Chemical contamination of our waterways

The prescribing of a medicine is the most common intervention in the NHS. It is used to diagnose, cure, treat and prevent disease with an annual spend of greater than £20 billion per year.

The use of medicines is increasing. In Scotland the use of medicines has increased by 40% over the last 50 years. This is due to:

• A growing population
• An older population
• A ’pill for every ill’ culture. We live in a consumerist society and the taking of medicine has become part of this consumerism. People turn to medicine for every complaint they have.
• Increase in waste
• Technological advances, for example medicines that cure disease including conditions that we could never treat before, such as Hepatitis C and HIV.

The Problem

Medicines are made to have a pharmacological effect at very small doses and they will have that effect in the right body with the right receptor. This applies to humans, animals and aquatic life.

• Whenever we take a medicine about 30 to 100% ends up in human excrement, down the toilet and into our wastewater treatment plants.
• Those treatment plants were never designed to remove small complex chemical molecules. They were designed to remove larger biological solids.

What do we know!

• 90% of the pollution we find in our rivers/environments is from medicines.
• 5% comes from people dumping them down the toilet as they think it is a safe place to get rid of medicine they do not want/need.
• 5% from pharmaceutical manufacturing processes

In 2022 Wilkinson et al published a paper looking globally at the pharmaceutical pollution of rivers.

They looked at every single continent, across 1052 sites, 258 rivers and 104 countries, and analysed for 61 pharmaceuticals

They found:

• pharmaceutical contamination all over the world. This is a global problem!.
• the most common drugs and in high concentrations were analgesics, antibiotics and anticonvulsants
• Most worryingly they found threat to environment and/or human health in greater than 25% of the waterways they analysed

There are many papers on the toxic effects of Diclofenac, Ibuprofen and Paracetamol, and you can read more about them via the links.

Paracetamol is the most prescribed drug in the world and it is acutely toxic to every species in the aquatic world.

Pharmaceutical contamination is concerning. It is affecting the reproduction, growth and behaviour of aquatic life

• There is also evidence of pharmaceutical contamination in waste water effluent. Effluent is the water that has already been treated.
• Pharmaceutical residues are also found in sewage sludge which is used as fertiliser. Active pharmaceutical compounds can be released from fertilisers and gets into the human food chain. There is evidence of vegetables like lettuce and soya and potatoes all having pharmaceutical contamination.

BUT, the biggest concern is the increase in antimicrobial resistance (AMR). Do carry onto the next step to find out more.