From the March 2008 Idaho Observer:

On March 9, 2008, an Associated Press story appeared in several newspapers nationwide alerting Americans to the presence of pharmaceutical drugs in our tap water.

The alarming story stated that "[a] vast array of pharmaceuticals—including antibiotics, anti-convulsants, mood stabilizers and sex hormones—have been found in the drinking water supplies of at least 41 million Americans."

Official denial. Many public utilities are insisting their water is safe due to the fact that many of the drugs discovered in their drinking water were in parts per billion. However, the presence of so many prescription drugs and over-the-counter medications like acetaminophen and ibuprofen in our drinking water has many scientists concerned about long-term consequences to human health.

Effects on aquatic animals. Research is showing that pharmaceutical drugs, PCBs and phthalates in our waterways are damaging wildlife across the nation and around the globe. On August 14, 2005, The Detroit News reported that fish in the Detroit River and Lake St. Clair had sexual abnormalities. Studies conducted in 2002 by Canadian Scientist Chris Metcalfe of Trent University in Peterborough, Ontario, showed that white perch caught for research had male and female sex organs.

A second study by Metcalf showed that male snapping turtles had traces of estrogen.

Metcalf’s suspicions are that the feminization of wildlife is linked to chemicals coming from sewage plants. Even the British Environmental Agency has confirmed that around a third of the male roach fish have developed female sex organs and are producing eggs. The cause of this change was traced to estrogen passing through sewage treatment plants and on into rivers. They found that where the sewage outflows were particularly heavy, all the male roach fish were "hermaphrodites."

These chemicals affect sperm quality, which also affects reproduction. Other scientists concur that the "feminization" of fish may be linked to estrogen—or chemicals that mimic estrogen—showing up in waterways from sewage treatment plants.

The estrogen shows up in water either through waste or through birth control pills flushed down toilets or sinks. Chemicals that mimic the effects of estrogen include atrazine, an herbicide that ends up in lakes and rivers. According to Linda Schweitzer, a professor of environmental chemistry at Oakland University, "[a]trazine actually affects the sexual development of organisms...Atrazine stimulates the enzyme aromatase, which induces the male hormone testosterone to become a form of the female hormone estrogen and that feminizes fish, frogs and possibly other organisms."

Cases in point. The global effects of trace amounts of pharmaceutical drugs on fish and wildlife are alarming, contributing to the near extinction of many species. Drugs in the water are being blamed for severe reproductive problems in many types of fish:

• The endangered razorback sucker and male fathead minnow have been found with lower sperm counts and damaged sperm.

• Some walleyes and male carp have become "feminized" fish, producing egg yolk proteins typically made only by females.

• Female fish have developed male genital organs. There are also skewed sex ratios in some aquatic populations and sexually abnormal bass that produce cells for both sperm and eggs.

• In Colorado’s Boulder Creek, 50 of the 60 white suckers collected downstream of Boulder’s wastewater treatment plant were female, compared to about half of them upstream.

• A 2003 study in northern Texas found that every bluegill, black crappie and channel catfish researchers caught living downstream of a wastewater treatment plant tested positive for active ingredients of two widely used antidepressants.

• Fish collected in waterways near Chicago; West Chester, Pa.; Orlando; Dallas; and Phoenix have tested positive for several pharmaceuticals: analgesics, antibiotics, antidepressants, antihistamines, anti-hypertension drugs and anti-seizure medications.

• Blood and liver samples of bull sharks in Florida’s Caloosahatchee River, a nursery area for juvenile bullsharks and home to six wastewater treatment plants, were tested for the presence of an array of medications this winter. Of the first 10 sharks sampled, nine tested positive for the active ingredient in an antidepressant.

Problems with other wildlife. Kidney failure in vultures, impaired reproduction in mussels and inhibited growth in algae have been reported. In northern India and Pakistan, the entire population of vultures has virtually disappeared after the birds ate the carcasses of cows that had been treated with an anti-inflammatory drug. In a 2004 study, scientists determined that the birds’ kidneys had failed from ingestion of the drug residue in cows.

In several recent studies of soil fertilized with livestock manure or with BioSolids from wastewater treatment plants, scientists found that earthworms had accumulated those same compounds, while vegetables—including corn, lettuce and potatoes—had absorbed antibiotics.

Although the hormonal affects of atrazine on humans is unknown, the Environmental Protection Agency has found that the herbicide can cause heart congestion, muscle spasms and possibly cancer.

Scientists from across the globe are also concerned about the gender-bending chemicals. More than 100 scientists from 15 countries in Europe signed a report in June, 2005, raising concerns about what it called the "high prevalence" of reproductive disorders in European males, genital malformations and low sperm counts. They called for a reduction of chemicals being released into waterways from sewage treatment plants and urged an acceleration of research into this issue.

"Off label" use of prescription drugs. At the same time, the Journal of the American Medical Association noted the following in a July 20, 2005 article: 80,000 chemicals are used commercially in the United States. There is evidence that the wide use of chemicals ending up in our water "may have" a hormonal effect on the body and long-term health risks.

Some of the potentially harmful chemicals come from left-over prescription medicine and birth control pills that are flushed down the toilet or bathroom sink.

Pilot pickup programs. A few counties across the country have developed a method for collecting unused medication as hazardous waste in order to avoid aggravating the problem we have collectively created for fish and other wildlife. For example, in 2005, the Macomb County Health Department in Michigan started a program to collect outdated or unused medication so it wouldn’t end up in the waste stream.

As of July 2005, 151 pounds had been disposed through their program. Considering that this is just one county and this program is only collecting pharmaceutical drugs, this nationwide "epidemic" becomes much clearer.

As a result, small pilot programs and one-day pickups of unused drugs have emerged in Maine, California, Washington and Florida. For example, in Maine, federal and state governments have split the $300,000 cost to launch a four-county trial in coming months. Purchasers of pharmaceuticals will take home prepaid mailers to send their leftover drugs to a way station, where most will be picked up for transport to incinerators.

Quantities are staggering. In Europe, Canada and Australia, government officials have acted more aggressively to reclaim unused drugs. In 2005, managers of a French program estimated that about 6,500 tons were recaptured at drug stores. One poll claimed that two-thirds of the French participate in the government’s program of collecting unused drugs for disposal.

The five-month AP investigation focused primarily on pharmaceutical drugs in our waterways contributing to both human and wildlife health problems. But also noted that when these same drugs combine with herbicide run-off, the proliferation of chemicals used in plastics—and even the chlorine commonly used to treat municipal water—the effects are even deadlier.

Climbing up the food chain. In an article in the Dec. 14, 2007 edition of The Portland Tribune, "Drugs climbing food chain? " researchers employed by the U.S. Geological Survey are testing the water in the Lower Columbia River for chemicals found in pharmaceuticals, personal care products, pesticides and common household products. The study will determine how these chemicals are traveling up the food chain affecting bodies of fish and birds.

Past studies in the region have shown that "legacy" chemicals—or now-banned chemicals such as the pesticide DDT—do accumulate up the food chain, having an impact on the overall health of wildlife species and the health of the humans who consume them. In previous work led by Elena Nilsen, a research chemist at the U.S. Geological Survey, 49 compounds were found in the Lower Columbia River and its tributaries in 2006 and 2007. The tributaries assessed included the Willamette River, along with the Tualatin River, Columbia Slough as well as Johnson, Kellogg, Tryon and Fanno creeks.

Compounds found in the rivers and creeks were caffeine, antibiotics, antacids, antidepressants, antihistamines, disinfectants, insect repellents, fungicide, fragrances, wood preservative, lotions, food additives, detergent, soap, flame retardant and manufacturing lubricants.

Nilsen’s study was the first to document the presence of the emerging contaminants in the river bottom in the Lower Columbia River and its urban tributaries. Nilsen said that the new study will take about three years to complete, but won’t answer questions about how the chemicals might affect human health; instead the focus is on how certain compounds move into the food chain.

Consumer consciousness needed. According to Debrah Marriott, executive director of the Lower Columbia River Estuary Partnership, knowing how chemicals move through the food chain will help in the development of strategies to reduce toxins in the environment. Marriott claims that keeping emerging contaminants out of local rivers and tributaries is largely a matter of smart shopping by consumers.

"There are certain ingredients in those products that are problematic and are causing those hormone problems (in fish)," she said. "The products already exist that are safe; it’s not a matter of changing the market. It’s a matter of getting consumers to use products that are less harmful."

Marriott said the agency is planning a consumer guide that spells out which products are safest to buy. For starters, she advises that consumers avoid plastic products containing certain chemical compounds known as phthalates and a synthetic disinfectant known as phenol A.

Prophylaxis study. In a January 31, 2008 article, "Toward A Cleaner, More Effective Method For Destroying Hormone-like Pollutants In Wastewater" from the American Chemical Society, researchers have discovered a powerful, environmentally-friendly catalyst that destroys various estrogens currently escaping into our watersheds from wastewater treatment plants.

In the new study, Nancy Shappell and colleagues explain that endocrine disrupters, both natural hormones and hormone-like compounds, have been detected in waterways. Many of these endocrine disrupters have estrogenic activity. Ethinylestradiol, for instance, is an active ingredient in both the birth control pill and the newly-introduced "no period pill." It is a major source of environmental estrogenic activity.

To address this problem, the researchers tested a new catalyst called Fe-TAML or Fe-B*. In the presence of hydrogen peroxide, the catalyst quickly and effectively destroyed various forms of estrogens typically found in post-treatment wastewater, removing 95 percent of the chemicals—including Ethinylestradiol—in 15 minutes.

Estrogenic activity was also diminished to a similar extent. Further research will evaluate Fe-B*’s efficacy on actual wastewater, in addition to more extensive evaluation of byproduct toxicities. Usefulness in wastewater treatment could be doubly beneficial, as Fe-B* has been reported to destroy harmful bacterial spores.

Regulatory apathy

Our municipal water and lakes, rivers and streams are unquestionably contaminated with residues of prescription and over-the-counter drugs. However, there is no national strategy to deal with them and no effective mandates to test, treat, limit or even advise the public. The government has also failed to set national standards for how much of any pharmaceutical is too much in waterways or taps. While recent research holds promise and educational programs are being put into place to address the problem and encourage the changing of consumers’ habits, there appears to be no regulatory firepower coming from the federal government. Several researchers, environmentalists, health professionals and water managers say it’s time for government to do more.

Not a CDC priority. According to Charles L. Green, spokesman at the National Center for Environmental Health of the Centers for Disease Control and Prevention, drugs in the environment are "not currently a priority."

Not an FDA priority. The Food and Drug Administration (FDA) is supposed to review the environmental impact of new drugs, but has never rejected one on this basis, according to Raanan Bloom, an FDA environmental officer. Most pharmaceuticals are excluded from environmental review on the basis of their presumed low concentrations in water.

EPA awaits more data. Even though residues of many types of prescription and over-the-counter drugs have been discovered in dozens of watersheds and drinking water systems nationwide, the EPA claims to be waiting for more survey data before considering action.

According to Suzanne Rudzinski, a manager at EPA’s Office of Water, the agency has little information "that goes into whether these substances are occurring in the environment...and at what level."

But even when the EPA claims to be taking action, very little is accomplished. The agency analyzed 287 pharmaceuticals for inclusion on a draft list of contaminants to be considered for regulation. Only one, nitroglycerin, a drug prescribed for heart problems, has been nominated. When asked to explain, an EPA spokesman admitted that the primary reason for inclusion was its use in making explosives (derived from parts per million diluted in water?).

Apparently the "War on Terror" is more important than the looming environmental holocaust.

Even though sales of pharmaceutical drugs are rising, treatment plants that filter sewage or drinking water are not required to remove drugs residues or even monitor for them.

The EPA has been asleep for far too long regarding its mandate to protect the nation’s water. It took a five-month investigation by The Associated Press that appeared as a three-part series in March 2008 in newspapers across the country for state governments to react.

Since the AP series revealed Chicago as being one of the largest cities that does not test its drinking water, Illinois Governor Rod Blagojevich ordered screening of his state’s waterways for pharmaceuticals.

However, the most disconcerting of responses came from the majority of bureaucrats around the country saying that although their city’s water supply hadn’t been tested for pharmaceuticals, there was no reason to be concerned. Consumers were reminded that traces of pharmaceuticals being reported nationwide are minute and the quality of their water exceeds all EPA water standards—standards easy to exceed considering the fact that the EPA does not impose any standards for drug residues in water.

Since synthetic pharmaceutical drugs and herbicides do not break down under natural biological processes, the problem will inevitably worsen until the public at large stops medicating themselves with drugs, starts growing their own food, and stops contributing to the poisoning of their water and food supply through the use of pesticides and herbicides