[Pharmwaste] Dopewater - article from New Orleans

Tenace, Laurie Laurie.Tenace at dep.state.fl.us
Wed Dec 10 08:40:22 EST 2008


Municipal water supplies around the country - including ours - contain trace
elements of discarded pharmaceuticals. Should you be worried?


Across the United States, scientists are detecting low concentrations of
pharmaceuticals in lakes, streams, drinking water and soils irrigated with
reclaimed water. More than 80 percent of waterways tested in America show
some traces of common medicines such as acetaminophen, hormones, blood
pressure medications, codeine and antibiotics, according to the United States
Geological Survey (USGS).

In early 2008, the Associated Press released a report detailing its
investigation of pharmaceuticals found in the drinking water of 50 American
cities. Philadelphia ranked highest on that list, with 56 pharmaceuticals and
pharmaceutical byproducts in its treated drinking water - including
azithromycin, tetracycline, amoxicillin and prednisone. Trace amounts of only
three pharmaceuticals were found in New Orleans tap water: the hormone
estrogen, the cholesterol-lowering drug clofibrate and the anti-inflammatory

While consumer watchdogs and scientists agree that New Orleans drinking water
is safe, some hold that any amount of dope in the water is too much. "It's
really disconcerting to learn [how many pharmaceuticals] have been found in
our waters," says Charlotte Smith, a pharmacist as well as founder and
president of PharmEcology Associates, a Wisconsin-based company dedicated to
managing pharmaceutical waste.

Karen Irion, administrator of the Safe Drinking Water Program for Louisiana's
Department of Environmental Quality (LDEQ), says the state does not test
drinking water for pharmaceuticals because the Environmental Protection
Agency (EPA) does not require it to do so.

"We're living in the toilet of the nation," Irion says. "We already know the
water is contaminated when it gets down here, so we take care of it through
to the molecular level."

The source of New Orleans drinking water is, of course, the Mississippi
River. Everything between the Rocky Mountains and the Appalachians drains
primarily into the Mississippi - including treated sewage water from
two-thirds of the United States. That suggests that most concentrations of
drugs found within the river's watershed region eventually will flow through
New Orleans, but not necessarily through your home tap.

Pharmaceuticals enter the sewer system when humans excrete unmetabolized
medicines or put medication down the drain. Wastewater treatment plants,
however, are not designed to remove medicine from sewer water. When treated
water is released from wastewater plants into streams, rivers and other water
bodies, the remnants of highly engineered chemical compounds enter the
environment. They can also enter through agricultural runoff, via animal
excrement and manure-based fertilizer. In New Orleans, pharmaceuticals may
also find their way into the environment through soft, sinking soils and
broken sewer lines, a problem associated with a pipe system more than a
century old.

Scientists are uncertain about the potential health risks pharmaceuticals -
as well as medications that mix with other pharmaceuticals, chemicals and
pathogens - may have on humans, aquatic life and the environment. One thing
they do know, however, is that "a release into the environment of antibiotics
in low levels can contribute to antibiotic resistance," says Herbert Buxton,
coordinator of the USGS Toxic Substances Hydrology Program. "Even soil
microbes get exposed at low levels, and they may start to develop an
antibiotic resistance."

Buxton points out that in addition to humans, livestock - which are often
treated with preventative medicines - can contribute to the problems.

"If an animal is sick and the pathogen escapes [into the environment] -
whether the pathogens are exposed to the antibiotic in the animal or in the
environment - it may either develop to maintain an antibiotic resistance or
to develop a [new] antibiotic resistance," he says.

All New Orleans tap water is filtered and chlorinated. It goes through
tertiary treatments including oxidation, in which oxygen is shot into water
to create a mini-explosion that destroys or breaks down chains of bacteria
and chemicals so they can be treated at the molecular level. Irion says the
process should break up pharmaceuticals as well. She is in charge of
enforcing drinking water rules for the whole state, following guidelines set
by a federal, EPA-provided list. Pharmaceuticals are not on that list;
instead, the LDEQ looks for the EPA's chosen 100 chemicals and
bacteriological constituents. The department also reviews the occurrence of
the EPA's "unregulated contaminates" in the environment, in order to
determine whether or not additional contaminants need to be regulated.

Researchers have tested New Orleans water for clofibrate and estrogen.
Clofibrate is not carcinogenic to humans, but is reported to form tumors in
laboratory rats. Its potential impact on the environment is in question. Dr.
Glen Boyd, who directed research on pharmaceuticals in New Orleans drinking
water through Tulane University prior to 2004, and others say artificial or
natural estrogens that get into the biological system may interfere with
normal function of the endocrine system.

The USGS has published more than 150 papers on the subject of emerging
contaminants in the environment. Protection agencies, including the USGS and
the EPA, red-flagged pharmaceuticals for further study when their European
colleagues began discovering the chemicals in large bodies of water.

Research scientist Dr. Shane Snyder has been studying pharmaceuticals in the
water and sediment for more than 15 years. At a U.S. Senate subcommittee
hearing on water quality in April, Snyder provided a statement saying
concentrations of pharmaceuticals being found in American drinking waters are
"unfathomably low."

Elements that have supposedly been detected in drinking water in New Orleans
and elsewhere were approximately 5 billion times lower than the therapeutic
dose. The concentration would be the equivalent to a half-inch in the
distance between the earth and the moon. In his statement, Snyder assured the
subcommittee that a person could safely consume 50,000 8-ounce glasses of
water per day without ill effects from the minuscule amounts of
pharmaceuticals in the water.

Boyd's group tested for the same three pharmaceuticals the AP reported were
found in New Orleans. His peer-reviewed, published reports demonstrated that
while some of the pharmaceuticals for which his group tested were detected in
local bayous and lakes, they were unable to survive the rigorous treatment
applied to local drinking water. But while Snyder and Boyd both argue that
pharmaceuticals in the drinking water do not pose a public health threat,
they both stress the need for researchers and law enforcement agents to keep
an eye on the matter.

It's likely pharmaceuticals have been in our water supply at trace levels for
several decades. What has changed is researchers' ability to track and
monitor their presence - and our awareness of environmental issues.

Irion says she has great confidence in New Orleans drinking water because the
state's water treatment techniques are top-notch: "The thing that people die
from is bacterial contamination," she says "They just had an outbreak in
Colorado, because they weren't putting chlorine in their water. New York City
doesn't treat their water at all. We're very, very careful here doing a lot
of testing in the water." Like Snyder and Boyd, Irion believes
pharmaceuticals found in the water nationwide are infinitesimal and are not a
threat to human health. "We're looking at parts per quatrillion, such tiny
amounts," she says. "We're far more concerned with their effect in the
environment, on environmental indicators [such as] insects and frogs."

The EPA currently has no policy to prohibit dumping waste pharmaceuticals in
the water, a common practice in homes and among health care professionals.

Howard Fielding manages the Drinking Water Protection Program (DWPP) for the
LDEQ. "This is the first year we've talked about pharmaceuticals," he says.
The DWPP is a community outreach program that works parish by parish with
businesses and the public to keep unwanted elements out of source waters,
including aquifers, reservoirs and lakes.

"The big thing is getting the public to know not to dispose of this stuff
down the drain," Fielding says. The DWPP recommends people get rid of
medicines they no longer can take by throwing them in the trash, unless the
manufacturer or health officials tell them otherwise.

Fielding says the group has not approached health care facilities regarding
the matter, but Tony Laurent, director of pharmacy at Tulane Medical Center,
says he thinks incineration, rather than drain disposal, is standard practice
- but not official policy - at local hospitals. PharmEcology's Smith suggests
the increased cost for health care facilities to treat pharmaceuticals as
hazardous waste, rather than pouring them down the drain, outweighs
environmental risks.

The "trace amounts" currently detected in drinking water may or may not have
a cumulative effect on humans. "We do know there's quite a bit of
pharmaceuticals in [lakes, rivers and aquifers]," Irion says. She
recommendations preventive medicine for the environment: Rather than flushing
unused medications, "Mix them with coffee grounds or something that will
destroy them and throw them in the trash," she says. "What you flush gets
into the environment, the food chain or in the drinking water."

Laurie Tenace
Environmental Specialist
Waste Reduction Section
Florida Department of Environmental Protection
2600 Blair Stone Rd., MS 4555
Tallahassee FL 32399-2400
P: 850.245.8759
F: 850.245.8811

Mercury: http://www.dep.state.fl.us/waste/categories/mercury/default.htm 

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