Reducing Discharge of Pharmaceuticals into the Environment

Although our toilets are the major route of pharmaceuticals entering the environment, we do not encourage a ban on them. At least, not yet. Between 30-90% of pharmaceuticals pass through our bodies and are excreted in urine.

“The consumption phase is considered to be the biggest contributor to the emissions of medicinal products into the environment, notably through excretions and incorrect disposal of unused medicines through sinks and toilets. Between 30 and 90% of the orally administered dose is generally excreted as active substance in the urine of animals and humans” (Mugdal et al. 2013)

We do not support a ban on toilets at this time

“Urban wastewater seems to be the dominant emission pathway for pharmaceuticals globally” (Haiba and Nei, 2017)

Septic systems and wastewater plants are not designed to remove pharmaceuticals, so many of them remain in the liquid effluent and enter our groundwater, our streams, lakes, rivers and oceans (Godfrey et al. 2007, Schaider et al. 2013, Gaw et al. 2014, CBC 2015, Schaider et al. 2017).

“Our loading estimates suggest that effluent from septic systems and centralized wastewater treatment plants contain similar concentrations of CEC (Contaminants of Emerging Concern). Thus, plans to extend sewer systems may not substantially decrease overall CEC loading, but would change the distribution of these inputs, moving them from newly sewered areas to places where treatment plants discharge” Schaider et al. 2013)

We need to keep our aim in focus. Its difficult to improve septic systems to degrade pharmaceuticals. Its possible to upgrade our wastewater plants through membrane bioreactors, oxidation and ultrafiltration, but its costly.

A small amount of the pharmaceuticals end up in the biosolids. Composting the biosolids is currently the best strategy to reduce pharmaceuticals, as it removes 50-90% of these products.

“conclusions are that sewage sludge application to farmland is an insignificant source of pharmaceuticals to the environment compared to sewage works discharge water, and that pharmaceuticals in sewage sludge are mostly retained in the surface soil and biodegraded there.” Magner 2016.

“Dr Magid concludes that the soil bacterial system is highly resilient and that organic contaminants in sewage sludge or other organic material, as applied, do not seem to pose problems.” Magid 2016

“Biological sewage treatment systems, which are designed for BOD (available organic carbon) removal are not optimal for removing pharmaceuticals and household chemical biocides. On the other hand, composting shows to be effective in achieving > 90% reduction for some organic household chemical biocides.” Butkovskyi 2016 EESP 2016 report

In November 2017, a group of 20 health and environment organizations called for an action plan to reduce the discharge of pharmaceuticals into the environment (EPHA 2017). One of the strategies included:

 “Improve municipal wastewater treatment facilities in order to prevent environmental pollution caused by excreted pharmaceuticals.”

In a circular economy, where we are called to be accountable for all of our actions including our discharges, we do need to keep our discharge of pharmaceuticals into the environment in perspective, and collectively do what we can to reduce them. Our health and our future depends on it.

References

EPHA. 2017.  20 Organizations call for Ambitious EU Action on Pharmaceuticals in the Environment. https://epha.org/20-organisations-call-for-ambitious-eu-action-on-pharmaceuticals-in-the-environment

Butkovskyi, A. 2016. Status of knowledge on pharmaceuticals in biosolids. EESP

CBC News. 2017. Pharmaceuticals in wastewater target of sewage treatment study. www.cbc.ca/news/canada/nov-scotia/pharmaceuticals-in-wastewater-target-of-sewage-treatment-study-1.3155804

Gaw, S., K.V. Thomas and TH. Hutchinson. 2014. Sources, impacts and trends of pharmaceuticals in the marine and coastal environment. Phi. Trans. R. Soc. B 369: 20130572. http://dx.doi.org/10/1098/rstb.2013.0572

Godfrey, E., W.W. Woessner and M.J. Benotti. 2007. Pharmaceuticals in on-site sewage effluent and ground water, Western Montana. Ground Water. 45: 263-271.

Haiba, E., and L. Nei. 2017. Sewage sludge composting and pharmaceuticals. European Scientific Journal Special Edition ISSN: 1857 – 7881.

Magid, J. 2016. Natural robustness of soil. In Report ESPP workshop Pharmaceuticals in sewage biosolids. Malmo, Nov 27, 2016. https://phosphorusplatform.eu/images/download/Malmo-pharmaceuticals-workshop/2016%20Report%20ESPP%20pharmaceuticals%20workshop.pdf

Magner, J. 2016. Fate of pharmaceuticals. In Report ESPP workshop Pharmaceuticals in sewage biosolids. Malmo, Nov 27, 2016. https://phosphorusplatform.eu/images/download/Malmo-pharmaceuticals-workshop/2016%20Report%20ESPP%20pharmaceuticals%20workshop.pdf

Mudgal, S., A. De Toni, S. Lockwood, L. Sales, T. Backhaus and B.H.Sorensen. 2013. Study on the environmental risks of medicinal products. Final Report. Executive Agency for Health and Consumers. December 2013. Bio Intelligence Service.

Schaider, L., K. Rodgers and R. Rudel. 2013. Contaminants of emerging concern and septic systems: A synthesis of scientific literature and application to groundwater quality on Cape Cod. Silent Spring Institute. Newton MA.

Schaider, L.A., K.M. Rodgers and R.A. Rudel. 2017. Review of organic wastewater compound concentrations and removal in onsite wastewater treatment systems. Environmental Science and Technology. 51: 7304-7317 DOI 10.1021/acs.est.6b04778.