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Retrospective environmental risk assessment of human pharmaceuticals in the Nordic countries 1997-2007

image of Retrospective environmental risk assessment of human pharmaceuticals in the Nordic countries 1997-2007

New pharmaceutical substances and formulations are constantly being introduced and marketed in the world, targeting an increasing number of human receptors. Consequently, the consumption of human pharmaceuticals has been rapidly increasing in the Nordic countries over the last decades. In the Nordic countries, a growing fraction of the population is the elderly. The increasing fraction of elderly people, having a higher propensity of getting several diseases and afflictions, will lead to even higher consumption of pharmaceuticals in the near future. The faith and possible effects of pharmaceutical residues, after they have been excretred from the patients taking them, has been attracting a growing interest whithin environmental scientific comunity. However, since there are over 1200 different active substances being sold as human pharmaceuticals on the Nordic market, it is very difficult for authorities and regulating bodies to prioritise among them and identify which substances that needs special attention (in terms of monitoring, adjustments in the waste water treatment plants, specific information or directives to prescribers). This report presents the predicted (i.e., calculated) environmental concentrations of the top-selling pharmaceuticals in the Nordic countries in retrospective (1997-2007), along with a calulated environmental risk associated. The authors elaborate on the data and identifie the pattern common to all Nordic countries.

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Ever increasing consumption of human pharmaceuticals?

The constant increase in medicines consumption, observed through the nineties, still continues in all Nordic countries (Figure 1). This can largely be attributed to the growing fraction of elderly people in the population, having a higher propensity of getting several diseases and afflictions. In all countries in Western Europe the share of elderly people in the population is increasing. According to new demographic studies, the total population in Western Europe gained its peak level in terms of number of inhabitants in 2005 and are now expected to decline, immigration not fully considered (UN, 1998). This is mainly due to the current fertility numbers within the EU attributed to a reproductive level below 2.1 children per fertile woman. In parallel with the decreased fertility, the average life expectancy within the EU has increased. The quotient between adults of working age (15-64 years) and the part of the population being older than 64 years has changed dramatically (the PSR, the Potential Support Ratio). In Sweden PSR has changed even more than the rest of the Nordic countries, and are expected to continue in that manner. According to Swedish statistics the number of people older than 65 years, which is high in Sweden today (> 17 % of the total population), will increase with 845 000 until the 2050, an increase of approximately 55 %, and then encompass 23-27 % of the total population (UN, 2000, SCB 2001a). Within this group, the group of people being older than 80 years will have increased by 100 % by 2050.

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