[Pharmwaste] excreted drugs & whole effluent toxicity?

Thu Sep 18 13:59:38 EDT 2014

Hi Joel et al,

P2 and lifestyle medicine are very similar.  Mr. Sabin’s article points out the deficiencies in our system that don’t support healthy lifestyles and good nutrition.  The ACA does have preventative medicine has a key piece, it is not being substituted for our very heavily loaded chronic care based system.  

Very truly yours,

Catherine Zimmer, MS, BSMT

Zimmer Environmental Improvement, LLC

St. Paul, MN 

Ph:  651.645.7509

 <mailto:zenllc at usfamily.net> zenllc at usfamily.net

From: drkreisberg at teleosis.org [mailto:drkreisberg at teleosis.org] On Behalf Of Dr. Joel Kreisberg
Sent: Wednesday, September 17, 2014 12:50 AM
To: Catherine Zimmer
Cc: Gilliam, Allen; pharmwaste at lists.dep.state.fl.us; Glassmeyer.susan at epa.gov
Subject: Re: [Pharmwaste] excreted drugs & whole effluent toxicity?

Hard to resist throwing this one in here, just as a reminder.

The Absurd Economics of Nutrition and Exercise

http://fontherapeutics.com/uncategorized/the-absurd-economics-of-nutrition-and-exercise/

of the nine key recommendations, this one caught my attention 

7. Provide reimbursement for health services that target lifestyle factors such as nutrition and exercise.

Our group calls it P2,  that group calls is lifestyle medicine, are they the same?  

Joel

On Fri, Sep 12, 2014 at 11:57 AM, Catherine Zimmer <zenllc at usfamily.net> wrote:

Hi Allen et al,

Yep, P2 is the way—and not just reduced doses, but  directed drugs (e.g. organ specific), less persistent rx and alternative therapies.  For example a study that just came out of a Canadian university showed better results using weight loss, exercise and PT for knees rather than replacements.  

Regarding testing of API in WW, there are few accepted methods.  Axys analytical laboratories is I believe one of the few commercial labs that does suites of API.  Their methods have been developed with EPA oversight to be the standards.  Unfortunately, there are a number of pharmaceuticals for which there are no standardized test methods, including controlled substances.  

And, Jim I agree waste body fluids from patients undergoing chemo, should be collected, not discharged to the sanitary sewer.  

Very truly yours,

Catherine Zimmer, MS, BSMT

Zimmer Environmental Improvement, LLC

St. Paul, MN 

Ph:  651.645.7509

zenllc at usfamily.net

From: pharmwaste-bounces at lists.dep.state.fl.us [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Gilliam, Allen
Sent: Friday, September 12, 2014 9:41 AM
To: 'pharmwaste at lists.dep.state.fl.us'
Cc: Glassmeyer.susan at Epa.gov
Subject: [Pharmwaste] excreted drugs & whole effluent toxicity?

Fellow Pharma folks,

Sorry for getting off the take-back programs for just a minute.

Maybe most of you have already seen this, but Dr. Christian Daughton recently authored this Eco-directed sustainable prescribing: feasibility for reducing water contamination by drugs @  <http://dx.doi.org/10.1016/j.scitotenv.2014.06.013> http://dx.doi.org/10.1016/j.scitotenv.2014.06.013 .  Its abstract itself may take a few readings to understand (at least it did for me), but I believe the underlying concept of the manuscript is P2’s source reduction.

I only briefly scanned several pages of its content and is way above this mechanical engineer’s head.  For those of you familiar with pharmacokinetics, you may be able to glean some important themes in the Dr’s contentions.  

Add another acronym to your vocabulary if you haven’t already because Biopharmaceutics Drug Disposition Classification System (BDDCS) runs throughout its core.

I would expect a brief synopsis from our dear friend, Dr. Charlotte Smith in a few weeks.

My original e-mail’s intent to several experts on this issue was mainly to discover which analytical methods could be used to measure low level APIs (which method measure what APIs or their metabolites?); therefore, helping to determine if their presence could potentially be the toxicant(s) in cities’ WET sublethality failures (growth and reproductivity).  

Dr. Susan Glassmeyer, e-cc’d above was suggested as a good source by Dr. Daughton.   Dr. Glassmeyer?  Would you please respond in some manner?  I’d love for more cities to get involved with their own w.w. treatment plant’s effluent quality.  Heretofore, most cities in the US are not sampling/analyzing for APIs or their metabolites.  At least I have seen very few reports about them except through the USGS.

Ciao,  

Allen Gilliam

ADEQ State Pretreatment Coordinator

501.682.0625

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