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<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Right about what, exactly?<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Jim missed an opportunity to point toward his disposal system for chemo wastes that deals with the problem at the source--as it should be, and instead blamed
the treatment plant taking in water from millions of toilets. I don’t see where she said anything about
</span>cyclophosphamide<span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> being safe. WWTPs can’t filter out/capture everything that is excreted, they never will be able to, even with the best technology. Source reduction is the
key here and it is far more difficult to address than where to put a collection box for unused pharms—and that took all of us on the list serve years to get in place. No one on this list serve advocates sewering unused pharms. Your “Fillabox” concept could
not exist for pharms if we hadn’t all worked toward separate collection vs. sewering and trashing. It is also lovely working in waste management for 30 years begging the average Joe to consider paying more taxes to put better water treatment systems in place.
To capture that 1 drop in a pool. No one in government wins that argument. The woman merely tried to put the ppt concept into terms people could understand from a risk related basis. That is also her job. The drinking water exposure doesn’t compare, for example,
to the TDCPP that we accumulate all day long from every surface that it is imbedded with it.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Aside from that, my frustration as of late is that the numbers are always converted for the potential impacts on humans, vs. the very real impacts that are
now occurring to aquatic species at the ppt level.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
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<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>Lawernce Kenemore Jr.<br>
<b>Sent:</b> Friday, October 30, 2015 4:17 PM<br>
<b>To:</b> pharmwaste@lists.dep.state.fl.us<br>
<b>Subject:</b> [Pharmwaste] Re: Pharmwaste Digest, Vol 120, Issue 21<o:p></o:p></span></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif""><img width="165" height="160" id="_x0000_i1025" src="cid:image002.jpg@01D11334.5639A2E0" alt="New Box Logo 5-1_edited-1.jpg"><o:p></o:p></span></p>
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<p class="MsoNormal"><b><span style="font-family:"Calibri","sans-serif"">Larry Kenemore Jr.</span></b><span style="font-family:"Calibri","sans-serif""><o:p></o:p></span></p>
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<p class="MsoNormal"><b><span style="font-family:"Calibri","sans-serif"">Inventor/Consultant to</span></b><span style="font-family:"Calibri","sans-serif""><o:p></o:p></span></p>
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<p class="MsoNormal"><b><span style="font-family:"Calibri","sans-serif"">Board of Directors</span></b><span style="font-family:"Calibri","sans-serif""><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">10092 Bianchi Way #207<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">Cupertino CA. 95014<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">(855) 873-4965<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#274E13">A Woman Owned/</span><span style="font-family:"Calibri","sans-serif""><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#274E13">Minority Owned Business</span><span style="font-family:"Calibri","sans-serif""><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">D&B #079463523<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">NAICS #562920<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">CAGE #079463523/7AKL<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:blue;background:#EEEEEE"><a href="mailto:Larrykenemorejr@fillaboxrecycling.com">Larrykenemorejr@fillaboxrecycling.com</a></span><span style="font-family:"Calibri","sans-serif""><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif""><o:p> </o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:blue;background:#EEEEEE">Jim</span><span style="font-family:"Calibri","sans-serif""><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:blue;background:#EEEEEE">You are so right set them straight.</span><span style="font-family:"Calibri","sans-serif""><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif""><img border="0" id="_x0000_i1026" src="https://app.mixmax.com/api/track/v2/YSzJwhnT33foZ5VNb/ISbvNmLslWYtdGQwATMyp2akxmI/gIzVnLsZmLlRXY0NnLwVGZuMHdzlGbAVGdzF2dtJXYoBnI/gIzVnLsZmLlRXY0NnLwVGZuMHdzlGbAVGdzF2dtJXYoBnI"><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif""><o:p> </o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">On Fri, Oct 30, 2015 at 12:57 PM, <<a href="mailto:pharmwaste-request@lists.dep.state.fl.us" target="_blank">pharmwaste-request@lists.dep.state.fl.us</a>> wrote:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">Send Pharmwaste mailing list submissions to<br>
<a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a><br>
<br>
To subscribe or unsubscribe via the World Wide Web, visit<br>
<a href="http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste" target="_blank">
http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste</a><br>
or, via email, send a message with subject or body 'help' to<br>
<a href="mailto:pharmwaste-request@lists.dep.state.fl.us">pharmwaste-request@lists.dep.state.fl.us</a><br>
<br>
You can reach the person managing the list at<br>
<a href="mailto:pharmwaste-owner@lists.dep.state.fl.us">pharmwaste-owner@lists.dep.state.fl.us</a><br>
<br>
When replying, please edit your Subject line so it is more specific<br>
than "Re: Contents of Pharmwaste digest..."<br>
<br>
Today's Topics:<br>
<br>
1. Finding clarity in water testing - testing for CECs in AZ<br>
(Tenace, Laurie)<br>
2. RE: Finding clarity in water testing - testing for CECs in AZ<br>
(Jim Mullowney)<br>
<br>
<br>
---------- Forwarded message ----------<br>
From: "Tenace, Laurie" <<a href="mailto:Laurie.Tenace@dep.state.fl.us">Laurie.Tenace@dep.state.fl.us</a>><br>
To: "<a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a>" <<a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a>><br>
Cc: <br>
Date: Fri, 30 Oct 2015 17:17:47 +0000<br>
Subject: [Pharmwaste] Finding clarity in water testing - testing for CECs in AZ<o:p></o:p></span></p>
<div>
<div>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">One million, seven hundred sixty thousand.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Or 1,760,000.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">That’s the number of 8-ounce glasses of water from Flagstaff’s Foxglenn Well a resident would have to drink to ingest a standard dose of Prozac from trace amounts in the well
water, according to the latest testing numbers. </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">It’s a figure Erin Young, the city’s water resources manager, makes sure to emphasize when explaining the latest data from the city’s efforts to test water for a multitude of
trace substances that aren’t currently regulated by state or federal agencies. The substances are categorized as compounds of emerging concern, or CECs, and they include things like pharmaceuticals, personal care products and endocrine disruptors.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Young presented interim results of that testing to the Flagstaff City Council last month.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">The challenge for Young and the city is to interpret those results, verify their accuracy and help people understand exactly what the data mean for their health and safety.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">“Since (CEC’s) are not regulated, what we’re missing is that conversation about...even if we find them, what do they mean?” said Brad Hill, director of the city's utilities department.
“Putting these things in perspective is something we struggle with in our industry.”</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:7.5pt;line-height:16.5pt;mso-line-height-rule:exactly">
<b><span style="font-size:13.5pt;font-family:"Helvetica","sans-serif";color:#404040">Crunching numbers</span></b><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Flagstaff is one of only a handful of cities willing to test for compounds of emerging concern, said Hill said. The city has been doing so since 2002. </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">The effort to sample for these substances stems in part from a federal mandate and part from a local push to know more about the potable water coming out of taps and the reclaimed
wastewater being sprayed over local parks and ski slopes.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Young’s report to city council in September reviewed results of water testing completed since 2013. It showed that zero to five CECs were detected at each of seven drinking water
sources across the system. The compounds that showed up include fluoxetine, or Prozac; Acesulfame-K, a calorie-free sugar substitute; and azithromycin, an antibiotic used to treat various types of infections.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">The number of such compounds detected in reclaimed wastewater and effluent discharged from the city’s treatment plants was approximately four to eight times higher, ranging from
23 to 47 substances detected at each test site. The sweetener sucralose; TDCPP, a flame retardant; amoxicillin, an antibacterial; and iohexol, an agent used in contrast radiography, were found in the highest concentrations.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">The city also separately tested for the chemical NDMA, a potential carcinogen, which was detected in both reclaimed wastewater and treated discharge. The chemical results when
ammonia lingering in wastewater reacts with chlorine used as a disinfectant. That reaction creates chloramines, which can form NDMA.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Those tests are on top of EPA-mandated testing the city completes for a list of 30 contaminants the agency is considering for future regulation. </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:7.5pt;line-height:16.5pt;mso-line-height-rule:exactly">
<b><span style="font-size:13.5pt;font-family:"Helvetica","sans-serif";color:#404040">Putting numbers in perspective</span></b><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Beyond the numbers themselves, key from a public health standpoint is the amount or concentration of the substances detected in Flagstaff’s water system. Prozac, which was detected
at the city’s Foxglenn groundwater well, was measured at 24 parts per trillion. That’s the equivalent of 24 grains of salt in an Olympic-sized pool, Young wrote in her report to the city.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Azithromycin, an antibiotic, was another compound found in Flagstaff’s drinking water at 37 nanograms per liter, or approximately 37 parts per trillion. A person would have to
drink more than 22,864 8-ounce glasses of water to ingest an amount of the chemical that would pose a health concern, according to data provided by the Water Research Foundation, a nonprofit that invests research dollars in a wide range of water issues.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">In reclaimed wastewater the concentrations of CECs were much higher.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Sucralose was the substance found in the highest concentrations in Flagstaff’s reclaimed wastewater at a maximum of 58,000 parts per trillion. A person would have to drink more
than 773 glasses of water per day of reclaimed water to receive a dosage above the level deemed safe.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">TDCPP, the flame retardant, was found to occur in Flagstaff’s reclaimed wastewater at a maximum level of 1400 nanograms per liter in reclaimed wastewater. At that concentration,
someone would have to drink more than 1,148 glasses of reclaimed wastewater to ingest a dangerous amount.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">At this point, no one in Flagstaff is drinking reclaimed wastewater.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">In all, Young wrote in her report that the trace contaminant levels found in Flagstaff’s drinking water and reclaimed water have remained much the same as in past years when the
city has tested for them.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:7.5pt;line-height:16.5pt;mso-line-height-rule:exactly">
<b><span style="font-size:13.5pt;font-family:"Helvetica","sans-serif";color:#404040">Need for review</span></b><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Young also emphasized that the city's testing data hasn’t yet been reviewed by the city’s CEC advisory panel, a group of doctors, private, government and university researchers,
city officials and health experts.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">That’s important because some of the results don’t seem quite right. Tests that detected fluoxetine, for example, didn’t detect sucralose, which commonly shows up with fluoxetine,
Young said. Fluoxetine levels also were much higher than other samples collected by the Water Research Foundation. The city found 20 to 30 nanograms per liter compared with a maximum level of 0.82 nanograms per liter listed in WRF statistics.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Young said the city’s testing lab compared Flagstaff’s results with 558 other test results for fluoxetine, though, and found the highest level detected was 215 nanograms per liter.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">“It may be that the results WRF is getting were run using a different analytical method. Or perhaps (WRF) has a mistake in units,” Young wrote in a follow-up email.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Determining the accuracy of the test results and the potential human health impacts also is becoming increasingly important, and sometimes increasingly difficult, as the sensitivity
of technology improves, compounds to be detected at smaller and smaller concentrations, Young said.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">“It’s really easy to contaminate samples at parts per trillion level,” she said.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">At such a small scale, there is a greater chance the devices detected false positives, or that a sample was contaminated.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">“We haven’t had somebody to look at data to see if it makes sense,” Young said.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:7.5pt;line-height:16.5pt;mso-line-height-rule:exactly">
<b><span style="font-size:13.5pt;font-family:"Helvetica","sans-serif";color:#404040">Evaluating health risk</span></b><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">It’s important to remember that the compounds of emerging concern haven’t been found to have health impacts at levels found in drinking water, said Alice Fulmer a senior research
manager with the Denver-based Water Research Foundation. The compounds also vary seasonally and even daily, so levels found one day may not be the same as those found a few months later, she said.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">“Detecting these compounds doesn’t necessarily indicate any risk,” Fulmer said. “Instead it’s the starting point that tells us, ‘Hey, let's start paying attention.’”</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Laurie Tenace<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Environmental Specialist<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Waste Reduction Section<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Florida Department of Environmental Protection<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">2600 Blair Stone Road, MS 4555<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Tallahassee, FL 32399-2400<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><a href="tel:850.245.8759" target="_blank"><span style="font-family:"Calibri","sans-serif"">850.245.8759</span></a><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><a href="mailto:Laurie.Tenace@dep.state.fl.us" target="_blank"><span style="font-family:"Calibri","sans-serif"">Laurie.Tenace@dep.state.fl.us</span></a><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
</div>
</div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif""><br>
<br>
---------- Forwarded message ----------<br>
From: Jim Mullowney <<a href="mailto:jmullowney@pharma-cycle.com">jmullowney@pharma-cycle.com</a>><br>
To: "Tenace, Laurie" <<a href="mailto:Laurie.Tenace@dep.state.fl.us">Laurie.Tenace@dep.state.fl.us</a>>, "<a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a>" <<a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a>><br>
Cc: <br>
Date: Fri, 30 Oct 2015 13:56:07 -0400<br>
Subject: RE: [Pharmwaste] Finding clarity in water testing - testing for CECs in AZ<o:p></o:p></span></p>
<div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">It is insidious to compare the amount of water you would need to drink when it comes to cytotoxic chemotherapy drugs. OSHA has a zero exposure limit and even the manufacturers go to great
lengths to protect the workers.<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">Chemicals known to cause birth defects miscarriages and cancer and are effective on a molecule by molecule basis. We cannot compare proczak to cyclophosphamide , the concern is not the dose
but the side effects. <o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">These chemicals are not dose dependent, they are designed to alter the DNA of rapidly dividing cells such as cancer cells and once that cell is altered it splits in two as a secondary cancer.<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">Tell that to a two year old who has every cell rapidly dividing, or a pregnant woman. <o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">Two four eight, just like that shampoo commercial from the 70s .<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">The problem is that upto 90 % of the drug is excreted in the sweat, urine feces and saliva contaminating the patients family and property.<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">Check out <a href="http://www.cytotoxicsafety.org" target="_blank">
www.cytotoxicsafety.org</a> if you doubt anything I am saying. <o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif""><o:p> </o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">So all of you water regulatory people are on notice that the world of drugs in the environment is not all rainbows and unicorns. <o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif""><o:p> </o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif"">Do your job.<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif""><o:p> </o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif""><o:p> </o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif""><o:p> </o:p></span></p>
</div>
<div>
<div>
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Calibri","sans-serif";color:#575757">Sent from my T-Mobile 4G LTE Device<o:p></o:p></span></p>
</div>
</div>
<div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:black">-------- Original message --------<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:black">From: "Tenace, Laurie" <<a href="mailto:Laurie.Tenace@dep.state.fl.us" target="_blank">Laurie.Tenace@dep.state.fl.us</a>>
<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:black">Date: 10/30/2015 1:17 PM (GMT-05:00)
<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:black">To:
<a href="mailto:pharmwaste@lists.dep.state.fl.us" target="_blank">pharmwaste@lists.dep.state.fl.us</a>
<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:black">Subject: [Pharmwaste] Finding clarity in water testing - testing for CECs in AZ
<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:black"><o:p> </o:p></span></p>
</div>
</div>
<div>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">One million, seven hundred sixty thousand.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Or 1,760,000.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">That’s the number of 8-ounce glasses of water from Flagstaff’s Foxglenn Well a resident would have to drink to ingest a standard dose of Prozac from trace amounts in the well
water, according to the latest testing numbers. </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">It’s a figure Erin Young, the city’s water resources manager, makes sure to emphasize when explaining the latest data from the city’s efforts to test water for a multitude of
trace substances that aren’t currently regulated by state or federal agencies. The substances are categorized as compounds of emerging concern, or CECs, and they include things like pharmaceuticals, personal care products and endocrine disruptors.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Young presented interim results of that testing to the Flagstaff City Council last month.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">The challenge for Young and the city is to interpret those results, verify their accuracy and help people understand exactly what the data mean for their health and safety.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">“Since (CEC’s) are not regulated, what we’re missing is that conversation about...even if we find them, what do they mean?” said Brad Hill, director of the city's utilities department.
“Putting these things in perspective is something we struggle with in our industry.”</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:7.5pt;line-height:16.5pt;mso-line-height-rule:exactly">
<b><span style="font-size:13.5pt;font-family:"Helvetica","sans-serif";color:#404040">Crunching numbers</span></b><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Flagstaff is one of only a handful of cities willing to test for compounds of emerging concern, said Hill said. The city has been doing so since 2002. </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">The effort to sample for these substances stems in part from a federal mandate and part from a local push to know more about the potable water coming out of taps and the reclaimed
wastewater being sprayed over local parks and ski slopes.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Young’s report to city council in September reviewed results of water testing completed since 2013. It showed that zero to five CECs were detected at each of seven drinking water
sources across the system. The compounds that showed up include fluoxetine, or Prozac; Acesulfame-K, a calorie-free sugar substitute; and azithromycin, an antibiotic used to treat various types of infections.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">The number of such compounds detected in reclaimed wastewater and effluent discharged from the city’s treatment plants was approximately four to eight times higher, ranging from
23 to 47 substances detected at each test site. The sweetener sucralose; TDCPP, a flame retardant; amoxicillin, an antibacterial; and iohexol, an agent used in contrast radiography, were found in the highest concentrations.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">The city also separately tested for the chemical NDMA, a potential carcinogen, which was detected in both reclaimed wastewater and treated discharge. The chemical results when
ammonia lingering in wastewater reacts with chlorine used as a disinfectant. That reaction creates chloramines, which can form NDMA.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Those tests are on top of EPA-mandated testing the city completes for a list of 30 contaminants the agency is considering for future regulation. </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:7.5pt;line-height:16.5pt;mso-line-height-rule:exactly">
<b><span style="font-size:13.5pt;font-family:"Helvetica","sans-serif";color:#404040">Putting numbers in perspective</span></b><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Beyond the numbers themselves, key from a public health standpoint is the amount or concentration of the substances detected in Flagstaff’s water system. Prozac, which was detected
at the city’s Foxglenn groundwater well, was measured at 24 parts per trillion. That’s the equivalent of 24 grains of salt in an Olympic-sized pool, Young wrote in her report to the city.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Azithromycin, an antibiotic, was another compound found in Flagstaff’s drinking water at 37 nanograms per liter, or approximately 37 parts per trillion. A person would have to
drink more than 22,864 8-ounce glasses of water to ingest an amount of the chemical that would pose a health concern, according to data provided by the Water Research Foundation, a nonprofit that invests research dollars in a wide range of water issues.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">In reclaimed wastewater the concentrations of CECs were much higher.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Sucralose was the substance found in the highest concentrations in Flagstaff’s reclaimed wastewater at a maximum of 58,000 parts per trillion. A person would have to drink more
than 773 glasses of water per day of reclaimed water to receive a dosage above the level deemed safe.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">TDCPP, the flame retardant, was found to occur in Flagstaff’s reclaimed wastewater at a maximum level of 1400 nanograms per liter in reclaimed wastewater. At that concentration,
someone would have to drink more than 1,148 glasses of reclaimed wastewater to ingest a dangerous amount.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">At this point, no one in Flagstaff is drinking reclaimed wastewater.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:6.75pt;line-height:13.5pt;mso-line-height-rule:exactly">
<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">In all, Young wrote in her report that the trace contaminant levels found in Flagstaff’s drinking water and reclaimed water have remained much the same as in past years when the
city has tested for them.</span><o:p></o:p></p>
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<b><span style="font-size:13.5pt;font-family:"Helvetica","sans-serif";color:#404040">Need for review</span></b><o:p></o:p></p>
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<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Young also emphasized that the city's testing data hasn’t yet been reviewed by the city’s CEC advisory panel, a group of doctors, private, government and university researchers,
city officials and health experts.</span><o:p></o:p></p>
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<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">That’s important because some of the results don’t seem quite right. Tests that detected fluoxetine, for example, didn’t detect sucralose, which commonly shows up with fluoxetine,
Young said. Fluoxetine levels also were much higher than other samples collected by the Water Research Foundation. The city found 20 to 30 nanograms per liter compared with a maximum level of 0.82 nanograms per liter listed in WRF statistics.</span><o:p></o:p></p>
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<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Young said the city’s testing lab compared Flagstaff’s results with 558 other test results for fluoxetine, though, and found the highest level detected was 215 nanograms per liter.</span><o:p></o:p></p>
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<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">“It may be that the results WRF is getting were run using a different analytical method. Or perhaps (WRF) has a mistake in units,” Young wrote in a follow-up email.</span><o:p></o:p></p>
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<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">Determining the accuracy of the test results and the potential human health impacts also is becoming increasingly important, and sometimes increasingly difficult, as the sensitivity
of technology improves, compounds to be detected at smaller and smaller concentrations, Young said.</span><o:p></o:p></p>
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<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">“It’s really easy to contaminate samples at parts per trillion level,” she said.</span><o:p></o:p></p>
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<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">At such a small scale, there is a greater chance the devices detected false positives, or that a sample was contaminated.</span><o:p></o:p></p>
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<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">“We haven’t had somebody to look at data to see if it makes sense,” Young said.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:7.5pt;line-height:16.5pt;mso-line-height-rule:exactly">
<b><span style="font-size:13.5pt;font-family:"Helvetica","sans-serif";color:#404040">Evaluating health risk</span></b><o:p></o:p></p>
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<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">It’s important to remember that the compounds of emerging concern haven’t been found to have health impacts at levels found in drinking water, said Alice Fulmer a senior research
manager with the Denver-based Water Research Foundation. The compounds also vary seasonally and even daily, so levels found one day may not be the same as those found a few months later, she said.</span><o:p></o:p></p>
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<span style="font-size:10.0pt;font-family:"Helvetica","sans-serif";color:#222222">“Detecting these compounds doesn’t necessarily indicate any risk,” Fulmer said. “Instead it’s the starting point that tells us, ‘Hey, let's start paying attention.’”</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Laurie Tenace<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Environmental Specialist<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Waste Reduction Section<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Florida Department of Environmental Protection<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">2600 Blair Stone Road, MS 4555<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Tallahassee, FL 32399-2400<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><a href="tel:850.245.8759" target="_blank"><span style="font-family:"Calibri","sans-serif"">850.245.8759</span></a><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><a href="mailto:Laurie.Tenace@dep.state.fl.us" target="_blank"><span style="font-family:"Calibri","sans-serif"">Laurie.Tenace@dep.state.fl.us</span></a><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
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