LEADS FORUM: What you can do for clean water

Jim Spicer - Pharmacist - Fireland Regional Medical Center Jeanie Wertenbach - Health Educat
Sandusky Register Staff
May 24, 2010

Jim Spicer - Pharmacist - Fireland Regional Medical Center

Jeanie Wertenbach - Health Education Supervisor - Erie Co. Health Department

Carl Kamm III - Attorney - Flynn, Py, and Kruse

As a society, we are consuming more medications than ever before. Contributing factors include surges in prescription and over-the-counter medications as well as the multi-billion dollar non-FDA regulated herbal and dietary supplement industry. In a 2002 Center for Disease Control survey, it was found that 85 percent of persons aged 65 or older consume three or more prescription medications. Sales of non-prescription medications have increased by 60 percent since the 1990s. Access to prescription and non-prescription medications is much easier today due to importation, online pharmacies and other vendors with limited security regulations. When considering population growth, The United States population of roughly 300 million in 2006 is expected to surpass 400 million by 2050. As we shift our focus from what is consumed to what is left over, we find millions of pounds of expired and unnecessary pharmaceutical waste that has no where to go, but into our water supply. Typically, medications are not entirely consumed due to changes in prescription or dosage, improvement in the patient's health, death or expiration. A 2004 survey by Earth 911 evaluated different methods of medication disposal in America and found 54 percent were thrown in the trash, 35.4 percent were flushed down the toilet or sink, 7.2 percent did not dispose of their medications, 2 percent used all medication prior to expiration and 1.4 percent retuned their medications to the pharmacy. Problems with all of these options include:

Medicine cabinet -- Keeping old medicines in the house can lead to accidents. People may get confused about which drugs to take, or take expired, ineffective medications. Children could also consume these medicines, which could lead to adverse consequences.

Flushing -- This option causes significant harm to the environment. Water and sewage treatment plants are not capable of removing these substances from the water supply and they settle in lakes and rivers as well as the water we drink every day. Some medications can also kill beneficial bacteria responsible for breaking down certain wastes in sewage treatment plants.

Trash -- Medications could end up in the hands of children, other persons, or be consumed by animals. Identity theft can also occur if personal information is left on medication bottles. Medications can leach into landfills and appear in our groundwater.

A recent Associated Press probe found detectable concentrations of many different prescription and over-the-counter medications in the drinking water of 41 million Americans in 24 major metropolitan areas. The concentrations were stated to be far below the concentrations of a medical dosage. Researchers are currently unsure as to the significance and impact of these findings on humans - both in the short term and long term - despite a large body of literature suggesting that these levels could harm humans. The AP's investigation also examined the impact of these chemicals on the nation's watersheds and determined that of the 35 watersheds tested, 28 had detectable levels of pharmaceuticals. When examining wildlife that drink from or live in the streams and rivers in certain areas of The United States, the Associated Press reported that pharmaceuticals in these areas are being linked to reproductive problems in many types of aquatic wildlife. Plants and birds are also being significantly affected. Interestingly, many of the most affected areas lie just downstream of water treatment plants suggesting a strong correlation between concentration and resultant risk.

Currently, there are no regulations addressing medication concentration monitoring in drinking water or other bodies of water. This includes the multi-billion dollar bottled water industry, which includes FDA limits for chemicals, bacteria and other contaminants, but does not address pharmaceuticals. In a 2002 U.S. Geological Survey, 80 percent of 139 streams in 30 states were found to be contaminated with pharmaceuticals, hormones and other organic compounds.

The size of pharmaceutical waste is staggering when taking into account hospital medication utilization as well as outpatient prescription volumes. The only way to safely eliminate these chemicals is to incinerate them. There is no standardized method to detect levels of many medications. There is also uncertainty regarding what is an acceptable or harmful level and these levels may vary by medication once determined. Other countries such as Canada, England, South Africa, China, Norway, Pakistan, Singapore and Japan have found similar problems in their water.

The Leadership Erie County Class of 2008 has created informational pieces and presentations to promote environmental stewardship throughout Erie County:

Awareness events

-- A display and informational presentation 5:30-8 p.m. April 1 at the Green Energy Symposium, BGSU Firelands, Huron Twp.

-- A display at Earth Day, April 19, at Sandusky Mall

-- Follow-up and current progress presentation at a statewide conference for solid waste districts, recycling professionals and educators Nov. 12-14 at The Sawmill Creek Resort

Medication collection

-- Noon-4 p.m. April 20 at Firelands Regional Medical Center Professional Building, Sandusky

-- 3-8 p.m. April 22 at Firelands Regional Medical Cetner Professional Building, Sandusky

Bring prescription, non-prescription and pet medications, pills, liquids, ointments, creams, patches and lotions. The collection personnel will not accept controlled substances (narcotics, sleeping pills, codeine and some other medications), used syringes, inhalers (or other drugs in aerosol containers) or chemotherapy medications. A pharmacist will assist and answer any questions. Refreshments and snacks will be provided.