PPCPs and the Environment

By Group E

Introduction

• Modern medicine has undoubtedly changed the human race; pharmaceuticals have extended our life expectancy and have allowed us to live virtually pain free lives.

• The changes are, however, not all good; an increasing amount of research is highlighting the adverse effects of PPCPs on the environment.

What are PPCPs?

• Pharmaceuticals and Personal Care Products include a wide range of medicines (both over-the-counter and prescription), illicit drugs, and byproducts from everyday items.

• The substances are referred to as either synthetic or nonsynthetic (natural) (US Department of Agriculture)

What are PPCPs?

• The most commonly found in municipal waste (and potentially most harmful) include: -antibiotics -antidepressants-birth control pills-hormone replacement therapy drugs estrogen and progestin)

-painkillers-caffeine-nicotine-tranquilizers (Breton 2003)

Pathways of PPCPs• PPCPs are introduced into the environment via:

*wastewaters from residential, industrial, and agricultural sources

*careless disposal of leftover medicines*medical waste from hospitals and clinics*landfills*sewage treatment plants*biosolids applied to land *topically applied personal care products (sunscreens,

perfumes, hairsprays)*farm chemicals*cruise ships*confined animal feeding operations (CAFOs)

(Xia et al, 2005; Bound et al, 1999; EPA Report)

Pathways of PPCPs

• The quantity of PPCPs in the environment is difficult to calculate because no current monitoring system is in place, and because these micro particles are difficult to detect.

• For example, the atrazine found in the Missouri river was .84 ppb

http://www.epa.gov/esd/chemistry/pharma/images/forum.pdf

Effects of PPCPs

• PPCPs in the environment are raising concerns of:

-Aquatic species

*feminized male fish, river otters and frogs are being found in rivers and lakes due to the presence of synthetic estrogen hormones from birth control pills and HRT.

-Increase of bacteria due to resistance to antibiotics

*antibiotics including penicillin and triclosan, the active ingredient found in antibacterial soaps, deodorants, and household cleaners, is being dumped into the water supply and killing natural bacteria, both good and bad. This may lead to an environment where bad bacteria can thrive.

(Hirsch et al, 1999)

Effects of PPCPs

-Risks of human health following ingestion of contaminated drinking water

*Though extensive research on PPCPs’ effects on humans has not been conducted, some evidence has been found surrounding the same hormone problem in fish occurring in human males. Males that live in rural areas that were exposed to certain pesticides as well as European males exposed to estrogen in the environment experienced lower sperm counts.

*A rise in the numbers of breast and uterine cancers, early puberty and birth defects of the genitals have been linked to environmental exposure to estrogenic compounds.

(McBride et al 2002)

Local Concerns• The USGS of Columbia, MO

took samples from the Missouri River in 2001. According to the report:

“Following a 28-day deployment in a wetland complex, consisting of treated effluent from a municipal wastewater treatment facility and water from the Missouri River, identification of a variety of compounds was achieved. The mass spectral data exhibited highly complex patterns indicating the presence of a large numbers of compounds.”

Source: http://www.epa.gov/esd/chemistry/ppcp/trends.htm

Some of the compounds included:

atrazine Caffeine Ibuprofen

Nicotinic

Acid Vitamin A Hydroxyat

razine

ethynylestradiol

nonyl

phenol

Causes

• One reason why PPCPs are creating such problems is the lack of public education concerning disposal of medication.

• In a study conducted be Kuspis and Krenzelok, a lack of information for the public is causing unsafe disposal techniques.

(Boehringer, 2004)

http://whitehousedrugpolicy.gov/drugfact/disposal.mov

1%

90%

7%

2%

returnedtopharmacy

threwaway/disposed of insink/toilet

did notdispose

used all

Existing Guidelines

• Currently, only a few guidelines concerning PPCP disposal exist in a few states.

• California, for example, has prohibited the disposal of sharps (lancets, syringes used in at-home treatments) in municipal waste.

• There, however needs to be more done to educate the public .

Source: [http://www.schoolhealth.com/shop/pdf/Senate%20Bill%201305%20White%20Paper.pdf]

Proposed Guidelines

• Some ideas for programs and amendments include:*allowing the return of unused medications from

consumers to pharmacies.*installation of incineration units at all pharmacies

to destroy unwanted/unused medications*special disposal drums at pharmacies and in

residences*trial prescriptions to reduce drug waste. If initial

prescription were written for smaller amounts, less drugs would go unused if the patient decided to discontinue use.

(Boehringer, 2005)

Conclusion

This is a potentially serious threat that can be solved with legislation.

We can prevent adverse effects for future generations