water pollution (or aquatic pollution) is the contamination of water bodies, usually as a result of human activities, so that it negatively affects its uses. Water bodies include lakes, rivers, oceans, aquifers, reservoirs and groundwater. ...
. "Pharmaceutical pollution is now detected in waters throughout the world," said a scientist at the Cary Institute of Ecosystem Studies in Millbrook, New York. "Causes include aging infrastructure, sewage overflows and
agricultural runoff Agricultural pollution refers to biotic and abiotic byproducts of farming practices that result in contamination or degradation of the environment and surrounding ecosystems, and/or cause injury to humans and their economic interests. The pol ...
. Even when wastewater makes it to
sewage treatment Sewage treatment (or domestic wastewater treatment, municipal wastewater treatment) is a type of wastewater treatment which aims to remove contaminants from sewage to produce an effluent that is suitable for discharge to the surrounding e ...
facilities, they aren't equipped to remove pharmaceuticals."


Sources and effects

Most simply from the drugs having been cleared and
excreted Excretion is a process in which metabolic waste is eliminated from an organism. In vertebrates this is primarily carried out by the lungs, kidneys, and skin. This is in contrast with secretion, where the substance may have specific tasks after lea ...
in the
urine Urine is a liquid by-product of metabolism in humans and in many other animals. Urine flows from the kidneys through the ureters to the urinary bladder. Urination results in urine being excreted from the body through the urethra. Cellular ...
. The portion that comes from expired or unneeded drugs that are flushed unused down the toilet is smaller, but it is also important, especially in hospitals (where its magnitude is greater than in residential contexts). This includes drug molecules that are too small to be filtered out by existing water treatment plants. The process of upgrading existing plants to use
advanced oxidation process Advanced oxidation processes (AOPs), in a broad sense, are a set of chemical treatment procedures designed to remove organic (and sometimes inorganic) materials in water and wastewater by oxidation through reactions with hydroxyl radicals (·OH) ...
es that are able to remove these molecules can be expensive. Drugs such as antidepressants have been found in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...
Great Lakes The Great Lakes, also called the Great Lakes of North America, are a series of large interconnected freshwater lakes in the mid-east region of North America that connect to the Atlantic Ocean via the Saint Lawrence River. There are five lak ...
. Researchers from the
University of Buffalo The State University of New York at Buffalo, commonly called the University at Buffalo (UB) and sometimes called SUNY Buffalo, is a public research university with campuses in Buffalo and Amherst, New York. The university was founded in 18 ...
have found high traces of antidepressants in the brains of fish. Fish behavior on antidepressants have been noted to have similar impacts and reducing risk-averse behavior, and thereby reducing survival through
predation Predation is a biological interaction where one organism, the predator, kills and eats another organism, its prey. It is one of a family of common feeding behaviours that includes parasitism and micropredation (which usually do not kill th ...
. Other sources include agricultural runoff (because of
antibiotic use in livestock An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention of ...
) and
pharmaceutical manufacturing Pharmaceutical manufacturing is the process of industrial-scale synthesis of pharmaceutical drugs as part of the pharmaceutical industry. The process of drug manufacturing can be broken down into a series of unit operations, such as milling, g ...
. Drug pollution is implicated in the sex effects of water pollution. It is a suspected a contributor (besides industrial pollution) in fish kills, amphibian dieoffs, and amphibian pathomorphology.


Pollution of water systems

In the early 1990s, pharmaceuticals were found to be present in the environment, which resulted in massive scientific research, new regulations, and public attention. Also during the 1990s, it was discovered that for the synthesis of one kilogram of an active pharmaceutical compound the amount of waste produced was fifty to hundred times that one kilogram, which was ending up in the environment. During the late 1990s, estrogens were discovered in wastewater. It was concluded that this was the cause of feminization of fish. This was another factor that caused greater attention to pharmaceuticals in the environment. Reviews and information on pharmaceuticals present in the environment date back to at least the 1980s. The majority of pharmaceuticals are intended to cause slight adverse effects for the target population. Low concentrations of pharmaceuticals can have negative effects on the freshwater ecosystems.


Pharmaceuticals in the environment

In the United States, Spain, Germany and the United Kingdom over 101 different pharmaceuticals were present in ground water, surface water, drinking water or tap water. Between 30 and 100 different pharmaceuticals were found present in the aforementioned waters in Thailand, Canada, Australia, India, China, South Korea, Japan, Sweden, Poland, Italy, the Netherlands, France and Brazil.


In rivers


Pharmaceuticals and their effects

* The excretion of
oral contraceptives Oral contraceptives, abbreviated OCPs, also known as birth control pills, are medications taken by mouth for the purpose of birth control. Female Two types of female oral contraceptive pill, taken once per day, are widely available: * The combin ...
into freshwater ecosystems has caused fish and amphibians to feminize. *
Antipsychotic Antipsychotics, also known as neuroleptics, are a class of psychotropic medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia but also in a range of ...
s were created about seventy years ago and it was not until 2007 that it was reported that antipsychotics were present in the environment. They are used to treat a plethora of illnesses including depression, schizophrenia, autism, attention deficit hyperactivity disorder and bipolar disease. Antipsychotics, once excreted by the patient by either feces or urine, travel to wastewater treatment plants, which does not remove the drugs and their metabolites. These drugs have been found in drinking water, all bodies of water, and hospital sewage. Once they reach the aquatic environment, they possibly undergo bioconcentration and bioaccumulation through the food web. *
Psychiatric Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psychiatry. Initial psy ...
drugs, such as fluoxetine, sertraline, citalopram, chlorpromazine and oxazepram, were found to change fish behavior and caused disruption in the hormones of fish. In invertebrates, these drugs were found to cause reproduction toxicity and hormone disruption and alter their behavior. *
Antineoplastic drugs Chemotherapy (often abbreviated to chemo and sometimes CTX or CTx) is a type of cancer treatment that uses one or more anti-cancer drugs (chemotherapeutic agents or alkylating agents) as part of a standardized chemotherapy regimen. Chemotherap ...
are employed during chemotherapy all over the world. They pollute water courses and have 'mutagenic, cytostatic, and ecotoxicological effects on the micro-organisms that are in the aquatic environment.' The wastewater treatment process is not able to remove antineoplastic drugs due to the intractable nature of them. Bodies of water that are contaminated with antineoplastic drugs possess grave consequences on the aquatic environment and even human health. Chemotherapy drugs such as cyclophosphamide 1, fluorouracil,
doxorubicin Doxorubicin, sold under the brand name Adriamycin among others, is a chemotherapy medication used to treat cancer. This includes breast cancer, bladder cancer, Kaposi's sarcoma, lymphoma, and acute lymphocytic leukemia. It is often used toge ...
,
cisplatin Cisplatin is a chemotherapy medication used to treat a number of cancers. These include testicular cancer, ovarian cancer, cervical cancer, breast cancer, bladder cancer, head and neck cancer, esophageal cancer, lung cancer, mesothelioma, ...
and mitomycin C were discovered to cause
genotoxicity Genotoxicity is the property of chemical agents that damage the genetic information within a cell causing mutations, which may lead to cancer. While genotoxicity is often confused with mutagenicity, all mutagens are genotoxic, but some genotoxic su ...
in aquatic organisms. * Antibiotics are widely produced and consumed to treat bacterial and fungal diseases. Since antibiotics are only partially metabolized, the non-metabolized antibiotics are released into the environment. Due to this, antibiotics are discovered in sludge, drinking water, wastewater, surface water, soil, groundwater and sediments. Residual antibiotics are not easily biodegraded so, they can survive in environments for long periods of time. There are calls for an urgent push to eradicate antibiotics from the environment because they could cause generation of antibiotics resistant bacteria and antibiotics resistance genes, which would pose an immense threat to the ecological system and human health. The excessive use and excretion of antibiotics to waterways makes the problem of antimicrobial resistance worse and will gradually affect the human population, possibly causing more deaths. Antibiotics were found to reduce growth in algae, aquatic plants and environmental bacteria.


Prevention

Drug pollution still remains to be a global problem, since current policy techniques are not adequate enough. Most policy approaches remain to be individualized, expensive, and reactive. Biomarkers could be extremely helpful in the risk assessment of pharmaceuticals for decision making in regulations. Biomarkers could help explain if a non-target organism was exposed to a pharmaceutical and the toxicity levels of the pharmaceutical in the organism if it is present. The main action for preventing drug pollution is to
incinerate Incineration is a waste treatment process that involves the combustion of substances contained in waste materials. Industrial plants for waste incineration are commonly referred to as waste-to-energy facilities. Incineration and other high ...
unwanted pharmaceutical drugs. Burning them chemically degrades their active molecules, with few exceptions. The resulting ash can be further processed before landfilling, such as to remove and recycle any heavy metals that may be present. There are now programs in many cities that provide collection points at places including drug stores, grocery stores, and police stations. People can bring their unwanted pharmaceuticals there for safe disposal, instead of flushing them ( externalizing them to the waterways) or throwing them in the trash ( externalizing them to a landfill, where they can become leachate). Another aspect of drug pollution prevention is environmental law and regulation, although this faces the problems of enforcement costs, enforcement corruption and negligence (see below), and, where enforcement succeeds, increased costs of doing business. The
lobbying In politics, lobbying, persuasion or interest representation is the act of lawfully attempting to influence the actions, policies, or decisions of government officials, most often legislators or members of regulatory agencies. Lobbying, which ...
of pros and cons is ongoing.


Manufacturing

One extreme example of drug pollution was found in India in 2009 in an area where pharmaceutical manufacturing activity is concentrated. Not all
pharmaceutical manufacturing Pharmaceutical manufacturing is the process of industrial-scale synthesis of pharmaceutical drugs as part of the pharmaceutical industry. The process of drug manufacturing can be broken down into a series of unit operations, such as milling, g ...
contributes to the problem. In places where environmental law and regulation are adequately enforced, the wastewater from the factories is cleaned to a safe level. But to the extent that the market rewards "looking the other way" in developing nations, whether through local corruption ( bribed inspectors or regulators) or plausible deniability, such protections are circumvented. This problem belongs to everyone, because consumers in well-regulated places constitute the biggest customers of the factories that operate in the inadequately regulated or inspected places, meaning that externality is involved.


References

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External links


Contaminants of Emerging Concern including Pharmaceuticals and Personal Care Products
- US Environmental Protection Agency Pollution Chemical safety Medical waste Social problems in medicine