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Drugs in Our Water

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  • Drugs in Our Water


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    A new class of water pollutants has been discovered during the

    past six years.[1] Pharmaceutical drugs given to people and to

    domestic animals --including antibiotics, hormones, strong pain

    killers, tranquilizers, and chemotherapy chemicals given to

    cancer patients --are being measured in surface water, in

    groundwater, and in drinking water at the tap. Large quantities

    of drugs are excreted by humans and domestic animals, and are

    distributed into the environment by flushing toilets and by

    spreading manure and sewage sludge onto and into soil.

    German scientists report that anywhere from 30 to 60 drugs can be

    measured in a typical water sample, if anyone takes the time to

    do the proper analyses.[2] The concentrations of some drugs in

    water are comparable to the low parts-per-billion (ppb) levels at

    which pesticides are typically found.[1] To some people this is

    reassuring, but others are asking, "What is the long-term effect

    of drinking, day after day, a dilute cocktail of pesticides,

    antibiotics, pain killers, tranquilizers and chemotherapy

    agents?" Of course no one knows the answer to such a question

    --it is simply beyond the capabilities of science to sort out the

    many chemical interactions that could occur in such a complex

    chemical soup. The only solution to such a problem would be


    The first study that detected drugs in sewage took place at the

    Big Blue River sewage treatment plant in Kansas City in 1976.

    The problem was duly recorded in scientific literature and then

    ignored for 15 years.[3] In 1992, researchers in Germany were

    looking for herbicides in water when they kept noticing a

    chemical they couldn't identify.[4] It turned out to be clofibric

    acid (CA), a drug used by many people in large quantities (1 to 2

    grams per day) to reduce cholesterol levels in the blood.[1]

    Clofibric acid is 2-(4)-chlorophenoxy-2-methyl propionic acid, a

    close chemical cousin of the popular weed killer 2,4-D.[1] Based

    on that early discovery, the search for clofibric acid (CA) in

    the environment was stepped up.

    Since 1992, researchers in Germany, Denmark and Sweden have been

    measuring CA and other drugs in rivers, lakes, and the North Sea.

    To everyone's surprise, it turns out that the entire North Sea

    contains measurable quantities of clofibric acid. Based on the

    volume of the Sea, which is 12.7 quadrillion gallons (1.27 x

    10E16 gallons), and the average concentration of CA, which is 1

    to 2 parts per trillion (ppt), researchers estimate that the Sea

    contains 48 to 96 tons of clofibric acid with 50 to 100 tons

    entering the Sea anew each year.[1] The Danube River in Germany

    and the Po River in Italy also contain measurable quantities of

    clofibric acid.[5,6] Of more immediate concern to humans is the

    finding that tap water in all parts of the city of Berlin

    contains clofibric acid at concentrations between 10 and 165

    ppt.[5] The water supplies of other major cities remain to be


    As a result of this European work, a few U.S. researchers are now

    beginning to pay attention to drugs in the environment.

    Individual scientists within the U.S. Food and Drug

    Administration (FDA) have been concerned about this problem for a

    decade,[7] but so far FDA has taken the official position that

    excreted drugs are not a problem because the concentrations found

    in the environment are usually below one part per billion


    Drugs are designed to have particular characteristics. For

    example, 30% of the drugs manufactured between 1992 and 1995 are

    lipophilic, meaning that they tend to dissolve in fat but not in

    water.[8] This gives them the ability to pass through cell

    membranes and act inside cells. Unfortunately, it also means

    that, once they are excreted into the environment, they enter

    food chains and concentrate as they move upward into larger

    predators. Many drugs are also designed to be persistent, so

    that they can retain their chemical structure long enough to do

    their therapeutic work. Unfortunately, after they are excreted,

    such drugs also tend to persist in the environment. A landfill

    used by the Jackson Naval Air Station in Florida contaminated

    groundwater with a plume of chemicals that has been moving slowly

    underground for more than 20 years. The drugs pentobarbital (a

    barbiturate), meprobamate (a tranquilizer sold as Equanil and

    Miltown) and phensuximide (an anticonvulsant) are still

    measurable in that groundwater plume.[8,pg.362]

    When a human or an animal is given a drug, anywhere from 50% to

    90% of it is excreted unchanged. The remainder is excreted in

    the form of metabolites --chemicals produced as byproducts of the

    body's interaction with the drug. Researchers report that some

    of the metabolites are more lipophilic and more persistent than

    the original drugs from which they were derived. Because of the

    complexity of the chemistry involved in drug metabolism, and the

    interactions of the metabolites with the natural environment,

    Danish researchers say is it "practically impossible to estimate

    predicted environmental concentrations (PEC) of any medical

    substances with available knowledge."[8,pg.385]

    Yet U.S. regulatory policy for new drugs depends entirely upon

    estimating concentrations that might result from excretion. When

    a new drug is proposed for market, FDA requires the manufacturer

    to conduct a risk assessment that estimates the concentrations

    that will be found in the environment. If the risk assessment

    concludes that the concentration will be less than one part per

    billion, the drug is assumed to pose acceptable risks.[2] FDA

    has never turned down a proposed new drug based on estimated

    environmental concentrations, and no actual testing is conducted

    after a drug is marketed to see if the environmental

    concentration was estimated correctly.

    German chemists have found that many drugs can be measured at

    environmental concentrations that exceed one ppb. And of course

    several drugs measured together can exceed one ppb. Furthermore,

    there is ample evidence from research conducted during the past

    decade showing that some chemicals have potent effects on

    wildlife at concentrations far below one ppb. For example

    estradiol, the female sex hormone (and a common water pollutant),

    can alter the sex characteristics of certain fish at

    concentrations of 20 ppt, which is 1/50 of one ppb.[2]

    Another problem resulting from drugs in the environment is

    bacteria developing resistance to antibiotics. The general

    problem of antibiotic-resistant bacteria has been recognized for

    more than a decade. (See REHW #402.) Antibiotics are only

    useful to humans so long as bacteria do not become resistant to

    their effects. Hospital sewage systems discharge substantial

    quantities of antibiotics into the environment.[9] Bacteria

    exposed to antibiotics in sewage sludge, or water, have an

    opportunity to develop resistance. Janet Raloff of SCIENCE NEWS

    quotes Stuart Levy, who directs the Center for Adaptation

    Genetics and Drug Resistance at Tufts University in Boston,

    saying, "[T]hese antibiotics may be present at levels of

    consequence to bacteria --levels that could not only alter the

    ecology of the environment but also give rise to antibiotic


    What can we learn from the emergence of this new problem?

    1) Hospitals and the health care industry are the major sources

    of these problems, especially antibiotics and chemotherapy

    chemicals.[10] The large national coalition of environmental and

    health groups, Health Care Without Harm,[11] might consider

    tackling this difficult but important problem.

    2) Sewage sludge provides a major pathway by which drugs enter

    the environment. Until the drug problem is understood and

    controlled, it provides a solid scientific rationale for labeling

    sewage sludge a dangerous soil amendment, the use of which should

    be forbidden.

    3) For a long time, people have worried that the world was going

    to run out of natural resources. It is now apparent that we have

    run out places to throw things away. There is no place left

    where we can throw away exotic substances without affecting

    people or wildlife (upon whose well being we ultimately depend).

    From the viewpoint of disposal, not many decades ago the world

    still looked pretty empty. Today there can be no doubt that the

    world is full --full of people armed with double-edged

    technologies. To survive in a full world will require quite

    different attitudes. We need to curb our numbers. We need to

    curb our technologies. We need to curb our appetites. And we

    need to operate from a position of humility. We should assume

    that anything we do will have negative consequences on the rest

    of the planet. We must limit our technological interventions

    into nature long before we have definitive scientific proof of

    harm. This is the principle of precautionary action, and if we

    don't adopt it, nature will get along just fine without us.

    --Peter Montague

    (National Writers Union, UAW Local 1981/AFL-CIO)


    [1] Hans-Rudolf Buser and Markus D. Muller, "Occurrence of the

    Pharmaceutical Drug Clofibric Acid and the Herbicide Mecoprop in

    Various Swiss Lakes and in the North Sea," ENVIRONMENTAL SCIENCE

    AND TECHNOLOGY Vol. 32, No. 1 (1998), pgs. 188-192.

    [2] Janet Raloff, "Drugged Waters," SCIENCE NEWS Vol. 153, No. 12

    (March 21, 1998), pgs. 187-189.

    [3] C. Hignite and D.L. Azarnoff, "Drugs and drug metabolites as

    environmental contaminants: chlorophenoxyisobutyrate and

    salicyclic acid in sewage water effluent," LIFE SCIENCES Vol. 20,

    No. 2 (January 15, 1977), pgs. 337-341.

    [4] H.J. Stan and Thomas Heberer, "Pharmaceuticals in the Aquatic

    Environment," ANALUSIS MAGAZINE Vol. 25, No. 7 (1997), pgs.


    [5] Thomas Heberer and H.-J. Stan, "Determination of Clofibric

    Acid and N-(phenylsulfonyl)-Sarcosine in Sewage, River, and


    ANALYTICAL CHEMISTRY Vol. 67 (1997), pgs. 113-124. And see:

    Thomas Heberer and others, "Detection of Drugs and Drug

    Metabolites in Ground Water Samples of a Drinking Water Treatment

    Plant," FRESENIUS ENVIRONMENTAL BULLETIN Vol. 6 (1997), pgs.


    [6] "Pille im Brunnen [Pills in the Fountain]," DER SPIEGEL No.

    26 (June 24, 1996), pgs. 154-155, translated for us by Thea

    Lindauer, Annapolis, Maryland.

    [7] Personal communication from Maurice Zeeman, U.S.

    Environmental Protection Agency, March, 1998.

    [8] B. Halling-Sorensen and others, "Occurrence, Fate and Effects

    of Pharmaceutical Substances in the Environment --A Review,"

    CHEMOSPHERE Vol. 36, No. 2 (1998), pgs. 357-393.

    [9] Andreas Hartmann and others, "Identification of Fluoroquinone

    Antibiotics as the Main Source of umuC Genotoxicity in Native


    17, No. 3 (1998), pgs. 377-382.

    [10] T. Steger-Hartmann and others, "Biological Degradation of

    Cyclophosphamide and Its Occurrence in Sewage Water,"



    [11] Contact: Charlotte Brody, Health Care Without Harm, c/o CCHW

    Center for Health, Environment and Justice, P.O. Box 6806, Falls

    Church, Virginia 22040. Phone (703) 237-2249. See

    Descriptor terms: drugs; pharmaceuticals; water pollution;

    sewage sludge; precautionary principle; fda; north sea; germany;

    ################################################## ##############


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    --Peter Montague, Editor
    [email protected]

    " We know that to err is human, but the HIV/AIDS hypothesis is one hell of a mistake"
    Dr. Kary Mullis, Nobel Prize Winner in Chemistry for inventing the Polymerase Chain Reaction

    "The fact is that you can not start off with bad science and end up with good medicine"

  • #2
    this is exactly why i not only do 2 stage on all my water but another 5 stage on my drinking ontop of that