In an editorial for the journal Nature, a call for global standards for the disposal of pharmaceutical waste is made. The journal notes there is ample evidence about how pharmaceutical waste can cause environmental disruption.
Need for control is highlighted in several cases. These include the case of hormones, from discarded contraceptives, which have caused male fish to grow female sex organs; and the incident of a painkiller, intended for livestock, killing millions of vultures in India (where the vultures fed on the carcasses of discarded animal remains.)
The pressing need has been discussed by the United Nations and by the U.S Environmental Protection Agency. In late September, the United Nations Environment Programme held a meeting on the subject.
At the meeting it was identified that the foremost way that pharmaceuticals pollute the environment is through discharges via wastewater, where potentially contaminated waste runs off into rivers and streams. One such concern is whether antimicrobials in wastewater promote the development of antibiotic resistant bacteria, which in turn enhance the risk of community-acquired infections.
A second prominent reason for environmental contamination is with the discard of unused medicines. This can happen in homes, as people clear their cupboards of unused or expired pills, and simply flush them down the lavatory or throw them out as garbage. There are also issues in developing countries with how donated medicines are handled.
Some in the pharmaceutical industry would argue that, once diluted in water, the concentrations of many active substances becomes so diluted that it cannot pose a risk to human health. However, some environmental experts and medics do not share this level of comfort. Here Nature refers to a U.S. Geological Survey which indicated that concentrations of drugs can be up to five times higher in the effluents of wastewater-treatment plants connected to pharmaceutical plants compared with water plants that serve domestic areas.
In the U.S., the matter is of sufficient concern for the Environmental Protection Agency (EPA) to issue a statement of intention. The EPA is proposing new rules for disposing pharmaceutical waste. According to PharmaMicro, the rule would, “ban healthcare facilities from flushing hazardous waste pharmaceuticals down the sink and toilet.” The agency estimates that such a decision “could prevent the dumping of more than 6,400 tons of hazardous waste pharmaceuticals annually.”
