Reader's Response (Draft 4)

In the article "Pharmaceutical Disposal", Burch (2015) discussed the rising concern of water pollution in United States due to the improper ways of drug disposal. In addition, Burch also mentioned the act of "flushing unwanted or unused medications" as a factor due to common practices and absence of drug filtration in "wastewater treatment plants". Although the effect on humans is unclear, the negative effect on "fish and aquatic life" has been proven. However, the severity of the issue is still uncertain due to the lack of regulations and/or policies in place. The author states that the problem of “flushing drugs” might be resolved by providing "access to safe and convenient pharmaceutical disposal options".

I agree with the author that improper disposal of pharmaceutical products is indeed a rising concern as a factor of water contamination. However, the author focused on it as a key issue and did not explore other contributing factors. I believe that there are contaminants from other sources which would require more recognition.

It is certainly true that improper disposal of pharmaceutical products is one of the factors contributing to water contamination, even in drinking supplies.  However, the article only considered "pharmaceutical disposal" by public and healthcare facilities. It did not include those of industrial waste even though a significant amount of waste enters the Great Lakes daily. For example, Bienkowski and Environmental Health News (2013) reported that "More than 1,400 wastewater treatment plants in the United States and Canada discharge 4.8 billion gallons of treated effluent into the Great Lakes basin every day" when they discussed about the findings of a study conducted by the International Joint Commission. In addition to the figures reported, the drug content from the waste will also accumulate in the water over time. Therefore, there is a need to recognize industrial waste as one of the contributing factors of water contamination.

In the article, adverse effects on the aquatic life were also mentioned. According to Shah (2010), toxicity research on wildlife is generally studied on aquatic species. However, I feel that we should also explore the chain effect in the other areas. There are no proper definitions as to which type of species or organisms in the ecosystem would provide an accurate representation of wildlife, since all of them have different behaviour patterns, anatomy etc. As mentioned by Kidd et al. (2014), "small-scale studies focusing solely on direct effects are likely to underestimate the true environmental impacts". Even though the negative effects on the aquatic life are proven, I feel that it should only serve as an indicator and reference while we continue to research the effects on the ecosystem. The sole inclusion of the impact on aquatic life with no elaboration does not reflect the severity and extent of the effects and does not inform the community of it. 

In the article, Burch also mentioned that "a critical part of the solution is to STOP flushing drugs" because it is a "highly prevalent and preventable source of pharmaceutical pollution." There is no doubt that it is a valid point. However, the proposed solution failed to consider involuntary factors such as pollution due to excretion and usage of personal care products. Medicines taken are not always metabolized fully and are usually excreted out of the human body. In addition, topical medications and care products applied are also introduced into the waste through bathing. Daughton and Ruhoy (2013) also mentioned that "excretion via urine and fecal material" is the main contributor of "Active Pharmaceutical Ingredients (APIs)" contamination found in the environment. Perhaps it would be more effective to advisce pharmacists, and other relevant medical positions, on the reduction or optimal prescribing of medicines to patients instead. There would be lesser residual medications being excreted, which would then serve as a plausible solution in reducing contamination via the involuntary secondary route. In addition, an alternative solution would be to research on ways to improve our current infrastructure. For example, researching on systems which will allow wastewater treatment plants to remove unwanted pharmaceutical impurities, or methods which will simplify the manufacturing process. 

Legislation was mentioned as a counter measure in the article. It is worth noting that even though the United States Environmental Protection Agency (EPA) regulates water pollutants with The Clean Water Act (CWA), the list does not include medicinal products (Cuevas, 2011). Perhaps improvements should be made to the regulation. Even though pharmaceutical products serve as a remedy to illness, they can also become an undesired toxin. In comparison to United States, there is stricter control in Singapore. Pollution control is regulated under the authority of the National Environmental Agency (NEA). Different factors are considered and cross-referenced as a whole, for example, the control of soil pollution is considered with the regulation of water pollution. In addition, NEA considers pharmaceutical and pathogenic wastes under their "list of toxic industrial wastes", along with many others.

In general, this article served well as a general introduction to water pollution by pharmaceutical factors. It included the main idea of contamination due to direct disposal, though it lacked insight into other factors beside the given point. Although it was sufficient to inform the public of the dangers by improper “pharmaceutical disposal”, the page could be build up with information of other relevant factors.

References:

Bienkowski, B., & Environmental Health News (2013, November 22). Only half of drugs removed by sewage treatment. Scientific American. Retrieved from: http://www.scientificamerican.com/article/only-half-of-drugs-removed-by-sewage-treatment/

Burch, L.W. (2015, March 4). Pharmaceutical disposal. Citizens Campaign for the Environment. Retrieved from: http://www.citizenscampaign.org/campaigns/pharmaceutical-disposal.asp

Cuevas, G. (2011, February 8) From therapeutic drugs to toxic contaminants: Pharmaceutical pollution in the water and strategies to regulate its impact. Columbia Journal of Environmental Law. Retrieved from: http://www.columbiaenvironmentallaw.org/articles/from-therapeutic-drugs-to-toxic-contaminants-pharmaceutical-pollution-in-the-water-and-strategies-to-regulate-its-impact

Daughton, C.G., & Ruhoy, I.S. (2013, January 15) Lower-dose prescribing: Minimizing “side effects” of pharmaceuticals on society and the environment. Science of The Total Environment, 443, p324–337. Retrieved from: http://www.sciencedirect.com/science/article/pii/S0048969712013927

Kidd, K.A., Paterson, M.J., Rennie, M.D., Podemski, C.L., Findlay, D.L., Blanchfield, P.J., & Liber, K. (2014, October 13). Direct and indirect responses of a freshwater food web to a potent synthetic oestrogen. Philosophical Transactions of the Royal Society, B 2014 369 20130578; DOI: 10.1098/rstb.2013.0578. Retrieved from: http://rstb.royalsocietypublishing.org/content/369/1656/20130578

National Environmental Agency. (n.d.) The Schedule. Retrieved from: http://www.nea.gov.sg/docs/default-source/anti-pollution-radiation-protection/soil-pollution/20100505422108755681.pdf?sfvrsn=2

Shah S. (2010, April 15) As pharmaceutical use soars, drugs taint water and wildlife. Yale Environment 360. Retrieved from: http://e360.yale.edu/feature/as_pharmaceutical_use_soars_drugs_taint_water_and_wildlife/2263/