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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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Triclosan, a suitable risk assessment marker substance for pharmaceuticals?

Early on when planning for this investigation, the use of a nonpharmaceutical type of substance to compare calculated environmental risks with emerged. Ideally, such a substance should share the same dispersion pathway as pharmaceuticals have; from the consumer (the patient) through the sewage system- the waste water treatment plant to the receiving water recipients. One such emerging pollutant is triclosan. Triclosan (IUPAC name: 5-chloro-2-(2,4-dichlorophenoxy)phenol) is a potent wide spectrum antibacterial and antifungal agent. The main use of triclosan is in products such as toothpastes, soaps (0.15-0.30%), deodorants, shaving creams, mouth washes, and cleaning supplies. It has also been infused in an increasing number of consumer products, such as kitchen utensils, toys, bedding, socks, and trash bags. Triclosan has been shown to be effective in reducing and controlling bacterial contamination on the hands and on treated products. For instance, showering or bathing with 2% triclosan has become a recommended regimen for the decolonization of patients in the US whose skin is carrying methicillin resistant Staphylococcus aureus (MRSA) following the successful control of MRSA outbreaks in several clinical settings (Brady et al., 1990, Zafar et al., 1995).

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