Saturday, October 4, 2008

Don't Flush Your Drugs!

I like listening to NPR while I work or write or read. Saturday was a piece about the Environmental Protection Agency (EPA) making this week “National Don’t Flush Your Drugs Week”. I can’t find the infomration online, but Google this, for half a million hits; you’ll get the idea. I must have water on the brain; since the piece regarding FLOW, I’ve been working on another I was going to call: “Pharmaceuticals in Water” I like the new title better …and I hope this important information isn’t lost in the length of this post! Please read this…there are things you can do to help.

A Growing Concern

A vast array of pharmaceuticals including antibiotics, anti-convulsants, mood stabilizers and sex hormones have been found in drinking water, according to the Associated Press investigation, which conducted an extensive investigation into the drinking water in at least twenty-four major American cities across the country. The amounts might be small, but scientists are worried about the long-term health and environmental consequences of their presence in the water supplies of some forty-one million Americans.

Concentrations are minute, but not unlike hormones and steroids given to cattle that show up in the milk we drink and the meat we eat, we have no idea what these percentages will do to us…over time. Who knew such science (again, Monsanto rules here) created to increase milk and lean-meat production would so effect our children?

Recent laboratory research has found that small amounts of medication have affected 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.

In the same measure, science is affecting the very water we need to live. According to the AP investigation, there has been found in our drinking water:
  • 80+ pharmaceuticals or byproducts, including medicines for pain, infection, high cholesterol, asthma, epilepsy, mental illness, hypertension and heart problems.

  • Anti-anxiety, anti-depressants and tranquilizers

  • Sex hormones, steroids

  • Fertilizers and flame retardants were also found

According to Amy Goodman, of Democracy Now, the five-month investigation of sixty-two metropolitan areas and fifty-one smaller cities found that many drinking water suppliers, including bottled water companies, do not even test for the presence of drugs in the water. The utilities that do test for drugs often don't tell customers about the trace amounts of medications in their water. Goodman interviewed Jeff Donn, a National Writer for the Associated Press and one of the reporters who led the AP investigation. Donn pointed out that while only about half the water-utilities test for pharmaceuticals…but very few report or publish what’s detected.

- Rural and bottled water also unchecked

Many of America's wastewater treatment plants are not designed to remove pharmaceuticals and personal care products, the EPA says. Even users of bottled water and home filtration systems don't necessarily avoid exposure. Bottlers, some of which simply repackage tap water, do not typically treat or test for pharmaceuticals, according to the industry's main trade group. The same goes for the makers of home filtration systems. We need to keep this stuff out of the water system!

The AP Article reported The Stroud Water Research Center, has measured water samples from New York City's upstate watershed for caffeine, a common contaminant that scientists often look for as a possible signal for the presence of other pharmaceuticals. Though more caffeine was detected at suburban sites, researcher Anthony Aufdenkampe was struck by the relatively high levels even in less populated areas. He suspects it escapes from failed septic tanks, maybe with other drugs, and said septic systems are essentially small treatment plants that are generally unmanaged and therefore tend to fail.

There's growing concern in the scientific community, meanwhile, that certain drugs or combinations of drugs may harm humans over decades because water, unlike most specific foods, is consumed in sizable amounts every day. Our bodies may shrug off a relatively big one-time dose, yet suffer from a smaller amount delivered continuously over a half century, perhaps subtly stirring allergies or nerve damage. Pregnant women, the elderly and the very ill might be more sensitive.

Many concerns about chronic low-level exposure focus on certain drug classes: chemotherapy that can act as a powerful poison; hormones that can hamper reproduction or development; medicines for depression and epilepsy that can damage the brain or change behavior; antibiotics that can allow human germs to mutate into more dangerous forms; pain relievers and blood-pressure diuretics.

- Medications not eliminated

Some drugs, including widely used cholesterol fighters, tranquilizers and anti-epileptic medications, resist modern wastewater treatment processes. Plus, the EPA says there are no sewage treatment systems specifically engineered to remove pharmaceuticals. The same article points out yet another issue: There is evidence that adding chlorine, a common process in conventional drinking water treatment plants, makes some pharmaceuticals even more toxic.

When communities flush their toilets, wastewater laced with traces of prescription drugs rushes through a series of pipes to the treatment plant. This flushing is the main pathway by which pharmaceuticals enter the environment. Hospitals and nursing homes routinely dump unused or expired pills down the toilet, and consumers have been advised to do the same; effluent from pharmaceutical manufacturers also ends up at municipal wastewater treatment plants…and eventually our rivers.

Such studies, on various rivers throughout our country, suggest the creeks carry the signatures of drugs consumed by anyone plumbed into the system. The effect of those drugs on the environment, and possibly on all those who drink water pumped from streams, is only beginning to be understood. Some experts say medications may pose a unique danger because, unlike most pollutants, they were crafted to act on the human body.

- Wildlife problems troubling

David Norris, an environmental endocrinologist, found that female white suckers outnumber males by more than five to one, and that 50 percent of males have female sex tissue. Similar intersex changes have been found in flat-head chubs and smallmouth bass. He says “You could have six chemicals below the no-effect level, but all together they are above the no-effect level."

In lab tests, frogs and rats have developed infections and deformities after being exposed to multiple pollutants at extremely low levels. Since exposure to only one compound is rare in the modern world, sorting out "mixture effects" is a daunting but critical research area. In the United Kingdom, hormones in the environment have been linked with lowered sperm counts and gynecomastia -- the development of breasts in men.

A Baylor University researcher found tiny amounts of Prozac in liver and brain tissue of channel catfish and black crappie captured in a creek near Dallas that receives almost all of its flow from a wastewater treatment plant. The creek also connects to a drinking water supply. A University of Georgia scientist found that tadpoles exposed to Prozac morphed into undersize frogs, which are vulnerable to predation and environmental stress.

The EPA reports that antidepressants can have a profound effect on spawning and other behaviors in shellfish and that calcium-channel blockers (used to relieve chest pain and hypertension) can dramatically inhibit sperm activity in some aquatic organisms. Even at extremely low levels, ibuprofen, steroids, and antifibrotics -- a class of drugs that helps reduce the development of scar tissue -- block fin regeneration in fish. According to a worldwide network of scientists and scientific institutions, more than 200 species -- aquatic and terrestrial -- are known or suspected to have experienced adverse reactions to such endocrine disruptors as estrogen and its synthetic mimics.

Pharmaceuticals in waterways are damaging wildlife across the nation and around the globe. Notably, male fish are being feminized; creating egg yolk proteins, a process usually restricted to females. Pharmaceuticals also are affecting sentinel species at the foundation of the pyramid of life -- such as earthworms in the wild and zooplankton in the laboratory. But that’s not all.

According to this article: The cumulative effect of trace amounts of pharmaceuticals and personal-care products in the water on humans isn't yet known, but the EPA is taking preventative measures. Pharmaceuticals have already been linked to behavioral and sexual mutations in fish, amphibians and birds.

Keep in mind the old canary in the mine-shaft; amphibians and birds are our red flags of problems to come. Also how the food chain works and why predators, including large birds and fish, suffer so from pollutants. Small birds eat worms and insects (affected by pollutants)…big birds eat small birds and become concentrated with said pollutants. Same goes for fish…ever wonder why we are cautioned about eating tuna (a big fish) too often? This is exactly what happened to our eagles and why we no longer use DDT. I wonder how many human lives that saved.


Allison MacKay, an environmental engineer who specializes in aquatic chemistry, says “I don't know about drugs, but pesticides have been reformulated to degrade faster and be less bioaccumulative in water-ways." There may be a tradeoff, but we must look into this. And, we must stop flushing our pharmaceuticals. Some cities and states have begun ‘take-back programs, where consumers bring unwanted or expired medications to an official collection site. Drugs are then either returned to manufacturers or disposed of by incineration; if we can do this with our printer-ink cartridges, disposable cameras and batteries, why not our prescriptions; why not our pesticides, insecticides, herbicides?

Jeff Donn also pointed out the French, for example, have had a program for some years where when you get medicine, you also get a prepaid mailer to send it back to the pharmacy if you don't use it, and that's eventually sent for incineration if it goes back to the pharmacy.

Since February of 2007, the federal government, for the first time, has put out guidelines for consumers, regular people like us, that, with the exception of a small number of medications that are particularly sensitive, asking we not any longer flush. Instead, to mix those medicines with something unsavory so pets or children don't get at it -- coffee grounds, cat litter -- and to put it in a bag and to throw it in your regular garbage. What happens to it then is another question, but at least it doesn't directly and immediately enter the water stream. [The U.S. Fish and Wildlife Service and the American Pharmacists Association recently launched "SMARxT DisPOSAL," a public education project about this important issue. There is a short video clip regarding just how to dispose of drugs if you cannot find a collection center.]

Goodman asked Donn about landfills and how they leache into our water. There's not much study of exactly how that process is occurring, but the scientists presume that to some degree it is possible; that some of that pharmaceutical residue will leach from waste areas, from landfills, from dumps, and eventually end up back in the groundwater. And there is research that shows that these low amounts of pharmaceuticals do end up in aquifers, the underground groundwater, and not just in streams and rivers and surface waters.

Bottled Water NOT the Answer

Here's why bottled water doesn't help, according to Food and Water Watch:

  • 40% of the bottled water sold in the United States is tap water anyway.

  • EPA requires hundreds of tests each month on municipal water supplies, but the Food and Drug Administration (FDA), which regulates bottled water, requires only one test a week on bottled water.

  • Only 40% of bottled water--that which is sold across state lines--is regulated by the FDA in the first place.

  • Plastic bottles in the United States require some 1.5 million barrels of oil to manufacture each year--enough to power 100,000 cars.

  • 86% of plastic bottles in the United States never get recycled.

  • Tap water costs about a penny a gallon and bottled waters costs up to $10 a gallon.

  • Chemicals that leach from plastic water bottles may affect our health.

  • If people abandon the use of municipal drinking water, then there will be no political will to ensure that we invest the necessary resources in the water infrastructure. The United States has some of the best drinking water in the world and we must work to keep it that way.

An Ounce of Prevention…

We have long used canaries to prevent unnecessary mining deaths; we already know marine life deformities and other health effects in wildlife occur as a result of PPCPs (as Pharmaceuticals and Personal Care Products have been dubbed)…we must pay attention if we are to prevent problems to our health and to the environment. Prevention should be our first line of defense.

  • Begin by reducing over-use and inappropriate use of pharmaceuticals and other PPCPs and by safely disposing unused products.

  • Consider purchasing only cosmetics that are phthalate-free and ask manufacturers of cosmetics you use regularly to publicly pledge to remove all chemicals linked to cancer and birth defects from their products, with labeling of all ingredients as an interim measure.

  • If you eat meat, eat organic…to reduce your intake of hormones and antibiotics and to support the green livestock & poultry industries.

  • Never dispose of unused and expired medications in the sink or toilet.

  • Ask your municipality and your pharmacy to encourage a program whereby prescriptions can be disposed of safely.

  • Click here for more ideas.



Elizabeth said...

This is so frightening! I blogged about it a while ago, but we need everyone to sound the alarm!

Just the other day I asked my father, a physician, what I should do with a bunch of expired OTC drugs (Tylenol, Immodium, etc.) that I found while cleaning out my bathroom. His first suggestion was to flush them down the toilet! This is one myth we need to work hard to expose as I believe it used to be the recommended practice!

Beverly said...

LOL I just realized this is NOT a 'new story'... but I guess it IS new that the EPA is finally at least 'looking into it'.

I don't know what the answer is...mixing drugs with coffee-grounds and adding them to the land-fill is obviously not going to work either.

I hope we discover that 'incineration' works...and can get the drug companies to sponsor 'bye-backs'. In the meantime, the more folks talk about it...the more likely they will quit flushing the stuff, at least!

Thanks for your comment!