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A Pharmacy on Tap

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[size=9:b7a1fdf854]Louise Valentine, The Epoch[/size:b7a1fdf854] As we down our medication one day or slather on lotion, do we realize that on another day someone may drink some of it, or a fish, amphibian or shellfish may absorb it? Up to 90% of every drug taken into the body is excreted unchanged or as metabolites ending up in the ground water, ultimately flowing out of the tap again to medicate someone else without even a prescription. These substances collectively known as Pharmaceutical and Personal Care Pollutants (PPCPs) include every kind of medication and body care substance we use, which in turn comprise more than 10,500 chemical ingredients. According to a leading researcher in the PPCP field, Dr. Christian G. Daughton, an EPA scientist, "The amount of pharmaceuticals and personal care products entering the environment annually is about equal to the amount of pesticides used each year." Recent advances in science that have enabled detection of infinitesimal amounts have opened up this area for research. Although the situation has existed for decades, no one really knows how PPCPs present in drinking water may be affecting our health, and there are no guidelines for industrial standards. There is no limit to what can be flushed into the ground water or treatment plants. Water tested in Europe, the United States, Canada and Australia has shown the presence of PPCPs. A study made of water in Berlin, Germany found significant amounts of antibiotics, ibuprofen, cholesterol-lowering drugs, estrogen and chemotherapy drugs. Prozac was found in Britain's water as well as in bluegill fish in Texas. People eating the fish also were found to have Prozac in their blood. Fluoxetine, the active ingredient in Prozac, reduces thyroid function, thus delaying development in fish and frogs. Estrogens from both hormones and bisphenols from plastic, which can latch on to estrogen receptor sites of cells, are very commonly found in water and have already affected wild life by feminizing fish, otters and frogs. In Nebraska, fish in the stream below the feedlot where cows are implanted with male and female hormones showed signs of underdevelopment in both sexes compared to the fish upstream of the feedlot. In the U.K., sperm counts of men have diminished more than half over the last 50 years from 160 million to 66 million per milliliter. Twenty million is considered a low count. Breast and uterine cancers along with early puberty are increasing. It is hard to say how much is from drinking estrogen-laced water, but it may be a contributing factor if the victims were not already on hormones. If we all went to natural substances or homeopathic remedies and organic gardening and farming, these problems would clear up. However, we are not about to do that. The next best is to use charcoal-activated systems in our homes and institutions. The water we wash with also needs to be purified, as the skin can absorb chemicals. The Water Quality Association (Home) gives a gold-seal certification recognized internationally on such equipment. Material for this article came from "Drugs and Chemicals Straight from the Tap" by Sherrill Sellman, ND (http://www.ssellman.com) in May-June 2005 issue of "Nexus."
 
[b:994ea8afe1][size=18:994ea8afe1]Drugs in water raise concerns[/size:994ea8afe1][/b:994ea8afe1] Residues of birth control pills, antidepressants, painkillers, shampoos and a host of other compounds are finding their way into the nation’s waterways, and they have public health and environmental officials in a regulatory quandary. On the one hand, there is no evidence the traces of the chemicals found so far are harmful to human beings. On the other hand, it would seem cavalier to ignore them. The pharmaceutical and personal care products, or PPCPs, are being flushed into the nation’s rivers from sewage treatment plants or leaching into groundwater from septic systems. According to the Environmental Protection Agency, researchers have found these substances, called “emerging contaminants,” almost everywhere they have looked for them. Most experts say their discovery reflects better sensing technology as much as anything else. Still, as Hal Zenick of the agency’s office of research and development put it in an e-mail message, “there is uncertainty as to the risk to humans.” In part, that is because the extent and consequences of human exposure to these compounds, especially in combination, are “unknown,” the Food and Drug Administration said in a review issued in 2005. And aging and increasingly medicated Americans are using more of these products than ever. So officials who deal with these compounds have the complex task of balancing reassurance that they take the situation seriously with reassurance that there is probably nothing to worry about. As a result, scientists in several government and private agencies are devising new ways to measure and analyze the compounds, determine their prevalence in the environment, and figure out where they come from, how they move, where they end up and if they have any effects. In many cases, the compounds enter the water when people excrete them or wash them away in the shower. But some are flushed or washed down the drain when people discard outdated or unused drugs. So a number of states and localities around the country have started discouraging pharmacies, hospitals, nursing homes and residents from disposing of drugs this way. Some are setting up “pharmaceutical take-back locations” in drugstores or even police stations. Others are adding pharmaceuticals to the list of hazardous household waste, like leftover paint or insecticides, periodically collected for safe disposal, often by incineration. For example, Clark County, Wash., has a program in which residents with unwanted or expired drugs can take so-called controlled substances, like prescription narcotics, to police stations or sheriffs’ offices for disposal. They can drop noncontrolled drugs at participating pharmacies, and 80 percent of the pharmacies in the county participate. In guidelines issued in February, three federal agencies, including the EPA, advised people with leftover medicines to flush them down the drain “only if the accompanying patient information specifically instructs it is safe to do so.” Otherwise, the guidelines say, they should dispose of them in the trash (mixed with “an undesirable substance” like kitty litter to discourage drug-seeking Dumpster divers) or by taking them to designated take-back locations. Worries about water-borne chemicals flared last summer when researchers at the U.S. Geological Survey said they had discovered “intersex fish” in the Potomac River and its tributaries. The fish, smallmouth and largemouth bass, were male but nevertheless carried immature eggs. Scientists who worked on the project said they did not know what was causing the situation, or even if it was a new phenomenon. But the discovery renewed fears that hormone residues or chemicals that mimic them might be affecting creatures that live in the water. In a survey begun in 1999, the agency surveyed 139 streams around the country and found that 80 percent of samples contained residues of drugs like painkillers, hormones, blood pressure medicines or antibiotics. The agency said the findings suggested that the compounds were more prevalent and more persistent than had been thought. Christopher Daughton, a scientist at the Environmental Protection Agency and one of the first scientists to draw attention to the issue, said PPCP concentrations in municipal water supplies were even lower than they were in water generally because treatments like chlorination and filtration with activated charcoal alter or remove many chemicals. Daughton, who works at the agency’s National Exposure Research Laboratory in Las Vegas, said he believed that if any living being suffered ill effects from these compounds, it would be fish and other creatures that live in rivers and streams. Initial efforts concentrate on measuring what is getting into the nation’s surface and groundwater. The discharge of pharmaceutical residues from manufacturing plants is well-documented and controlled, according to the EPA, but the contribution from individuals in sewage or septic systems “has been largely overlooked.” Many of the compounds in question break down quickly in the environment. In theory, that would lessen their potential to make trouble, were it not for the fact that many are in such wide use that they are constantly replenished in the water. And researchers suspect that the volume of PPCPs excreted into the nation’s surface water and groundwater is increasing. For one thing, per capita drug use is on the rise, not only with the introduction of new drugs but also with the use of existing drugs for new purposes and among new or expanding groups of patients, like children and aging baby boomers. Also, more localities are introducing treated sewage into drinking water supplies. Researchers who have studied the issue say there is no sign that pharmaceutical residues accumulate as water is recycled. On the other hand, the FDA said in its review, many contaminants “survive wastewater treatment and biodegradation, and can be detected at low levels in the environment.” Given all this uncertainty, policymakers find it difficult to know what to do, other than continuing their research. Studies of “the fate and transport and persistence” of the PPCPs will allow scientists to make better estimates of people’s exposure to them, Zenick said, and “to assess the potential for human health effects.” Worcester Telegram : Local News, Politics & Sports in Worcester, MA
 
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