A press release was issued yesterday from IVL Swedish Environmental Research Institute, in collaboration with Umeå University and the Swedish Environmental Protection Agency, regarding a study on pharmaceutical resudues, from 101 active pharmaceutical ingredients (API), in water. The study has also been commented upon in several news media, e.g. Dagens Apotek. The study looks upon incoming waste water to waste water treatment facilities, on the effluent from those facilities, and on concentrations in receving water bodies as well as in some cases also the concentration of APIs in fish (perch).
The results show that 92 out of 101 APIs could be detected in incoming waste water, 85 APIs were found in treated effluent leaving the treatment plant. 23 APIs were also found in fishes investigated and 26 APIs were found in drinking water.
Jerker Fick, at Umeå University, says to Dagens Apotek that the identified concentrations in drinking water are extremely low compared to therapeutic doses. Hence, there is no known risk for humans consuming drinking water. The study however states that the concentrations of some of the APIs in surface water could potentially impact water living organisms such as fishes.
As has been discussed for several years now, the type of impact, the degree of that impact to water living organisms, and potential consequences (especially on an ecosystem level) are however not known. I hope that MistraPharma and similar research initiatives could help us to understand these matters better, and also help society to identify, and specify, any potential further investments in the waste water treatment facilities.
Jan Christiansson, at the Swedish EPA, states in the press release that in addition to upgraded waste water treatment plants there is also a need for industry to design the APIs in a more "environmentally adapted" way, hence for instance allowing for faster biodegradation of the substances. I have commented on this matter of "green design" previously and I couldn't agree more in principle, however huge difficiulties exist... It is not an easy task for our scientists to both make substances with good therapeutic effects, without severe adverse health effects, and simultaneously perfectly control the degradability. The substance should not degrade until it has given it's intended medical effect, but preferentially directly afterwards. Not easy, but something industry tries to accomplish...
So I agree with Jan Christiansson that upgrades of certain waste water treatment plants will most likely be necessary, but we should also never forget to strongly communicate to the public, to all users of pharmaceuticals, that un-used medicines should never be thrown into the toilet! Un-used medicines should be brought back to a pharmacy for controlled disposal.