The steady ageing of Europe’s population will result in an increased consumption of medicines, which will consequently lead to higher concentrations of pharmaceutical residues in the aquatic environment and pose potential threats to public health, a new study has warned.
Uncertainty about the impact on human health calls for an urgent and comprehensive response. However, the European Commission is already behind schedule on planned actions on the issue.
A study by Civity Management Consultants, commissioned by the German association of energy and water industries (BDEW), predicted that consumption of medicines in Germany will rise by 70% in the next 30 years.
The study modelled future consumption levels based on trends of increasing per capita consumption of medicines, and an ageing German population (octogenarians consume 20 times more medicines than 20-year-olds).
According to the report, human medicines reach communal wastewaters relatively easily, through human excretion or improper disposal via the toilet or the drain, and from there spread into the aquatic environment.
The German water industry highlights that while further research into the environmental risks of medicinal drug residues is needed, several individual studies confirm the “damaging consequences of higher concentrations of the active ingredients of particular drugs on the health of individual animal species”.
“Although there is currently no danger to human drinking water, the rising quantities of medicinal drugs in circulation should prompt us to protect the aquatic living environment and raw water resources as a whole,” the report noted.
Moreover, a 2013 European Commission study pointed out there was a “substantial margin of safety” before current levels of concentration of pharmaceuticals could trigger adverse effects to human health.
However, it also recognised that the proxy levels used in the study were often lower than actual levels and that a number of uncertainties remain on how different pharmaceuticals interact with each other and what happens when people are exposed to low doses over a long period of time.
The Commission is running late
A directive on priority substances in water policy requires the European Commission to develop a strategic approach to water pollution by pharmaceuticals and to suggest measures (including mandatory initiatives) to reduce their release into the water.
However, the Commission is behind schedule: a consultation open to stakeholders was to have been launched earlier this year, in order for the Commission to come up with a plan by spring 2017, but this hasn’t happened and is not scheduled for the foreseeable future.
Contacted by EURACTIV, EU sources commented, “Work is underway towards finalising documents to launch the consultation.”
“[The delay] is about the revision of the Drinking Water Directive. Pharmaceuticals are an issue that is part of the revision of the Directive ongoing – but work had not been concluded and thus we cannot say more at this stage,” EU sources explained.
A holistic approach
Certain drugs have the same effects but are highly polluting, and not all pharmaceutical residues can be removed by “end-of-the-pipe” wastewater treatment. The German Association of Energy and Water Industries calls for a holistic approach involving all actors in the pharmaceutical chain- starting with drug companies.
Producers should increase the biodegradability of drugs and replace or reduce environmentally damaging components, as well as inform consumers of drugs’ environmental impacts on the boxes. Doctors should prescribe minimum doses and favour biodegradable drugs, while consumers should dispose of them by returning them to pharmacies rather than flushing them down the toilet, and reduce unnecessary self-medication.
Martin Weyand, head of water division at BDEW, told EURACTIV: “Our aim is to sensibilize the public and especially politics. The foreseeable increasing consumption could impact seriously our water resources and will certainly increase costs for the water industries. This could lead to higher prices for customers. This proves that the ‘end-of-pipe’ solution is not sustainable. Rather, we should be looking at implementing a source-control approach.”