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NACWA is pleased to announce the release of Pharmaceuticals in the Water Environment , an expert review paper commissioned by NACWA and the Association of Metropolitan Water Agencies (AMWA).  Through its Critical Issues Action Initiative, NACWA worked with AMWA to convene a group of seven of the top experts on the subject of pharmaceuticals in water to provide the associations with an independent review of the current data and information on the subject and a set of recommendations based on that review.  The paper represents the culmination of a year-long effort from the expert panel and will serve as a valuable tool for NACWA member agencies and NACWA’s advocacy efforts on the national level.

Background

The presence of pharmaceuticals in the nation’s waters and the discovery of physiological abnormalities in fish have spurred interest in the press and subsequently raised the awareness level of this issue with the public.  Congressional and federal agency attention has also increased.  Concentrations of these substances to date have been low and no evidence has been found of human health effects from pharmaceuticals in the environment.  However the presence of these substances over the long-term and the potential impacts on aquatic life in source waters warrant ongoing study.  Recognizing the importance of this issue, NACWA and AMWA convened the panel to review the existing information and provide a list of recommendations on the appropriate national response to this issue.

NACWA and AMWA selected panel members from key areas of expertise, including environmental and human health toxicology, water and wastewater treatment, water policy and analytical method development.  The panel was co-chaired by Dr. Shane Snyder, Research and Development Project Manager, Southern Nevada Water Authority and Dr. Cecil Lue-Hing, Former Director of Research for the Metropolitan Water Reclamation District of Greater Chicago and was comprised of:

• Joe Cotruvo: President, Joseph Cotruvo & Associates LLC, Washington, DC.

• Jorg E. Drewes: Professor and Director, Advanced Water Technology Center (AQWATEC), Colorado School of Mines, Golden, Colorado.

• Andrew Eaton: Laboratory Technical Director, MWH Laboratories, Monrovia, California.

• Richard C. Pleus: Managing Director, Intertox, Inc., Seattle, Washington

• Dan Schlenk: Professor, Department of Environmental Sciences, University of California, Riverside, California.

The panel held three in-person meetings.  One took place in Washington D.C., and two in Henderson, Nevada.  Several teleconferences also were held.  Experts from the pharmaceutical manufacturing industry, the U.S. Environmental Protection Agency, and the U.S. Geological Society briefed the panel on the latest information on the subject and provided valuable insight for the final recommendations.

More Data Needed before Regulations Should Be Considered

The paper provides an excellent summary of the issues the panel discussed, including the potential for human health and ecological impacts, important sources and options for source control, treatment options available and barriers to their use, and a careful examination of the need for additional work on analytical methods. 
The panel’s overarching recommendation was that due to “uncertainties in occurrence and toxicity databases, more data are needed before meaningful, human and ecological health-based federal criteria and regulations should be considered.”  The panel provided a list of detailed recommendations (below) of the types of information that would be needed before Clean Water Act water quality criteria or federal drinking water standards could be considered.
 

• A prioritization scheme should be developed to identify pharmaceuticals of greatest concern based upon key influencing factors, including the volume of the pharmaceutical produced, potency, and fate.

• Standardized analytical methods, with sufficient sensitivity and reliability, are needed to generate national occurrence data to fully assess the magnitude and prevalence of prioritized pharmaceuticals in drinking and waste water.

• A national occurrence study that encompasses diverse watersheds (e.g., pristine versus impacted) is needed.

• More studies exploring the toxicodynamics (e.g., mode of action) and toxicokinetics (e.g., accumulation) of pharmaceutical agents in fish and wildlife are necessary to better understand the risk to biota of individual compounds as well as mixtures.

• More population-based studies are necessary at environmentally relevant concentrations to address ecological impacts.

• Since pharmaceuticals undergo mandated clinical trials and are generally subject to follow-on monitoring studies in patients, the body of knowledge of human toxicity and other adverse effects from exposure to pharmaceuticals is far greater than for other environmental contaminants (i.e., pesticides, disinfection byproducts, etc.). However, more data are necessary to properly address the potential for interactions from mixtures of pharmaceuticals and for long-term chronic exposure.

• More research is needed to develop rapid, accurate, cost-effective toxicological screening tools (e.g., risk assessment and/or experimental assays).

• More research is needed to determine whether, and if so, how new generations of pharmaceuticals can be evaluated using standard toxicological procedures (e.g., nano-pharmaceuticals).

• Studies should be conducted to determine if reductions of pharmaceuticals used in nontherapeutic applications in animal husbandry will significantly reduce environmental loading.

• Source control, such as disposal of unused pharmaceuticals (domestic and industrial), should follow best-management recommendations to minimize environmental exposure.

• Water treatment goals that define levels of pharmaceuticals in final water quality should be based on human and ecological health endpoints, not simply on detection alone.

• Monitoring strategies using surrogates are needed that can assure proper performance of treatment processes selected to remove pharmaceuticals.

• Communication to the public should be open, transparent, accurate and understandable.

NACWA Next Steps

In addition to distributing the paper to the membership, NACWA will be sharing it with key EPA and Congressional staff who are working on this issue.  The paper will serve as a key tool for any NACWA advocacy efforts on this issue going forward and will help inform ongoing and future research to ensure decision-makers have enough information before considering regulatory options.