Bengt Mattson

SWEDISH SUMMARY: På FIP kongressen i Amsterdam deltog jag in mycket intressanta diskussioner kring läkemedel, miljö och vatten. Utöver mig som föreläsde om olika svenska initiativ såsom MistraPharma, Läkemedelsverkets olika miljöförslag och Miljömålsberedningen samt LIF och industrins arbete med miljöinformation på Fass.se och gröna ekonomiska incitament, deltog också Peter Schulte från Pacific Institute, Peter Pärt från EEA, Mike Murray representerande EFPIA samt Ulf Janzon från MSD och Tessa Brandsema från Apotheek Esmarke Enschede.

I have been in Amsterdam for the last few days, participating in the FIP centennial congress 2012. It was fascinating to see the very broad scientific program and the strong networking of thousands of pharmacists from around the globe.

I gave a lecture at the Pharmaceuticals and Water session which was chaired by Ulf Janzon from MSD (and representing FIP). Ulf had managed to bring together an interesting group of speakers. In addition to myself representing LIF (The Swedish Association of the Research Based Pharmaceutical Industry), there were

- Peter Schulte from the Pacific Institute talking about water as a critical sustainability issue and also definitely a critical business issue,

- Peter Pärt from the European Environment Agency (EEA) in Copenhagen, talking about pharmaceuticals and other emerging contaminants in European waters,

- Mike Murray from ABPI, representing EFPIA (The Europan Federation of Pharmaceutical Industries and Associations) presenting EFPIA's perspective on Pharmaceuticals in Waters and in the Environment.

Mike Murray at FIP in Amsterdam
Mike Murray at FIP in Amsterdam

- and Tessa Brandsema from Apotheek Esmarke Enschede.

Several different initiatives were presented in the lectures. Peter Schulte gave examples from the UN CEO Water Mandate, and presented water stress indicators based upon Smakhtin, Revenga and Doll's work from 2004 and the view on the water supply crises as discussed on the World Economic Forum 2012. I felt that Peter's sustainability oriented and broader perspective on the global water issues were extremely important for us all. It helped us to lift the discussion "to a higher level". It is important for us not to get lost in discussing just the different contaminants in waters, but also the greater picture! His summary on the effects of water supply and pollution challenges are important to bear in mind:

A lack of water means...

- Less drinking water and hence human health concerns

- Less irrigation and hence threatened food security

- Less water for thermo- and hydro-electric energy sources

- Less water for industry and hence limited economic growth

- Less environmental flows and hence loss of biodiversity and ecosystem services

Polluted water means...

- Contaminated drinking water

- Damaged ecosystems and habitat

- High treatment costs for industry

- Reduced agricultural production

Peter Pärt told us about some of EEA's reports on "specific topics" such as

- EEA Technical Report 2/2012 on Endocrine disruptors

- EEA Technical Report 1/2010 on pharmaceuticals

- EEA Technical Report 8/2011 on hazardous substances

Peter also discussed different regulatory measures, e.g. REACH and WFD (the water Framework Directive). As you probably know, three pharmaceuticals substances has been proposed to be introduced into the so called Priority List in the WFD. The three substances are ethinyl estradiol, estradiol, and diclofenac. For substances on the Priority List, environmental quality standrds (EQS) are to be developed. A proposed EQS for ethinyl estradiol (EE2) is 0.035 ng/l. Peter shared with us the conclusions from Susan Jobling and Richard Owen (from Nature, May 24, 2012) that implementation of an EQS at 0.035 ng/l for EE2 would incur costs for waste water treatment in UK alone on 30 billion Euros...

Peter also discussed the risks for antimicrobial resistance development due to pharmaceuticals in the environment. Peter both mentioned releases from manufacturing operations (such as the ones in Hyderabad, India, reported by Joakim Larsson and coworkes - see for instance the blog post from Feb 18, 2011 on this topic) and the potential "leakage" of antibiotics from salmon farming in Norway.

Mike Murray gave several examples on industry initiatives. He talked upon Green Chemistry and the Pharmaceutical Round Table of the Green Chemistry Institute, on third party manufacturing audit programs in the pharmaceutical industry, and about initiatives for responsible disposal of unused medicines. Mike had two important key messages:

- "there are no appreciable health impacts to humans from exposure to pharmaceuticals in the environment", although that does not mean that industry and society should not take the issue seriously

- "excretion via patient is by far the largest contributor to presence of pharmaceutcals in the environment", i.e. a larger contributor than manufacturing releases and unused medicines

I then presented some different Swedish Initiatives from academia, government, and from industry:

- Academia: the MistraPharma project

- Government: The Swedish MPA proposal of inclusion of environmental requirements in GMP, the All-Party Commission on Environmental Objectives, and the "Sofia Wallström-review" of green economic incentives.

- Industry: Environmental classification of pharmaceutical substances on Fass.se, campaign to return unused medicins to pharmacies, and the development of an environmental risk assessment methodology for pharmaceutical products to be used for green economic incentives.

And finally as an introduction to the panel discussion Tessa Brandsema presented the work they have done on occurence of pharmaceutical substances in waters in Holland.

An interesting session with good discussions. Thanks to the FIP organizing committee for inviting us!

Bengt Mattson