When Clear Water Isn’t Clean Water

Most people do not realize that their medicine chests, bathrooms and kitchen sinks are the starting point for water contaminants entering our rivers and streams. The culprits? Pharmaceutical and personal care products (PPCPs). Pharmaceuticals include both prescription and over-the-counter medications, and nutritional supplements. Personal care products with harmful ingredients or by-products range from soap and shampoo, to cosmetics and fragrances.

The Problem: Pharmaceuticals Entering our Rivers and Streams

Every time you flush medicine down your toilet or sink, you are sending it to your local waterway. While your wastewater typically goes into a municipal wastewater treatment plant, wastewater treatment cannot remove most of the chemicals and other compounds in pharmaceuticals that pollute the water and that can cause harm to aquatic species. Unfortunately at this time, most people dispose of medicines by flushing them down their toilets or sink, or just throwing them into the trash In one study, almost 90 percent of the participants said they dispose their unused and/or unwanted medicines via the toilet, sink, trash, or by simply not disposing them at all. Health care facilities or providers such as clinics, labs and pharmacies can also be sources of improperly disposed pharmaceuticals.

Pharmaceuticals also enter our water indirectly as waste from humans and animals. The source problem isn’t just limited to humans; we bathe our pets with soap, we treat their illnesses with medication. Outside urban areas livestock operations frequently use medications or other compounds such as steroids in producing meat, dairy products and eggs. Approximately two-thirds of the beef cattle raised in the United States are given growth hormones; up to 75 percent of the hormones and other drugs given to animals end up being eliminated through their urine and manure.

Harmful ingredients from pharmaceuticals are becoming more common in our rivers and streams. Studies on the presence and levels of pharmaceutical chemicals have been conducted for a number of years, with recent studies confirming the persistence of these compounds in rivers. A 2002 study by the U.S. Geological Study tested 139 streams nationwide for 95 different chemicals; 80 percent of the stream water samples contained at least one-third or more of these chemicals. Land use upstream from the sampling sites was predominantly developed. Another USGS study, published in 2006, found that levels of pharmaceutical chemicals, including endocrine disrupting compounds, increased dramatically in water samples taken downstream from a wastewater treatment plant.

The hydrological connection of water sources also means that the presence of pharmaceutical agents is not be limited to rivers and streams, and that impacts from these chemicals can spread to aquatic species which live in other water bodies. As a receiver of river and creek water, pharmaceuticals can enter lakes and wetlands. Groundwater quality can also be impacted by the quality of the river waters recharging an aquifer.

Effects of Pharmaceuticals on Aquatic Organisms

There are a number of active ingredients found in medications and personal care products that can impact the quality of our rivers and aquatic habitats, but two in particular are receiving increased attention: estrogens or other endocrine disruptors (see below) and anti-depressant and obsessive-compulsive medications. A 2006 USGS study specifically notes native fish populations downstream of the wastewater treatment plant showed symptoms of endocrine disruption, or a “feminization effect;” these impacts include fish developing both female and male reproductive organs and decreased numbers of males in the population. Ultimately reproductive and gender imbalances within a species can lead to population declines or worse.

Endocrine systems include both glands and hormones that regulate body functions such as growth and maturation, as well as the normal functioning of organs, including the pituitary, thyroid, and reproductive organs. This system works by a complex series of hormonal messages. Endocrine disruptors alter normal hormonal levels, creating breakdowns in the body’s chemical message system by: 1) mimicking the function of a particular hormone (like estrogen); 2) blocking normal hormonal signals; and 3) stimulating or inhibiting endocrine receptor, causing overproduction or underproduction of a hormone.

Studies on the effects of anti-depressants and obsessive-compulsive regulators on aquatic life note the chemicals contained in these medications are likely the primary cause of other aquatic species disorders, including premature spawning in shellfish and the inability of damaged fish fins to heal. They also cause slower heart rates in the Daphnia water flea; a lowered heart rate is one indicator of potentially broad physiological effects.

Smaller aquatic organisms like water fleas have a short lifespan, which means that multiple generations will be exposed to a contaminant. This could have a catastrophic impact on a species’ sustainability. In addition, reduced numbers or the loss of species at the bottom of the food chain impacts higher level species that depend on these organisms for food or other benefits.

Why care?

It is not a new story that chemically induced changes in natural hormonal functioning have disastrous impacts on wildlife. Beginning in the 1960s researchers began studies that eventually confirmed the relationship between the pesticide DDT and reproductive failures in eagles and sea gulls (due to extreme thinning of the birds’ eggshells). In the 1980s alligators in Florida’s Lake Apopka suffered reproductive abnormalities, including feminization effects and a high egg mortality rate; these impacts were attributed to pollutants, including DDT in the lake water.

What has changed in the more than forty years since those early studies is the number and type of different chemicals entering our waterways, including those contained in pharmaceuticals and personal care products. A 2004 report by the National Center for Health Statistics (NCHS) indicates prescription drugs use has been increasing. It further reports that over half of U.S. citizens use prescription medication, with 1 out of 6 people using three or more drugs. Much of the increase in use is due to a significant rise in the number of prescriptions for a few drug types: antidepressants, blood sugar/glucose regulators, and cholesterol lowering statins. Although not mentioned in the study, the reality of the aging baby boomer generation is also a factor in current and future increases in pharmaceutical use.

As stated previously, water treatment processes are not able to eliminate most of the harmful chemicals contained in pharmaceuticals and personal care products. In fact, some pharmaceuticals, such as antibiotics, actually kill bacteria used in wastewater treatment to break down organic waste materials. Some water, such as storm water or sewer overflow resulting from heavy rain, never reaches a treatment facility. While a few treatment techniques are available to destroy a small number of the chemicals in pharmaceuticals, they are not being put into place because of the cost and because the treatment is effective only for a single or small range of contaminants.

The Solution: Proper Pharmaceutical Disposal

The best way to keep pharmaceutical and harmful personal care products from entering our rivers and streams is to prevent them from getting into the water. How can we do this?

Permanent collection and take-back programs are the best way to keep contaminants out of our rivers and streams. Places in Illinois that have been used for permanent collection program include hazardous waste facilities, pharmacies, county health departments, and police stations. The advantage of permanent collection facilities is that they: 1) offer a continuous, known place for people to return their unused and unwanted pharmaceuticals; 2) offer a secure site for storage; and 3) guarantee that pharmaceuticals they receive will be destroyed.

One-day collection events are held in a variety of places with different groups acting as sponsors. These may be general hazardous waste collections which include pharmaceuticals or events that are specifically collecting unused, unwanted medications. Like permanent collection facilities, one-day events offer a secured location for collection, with the items collected being destroyed. However, they may not be held on a day or at a time that is convenient.

In Illinois, permanent facilities and collection days are not available in most parts of the state. As awareness of this problem is growing, and public demand increases for these services, additional programs will be started. However, adequately addressing the problem of improper pharmaceutical disposal requires a comprehensive statewide program that ensures accessibility, security, and safe, permanent destruction of collected contaminants.

What can I do today to protect rivers and streams from pharmaceutical contamination?

Other states have adopted comprehensive take-back and/or collection programs that provide all residents with the opportunity to safely dispose of unwanted and unused medications. During the 2007-2008 Illinois legislative session, the House unanimously passed a bill to establish a cancer drug repository program; the bill was close to passage in the Senate, but was stalled in the Rules Committee before the final reading and vote. Until Illinois has a comprehensive statewide program for pharmaceutical collections, individuals will have to rely on what facilities or programs are in their area.

If there are no collection sites available to you, there are steps you can take to properly dispose of your unused, expired, or unwanted medications:

  • Do not flush pharmaceuticals down the toilet or sink
  • Put the medication into a leak-proof bag; add a small amount of water to a solid drug or some absorbent material such as kitty litter or coffee grounds to liquid drugs to make them unpalatable to animals and humans
  • Place the medication in a second bag and seal it securely before throwing in the trash
  • Remove the labels from the original medication container or mark out any personal and content information on the label.

Prevention is always the best strategy for reducing contamination, so consider how you can also reduce the amount of pharmaceuticals and personal care products that eventually enter the waste stream:

  • only purchase what you need
  • put all your pharmaceuticals in one location so you know what and how much you have
  • don’t take samples unless you are going to use them
  • support organic methods in livestock and dairy product production

Visit a compilation of websites, research studies, and news articles on pharmaceuticals in the environment at our Pharmaceuticals Resource Library.

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