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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='color:#1F497D'>Hi Allen et al,<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>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. <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>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. <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>And, Jim I agree waste body fluids from patients undergoing chemo, should be collected, not discharged to the sanitary sewer. <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><div><p class=MsoNormal><span style='color:#1F497D'>Very truly yours,<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Catherine Zimmer, MS, BSMT<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Zimmer Environmental Improvement, LLC<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>St. Paul, MN <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Ph: 651.645.7509<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><a href="mailto:zenllc@usfamily.net"><span style='color:blue'>zenllc@usfamily.net</span></a><o:p></o:p></span></p></div><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><div><div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>From:</span></b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] <b>On Behalf Of </b>Gilliam, Allen<br><b>Sent:</b> Friday, September 12, 2014 9:41 AM<br><b>To:</b> 'pharmwaste@lists.dep.state.fl.us'<br><b>Cc:</b> Glassmeyer.susan@Epa.gov<br><b>Subject:</b> [Pharmwaste] excreted drugs & whole effluent toxicity?<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Fellow Pharma folks,<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Sorry for getting off the take-back programs for just a minute.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Maybe most of you have already seen this, but Dr. Christian Daughton recently authored this <u><span style='color:#262626'>Eco-directed sustainable prescribing: feasibility for reducing water contamination by drugs</span></u><span style='color:#1F497D'> @ </span><a href="http://dx.doi.org/10.1016/j.scitotenv.2014.06.013"><span style='color:#0563C1'>http://dx.doi.org/10.1016/j.scitotenv.2014.06.013</span></a> . 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.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>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. <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Add another acronym to your vocabulary if you haven’t already because Biopharmaceutics Drug Disposition Classification System (BDDCS) runs throughout its core.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>I would expect a brief synopsis from our dear friend, Dr. Charlotte Smith in a few weeks.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>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). <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>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.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Ciao, <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Allen Gilliam<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>ADEQ State Pretreatment Coordinator<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>501.682.0625<o:p></o:p></span></p></div></body></html>