[Pharmwaste] Bathing and showering: Underappreciated sources of water pollution from medicines

[Massoomi, Fred]

Bathing and showering: Underappreciated sources of water pollution from
medicines

That bracing morning shower and soothing bedtime soak in the tub are
potentially important but until now unrecognized sources of the
hormones, antibiotics, and other pharmaceuticals that pollute the
environment, scientists reported here today at the 239th National
Meeting of the American Chemical Society. The first-ever evaluation,
they said, could lead to new ways to control environmental pollution
from active pharmaceutical ingredients (APIs), which has been the source
of growing concern.

Ilene Ruhoy, M.D., Ph.D., who co-authored the study, said that
scientists have long known that bathrooms are a portal for release of
APIs into the environment. An active ingredient in a pill is the
medicine, usually combined with binders to hold the pill together,
stabilizers, and other inactive ingredients. However, scientists and
pollution control officials assumed that toilets were the main culprit,
with APIs excreted in urine and feces and flushed into sewers and sewage
treatment plants. APIs may go right through the disinfection process at
those plants, and enter lakes, rivers, and oceans. Some also end up in
the environment when people flush unused drugs down the toilet.
Scientists have found traces of the active ingredients of birth control
pills, antidepressants, and scores of other drugs in waterways. Some end
up in drinking water - at extremely low, trace levels. 

"We've long assumed that the active ingredients from medications enter
the environment primarily as a result of their excretion via urine and
feces," said Dr. Ruhoy. She directs the Institute for Environmental
Medicine at TouroUniversity in Henderson, NV, and did the research with
Christian Daughton, Ph.D., of the U.S. Environmental Protection Agency's
National Exposure Research Laboratory in Las Vegas. "However, for the
first time, we have identified potential alternative routes for the
entry into the environment by way of bathing, showering, and laundering.
These routes may be important for certain APIs found in medications that
are applied topically, which means to the skin. They include creams,
lotions, ointments, gels, and skin patches."

Ruhoy and Daughton identified this potential new source of APIs through
a comprehensive review of hundreds of scientific studies on the
metabolism and use of medications. They focused on APIs in medications
that are applied to the skin or excreted from the body via sweat glands.
These two sources can result in residues being washed off the body and
down bathroom drains. These include steroids (such as cortisone and
testosterone), acne medicine, antimicrobials, narcotics, and other
substances. Another previously unrecognized route by which APIs may
reach the environment includes perspiration (many APIs are released in
sweat) and laundering of clothing that has come into contact with
topical medications from their dermal application or from sweating. 

Ruhoy cited steps by which consumers can reduce the potential
environmental impact of these skin-based pharmaceuticals by following
directions and applying only the recommended amount, rather than
thinking that "if a little is good, more must be better." Doctors can
help by prescribing the lowest possible dose for the shortest period of
time necessary. Scientists should continue efforts to develop better
drug delivery systems for topical medications so that APIs, for
instance, are absorbed faster and more completely, she said. Design of
dermal patches so that less API residue remains after use would be
particularly helpful in reducing accidental poisonings from carelessly
discarded patches and the quantities of APIs flushed down toilets. Visit
here for the article
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Firouzan 'Fred' Massoomi, Pharm.D., FASHP

Nebraska Methodist Hospital

Pharmacy Operations Coordinator

Department of Pharmacy Services

8303 Dodge St.

Omaha, NE  68114

fred.massoomi at nmhs.org

(402) 354-4340 office            (402) 354-3139 fax

A proud supporter of the Multiple Sclerosis Society

P Think Green & Think before YOU print. 

 



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