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<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'>J. U. Mullot: Thank you for this very
interesting and detailed post on the variables involved in correlating sales,
pharmacokinetics and environmental concentrations and, especially, how your hospital
modeling exercise proposes to account for them. Please keep the Listserve posted
on results on your important work. </span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'> </span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'>Jack</span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'> </span></font></p>
<div>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>John L. (Jack) Price</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Environmental Manager</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Hazardous Waste Management MS 4555</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Florida Department of Environmental
Protection</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>2600 Blair Stone Road</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Tallahassee</span></font><font
color=blue><span style='color:blue'>, FL 32399-2400</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Phone:850.245.8751</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Fax: 850.245.8811</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>john.l.price@dep.state.fl.us</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>www.dep.state.fl.us/waste</span></font></p>
<p class=MsoNormal><font size=1 color=black face=Arial><span style='font-size:
7.5pt;font-family:Arial;color:black'>Please Note: Florida has a very
broad public records law. Most written communications to or from state
officials regarding state business are public records available to the public
and media upon request. Your e-mail is communications and may therefore
be subject to public disclosure.</span></font></p>
</div>
<div>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center tabindex=-1>
</span></font></div>
<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
pharmwaste-bounces@lists.dep.state.fl.us
[mailto:pharmwaste-bounces@lists.dep.state.fl.us] <b><span style='font-weight:
bold'>On Behalf Of </span></b>JuMullot@aol.com<br>
<b><span style='font-weight:bold'>Sent:</span></b> Friday, February 23, 2007
8:36 AM<br>
<b><span style='font-weight:bold'>To:</span></b>
pharmwaste@lists.dep.state.fl.us<br>
<b><span style='font-weight:bold'>Subject:</span></b> [Pharmwaste] Re:
Pharmwaste Digest, Vol 16, Issue 24</span></font></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
<div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Dans un e-mail daté du 22/02/2007
07:24:56 Paris, Madrid, pharmwaste-request@lists.dep.state.fl.us a écrit :</span></font></p>
</div>
<blockquote style='border:none;border-left:solid blue 1.5pt;padding:0in 0in 0in 4.0pt;
margin-left:3.75pt;margin-top:5.0pt;margin-bottom:5.0pt'>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Responding to "Measuring the
amount...."</span></font></p>
</blockquote>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Dear Collegues,</span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'> </span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>I'm a european (French) doctorant,
following your discussions in this forum since several month and I would like
to share my opinion about the measurment/modelling of pharmaceutical amounts in
aquatic ressources.</span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'> </span></font></p>
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<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>In europe also, it is quite easy to find
consumption data in financial units ($ or euros) but it is something very
very difficult to find a robust correlation between financial units and
amounts (in mass of active ingredient for example) for the following reasons :</span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'> </span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>- public prices are controlled (in france) but not for hospitals, clinics and health centers (in this case, prices are free of
regulatory control). For example, you can pay a lot for a molecule in the
pharmacy store just located in your street but the same molecule can be
provided for no charge at the hospital pharmacy where you can be hospitalized
... but an other hospital pharmacy can pay a different price because they do
not negociate,</span></font></p>
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<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'> </span></font></p>
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<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>- for a same active ingredient you can
have different presentations and/or routes of administration and the prices can
be very different between these presentations,</span></font></p>
</div>
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<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'> </span></font></p>
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<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>- between the sales and the environment
you have humans that can metabolize the active ingredient and pharmacokinetic
data are not always avalaible and/or of good quality for modelling purposes
(and there are interindividual variations of pharmacokinetic data)</span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'> </span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>In my opinion, this is a reason why
mesured environmental concentrations and predicted environmental concentrations
do not often correlate, especially when calculated with amounts derived
from financial informations.</span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'> </span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>For these reasons I'm actually trying to
build a model at the hospital scale with daily amounts delivered in patients
(in g of active ingredient), daily water consumptions and PBPK
data as main variables and we compare measured concentrations in
hospital wastewater (proportional sample) with calculated concentrations for
several API of each major therapeutic class (about 15 target molecules) and for
different hospitals. First data will be avalaible in few months ... for
integration in other models from urban wastewater to other environmental
compartments.</span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'> </span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>To my knowledge a firm, called "IMS
Health" can provide data of API consumption in mass amounts but you should
pay for that. The website adress is <a href="http://www.imshealth.com/">http://www.imshealth.com/</a></span></font></p>
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<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'> </span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Ready to answer you questions and discuss
again about this subject,</span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'> </span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Best regards,</span></font></p>
</div>
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<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'> </span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Jean Ulrich MULLOT</span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Pharmacist, Doctorant in Human and
Environmental Risk Assessment (mainly exposure assessment)</span></font></p>
</div>
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<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'> </span></font></p>
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