Who among us would collect the pills from our neighbors’ medicine cabinets and randomly swallow a handful, or unscrew the top of a shampoo bottle and drink it? Yet with the discovery that pharmaceuticals and personal care products (PPCPs) are ubiquitous in our water supplies, we may be doing just that, albeit in much smaller quantities. Although, over time, these assaults on our bodies do add up.
Drugs and Chemicals in Your Drinking Water: What You Need to Know
This alarming news has prompted demands to find the sources of the problem and to learn how we can protect ourselves from exposure to these chemicals. Although there are few definitive answers on the extent of contamination, the possible health and ecological effects, and the best prevention and removal techniques, there is also a lot you can do now to stop contributing to the problem and to protect the health of yourself and your family.
Between 1999 and 2000, the Toxic Substances Hydrology Program of the US Geological Survey (USGS) tested 139 streams in 30 states for chemicals derived from PPCPs, which include human and animal drugs, pesticides, cleaning products, cosmetics, and hormones. Roughly 80% of the streams tested contained one or more compounds, half contained seven or more, and 95 different chemicals were detected.
In an extensive investigation into this topic, the Associated Press analyzed reports, examined treatment plants, and interviewed over 200 scientists and officials. The study revealed that PPCPs were detected in water supplies of 24 major metropolitan areas affecting at least 41 million homes.
Chemicals found included caffeine, cotinine (a metabolite of nicotine), and active ingredients from acetaminophen, antibiotics, codeine, anticonvulsive drugs, estrogen, and heart medications. The PPCP levels were very low, measured in parts per billion or trillion—well below clinical doses. While much lower than other water contaminants currently monitored, PPCPs are unique because they were specifically designed to interact with the body.
Research is needed to know what effects long-term exposure to these low doses may have and how multiple compounds will interact, but preliminary results have shown adverse effects on human cells. Among human health concerns are the generation of antibiotic-resistant bacteria and the reduction of male fertility by estrogens, according to Dr. Ronald Tjeerdema, Chair of the Department of Environmental Toxicology at the University of California, Davis.
PPCPs have also been detected in a number of watersheds, prompting environmental-impact studies by the Environmental Protection Agency (EPA) and other institutions. Initial findings have shown negative effects on a variety of aquatic organisms, including impairments in the sexual development of fish and reptiles attributed to the presence of hormones, according to Dr. Tjeerdema.
Consumers of a well and bottled water may not be safe from PPCP contamination either. Testing has revealed that PPCPs can percolate into the underground aquifers supplying private wells, especially if in the vicinity of a large urban area or a major livestock-production facility. While the Food and Drug Administration (FDA) regulates bottled water, there are no current standards for PPCP levels.
Main Sources of the Problem
According to the EPA, individuals cause 85-90% of all PPCPs in our water sources. When you take a pharmaceutical, only a small percentage, as little as 10%, is absorbed by your body; the rest is excreted into the sewage system. Cosmetics, perfumes, and lotions that rinse off during bathing, as well as the flushing and improper disposal of unused medications, add to the total. PPCPs pass through sewage-treatment plants not designed to remove them and thus enter the environment or water supply. Dr. Tjeerdema agrees with the EPA’s figure, stating, “Much of what ends up in the environment comes from our drains and trash cans.“
Other sources of PPCPs include wastewater from pharmaceutical manufacturing plants, hospitals, livestock production facilities, veterinary clinics, and other industrial uses.
Livestock production often uses large amounts of hormones, antibiotics, and vitamins—most of which pass through the animals intact entering water sources. US manufacturers released 217 million pounds of PPCPs into waterways, according to the AP investigation. These manufacturers include both drug makers and the producers of products that use pharmaceutical ingredients. For example, nitroglycerin is used in both heart medication and explosives, and the drug lithium is used in ceramics.
According to the EPA, while certain chemicals such as organic solvents used in manufacturing are monitored, there is no federal regulation of the active ingredients from drugs released in wastewater. While both the EPA and the USGS have begun studying the effluent from pharmaceutical manufacturers, it is “premature” to focus on them as a major contributor to PPCPs in drinking water, insist EPA officials.
Assessing Scope and Risk
EPA officials have stressed that PPCPs are “a primary concern,” yet any actions or regulations must be based on sound science. The priority is to “assess the scope and risk of the problem,” which requires developing the assays needed to detect the chemicals, followed by extensive testing.
The EPA maintains a contaminant-candidate list when evaluating water quality. To date, PPCPs have not been added, thus water providers are not required to test for them or report any they might find. Conclusive research on adverse effects would be needed before any PPCPs could be added to the EPA’s list, a policy with which Dr. Tjeerdema agrees: “Drugs are quite useful tools, and their presence in the environment in trace amounts—if they are not causing a toxic problem—should be tolerated in lieu of their benefits to mankind.“
The Difficulty of Removal
Even if certain chemicals are deemed hazardous, their removal could prove troublesome. “The problem is that sewage treatment plants are not designed to degrade such compounds, so they are released to the environment,” states Dr. Tjeerdema. Chlorination is one of the most widely used methods for water treatment, yet is not effective at removing PPCPs. In fact, preliminary research has shown that the process may even change some chemicals, making them more toxic.
Other treatment methods are available, but not without drawbacks. For example, reverse osmosis is effective at removing PPCPs, but this expensive process would increase the cost of water, and produce several gallons of contaminated water for every clean gallon.
Avoiding and Preventing PPCPs
Unfortunately, there are few options for avoiding PPCPs. “At present, there are no home water-treatment systems certified for removal of pharmaceuticals,” according to Cheryl Luptowski of NSF International, a non-profit organization involved in setting standards for various public health issues. Bottled water is not regulated for PPCPs, and private wells may or may not be contaminated depending on their location.
Currently, the best action for the public is prevention. To reduce PPCP release, limit the use of unnecessary medications and personal-care products, follow the federal guidelines for the proper disposal of unused pharmaceuticals, and utilize drug take-back programs sponsored by local organizations.
Lobbying for Government Action
Contacting elected officials and monitoring legislation is another course of action. Current federal bills include measures to promote drug take-back and disposal programs and to improve the infrastructure of water and wastewater facilities. Also, several state and local governments are considering measures, mostly involving studying the scope of the problem. Looking into your state’s department of environmental and natural resources, and the department of health can inform you as to what is being done in your area.
No one wants to consume a cocktail of pharmaceuticals and chemicals when drinking a glass of water. Yet the solution will not be definitive until the extent of contamination and the effects on both human health and the environment are determined. Actions will most likely require individual responsibility to limit PPCP release, governmental regulation of manufacturers and livestock facilities, and an expensive upgrade to water-treatment practices in a cooperative effort to protect our water supplies. In the meantime, we can each do our part to properly use and dispose of the pharmaceuticals and personal care products within our purview.
- Drugs and Personal Care Products Polluting Water, Reviewed By OnHealth
- Pharmaceuticals, Hormones, and Other Organic Wastewater Contaminants in US Streams
- National Science Foundation Drinking Water Guide