Bathing and showering: Under-appreciated sources of water pollution from medicines

[OKIsItJustMe]

http://portal.acs.org/portal/PublicWebSite/pressroom/newsreleases/CNBP_024343

March 24, 2010

Bathing and showering: Under-appreciated sources of water pollution from medicines

SAN FRANCISCO, March 24, 2010 — That bracing morning shower and soothing bedtime soak in the tub are potentially important but until now unrecognized sources of the hormones, antibiotics, and other pharmaceuticals that pollute the environment, scientists reported here today at the 239th National Meeting of the American Chemical Society. The first-ever evaluation they said, could lead to new ways to control environmental pollution from active pharmaceutical ingredients (APIs), which has been the source of growing concern.

Ilene Ruhoy, M.D., Ph.D., who co-authored the study, said that scientists have long known that bathrooms are a portal for release of APIs into the environment. An active ingredient in a pill is the medicine, usually combined with binders to hold the pill together, stabilizers, and other inactive ingredients. However, scientists and pollution control officials assumed that toilets were the main culprit, with APIs excreted in urine and feces and flushed into sewers and sewage treatment plants. APIs may go right through the disinfection process at those plants, and enter lakes, rivers, and oceans. Some also end up in the environment when people flush unused drugs down the toilet. Scientists have found traces of the active ingredients of birth control pills, antidepressants, and scores of other drugs in waterways. Some end up in drinking water – at extremely low, trace levels.

“We’ve long assumed that the active ingredients from medications enter the environment primarily as a result of their excretion via urine and feces,” said Dr. Ruhoy. She directs the Institute for Environmental Medicine at Touro University in Henderson, Nev., and did the research with Christian Daughton, Ph.D., of the U.S. Environmental Protection Agency’s National Exposure Research Laboratory in Las Vegas. “However, for the first time, we have identified potential alternative routes for the entry into the environment by way of bathing, showering, and laundering. These routes may be important for certain APIs found in medications that are applied topically, which means to the skin. They include creams, lotions, ointments, gels, and skin patches.”

Ruhoy and Daughton identified this potential new source of APIs through a comprehensive review of hundreds of scientific studies on the metabolism and use of medications. They focused on APIs in medications that are applied to the skin or excreted from the body via sweat glands. These two sources can result in residues being washed off the body and down bathroom drains. These include steroids (such as cortisone and testosterone), acne medicine, antimicrobials, narcotics, and other substances.

Another previously unrecognized route by which APIs may reach the environment includes perspiration (many APIs are released in sweat) and laundering of clothing that has come into contact with topical medications from their dermal application or from sweating.

Ruhoy explained that some APIs in topical medications enter the environment in a form that has the potential for having greater impact than those released in feces and urine. While some medications are excreted substantially unchanged, and therefore enter the environment as the parent compound, other APIs, prior to excretion from the body, are largely metabolized, or broken down, in the liver and kidneys.

“Topical APIs, from bathing and showering, however, are released unmetabolized and intact, in their full-strength form,” Ruhoy said. “Therefore, their potential as a source of pharmaceutical residues in the environment is increased.”

Ruhoy cited steps by which consumers can reduce the potential environmental impact of these skin-based pharmaceuticals by following directions and applying only the recommended amount, rather than thinking that “if a little is good, more must be better.” Doctors can help by prescribing the lowest possible dose for the shortest period of time necessary. Scientists should continue efforts to develop better drug delivery systems for topical medications so that APIs, for instance, are absorbed faster and more completely, she said. Design of dermal patches so that less API residue remains after use would be particularly helpful in reducing accidental poisonings from carelessly discarded patches and the quantities of APIs flushed down toilets.

“We need to be more aware of how our use of pharmaceuticals can have unwanted environmental effects,” Ruhoy said. “Identifying the major pathways in which APIs enter the environment is an important step toward the goal of minimizing their environmental impact.”

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[NNadir]

1. One Possible Factor Is Better Analytical Methods.

With LC/MS/MS it is now possible to detect API's and metabolites at concentrations of picograms/ml.

Some columns are loaded with femtograms of material, and coupled with solid phase extraction and other methods, one can see extraordinarily low concentrations.

I suspect that API's have long been present, along with metabolites, but were not recognized as such.

[Xipe Totec]

4. A more appropriate way to define concentrations

is parts per million, or parts per billion, etc..

After all, a femtogram of poison in a femtogram of material, is still 100% poison.

Lets assume that a substance can be detected in water in parts per billion (1.0E9).

There are 307 million Americans, each consuming about 70 gallons of water per day.

That's about 7.8E12 gallons annually.

If there is a substance disolved in this water at a concentration of one part per billion, then there are 7.8E3 gallons of the substance released into the water annually.

That's 7,800 gallons of the pure substance released every year.

[NNadir]

5. I actually disagree with this. Selenium is a fairly toxic element, however selenocysteine

is known to be essential to several important biological processes, notably in the glutathione peroxidase system important to most eucaryotic species, including human beings.

One issue with a selenium deficiency is an increased risk of cancer.

Therefore it cannot be said that selenium is 100% poison at a femtogram level, although clearly it is a the milligram level and above.

Copper can be, and is used as a herbicide, and yet many important enzymes in both plant and animal systems involve copper.

The assmuption of linear response curves is not nearly as justifiable as people think they are.

[Xipe Totec]

6. Selenium is poisonous at the femtogram per gram level

A gram of selenium dissolved in the ocean is harmless.

It's the relative quantity, not the absolute quantity that matters.

[NNadir]

7. So let me see if I understand this. All species with glutathione peroxidase don't exist?

Let me see if I can make this any clearer.

Most higher organisms wouldn't exist without selenium at a femtogram level. Thus it is explicitly NOT poisonous at a femtogram level. On the contrary it is essential.

I can't see how this could be any clearer.

In fact, a cursory search suggests that nanoselenium deprivation is toxic to goat semen:

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T43-4XHM17R-1&_user=10&_coverDate=04%2F30%2F2010&_alid=1268468625&_rdoc=2&_fmt=high&_orig=search&_cdi=4963&_sort=d&_docanchor=&view=c&_ct=573&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=8dbb087f8ddd1f88da15fca4c83f391c">Toxic Goat Semen?

Now, it happens that there are many places in the world where there is too much selenium, leading to the incorporation of selenium methionine and selenium cysteine into tissues where they cause problems in protein structure, but the claim that "selenium is poisonous at the femtogram per gram level" is, um, ridiculous, since clearly life depends upon having, in some cases, millions of femtograms of selenium to exist at all and will thus die without it.

The linear hypothesis for selenium toxicity is garbage, period, since life evolved in such a way as to not only safely metabolize it, but to require it.

Sheesh.

[Xipe Totec]

8. Clearly, you do not understand the concept of concentrations

You keep repeating femtogram as it it was some kind of magical incantation.

Concentrations are expressed as ratios, not raw weights.

If you don't understand that basic concept, we cannot carry on a conversation.

[DesertFlower]

2. we have our own well.

it's more than 800 feet deep. it's nice to not have chlorine and fluoride in the water.

supposedly the chlorine vapors are dangerous.

[OKIsItJustMe]

3. Chlorine gas was used for chemical warfare in World War I

Of course it was in much greater concentrations than you will encounter, drawing a glass of water from the tap.

Still, I don't care much for chlorine (or its by-products) in my drinking water.

I also don't care for fluoride in my drinking water.
http://www.nap.edu/catalog.php?record_id=11571