Impacts of Pharmaceuticals & Personal Care Products

In recent years there has been mounting concern about the presence of chemicals from pharmaceuticals and personal care products, such as cosmetics, in the nation’s streams and rivers. There is no question that these chemicals are present in the nation’s waterways. The USGS conducted the first major investigation in 2002 and found, on average, seven chemical compounds in the streams they surveyed. In 2008, the Associated Press found an array of pharmaceuticals, from pain killers to antibiotics to mood stabilizers, in the drinking water of 24 major metropolitan water suppliers. Even worse, 34 of the 62 water suppliers contacted by the AP couldn’t provide results as they had never tested for pharmaceutical compounds.

This problem won’t go away anytime soon. American drug consumption has increased rapidly in recent years, and Americans fill 3.7 billion prescriptions every year. The chemicals in these drugs end up in waterways after being excreted from the body or when unused medication is flushed down the toilet. Most sewage treatment facilities do not remove the compounds, and major upgrades would be required to do so. The federal government hasn’t stepped in to require testing or set safety limits, leaving many questions unanswered.

American Rivers recommends the following steps to reduce the risk of long-term human health effects:

  • Proper drug disposal: The cheapest and easiest way to limit pharmaceutical contamination is to keep drugs from entering our waterways in the first place. Drug take back programs, public education on proper disposal, and regulations to limit large-scale medicine flushing at hospitals and nursing facilities are important first steps that can greatly reduce the amount of contaminants entering our waterways. Some states and counties have begun to experiment with take-back programs. Washington State, for example, collected and disposed of over 15,000 pounds of unwanted medications during a two year pilot program. Legislation in the House of Representatives would loosen federal restrictions on controlled substances to make take back programs easier to implement.
  • Research: Additional research is needed to assess potential human health effects and identify the best methods for removing pharmaceutical compounds at treatment plants. If there is a significant long-term risk to public health, more aggressive efforts to control the problem may be needed. Several studies have been proposed as part of water infrastructure legislation.
  • Long-term solutions:  While proper disposal can limit pharmaceutical contamination, more work on source control will ultimately be needed in addition to upgrading treatment infrastructure and reassessing our approach to use and dispose of pharmaceuticals and personal care products.

Little is known about how these compounds affect human and ecosystem health. Fish and other aquatic species appear to be the most vulnerable. Male fish in the Potomac River near Washington, DC have been found with male and female sex organs, a mutation thought to be caused by pharmaceutical compounds. The impacts on human health are less clear.

Pharmaceutical compounds are found at much lower concentrations in rivers and streams than the normally prescribed doses, but there is concern that chronic exposure to numerous compounds could cause serious health problems and that compounds can act synergistically to cause adverse health effects. Of particular concern is the presence of endocrine disruptors, which come from a variety of agricultural, industrial, and domestic sources, including pharmaceuticals. These compounds disrupt internal biological processes such as development, growth, and reproduction that are regulated by hormones. Whether these compounds are present in sufficient levels in our waterways to affect human health remains a topic of serious concern and ongoing research.