Tuesday, February 10, 2009 by: David Gutierrez, staff writer
(NaturalNews) The Associated Press (AP) estimates that hospitals and long-term medical care institutions across the United States are dumping 250 million pounds of pharmacologically active drugs directly into public sewer systems each year.
Because the government does not require health institutions to keep records on their disposal of pharmaceutical products, there are no definitive numbers on the volume of drugs going into the water supply. In order to construct an estimate, AP investigators extrapolated from a survey of 14 urban and rural Minnesota hospitals.
Minnesota's state government strongly encourages health care facilities to keep records of drug disposal.
After adjusting for Minnesota's relatively low rate of prescription drug use and doubling the number to account for the greater waste typically produced by long-term care facilities, the AP concluded that at least 250 million pounds of drug waste and drug-contaminated packaging are thrown away each year. This includes expired or spoiled drugs, leftovers from too-large prescriptions, drugs that are prescribed but not needed, drugs that patients refuse to take or that are halted due to negative side effects, or drugs left over when patients die.
The researchers could not determine what proportion of the 250 million pounds consists of packaging, but experts estimate that it may be roughly half.
The vast majority of this waste is disposed of by flushing it down sinks or toilets, according to the Environmental Protection Agency (EPA). A 2006 survey by a water company of 45 long-term care centers found that roughly two-thirds of drug waste was disposed of through the sewer system.
"Obviously, we're flushing them - which is not ideal," said Mary Ludlow of White Oak Pharmacy, a company that works with nursing homes and assisted-living facilities.
This pharmacological waste is much more potent than the drugs that patients flush down their own home toilets, including not only stronger versions of over-the-counter drugs but also highly toxic chemicals like cancer treatments. Tests of hospital sewers in Oslo and Paris have revealed high concentrations of antibiotics, heart drugs, hormones, painkillers skin medication -- in addition to the well-known high concentrations of bacteria, viruses and other pathogens.
Dumping drugs into water is far from harmless, although the exact nature of the danger remains poorly understood. But scientists agree that drugs remain pharmacologically active even after disposal, and can have severe effects on humans and wildlife. Studies of wastewater near hospitals in Europe and the United States have found higher concentrations of antibiotic resistant bacteria and of organisms with genetic mutations similar to those that can cause cancer in humans. Another study on antibiotics in the fluoroquinolone family, including best-seller ciproflaxin, found that these drugs could cause changes to bacterial DNA.
Even worse, hospitals and long-term care facilities are only two sources of the drugs that, all across the country, are being dumped in large quantities into the water supply. Vast quantities of unprocessed drugs are excreted by people's bodies into the sewage system, while other institutions such as small medical and veterinary practices and hospitals at facilities such as prisons are also flushing unmetabolized drugs. According to Linda Peterson, a nurse at a prison in Oak Park Heights, Minn., her prison throws out approximately 12,000 pills per year, including antibiotics, heart drugs and narcotics.
"We flush it and flush it and flush it - until we can't see any more pills," Peterson said. "So what are [other] facilities doing, if we're throwing away about 700 to 1,000 pills a month?"
Even after highly diluted with thousands of gallons of water, such drugs remain biologically active. Early research into the problem suggests that in concentrations equivalent to those found in drinking water across the country - according to AP, a minimum of 46 million people are exposed to such water, with most water still untested - drug residue can cause harm to aquatic species like fish and amphibians. Laboratory tests confirm that such concentrations also disrupt healthy growth of human cells.
According to pharmacist and researcher Boris Jilibois from the Compiegne Medical Center, there's enough proof of risk to justify immediate action.
"Something should be done now," he said. "It's just common sense."
The scale of the problem is so large that the EPA has classified pharmaceutical products as "major pollutants of concern."
"Treating the toilet as a trash can isn't a good option," said Ben Grumbles, the agency's head water administrator.
But the agency has stopped short of imposing regulations on the disposal of such products or their contaminated packaging.
"It's strange that we have rules about the oil from your car; you're not allowed to simply flush it down the sewer," said U.S. Rep. Tim Murphy. "So why do we let these drugs, without any kind of regulation, continue to be flushed away in the water supply?"
According to Grumbles, the EPA should decide whether to impose some sort of regulations by the end of next year. One measure that has been suggested is requiring pharmaceutical companies to pay for proper disposal of their products, as financial considerations are a major factor influencing hospitals into simply dumping drugs down the drain. Incinerating a pound of drugs in a hazardous waste incinerator, for example, costs about $2, compared to 35 cents in a normal trash incinerator.
No one seems to agree, however, what a favorable method of drug disposal would be. While drugs leach more slowly out of landfills, they do still infiltrate the groundwater over time. Incinerators destroy drugs more thoroughly, but contribute significantly to air pollution and can even eject trace amounts of pharmaceuticals into the air.
"I don't think we're encouraging incineration of anything," Stephen DiZio of the California Department of Toxic Substances Control said. "The public outcry would be so great."
Sources for this story include: www.usatoday.com.