Bathing Unrecognized Source of Water Pollution from Medicines

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Guidelines for disposal of unused prescription medications recommend that the drugs not routinely be flushed as this has become a recognized source of environmental water pollution from active pharmaceutical ingredients (APIs).

Scientist at the 239th National Meeting of the American Chemical Society have reported that bathing and showering is an unrecognized source of environmental water pollution. This simple act of hygiene washes hormones, antibiotics, and other pharmaceuticals down the drain into the water supply.

Ilene Ruhoy, M.D., Ph.D., who co-authored the study, said that scientists have long known that bathrooms are a portal for release of APIs into the environment, but assumed that toilets were the main culprit with APIs excreted in urine and feces and flushed into sewers and sewage treatment plants. Same for the flushed unused medications.

APIs may go right through the disinfection process at sewage treatment plants, and enter lakes, rivers, and oceans. Trace amounts of the active ingredients of birth control pills, antidepressants, and other drugs have been found in waterways. Some end up in drinking water – at extremely low, trace levels.

Dr. Ruhoy and colleague Christian Daughton, Ph.D. looked at potential alternative routes for the entry into the environment by way of bathing, showering, and laundering. These routes may be important for certain APIs found in medications that are applied topically to the skin. They include creams, lotions, ointments, gels, and skin patches.

Ruhoy and Daughton identified this potential new source of APIs through a comprehensive review of hundreds of scientific studies on the metabolism and use of medications, focusing on APIs in medications that are applied to the skin or excreted from the body via sweat glands.

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Residual topical and body sweat APIs are two sources that can result in residues being washed off the body and down bathroom drains. These APIs include steroids (such as cortisone and testosterone), acne medicine, antimicrobials, narcotics, and other substances.

Ruhoy feels some APIs in topical medications have the potential of having a greater impact than those released in feces and urine. Topical medications are un-metabolized and full-strength when washed off. Those in feces and urine have been metabolized and are not full-strength.

"We need to be more aware of how our use of pharmaceuticals can have unwanted environmental effects," Ruhoy said. "Identifying the major pathways in which APIs enter the environment is an important step toward the goal of minimizing their environmental impact."

Things you can do as a responsible citizen:

  1. Use the topical prescription as directed, in the amount needed (more is not better, especially for the environment).
  2. Do not flush prescription drugs down the toilet or drain unless the label or accompanying patient information specifically instructs you to do so.
  3. To dispose of prescription drugs not labeled to be flushed, you may be able to take advantage of community drug take‐back programs or other programs, such as household hazardous waste collection events, that collect drugs at a central location for proper disposal.
  4. Call your cit

y or county government’s household trash and recycling service and ask if a drug take‐back program is available in your community.

Related stories
FDA, State Websites Explain Medication Disposal

Sources
American Chemical Society
American Pharmacy Association
White House Drug Policy

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