Title: Pharmaceuticals and Personal Care Products PPCPs as Environmental Pollutants Pollution from Personal
1Pharmaceuticals and Personal Care Products
(PPCPs) as Environmental Pollutants Pollution
from Personal Actions lt
- Christian G. Daughton, Ph.D.
- Chief, Environmental Chemistry Branch
- Environmental Sciences Division
- National Exposure Research Laboratory
- Office of Research and Development
- Environmental Protection Agency
- Las Vegas, Nevada 89119
- daughton.christian_at_epa.gov
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3U.S. EPA Notice
- The U.S. Environmental Protection Agency (EPA),
through its Office of Research and Development
(ORD), funded this research and approved the
materials that formed the basis for this
presentation. While the text for
this presentation has been peer
reviewed by EPA, the oral narrative has not.
4Wealth of other materials and links to most of
the ongoing work relevant to this topic are
available at the U.S. EPAs PPCPs Web Site
- http//www.epa.gov/nerlesd1/
- chemistry/pharma/index.htm
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6Disclaimers
- PPCPs entering the environment
- End-Use vs. Manufacturing
- Focus of this discussion is primarily on PPCPs
originating from end-use rather than from
manufacturing. - Emphasis is on use/disposal of PPCPs as
originating primarily from activities/actions of
individuals and to a lesser degree from hospitals
and industry not from the PPCP manufacturing
sector (whose waste streams are much better
defined, confined, and controlled/controllable).
continued -
7Clarification of Acronyms
- Pharmaceuticals Personal Care Products PPCPs
- Endocrine Disrupting Compounds
- EDCs
- A plethora of other terms have often been used
interchangeably with EDCs (rightly and wrongly).
These include environmental estrogens,
endocrine-disruptors, endocrine-modulators,
estrogenic mimics, ecoestrogens, environmental
hormones, xenoestrogens, hormone-related
toxicants, hormonally active agents (HAAs),
endocrine-active chemicals (EACs), endocrine
active substances (EASs), phytoestrogens (a
naturally occurring subset). Note estrogens
represent but one mode of action others include
androgens
8EDCs vs. PPCPs
- PPCPs vs. EDCs PPCPs ? EDCs
- PPCPs and EDCs are not synonymous they are
intersecting sets. - Must avoid confusion regarding their
relationship. - Only a small subset of PPCPs are known/suspected
of being direct-acting EDCs (e.g., synthetic
steroids) toxicological concerns usually differ.
EDCs comprise members from many disparate
chemical classes.
9Endocrine Modulators and Homeostasis
C.D. Daughton, 21 November 2001 U.S. EPA-Las Vegas
10EDCs versus PPCPs
C.D. Daughton, 21 November 2001 U.S. EPA-Las Vegas
11PPCP-Relevant Goals for the U.S. EPAsOffice of
Research and Development
- Identification of potential (future)
environmental concerns anticipatory research
emerging issues. Identify pivotal sources of
uncertainty that affect risk estimates. - Proactive vs. Reactive Pollution prevention
vs. remediation/restoration Identify and foster
investigation of hidden or potential
environmental issues/concerns before they become
critical ecological or human health problems. - Foster interdisciplinary research
collaboration Catalyze research by academe,
private sector, government. - Ruling-in/ruling-out vs. Uninformed rules
Provide bases for informed decisions. Ensure that
science leads eventual decisions for guidance or
to regulate/not regulate.
12PBTs, POPs, BCCsOnly one part of the risk
puzzle?
- Since the 1970s, the impact of chemical pollution
has focused almost exclusively on conventional
priority pollutants, especially on those
collectively referred to as persistent,
bioaccumulative, toxic (PBT) pollutants,
persistent organic pollutants (POPs), or
bioaccumulative chemicals of concern (BCCs). - The dirty dozen is a ubiquitous, notorious
subset of these, comprising highly halogenated
organics (e.g., DDT, PCBs). - The conventional priority pollutants, however,
are only one piece of the larger risk puzzle. - it is important to recognize that the current
lists of priority pollutants were primarily
established in the 1970's in large part for
expediency that is, they could be measured with
off-the-shelf chemical analysis technology.
Priority pollutants were NOT necessarily selected
solely on the basis of risk.
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16Prevalence of Xenobiotic Occurrence Some
Possible Generalizations Regarding Ubiquity
- The lower the concentration, the higher the
probability of larger numbers of distinct
chemicals occurring - Exponentially more types of chemicals occur at
exponentially lower concentrations (does the
distribution of chemical types versus their
concentrations follow a power law, as shown for
such a wide array of other phenomenon? e.g., see
M. Buchanan "Ubiquity", Crown Publishers 2000) - At the very lowest concentrations (zeptomolar to
yoctomolar, zM - yM), the off-the-cuff truism may
apply - "Everything can be found everywhere"
continued -
17Prevalence/Distribution of Xenobiotic Occurrence
18Einstein onEnvironmental Monitoring
Not everything that can be counted counts, and
not everything that counts can be counted.
(oft attributed to Albert Einstein) corollary
for environmental monitoring Not everything that
can be measured is worth measuring, and not
everything worth measuring is measurable.
19further truisms regardingEnvironmental Monitoring
- What one finds usually depends on what one aims
to search for. - Only those compounds targeted for monitoring
have the potential for being identified and
quantified. - Those compounds not targeted will elude
detection. - The spectrum of pollutants identified in a
sample represent but a portion of those present
and they are of unknown overall risk significance.
20Toxicity of Complex Environmental Mixtures Major
Unanswered Question
Is the overall toxicity (or the spectrum of
unique toxic effects) of a complex mixture caused
by few or many chemical constituents? And do
these constituents comprise a small or large
fraction of the total dissolved mass?
21Emerging Risks
- It is reasonable to surmise that the occurrence
of PPCPs in waters is not a new phenomenon. It
has only become more widely evident in the last
decade because continually improving chemical
analysis methodologies have lowered the limits of
detection for a wide array of xenobiotics in
environmental matrices. There is no reason to
believe that PPCPs have not existed in the
environment for as long as they have been used
commercially.
22PPCPs as Environmental Pollutants?
- PPCPs are a diverse group of chemicals
comprising all human and veterinary drugs
(available by prescription or over-the-counter
including the new genre of biologics),
diagnostic agents (e.g., X-ray contrast media),
nutraceuticals (bioactive food supplements such
as huperzine A), and other consumer chemicals,
such as fragrances (e.g., musks) and sun-screen
agents (e.g., methylbenzylidene camphor) also
included are excipients (so-called inert
ingredients used in PPCP manufacturing and
formulation). - Drugs differ from agrochemicals in that they
often have multiple functional groups (many are
amphiphilic) and usually have lower effective
doses. This complicates fate/transport modeling
and lends an extra dimension to the analytical
techniques required for monitoring. Also designed
for use by/for the individual consumer. - In contrast to the conventional PBTs, most PPCPs
are neither bioaccumulative nor volatile some,
such as the musks, however, do indeed fulfill the
criteria for PBTs.
23Inter-Connectedness of Humans and the Environment
- Occurrence of PPCPs in the environment mirrors
the intimate, inseparable, and immediate
connection between the actions and activities of
individuals and their environment. - PPCPs owe their origins in the environment to
their worldwide, universal, frequent, and highly
dispersed but cumulative usage by multitudes of
individuals.
24Overview Pharmaceuticalsin the Environment
- Certain pharmaceutically active compounds (e.g.,
caffeine, aspirin, nicotine) have been known for
over 20 years to occur in the environment. - Environmental occurrence primarily resulting
from treated and untreated sewage effluent. - Only more recently has a larger picture emerged
numerous PPCPs can occur (albeit at very low
concentrations). - Prior discovery delayed primarily by limitations
in analytical environmental chemistry
(ultra-trace enrichment and detection). - Domestic sewage is a major source not just
hospital sewage. CAFOs are a major source of
antibiotics. - continued -
25Origins of PPCPs in the Environment
- Portions of most ingested drugs are excreted in
varying unmetabolized amounts (and undissolved
states, primarily because of protection by
excipients) primarily via the urine and feces. - Other portions sometimes yield metabolites that
are still bioactive. Still other portions are
excreted as conjugates. - Free excreted drugs and derivatives can escape
degradation in municipal sewage treatment
facilities (removal efficiency is a function of
the drugs structure and treatment technology
employed) the conjugates can be hydrolyzed back
to the free parent drug. - Un-degraded molecules are then discharged to
receiving surface waters or find their way to
ground waters, e.g., leaching, recharge. - continued -
26Overview Pharmaceuticalsin the Environment
- Continual input of PPCPs to aquatic environment
via sewage can impart a persistent quality to
those compounds that otherwise possess no
inherent environmental stability. - The full extent, magnitude, and ramifications of
their presence in the aquatic environment are
largely unknown. - Vast majority of all ecological monitoring
studies to date have been performed in Europe
(with exception of USGS). - Use/release of antibiotics and natural/synthetic
steroids to the environment has generated most of
the controversy to date, but a plethora of other
PPCPs have yet to be examined. Scope of overall
issue is ill-defined. - continued -
27Overview Pharmaceuticalsin the Environment
- Toxicological significance for both humans and
ecological exposure to multiple chemicals at
trace concentrations (ppb-ppt) for long durations
is poorly understood. - If PPCPs eventually prove to be an environmental
concern, it is unknown whether sewage treatment
facilities could be cost-effectively modified to
reduce emissions. - Source control (aimed at both disposal and
medical practices) may prove more effective
(environmental stewardship programs). - Focus should be on proper and sufficient science
for establishing occurrence, exposure,
susceptibility/effects, so that sound decisions
can be made regarding human and ecological
health. - - concluded -
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29Origins of PPCPs in the Environment
- Other potential routes to the environment
include leaching from municipal landfills, runoff
from confined animal feeding operations (CAFOs)
and medicated pet excreta, loss from aquaculture,
spray-drift from agriculture, direct discharge of
raw sewage (storm overflow events residential
straight piping), sewage discharge from cruise
ships (millions of passengers per year), oral
contraceptives used as soil amendment and plant
growth tonic (urban legend), and transgenic
production of proteinaceous therapeutics by
genetically altered plants (aka molecular
farming biopharming). - Direct discharge to the environment also occurs
via dislodgement/washing of externally applied
PPCPs. - - continued
30Unanticipated Routes of Exposure
- Given that the predominate route of release of
drugs to the environment is probably via
effluents from municipal sewage and CAFOs, the
major route of inadvertent ecological and human
exposure is via water (and secondarily sludges
and sediments). - Despite this generalization, additional routes
of release and exposure could prove to be highly
significant in certain local situations. One such
route of exposure to drugs rarely considered is
inhalation (especially since few drugs are
volatile). - Despite low volatility, sorption of drugs to
respirable particulates could serve as a route of
exposure. - For example, dust from confined animal feeding
operations where drugs are used to supplement
feed and administered directly to animals for
therapeutic and prophylactic purposes. Pig house
dust can originate from feed (e.g., antibiotics),
bedding, feces, and shedding. In dust samples
from a 20-year period, five antibiotics were
found in combined concentrations up to 12.5 mg/kg
dust.
Source Antibiotics in dust originating from a
pig fattening farm a new source of health hazard
for farmers? Hamscher G, Pawelzick HT, Sczesny S,
Nau H, and Hartung J. 2003. Environ. Health
Perspect. (on-line 18 June 2003).
31 Available http//www.epa.gov/nerlesd1/chemistry
/pharma/image/drawing.pdf
32Nationwide studies relevant to potential for PPCP
occurrence and distribution in the environment
- 1999-2000 USGS implemented first-ever U.S.
national reconnaissance of emerging
pollutants in waters - objective was to
establish baseline occurrence data - included
were some commonly used PPCPs - data collected
from 142 streams, 55 wells, 7 effluents (in 36
states) - findings published in 15 March 2002
issue of - Environmental Science and Technology
- - detailed information available
at http//toxics.usgs.gov/highlights/w
hatsin.html - 2001 first-ever study published on geographic
variation (across U.S.) of prescription drug
usage - Prescription Drug Atlas (Express Scripts,
2001), available at http//www.express-scripts.c
om/other/news_views/outcomes_research/atlas2002/at
las_ex_sum.htm
33Significance of the USGS Monitoring Study
- The PPCPs documented in the USGS study to occur
in US surface waters probably represent but a
fraction of all those that actually occur. - Whether the potential for health effects from
this subset of PPCPs is eventually demonstrated
is in large part irrelevant. - More importantly, these occurrence data
demonstrate the potential for ANY consumer-use
chemical to enter the environment, and thereby
give us the advance opportunity to be watchful
regarding the future introduction to commerce of
drugs with new mechanisms of action and
ever-increasing biochemical potencies.
34Drugs Having Double UsesMedicinals and
Pest-Control Agents(alternative sources for
introduction to the environment)
- Some chemicals serve double duty as both
existing/experimental drugs and as pest-control
agents. While this shows the broad utility of
certain drugs, it also poses the possibility that
these alternative uses serve as additional
sources for their introduction to the
environment. The potential significance of these
alternative uses as sources for environmental
release has never been explored. Examples
include - 4-aminopyridine experimental multiple sclerosis
drug and an avicide - warfarin anticoagulant and a rat poison
- triclosan general biocide and gingivitis agent
used in toothpaste - azacholesterols antilipidemic drugs and
avian/rodent reproductive inhibitors e.g.,
Ornitrol - certain antibiotics used for orchard pathogens
- acetaminophen an analgesic and useful for
control of Brown Tree snake - caffeine stimulant and approved for control of
coqui frog in Hawaii also repels and kills
snails and slugs at concentrations exceeding 0.5.
35Caffeine for control of frog pests
U.S. EPA approved (27 Sept 2001) specific
exemption from FIFRA allowing use of caffeine to
control coqui frogs in Hawaii. Exemption allows
application of 100-200 pounds per acre (max total
1,200 lbs/year). In absence of natural predators,
coqui frog can reproduce to high densities
(10,000/acre).
Out-compete native birds by massive consumption
of insects. Chirping frequency is extremely
piecing and annoying (upwards of 100 db).
single
chorus
36Acetaminophen for control of Brown Tree snakes
Brown Tree snakes (Boiga irregularis ), native to
eastern Indonesia, become invasive pests on Guam
starting in the 1940's/1950's. Without natural
predators, the Brown Tree snake's population in
Guam is estimated at upwards of 15,000 per
square mile. Have decimated certain native bird,
bat, and reptile populations, as well as caused
extensive economic losses (agriculture, pets,
human bites, electric grid outages/repairs). No
safe and effective chemical-controls until
discovery by USDA that acetaminophen (80 mg) will
effectively kill Brown Tree snakes within 3 days
of even a brief exposure to baited, dead
mice. Acute effects of larger doses of
acetaminophen on local non-target species have
not been detected. see J. J. Johnston et al.
"Risk Assessment of an Acetaminophen Baiting
Program for Chemical Control of Brown Tree
Snakes on Guam Evaluation of Baits, Snake
Residues, and Potential Primary and Secondary
Hazards," Environ. Sci. Technol. 2002,
36(17)3827-3833 also http//www.aphis.usda.gov/
lpa/inside_aphis/features10d.html.
37Decline of Gyps spp. Vultures in Pakistan India
Possible Link with Diclofenac
- Beginning in the early 1990s, vultures
(especially white-backed vultures such as Gyps
bengalensis) have experienced dramatic population
declines (as great as 95) in Southern Asia
particularly India and spreading to Pakistan and
Nepal. - Various hypothesized causes have ranged from
pathogens to pesticides. The causative agent(s)
result in acute renal failure (manifested as
visceral gout from accumulation of uric acid),
leading to death of the breeding population.
- At the 6th World Conference on Birds of Prey and
Owls (Budapest, Hungary, 18-23 May 2003), Prof.
J. Lindsay Oaks (Washington State University)
presented evidence that (at least in Pakistan)
the die-offs may have resulted from diclofenac
poisoning. - Diclofenac, although primarily a human NSAID, is
used in veterinary medicine in certain countries.
In India, diclofenac is used for cattle, whose
carcasses are a major food source for Gyps.
- Diclofenac seems to be selectively toxic to Gyps
spp. versus other carrion-eating raptors. - Health hazards grow from the accumulation of
uneaten cattle carcasses (as well as human),
which now serve to attract growing packs of
dangerous feral dogs, which can also carry
rabies.
38PPCPs in Receiving WatersA Global, Ubiquitous
Process with Unique Local Expression
- Important to recognize that ALL municipal
sewage, regardless of location, will contain
PPCPs. Issue is not unique to any particular
municipal area. - Each geographic area will differ only with
respect to the types, quantities, and relative - abundances of individual PPCPs.
39PPCPs in Receiving Waters
- Occurrence differences in
- raw sewage are a function of (i) local
prescribing and usage customs, (ii) confluence of
hospitals, (iii) state policies and customs
regarding disposal of unused PPCPs, and (iv)
local manufacture and usage of illicit and abused
drugs. - surface and ground waters are a function of
- (i) whether treatment technologies are employed
(straightpiping, malfunctioning septic systems,
overflow events), (ii) types of treatment
technologies employed for sewage, potable water,
or reinjection waters, and - (iii) local/seasonal fluctuations in
biophysicochemical transformation potential
(e.g., biodegradation, photolysis). - - concluded -
40Sources of Raw Sewage in U.S.released to
streams, lakes, estuaries, oceans, groundwater
- combined sewer overflows (CSOs) 4.5 X 1012
L/year - CSOs handle rainwater runoff, domestic sewage,
and industrial wastewater, and are designed to
discharge untreated sewage during adverse storm
events - http//cfpub.epa.gov/npdes/home.cfm?program_id5
- sanitary sewer overflows (SSOs) severe weather,
system malfunction, improper system
operation/maintenance - leakage from sewage transport infrastructure
sewer pipe cracks caused by tree roots and
defective/collapsed pipes - failing septic systems 1990 U.S. census showed
ca 25 of all housing units use on-site
wastewater handling system (e.g., septic system)
see "SepticStats An Overview", Graham Knowles,
1998 http//www.nesc.wvu.edu/images/SepticStat.pd
f. In certain locales, the percentage is much
higher. - unpermitted privies
- straight-piping
continued -
41Drinking Waste Water Infrastructure Needs
2001 Report Card for America's Infrastructure
American Society of Civil Engineers (ASCE)
(http//www.asce.org/reportcard/index.cfm?reactio
nfull) Nationwide grades of D assigned for
both drinking water and wastewater
infrastructures (http//www.asce.org/reportcard/i
ndex.cfm?reactionfullpage2) Over 20 billion
dollars annually is the estimated need for
rectifying the nations degenerating water/waste
infrastructures The nation's 54,000 drinking
water systems face an annual shortfall of 11
billion needed to replace facilities that are
nearing the end of their useful life and to
comply with federal water regulations. Non-point
source pollution remains the most significant
threat to water quality. The nation's 16,000
wastewater systems face enormous needs. Some
sewer systems are 100 years old. Currently, there
is a 12 billion annual shortfall in funding for
infrastructure needs in this category however,
federal funding has remained flat for a decade.
More than one-third of U.S. surface waters do not
meet water quality standards.
42Subtle (currently unrecognized) Effects a
Troubling Scenario?
- Uses for which PPCPs were designed differ
radically from those of industrial and
agro-chemicals. - Intended biological targets (receptors) are
numerous and frequently exquisitely specific and
sensitive. - Intended/unintended receptors of exposure and
effects can differ greatly from those of
currently regulated pollutants. - Receptors in non-target species could differ
from those in humans. continued -
43Subtle (currently unrecognized) Effects
- some examples
- Profound effects on development, spawning, and
wide array of other behaviors in shellfish,
ciliates, and other aquatic organisms by SSRI and
tricyclic antidepressants. - Dramatic inhibition of sperm activity in certain
aquatic organisms by calcium-channel blockers. - Antiepileptic drugs (e.g., phenytoin, valproate,
carbamazepine) have potential as human
neuroteratogens, triggering extensive apoptosis
in the developing brain ? neurodegeneration. - ppm and sub-ppm levels of various drugs (NSAIDS,
glucocorticoids, anti-fibrotics) affect collagen
metabolism in teleost fish, leading to
defective/blocked fin regeneration - Multi-drug transporters (efflux pumps) are
common defensive strategies for aquatic biota
possible significance of efflux pump inhibitors
in compromising aquatic health? - continued -
44Subtle (currently unrecognized) Effects a
Troubling Scenario?
- Could immediate biological actions on non-target
species be imperceptible but nonetheless lead to
adverse impacts as a result of continual
accretion over long periods of time? For example,
latent damage, only surfacing later in life. The
issue of resiliency. - Could subtle effects accumulate so slowly
(perhaps seeming to be part of natural variation)
that major outward change cannot be ascribed to
the original cause? - Effects that are sufficiently subtle that they
are undetectable or unnoticed present a challenge
to risk assessment (especially ecological)
e.g., subtle shifts in behavior or intelligence. - Advances required in developing/implementing new
aquatic toxicity tests to better ensure that such
effects can be detected. - - concluded -
45Sidebar Incremental Poisoning Designed to Appear
Natural a Popular Historical Practice
- The use of slow poisoning in homicides (usually
administered by food and drink) was practiced
widely in Europe from the early to late 1600s
with a resurgence in the 1800s - The atrocious system of poisoning, by poisons so
slow in their operation, as to make the victim
appear, to ordinary observers, as if dying from a
gradual decay of nature, has been practised in
all ages. - Those who are curious in the matter may refer to
Beckmann on Secret Poisons, in his History of
Inventions, in which he has collected several
instances of it from the Greek and Roman writers.
Early in the sixteenth century the crime seems to
have gradually increased, till, in the
seventeenth, it spread over Europe like a
pestilence. It was often exercised by pretended
witches and sorcerers, and finally became a
branch of education amongst all who laid any
claim to magical and supernatural arts. In the
twenty-first year of Henry VIII. an act was
passed, rendering it high-treason those found
guilty of it, were to be boiled to death. - The Slow Poisoners in
- Extraordinary Popular Delusions and the Madness
of Crowds - by Charles MacKay, 1841
46Aquatic organisms captive to continual,
life-cycle chemical exposures
- Aquatic Exposure is Key Any chemical introduced
via sewage to the aquatic realm can lead to - continual, multigenerational exposure for
- aquatic organisms.
- Re-evaluation of Persistence Chemicals
continually infused to the aquatic environment
essentially become persistent pollutants even
if their half-lives are short their supply is
continually replenished (analogous to a bacterial
chemostat). These can be referred to as
pseudo-persistent chemicals (P2s).
47 Exposure to Multiple, Trace-Level PPCPs Below
Human Therapeutic Doses
- Potential Toxicological Significance Can Exist as
a Result of - (1) Risk Cup body burden Potential for additive
effects from multiple agents sharing common MOAs
to exceed an effects level. This becomes
especially important if the exogenous PPCPs add
to a pre-existing burden of endogenous toxicants
that share the same MOA. - (2) Possible interactive effects, especially
synergism. Drug industry attempts to avoid
developing new candidate drugs with potential
adverse drug reactions. But the strategy is based
upon focusing on those drug combinations that are
most probably encountered in practice (e.g., a
candidate cardiac drug would be screened against
drugs that cardiac patients typically take), as
opposed to all drugs (a currently economically
infeasible approach). - continued -
48Potential Toxicological Significance Can Exist as
a Result of
- (3) Non-target species receptor repertoires not
as well characterized. Variation in receptor
repertoires across species, and unknown overlap
with humans leads to countless questions
regarding potential effects. - (4) Hormesis Effects below NOELs. U-shaped
curves. Data acquired solely at higher
therapeutic doses (where testing is usually
performed) has no predictive capability for the
type or amplitude of response at lower
concentrations. - (5) Comparatively little research performed at
extremely low concentrations (nM-pM and below).
Some agents have ability to impart effects at
ultra-trace concentrations. - (6) Susceptible genetic outliers within species.
- (7) MOAs not fully understood. Most drugs can
each have a multitude of effects. Most remain to
be discovered. - - concluded -
49Collateral Benefits of RD Efforts with PPCPs
- Regardless of whether PPCPs as trace pollutants
eventually prove to pose ecological or human
health concerns, there are several major reasons
for developing the means for reducing their
introduction to the environment. - These reasons have been largely unrecognized or
unappreciated and they are unrelated to PPCPs
themselves, and they involve the numerous
collateral benefits that would automatically
accrue to people and their environment. - Two of these reasons center around various
actions to reduce the purposeful (for example,
disposal of unused PPCPs via toilets) and
inadvertent (primarily through physiological
excretion) release of PPCPs to the environment.
continued -
50Collateral Benefits of RD Efforts with PPCPs
(con't) Waste Treatment Research
- The first major collateral benefit derives from
optimizing or improving existing
wastewater/sludge treatment technologies
(primarily for POTWs) or developing or
implementing new, cost-effective technologies for
further lowering the trace levels of PPCPs. - Any improvements in engineering treatment
technology targeted for the removal of trace
levels of PPCPs from waste and drinking waters
will more than likely also serve to remove
numerous other unregulated pollutants from water,
many which have yet to be identified, and others
which will derive from chemicals new to commerce.
continued -
51Collateral Benefits of RD Efforts with PPCPs
(con't) Cradle-to-Cradle Stewardship
- A wide array of activities and efforts centered
on pollution prevention (source reduction,
minimization, elimination) could have significant
consequences for improved consumer health and
economy. These pollution prevention efforts fall
under the umbrella of "Cradle-to-Cradle
Stewardship." Most of these actions would
originate from a broad range of sectors in the
healthcare industry but some would also originate
with the consumer. - Design and implementation of a successful
voluntary compliance approach to life-cycle
stewardship of PPCPs (a holistic
"cradle-to-cradle" approach) could not only
minimize any potential for adverse environmental
impact, but could also improve medical healthcare
outcomes and consumer safety as well as reduce
healthcare costs.
continued -
52Collateral Benefits of RD Efforts with PPCPs
(con't) Cradle-to-Cradle Stewardship
- Numerous suggestions for a pollution prevention
program centered on environmental stewardship
have been compiled in a two-part monograph
published in Environmental Health Perspectives
111, 2003 - (1) Cradle-to-Cradle Stewardship of Drugs for
Minimizing Their Environmental Disposition while
Promoting Human Health. I. Rationale and Avenues
toward a Green Pharmacy (Daughton, CG), 757-774. - (2) Cradle-to-Cradle Stewardship of Drugs for
Minimizing Their Environmental Disposition while
Promoting Human Health. II. Drug Disposal, Waste
Reduction, and Future Direction (Daughton, CG),
775-785.
continued -
53Wealth of materials and links for Environmental
Stewardship of PPCPs at the U.S. EPAs web page
on theGreen Pharmacy
- http//www.epa.gov/nerlesd1/
- chemistry/ppcp/greenpharmacy.htm
- concluded -
54Water Re-Use
Communicating Risk More Effectively
Growing importance of public acceptance of
wastewater re-use for human consumption
(especially "toilet-to-tap" re-use programs)
highlights the need for vastly improved
approaches to risk communication.
- Points to need for scientists to better convey
the significance of their work to the public. - Points to need for exploring more effective
means for aligning the long-troubling disconnect
of disparate views of risks as held by scientists
versus the public real hazard vs. risk
perception. - Receiving little attention is the more
substantive role that could be played by the
cognitive sciences (social scientists and
psychologists) in helping to bridge the
communications gap.
55Importance of Forging Collaborations between
Environmental Scientists Medical Community
- Existing literature almost exclusively a result
of efforts from environmental scientists
(primarily analytical chemists). - Much could be contributed from the many fields
of medical science and practice. - Cross-communication and collaborations would
prove extremely useful. - Partly in an attempt to catalyze
inter-disciplinary efforts, the British medical
journal The Lancet recently published a
commentary that covers this topic and others - Environmental stewardship and drugs as
pollutants (C.G. Daughton), The Lancet, 2002,
3601035-1036
56 Major Future Areas to Consider Regarding PPCPs
as Environmental Pollutants
- Ensuring safety of drinking water supplies.
Ensure adequate removal of PPCPs and other
unregulated pollutants from treated wastewater,
especially water destined for aquifer recharge - Improvement of decaying water/sewage
infrastructure and development of cost-effective
technologies for optimal removal of PPCPs from
sewage and source control (e.g., raw sewage
discharge) - Concerns regarding introduction of PPCPs to
environment from molecular farming
continued -
57 Major Future Areas to Consider Regarding PPCPs
as Environmental Pollutants
- Development of integrated industry-consumer
stewardship programs for minimizing the
introduction of PPCPs to the environment
(pollution prevention, source control) - Development of cohesive national (or
international) guidance for disposal/recycling of
PPCPs - NOTE Progress in most of these could also afford
collateral benefits to consumers and the
environment in other, unrelated and previously
unanticipated ways
58(No Transcript)
59Questions
- feel free to contact
- Christian Daughton, Ph.D.
- Chief, Environmental Chemistry Branch
- Environmental Sciences Division
- National Exposure Research Laboratory
- U.S. Environmental Protection Agency
- daughton.christian_at_epa.gov
- 702-798-2207
http//www.epa.gov/nerlesd1/chemistry/pharma/
60- prepared for
- Emerging Pollutants Workshop
- 11-14 August 2003
- Chicago, IL
- Christian Daughton, Ph.D.
- Chief, Environmental Chemistry Branch
- Environmental Sciences Division
- National Exposure Research Laboratory
- U.S. Environmental Protection Agency
- daughton.christian_at_epa.gov
- 702-798-2207
- prepared 5 August 2003