1、1,Protecting the Ecosystem from Improperly Disposed Pharmaceuticals,John M. Polimeni Assistant Professor of Economics Albany College of Pharmacy,2,What do all these products have in common?,3,Outline,Purpose Overview of PPCPs and veterinary medicines in the water supply Possible solutions Discussion
2、 and questions,4,Purpose,Fate of PPCPs and veterinary medicines in the environment Prevalence of PPCPs and veterinary medicines in the environment Human and environmental health implications To identify possible solutions,5,The Problem,Pharmaceutical & Personal Care Products (PPCPs) and Veterinary M
3、edicines are in our groundwater supply,6,History,1977 - first identification of drugs in the water system in a Missouri Sewage Treatment Plant (STP)1990s - researchers in the US and Europe started to investigate problem1998 - medias discovery of topic,7,8,Modes of Entry,9,Prevalence in the Environme
4、nt,As shown on the previous diagram effluents eventually make it into the groundwater Global problem High percentages of pharmaceuticals can be excreted without being metabolized,10,Triclosan,One of the most frequently found compounds in USGS stream reconnaissance An antimicrobial preservative found
5、 in: Hand soap Dish-washing products Laundry detergents and softeners Plastics (e.g., toys, cutting boards) Toothpaste Deodorants and antiperspirants Cosmetics Hair conditioners Pesticides,11,Impacts of Triclosan,Affects algae colonies Bioaccumulates in fish at levels thousands times greater than le
6、vels found in water Swiss study found it in breast milk Degrades to harmful compounds like methyl triclosan, dioxins, chloroform, and other chlorinated compounds. City of Palo Alto, CA has a ban Triclosan free soaps in all city soap dispensers Pushes in San Jose and Denver for same ban,12,Whats the
7、Big Deal?,Only traces were found in these samples, so why is this a concern? Properties of PPCPs and veterinary medicines Antibiotic Resistance Hormones and hormone-regulators Genotoxins,13,Antibiotics,A unique case Resistance does not require large dosages A natural function of the environment Incr
8、eased use has led to more harmful and stronger bacteria Serious public health threat - MRSA,14,Antibiotic Resistance,Found inRiver and coastal areas Domestic sewage Surface water and sediments Lakes Sewage polluted ocean water Drinking water,15,Concentration vs Time Dependant,Shortening the duration
9、 of antibiotic therapy will decrease resistance Some antibiotics concentration dependant Some antibiotics time dependant Shortening duration MAY decrease contamination in the environment and therefore decrease resistance there If make duration too short in humans you WILL increase resistance in thos
10、e patients This is why the pharmacist always says to finish taking your antibiotics until they are gone, even if you start to feel better!,16,Hormones and Hormone-Regulating Drugs,Can cause major environmental damage Need only a few nanograms per liter 1,000 times less concentrated than the g/l that
11、 has been found in samples Estradiol alters reproductive tissues in fish Endocrine disruptors,17,Reports focus on substances known or suspected to act on sex hormone receptors and pathways Estrogen receptor most studied Estrogen receptor agonists Methoxychlor (pesticide) PCBs Bisphenol A (from polyc
12、arbonate plastic production) Pharmaceutical estrogens Phytoestrogens from plants Estrogen receptor antagonists Vinclozolin (fungicide) DDT metabolites Phthalates (found in makeup, shampoo, soaps, plastics, paints, and some pesticides),Endocrine Disrupting Chemicals,18,Daily articles about environmen
13、tal impacts Reproductive and developmental abnormalities found in birds, frogs, seals, polar bears, marine mollusks, alligators, fish, and DOZENS more species Report in Pure and Applied Chemistry from 2003 suggested over 200 species of animals have been / suspected affected by these chemicals Curren
14、t testing methods Hard to decipher the different EDC from one another Hard to pinpoint what is actually there,Endocrine Disrupting Chemicals,19,Pharmaceutical Estrogens,All hormonal therapies are FDA Category X in pregnancy Evidence of fetal risk in humans, no benefit from use can be identified Othe
15、r substances in Category X for pregnancy Alcohol TobaccoRisks of estrogen exposure Congenital heart defects Limb malformations Virilization = male characteristics,20,Genotoxicity,Correlated to Cancer Highly toxic Damages cellular DNA Antineoplastics carcinogenic, mutagenic, embryotoxic, or teratogen
16、ic,21,PPCPs and the Environment?,Yes! Remember, where do many PPCPs come from? Perhaps no greater illustration of the connection between the environment and human health,22,What Can Be Done?,Let the market solve the problem Upgrade sewage treatment plants Use regulatory oversight,23,Regulatory Alter
17、natives,Day Program Mail Program Take-back Program,24,Take-back Program,Arguably the most successful initiative Voluntary program 1st one November 1996 in British Columbia Only for retail customers Huge Success,25,Take-Back Program,The Australian RUM July 1998 Community pharmacies Consumer awareness
18、 programs $750,000 annual cost,26,Take-Back Program,The EU 11 countries involved 5 are sponsored by the pharmaceutical industry 6 are community pharmacies collaborating with waste collection companies,27,Take-Back Program,The United States Vary in use No permanent programs,28,Other Solutions?,Deposi
19、t program,29,Deposit Program,Medication deposit system: Consumers pay deposit on medication container Receive deposit refund upon containers return Returned medications collected for disposal as hazardous waste Medication container recycled Venue: Community Pharmacies,30,Deposit Program,Model based
20、upon: Recyclable goods Consumer behavior patterns Deposit system maximizes participationFinancial incentive Increases medication return Initiates medication container recycling,31,Deposit Program,LimitationsConsumer resistanceAgricultural agents,32,Deposit Program Analysis,Consumers pay deposit Rece
21、ive refund upon return Those who find it too inconvenient will not participate Uncollected deposits entice producers to participate Goal to maximize medication return to decrease PPCP pollution Limitation of consumer resistance,33,Other Solutions,Are there other possible solutions to the problem?,34,Questions,
