Environmental Effects of Human Pharmaceuticals
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Environmental Effects of Human Pharmaceuticals
John Phillip Sumpter, BSc, PhD, DSc Professor of Aquatic Ecotoxicology, Institute for the Environment, Brunel University, Uxbridge, Middlesex, UK
Key Words Ecotoxicology; Ethinyl estradiol; Diclofenac; Adverse effects; Aquatic environment Correspondence Address Professor John Sumpter, Institute for the Environment, Brunel University, Uxbridge, Middlesex, UB8 3PH, UK (e-mail: [email protected]). Research in the author’s laboratory is supported by the European Union, NERC, DEFRA, AstraZeneca, and Pfizer. This article was presented at the joint DIA/HESI/SAPS Conference on Environmental Assessment of Human Medicines, held in Stockholm, Sweden, May 22–23, 2006.
In the last few years, it has been demonstrated that many human pharmaceuticals are present in the aquatic environment, albeit at very low concentrations. Nevertheless, in at least one case, that of ethinyl estradiol, it is very likely that in some locations ethinyl estradiol is adversely affecting fish through its “feminization” of males. Another pharmaceutical, diclofenac, has caused the deaths of millions of vultures in Southeast Asia through its use in veterinary medicine. Those examples have highlighted our lack of understanding of fate, behavior, and effects of pharmaceuticals once they reach the environment. It is unclear presently whether these are isolated examples or whether there is a more
INTRODUCTION There is now no doubt that many human pharmaceuticals (and probably also their metabolites) are present in effluents of sewage treatment works (STW; see article in this issue by Williams and Cook). Concentrations generally seem to be in the nanogramper-liter range, with perhaps a few present at very low microgram-per-liter concentrations. There will be dilution of the STW effluent in the receiving water (usually a river) and further degradation, such that aquatic organisms will be exposed to very low concentrations. Is it conceivable that such low concentrations could cause effects in exposed wildlife (such as fish), and if they did, what effects are likely, and what might be the consequences of any of these effects? Only when we have answers to these questions will it be possible to gauge how serious, or not, the issue of pharmaceuticals in the environment actually is. Currently, it is my opinion that, for most pharmaceuticals, we are a long way from having the answers we require, and hence it is not possible to conduct meaningful environmental risk assessments for most pharmaceuticals in use today.
general problem. If wildlife are to be protected from the effects of current and new pharmaceuticals, then our knowledge and understanding of this issue need to improve substantially. The recent European Medicines Agency guidelines covering the environmental risk assessment of human pharmaceuticals are a step in the right direction, but a more sophisticated approach, rather than a “one-fits-all” solution, is probably needed. Recent collaboration between industry scientists and academic ecotoxic
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