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<div style="direction: ltr;font-family: Tahoma;color: #000000;font-size: 14pt;"><font size="1">Hmmm, maybe the WWTPs should get into the pharmaceutical business to pay for the upgrades they need to meet effluent standards...</font><br>
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<div id="divRpF673622" style="direction: ltr;"><font face="Tahoma" size="2" color="#000000"><b>Sent:</b> Friday, May 15, 2015 9:13 AM<br>
<b>To:</b> pharmwaste@lists.dep.state.fl.us<br>
<b>Subject:</b> [Pharmwaste] Bacteria making meds in wastewater outflows <br>
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<p class="MsoNormal"><a href="http://www.environmentalhealthnews.org/ehs/news/2015/may/bacteria-making-meds-in-wastewater-outflows" target="_blank">http://www.environmentalhealthnews.org/ehs/news/2015/may/bacteria-making-meds-in-wastewater-outflows</a></p>
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<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">May 13, 2015</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">By
<a href="http://www.environmentalhealthnews.org/archive?text=&start_date=&end_date=&publisher=&reporter=Brian+Bienkowski&article_type=&subject=" target="_blank">
Brian Bienkowski</a><br>
Environmental Health News</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">Wastewater treatment plants not only struggle removing pharmaceuticals, it seems some drugs actually increase after treatment.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">When researchers tested wastewater before and after treatment at a Milwaukee-area treatment plant, they found that two drugs — the anti-epileptic carbamazepine and antibiotic
ofloxacin — came out at higher concentrations than they went in. The study suggests the microbes that clean our water may also piece some pharmaceuticals back together.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">Carbamazepine and ofloxacin on average increased by 80 percent and 120 percent, respectively, during the treatment process. Such drugs, and their metabolites (formed as part
of the natural biochemical process of degrading and eliminating the compounds), get into the wastewater by people taking them and excreting them. Flushing drugs accounts for some of the levels too.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">“Microbes seem to be making pharmaceuticals out of what used to be pharmaceuticals,” said lead author Benjamin Blair, who spearheaded the work as a PhD. student at the University
of Wisconsin-Milwaukee. Blair is now a postdoctoral fellow at the University of Colorado Denver.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">Blair and colleagues found 48 out of 57 pharmaceuticals they were looking for at the South Shore Water Reclamation Facility in Oak Creek, Wisconsin, which serves the greater
Milwaukee area.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">The researchers have a clue as to how this might happen: microbes.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">After removing the solids from incoming wastewater, treatment plants use microbes — tiny single-celled organisms — to decompose organic matter that comes in the sewage.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">Blair's best guess is that people take the drugs, their body breaks them down into different metabolites that are excreted, and the microbes take these different parts of the
drug and put them back together.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">“It’s a fascinating idea,” Blair said.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">Tanja Rauch-Williams, principal technologist at the environmental engineering company Carollo Engineers, said it was a strong study but cautioned that this doesn’t mean wastewater
treatment plants are acting as pharmaceutical factories.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">“It’s a large amount of pharmaceuticals that we [wastewater treatment plant researchers] look at, it’s not a trend that the plants generate higher compound concentrations,”
she said. “It’s very specific compounds.”</span></p>
<p style="margin-bottom:0in; margin-bottom:.0001pt"><b><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#057234">"Microbes seem to be making pharmaceuticals out of what used to be pharmaceuticals."<em><span style="font-family:"Helvetica",sans-serif">-Benjamin
Blair, University of Colorado-Denver</span></em></span></b><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">She said that this apparent piecing back together of metabolites into pharmaceuticals could, in principle, also happen
in the environment after effluent discharge. <br>
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It’s not the first time researchers have noticed this trend. Canadian <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2665886/" target="_blank">
researchers found</a> carbamazepine more than doubled its initial medicinal load after treatment at a Peterborough, Ontario, plant.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">“When others have found this, people thought it was due to things like sampling errors,” Blair said. “But we found a clear upward trend over time.”</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">What remains unclear is why only certain drugs would increase post-treatment. Blair and colleagues saw the trend in just two of the 48 pharmaceuticals found in their wastewater
samples.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">“We need to look for what the structural or metabolic commonality is in these compounds. And then we could possibly predict whether some would increase [after treatment],”
Rauch-Willlaims said.</span></p>
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<p class="MsoNormal" style="margin-bottom:7.5pt"><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333"><img id="Picture_x0020_1" src="cid:image001.jpg@01D08EF7.C4F12A30" alt="http://www.environmentalhealthnews.org/ehs/images/2015/ehn-and-tdc/may/wastewater-increase/Microbes.jpg/" height="297" width="390" border="0"></span><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333"></span></p>
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<span style="font-size:8.0pt; font-family:"Helvetica",sans-serif; color:#999999"><a href="http://climate.nasa.gov/news/825/" target="_blank"><span style="font-size:6.0pt; color:#999999">NASA</span></a></span></p>
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<p class="MsoNormal" style="margin-bottom:7.5pt; line-height:12.0pt"><span style="font-size:7.5pt; font-family:"Helvetica",sans-serif; color:#555555">It seems that the microbes that clean our water at wastewater treatment plants piece some pharmaceuticals back
together. </span><span style="font-size:9.0pt; font-family:"Helvetica",sans-serif; color:#555555"></span></p>
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<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">Even with the increases, the pharmaceuticals are at levels far below what could impact humans if they consume the water, she said. But the ubiquity of the drugs in wastewater
is a concern for fish and other aquatic creatures.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">Carbamazepine, used as an anti-epileptic drug, impacted the enzymes in gills, livers and muscles of common carp, according to a
<a href="http://www.sciencedirect.com/science/article/pii/S1018364711000024" target="_blank">
2011 study</a>. Such enzyme changes are indicative of tissue damage and impaired cells. The drug also
<a href="http://www.ncbi.nlm.nih.gov/pubmed/23351725%20" target="_blank">has been linked</a> to endocrine disruption and reproductive problems in zebrafish. </span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">Rauch-Williams said the wastewater industry is getting more efficient at removing pharmaceuticals. “Things like advanced oxidation, UV disinfection coupled with peroxide, different
membrane processes … these remove a large majority of these compounds,” she said.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">Blair said the drawback to many of the more effective treatments is expense. And there’s no urgency for plants to upgrade because there aren’t any U.S. regulations for pharmaceuticals
in water, he added.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">The U.S. Environmental Protection Agency evaluates substances that may be in drinking water by developing Contaminant Candidate Lists and periodically issuing a Regulatory
Determination.</span></p>
<p><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">The EPA’s latest drinking water contaminant candidate list — water pollutants not subject to regulations yet but that might render water unsafe — includes several pharmaceuticals
that act on hormones. <br>
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<p><em><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">EHN welcomes republication of our stories, but we require that publications include the author's name and Environmental Health News at the top of the piece, along with
a link back to EHN's version.</span></em><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333"></span></p>
<p><em><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333">For questions or feedback about this piece, contact Brian Bienkowski at
<a href="mailto:bbienkowski@ehn.org" target="_blank">bbienkowski@ehn.org</a>.</span></em><span style="font-size:10.5pt; font-family:"Helvetica",sans-serif; color:#333333"></span></p>
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<p class="MsoNormal">Laurie Tenace</p>
<p class="MsoNormal">Environmental Specialist</p>
<p class="MsoNormal">Waste Reduction Section</p>
<p class="MsoNormal">Florida Department of Environmental Protection</p>
<p class="MsoNormal">2600 Blair Stone Road, MS 4555</p>
<p class="MsoNormal">Tallahassee, FL 32399-2400</p>
<p class="MsoNormal">850.245.8759</p>
<p class="MsoNormal">Laurie.Tenace@dep.state.fl.us</p>
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