Abstract
There has been increasing concern of late over measurable levels of pharmaceutical contaminants in drinking water. Because most data on water contaminants pertains to aquatic organisms, we wished to assess the risk of these contaminants to human health at currently reported levels. Unlike most other chemicals, there are large amounts of information for the effects of most pharmaceuticals to humans and the current model uses the clinical dose required to cause biological effects as an endpoint to assess risks for pregnant women, children, and the healthy adult population. Twenty-six drugs have been detected in water systems worldwide: 7 in drinking water, 16 in ground water and post-treatment effluent, and 3 in both. Current water treatment practices, clearly, do not always remove pharmaceutical residues. Although healthy adults are unlikely to be adversely affected at the levels of exposure reported, children were shown to have up to eightfold higher risk and may be exposed to several drugs that are contraindicated or not established for safe use in pediatric medicine. The time taken to ingest a single clinically used dose was 3.4–34,000 years. In addition, pregnant women may be exposed to several drugs that are teratogenic (range of % single doses ingested over 36 weeks was 0.0006–12.6%) and in the post-natal period to drugs that are not recommended during breastfeeding. Albeit at low levels, the exposure of pregnant women and children to contraindicated drugs through drinking water is of concern. Further research in this area should focus on integrated ecological and human health consequences of long-term, low-level exposure to pharmaceutical contaminants, particularly in pregnancy and childhood.
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References
Aherne G, Briggs R (1989) The relevance of the presence of certain synthetic steroids in the aquatic environment. Journal of Pharmacy and Pharmacology 41:735–736
Aherne G, English J, Marks V (1985) The role of immunoassay in the analysis of microcontaminants in river samples. Ecotoxicology and Environmental Safety 9:79–83
Aherne G, Hardcastle H, Nield A (1990) Cytotoxic drugs and the aquatic environment: estimation of bleomycin in river and water samples. Journal of Pharmacy and Pharmacology 42:741–742
Briggs G, Freeman R, Yaffe S (2005) Drugs in Pregnancy and Lactation, Philadelphia: Lippincott Williams & Wilkins
Brunton LL, Lazo JS, Parke KL (2006) Goodman and Gilman’s Pharmacological Basis of Therapeutics, New York: McGraw-Hill Professional
Daughton C (2001) Pharmaceuticals in the environment: overarching issues and overview. In: Daughton CG, Jones-Lepp T (editors) Pharmaceuticals and Personal Care Products in the Environment: Scientific and Regulatory Issues, Symposium series 791. Columbus, OH: ACS pp 2–38
Halling-Sorensen B, Nielsen SN, Lanzky P, Ingerslev F, Lutzheft H, Jorgensen S (1998) Occurrence, fate and effects of pharmaceutical substances in the environment: a review. Chemosphere 36:357–393
Hayes T, Collins A, Lee M, Mendoza M, Noriega N, Stuart A, et al. (2002) Hermaphroditic, demasculinized frogs after exposure to the herbicide atrazine at low ecologically relevant doses. Proceedings of the National Academy of Sciences 99:5476–5480
Heberer T, Stan H (1996) Occurrence of polar organic contaminants in Berlin drinking water [in German; abstract in English]. Vom Wasser 86:19–31
Holm J, Rugge K, Bjerg P, Christensen T (1995) Occurrence and distribution of pharmaceutical organic compounds in the groundwater downgradient of a landfill (Grindsted, Denmark). Environmental Science and Technology 29:1415–1420
Jones O, Lester J, Voulvoulis N (2005) Pharmaceuticals: a threat to drinking water? Trends in Biotechnology 23:163–167
Lam L, Leung D (1988) More on simplified calculation of body-surface area [letter]. New England Journal of Medicine 318:1130
Mahler R, Simmons R, Sorensen F, Miner J (2004) Priority water issues in the Pacific Northwest. Journal of Extension 42
Martindale JEF Reynolds (1996) Martindale’s Extra Pharmacopoeia, London: The Pharmaceutical Press
National Center for Health Statistics and CDC (2000a) 2 to 20 Years: Boys Stature-for-Age and Weight-for-Age Percentiles, Atlanta, GA: Centers for Disease Control, Atlanta, GA
National Center for Health Statistics and CDC (2000b) 2 to 20 Years: Girls Stature-for-Age and Weight-for-Age Percentiles, Atlanta, GA: Centers for Disease Control, Atlanta, GA
Richardson M, Bowron J (1985) The fate of pharmaceuticals in the aquatic environment—a review. Journal of Pharmacy and Pharmacology 37:1–12
Stackelberg P, Furlong E, Meyer M, Zaugg S, Henderson A, Reissman D (2004) Persistence of pharmaceutical compounds and other organic wastewater contaminants in a conventional drinking-water-treatment plant. Science of the Total Environment 329:99–113
Steger-Hartmann T, Kummerer K, Schecker J (1996) Trace analysis of the antineoplastics ifosfamide and cyclophosphamide in sewage water by two-step solid-phase extraction and gas chromatography-mass spectrometry. Journal of Chromatography A 726
Tauber R (2003) Quantitative Analysis of Pharmaceuticals in Drinking Water from Ten Canadian Cities, Waterloo, Ontario, Canada: Xeno-test division, Enviro-Test Laboratories
Ternes T (2001) Pharmaceuticals and metabolites as contaminators of the aquatic environment. In: Daughton CG, Jones-Lepp T (editors) Pharmaceuticals and Personal Care Products in the Environment: Scientific and Regulatory Issues, Symposium series 791. Columbus, OH: ACS, p 39–54
Thomson I (2006) The Physicians Desk Reference, Montvale, NJ: Thomson PDR
Villanueva C, Durand G, Coutte M, Chevrier C, Cordier S (2005) Atrazine in municipal drinking water and risk of low birth weight, preterm delivery, and small-for-gestational-age status. Occupational and Environmental Medicine 62:400–405
Webb S, Ternes T, Gibert M, Olejniczak K (2003) Indirect human exposure to pharmaceuticals via drinking water. Toxicology Letters 142:157–167
Westerhoff P, Yoon Y, Snyder S, Wert E (2005) Fate of endocrine disruptor pharmaceutical, and personal care product chemicals during simulated drinking water treatment processes. Environmental Science and Technology 39:6649–6663
Zuccato E, Calamari D, Natangelo M, Fanelli R (2000) Presence of therapeutic drugs in the environment. Lancet 355:1789–1790
Zuhlke S, Dunnbier U, Heberer T (2004) Detection and identification of phenazone-type drugs and their microbial metabolites in ground and drinking water applying solid-phase extraction and gas chromatography with mass spectrometric detection. Journal of Chromatography A 1050:201–209
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This work was assisted by a grant from the Dean’s Office at the John A. Burns School of Medicine.
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Collier, A.C. Pharmaceutical Contaminants in Potable Water: Potential Concerns for Pregnant Women and Children. EcoHealth 4, 164–171 (2007). https://doi.org/10.1007/s10393-007-0105-5
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DOI: https://doi.org/10.1007/s10393-007-0105-5