Home' Australian Pharmacist : Australian Pharmacist April 2015 Contents Australian Pharmacist April 2015 I ©Pharmaceutical Society of Australia Ltd.
APIs in the environment may occur
due to lack or inefficiency of treatment
facilities or inappropriate disposal
practices. A range of APIs has been
detected in different environmental
compartments over the years. Some of
these compounds (e.g. carbamazepine,
fluoxetine, fluroquinolones and
tetracycline antibiotics) may persist
in the environment. Consequently,
increasing attention is being placed
globally on the impacts of APIs that are
present in the environment.’
All of this is affecting the environment
and a range of studies has shown
marked impacts on fish and other
aquatic species, as well as birds.
The pollution is not just from
domestic waste. In a 2004‐09 study,
US Geological Survey scientists reported
facilities could be a significant source
of pharmaceuticals in the environment.
Effluents from two wastewater
treatment plants (WWTP) that received
discharge from pharmaceutical
manufacturing facilities had 10 to
1,000 times higher concentrations of
pharmaceuticals than effluents from
24 treatment plants across the nation
that did not receive WWTP discharge.
The effluents from these two WWTPs
were discharged to streams where the
measured pharmaceuticals were traced
downstream, and as far as 30 kilometres
from one plant’s outfall.
The Geological Survey surmised that:
‘ While pharmaceuticals have been
measured in many streams and aquifers
across the nation, levels are generally
lower than one part per billion (1 ppb).
Concerns persist, however, that higher
levels may occur in environmental
settings where wastewaters are released
to the environment.’
Researchers claim that the effect of
pharmaceuticals in water, particularly
fluoxetine (the main active ingredient in
Prozac), has resulted in fish changing sex
and their behaviour, like that of some
birds, being altered to make them more
susceptible to predators.
A great deal of research has been
undertaken internationally and Australia
is also looking at the issue with one
research project being headed by Mike
Grace, Associate Professor in School of
Chemistry at Monash University and
Director of the Water Studies Centre.
Professor Grace’s work is in its early
stages and he emphasises that:
‘We don’t distinguish between proper
and improper disposal or how the
pharmaceuticals got into the water, just
if they are there.
He said a number of international studies
had found quite adverse effects from a
range of pharmaceuticals but at much
higher concentrations than would
normally be found, except perhaps at the
outfall of a waste water treatment plant.
‘So we are interested in looking at
concentrations you would find in urban
waterways rather than what you would
find at outfalls of waste water treatment
plants,’ he said.
‘We are looking at fluoxetine because it’s
Professor Grace’s comments regarding
fluoxetine are backed by a report issued
by the British Environment Agency
which found traces of fluoxetine in the
nation’s drinking water.
The Observer newspaper reported the
agency found so many people were
taking the drug it was building up in
rivers and groundwater, entering the
rivers and water system via treated
The use of pharmaceuticals is rising with
increases in the human population and
the livestock it keeps. Environmental
exposure is also rising as sewage is
increasingly used to irrigate or fertilise
farmland. In the US, for example, about
4 million tonnes of dry sewage biosolids
are applied to land each year.
A recent report on prescribing
patterns of antidepressants and other
psychotropic medications in Australia
reported a 58.2% increase in the
dispensing of psychotropic drugs over
the period from 2000 to 2011, including
a 95.3% increase in antidepressants.
More than 10% of US citizens, or about
27 million people, used the drugs in
2005, according to a 2009 paper in the
journal Archives of General Psychiatry)
CSIRO’s Dr Kookana says that researchers
found Australia had a comparatively low
risk of pollution from pharmaceuticals,
but Kookana says there is still reason
‘Our population is ageing rapidly so
our reliance on pharmaceuticals is
increasing,’ he says.
‘We are trying to answer the question
“What pharmaceuticals are in our
waterways and in what concentrations?”
‘We are initially expecting the
pharmaceuticals you find in other
countries at about the same
concentrations. It’s a difficult analytical
chemical challenge to identify individual
compounds when you are talking
concentrations of parts per trillion.
‘ The more interesting question perhaps
is that if these chemicals are there at
these concentrations, are they having
any adverse environmental effects.’
‘It’s bit too early to give results but we
are looking at pharmaceuticals including
fluoxetine, diphenhydramine found in
anti‐histamines, caffeine, and several
rapidly so our
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