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November 22, 2008

June 2003: Volume 45, Number 6

Pharmaceuticals in Drinking Water Supplies
by Kelly A. Reynolds, MSPH, Ph.D.

Have you ever comeacross a bottle of prescription pills you no longer needed or
perhaps had passed their expiration date? You probably disposed of the substance by flushing the remainder down the toilet or tossing it in the waste disposal. Gone and forgotten, right? Well, forgotten yes, but gone? Probably not. Scientists are becoming increasingly concerned about the potential public health impact of environmentalcontaminants originating from industrial, agricultural, medical and common household practices, i.e., cosmetics, detergents and toiletries. A variety of pharmaceuticals including painkillers, tranquilizers, anti-depressants, antibiotics, birth control pills, estrogen replacement therapies, chemotherapy agents, anti-seizure medications, etc., are finding their way into the environment via human andanimal excreta from disposal into the sewage systemﾗi.e., flushing unused medication down the toiletﾗand from landfill leachate that may impact groundwater supplies. Agricultural practices are a major source and 40 percent of antibiotics manufactured are fed to livestock as growth enhancers. Manure, containing traces of pharmaceuticals, is often spread on land as fertilizer from which it can leachinto local streams and rivers. Conventional wastewater treatment isnﾒt effective to eliminate the majority of pharmaceutical compounds. Little is known about the occurrence, transport, fate, synergistic, accumulative, and/or long-term effects of pharmaceuticals and other personal care products following their end use. Currently, thereﾒs no national coordinated effort requiring the monitoring orfocused treatment of waters and wastes for the presence of pharmaceuticals; however, pharmaceutical contamination is considered an important and emerging issue in water quality. Prevalence in the environment The prevalence of pharmaceuticals in water is nothing new. In fact, itﾒs reasonable to assume that as long as pharmaceuticals have been in use, theyﾗand their metabolitesﾗ have contributed tothe overall environmental contamination load. Whatﾒs new is our ability to detect trace amounts (sub-parts per billion, ppb) of these contaminants in water. Hence, weﾒre finding pharmaceuticals in water because weﾒre finally able to detect them. The topic first gained notice in Europe in the early-1990s where scientists initially found clofibric acid, a cholesterol-lowering drug, in groundwater.According to an article published in the December 2002 issue of Environmental Health Perspectives, the amount of pharmaceuticals and personal care products (PPCPs) released into the environment each year is tantamount to the amount of pesticides used each year. Due to a multitude of sources, both point and non-point, the amount of pharmaceuticals likely to find their way into the environment isdifficult to estimate. We do know that from 1999-2000, U.S. retail pharmaceutical sales were approximately $100 billion, half of the worldwide total of approximately $200 billion. During 1999-2000, the U.S. Geological Survey conducted the first nationwide investigation of the occurrence of pharmaceuticals, hormones and other organic contaminants in 139 streams from 30 states. A total of 95 contaminantswere targeted including antibiotics, prescription and nonprescription drugs, steroids and hormones, 82 of which were found in at least one sample. Although researchers caution that sites were chosen based on their increased susceptibility to contamination from urban or agricultural activities, a surprising 80 percent of streams sampled were positive for one or more contaminant. Furthermore, 75...