In the right place, pharmaceuticals save lives and prevent disease, but it is well known that pharmaceuticals in the environment represent a global pollution problem – over 600 different pharmaceutical agents or their metabolites have been detected in 71 countries on all continents. They are already damaging the environment and in the long-term, they could cause widespread damage to human health. Humans, animals, and other organisms that are exposed to pharmaceuticals in water, soil, or by feeding on medicated animals can experience behavioural, physiological, and histological effects. Antibiotics in the environment can also propagate antibiotic-resistant pathogens.
Aside from manufacturing, two ways that pharmaceuticals enter the environment is through improper disposal (e.g. sinks and toilets) and through human excretion.
Each year in the UK alone, an estimated £300m (approximately €375m) worth of dispensed medicines go unused and are ultimately discarded.
Even when pharmaceuticals are consumed as prescribed, between 30-90% of an oral dose of medicine can be excreted as an active substance in urine and wastewater treatment plants are unable to completely filter out these residues. This means they can re-enter the water supply and spread to surface waters and agricultural lands and ultimately end up in drinking water, vegetables, and fish. We can therefore be unintentionally exposed to these residues by consuming contaminated water and food.
Doctors control the duration and dosage of individual prescriptions, and are well positioned to help reduce the risk for accumulation of unused pharmaceuticals that become waste and can end up in the environment.
HCWH Europe’s publication: How doctors can help reduce pharmaceutical pollution provides clear and simple ways that doctors can adapt their prescription practices and conversations with patients. This publication is now available in five languages on the HCWH Europe website: