Bewley 1 Pharmaceuticals in the Water Supply

Pharmaceuticals in the American Water Supply Sam Bewley Santa Barbara City College COMM 235, Spring 2012 Professor Cameron Sublett March 5, 2012

Bewley 2 Pharmaceuticals in the Water Supply Pharmaceuticals in the United States Drinking Water It is a common expression that what you do not know cannot hurt you. This statement lets us take refuge in our ignorant bliss and continue our daily lives assuming we live in a safe nest provided by our federal and state governments. We assume that agencies such as the Food and Drug Administration (FDA), Federal Bureaucracy of Investigation (FBI), Environmental Protection Agency (EPA), and furthermore, control and eliminate threats to our health, safety and environment. As our societys technology becomes more advanced and as our population increases, we are vulnerable to new threats that had not posed a problem in previous years. Pharmaceutical drugs have been on the rise, and this trend does not seem to be slowing down. According to the National Center for Health Statistics, 48.3% of all Americans from 2007-2008 have used at least one prescription drug. One out of five children is on prescription medications while nine out of 10 elderly citizens use medications daily (2010). Pharmaceutical drugs have not only helped our life expectancy rates increase dramatically, they also effectively protect and help heal us from illness, injury and disease. Although pharmaceuticals are in no doubt a beneficial factor of our modern society, with new technology comes new threats. "It's often said that what you don't know won't hurt you, but when it comes to our drinking water, not knowing may have devastating health consequences," said Congressmen Edward Markey in a 2011, Government Accountability Office press release in September that year (Brad, 2011). In this official government press release, it is clearly stated that we are faced with yet another problem of a developed society, the problem of our pharmaceutical drugs becoming more prevalent in our countries drinking water. It is of majority public and government belief that our drinking water, when abiding by government regulatory standards, is safe for human ingestion. Due to recent scientific detection studies we have strong reason to believe that our current presumption may be inaccurate. The proposition of this essay is that pharmaceutical drugs are found in the United States water supply. In this following paper, I will give background to: (1) which sources of water will be

Bewley 3 Pharmaceuticals in the Water Supply discussed, (2) explain the standard procedures of delivering water to citizens homes and (3) explain the methods in which these pharmaceuticals find their way into our drinking water. I will then make it clear that (1) our water supply is indeed contaminated with pharmaceutical drugs, and (2) our current government standard of water purification is not sufficient in providing Americans with clean drinking water. There are multiple methods of delivery of water to the American public, depending on geographical location and the available raw water supplies around the area, and are all controlled by separate water districts. For example, The Goleta Water district supplies water from Goleta to Carpentaria, originating from Lake Cachuma, imported water, ground water, and recycled water. The water from Lake Cachuma is dammed and diverted through the San Ynez Mountains to the South Coast Conduit. This South Coast Conduit travels an approximate 24 miles along the coast delivering water to Santa Barbara country. Ground water is pumped from underground water basins and must abide by government regulated standards to be deemed safe for use. Recycled water is waste water which goes through treatment plants to rid the water of dangerous pathogens. This recycled water is often used to refill groundwater basins, as well as used for direct recharge of drinking water aquifers (Bachman, 2010). This is one example of a local water districts operations, but many other sources of water include divergence of river and stream water, which goes through similar processes. The problem with our drinking water cycle is that it all interconnects. For instance, waste water from households comes through waste water treatment plants (WWTP), which are output to landfills, agricultural land, and surface water. Landfills contaminate underground water basins, agricultural land produces run off into surface water sources, which combine with the excretory treated water which gets fed to drinking water treatment plants (DWTP). The public water cycle is all interconnected and although we have filtering and purification checkpoints, the cycle continues to bring new pathogens and contaminants to our drinking water supply (Jelic, Petrovic & Barcelo, 2012).

Bewley 4 Pharmaceuticals in the Water Supply Pharmaceuticals may enter the water supply through various points of entry. The main sources of pharmaceutical entry to be discussed are (1) waste water from households, industry and commercial facilities, (2) fertilizer and veterinary pharmaceuticals run-off, and (3) underground septic tanks and landfills (Trimble, 2011). Human used pharmaceuticals enter the environment in three ways: Excretion, sewage disposal, and landfill disposal. Once ingested, the excretion of extensively metabolized drugs comes back through urine and feces, and topical substances are washed off into household sewage drainage. When one is attempting to dispose of expired drugs, the recommended option is to return the drugs to the pharmacy for proper disposal, but alternative methods including flushing the medication or disposing them into landfills allow these disposed drugs to enter either (a) sewage which gets sent to waste water treatment plants (WWTP) or (b) gets directed to landfills which contaminate local groundwater (Jelic, Petrovic & Barcelo, 2012). According to an Associate Press investigation, U.S. manufactures, including major drug manufactures, have legally released at least two-hundred and seventy-one million pounds into waterways (Donn, Mendoza & Pritchard, 2009). The same investigation also found that an Ohio company, Boehringer Ingelheim Roxane Inc., discharged close to two-thousand two hundred and eighty-five pounds of lithium carbonate, used to produce bi-polar medication, to a local waste water treatment plant between 1995 and 2006 (Donn, en al., 2009). Veterinary Pharmaceuticals at an estimated 11.2 million kilograms of antibiotics are administered to animals for disease control. Large amounts of these pharmaceuticals are excreted and contribute to waste water runoff from manure as parent compounds or metabolites (Song, Ding, Chiou & Li, 2010). Possibly the most significant factor in groundwater contamination is underground basin penetration from landfills and underground septic tanks. Contamination seeps through soil with water as the medium, which penetrates into underground water basins. Since the water cycle is interconnected, the water pumped from water basins enters the cycle through wastewater treatment facilities, which redistributes the treated water.

Bewley 5 Pharmaceuticals in the Water Supply To further clarify and give insight to the pharmaceuticals in the water supply, the following section will be dedicated to the pharmaceuticals most commonly reported and found in the water supply. Pharmaceuticals are broken down into three different categories which the United States Geological Survey (USGS) uses to categorize the drugs they find in water: (1) nonprescription drugs, (2) prescription drugs, (3) veterinary and human antibiotics. The most commonly found non-prescription drugs, as reported by the USGS are cotinine (nicotine metabolite), 1, 7-dimethytxanthine (caffeine metabolite), acetaminophen (antipyrectic, commonly known as Tylenol), caffeine (stimulant), and Ibuprofen (anti-inflammatory) (Trimble, 2011). The most prevalent prescription drugs are carbamazepine (anticonvulsant), Diphenhydramine (antihistamine), Dehydronifedipine (metabolite of nifedipine, an antianginal), and Codeine (analgesic). Commonly occurring veterinary and human antibiotics are erythromycin-H20, enrofloxacin, and trimethoprim (Trimble, 2011). These are merely a handful of substances found in our water supply but are reported as the most prevalent. In order to proceed in establishing contentions supporting the proposition that pharmaceuticals are in our drinking water, definitions of crucial terms must be determined to encourage clarity and understanding of the situation. The initial claim that the prevalence of pharmaceutical drugs found in the United States water supply pose potential health risks for American citizens has several terms that could be considered subjective or debatable. These terms to be defined are (1) pharmaceuticals and (2) drinking water supply. Pharmaceutical, and/or drug, will be the term which represents any chemical or substance which is used intentionally to produce intended effects on human health or mental state when taken at the correct dosage determined by pharmacology experts. Examples of pharmaceuticals are ibuprofen, caffeine, acetaminophen, anticonvulsants, anti-depressants, analgesics, antibiotics, and any other human produced substance which provides change to human health or mental state, which would not have occurred without the use of the substance. Drinking water supply will be the term to represent any source of public water supply used for the benefit of society as method of personal

Bewley 6 Pharmaceuticals in the Water Supply hydration, crop irrigation, and any water used with the intention of being proved to humans for ingestion. This includes any surface water, treated water, groundwater and any source of water which is subject of, but not limited by, government regulation. After an overview of entry methods of pharmaceuticals into the water supply, water delivery methods, and a definition of key terms, it is essential to assess the extent of prevalence of these drugs in our water environments and examine methods of removal. Contentions to support the argument, acting as evidence towards the claim that pharmaceuticals have contaminated the drinking water of the United States are: (1) detectable amounts of pharmaceuticals found in the water supply and (2) proof that current government regulatory water treatment facilities do not effectively remove these pharmaceutical contaminates from the water supply. In 2001, the United States Geological Survey (USGS) conducted a study which collected water samples from 74 locations in 25 states and Puerto Rico. These locations ranged from providing one family with water, to providing over 8 million people. The study aimed to report the presence of 100 contaminants, 36 of which were pharmaceuticals. The USGS found that 53 of the 74 locations contained one or more pharmaceuticals present in the water supply (Trimble, 2011). An investigation by Associated Press in 2008 summarized their findings in easily comprehended terms. The investigation found that 56 pharmaceuticals such as medications for pain, infection, high cholesterol, asthma, epilepsy, mental illness, and heart condition were found in the public treated drinking water supply. Anti-epileptic and anti-anxiety medications were detected in a southern California water supply which supports 18.5 million people and sex hormones have been reported in San Franciscos drinking water (Donn, Mendoza & Pritchard, 2008). The USGS is the leading research group in the study of this issue of prevalence of pharmaceuticals, but other research groups have found results which coincide with those of the USGS. The National Water Research Institute tested for 50 contaminants in 126 samples taken from 32 locations from various point in three watersheds in California that provide water for 25 million

Bewley 7 Pharmaceuticals in the Water Supply Californians over a one year period from April 2008 to April 2009. The studys sample locations were both upstream as well as downstream from a wastewater treatment plant and showed that at least 1 contaminant was found in each of the 125 samples (Guox & Krasner, 2010). The majority of prior studies have focused on source water; more recent studies have begun focusing on treated drinking water. The American Water Works Association (AWWA) tested for 20 pharmaceuticals, as well as other contaminants, in 19 different drinking water treatment plants across the U.S., which in collaboration; provide drinking water for 28 million Americans. The study detected that every source of treated drinking water held at least 9 of the 20 pharmaceuticals tested for (Benotti, Trenholm, Vanderford, Holady, Standord & Snyder, 2009). The prevalence of pharmaceutical drugs in our source water and drinking water is near irrefutable. The waste water treatment plant (WWTP) and drinking water treatment plant (DWTP) processes our no doubt advanced and extremely effective at removing dangerous pathogens from our water. Although the removal of many dangerous substances provides us with water that meets government regulatory standards, this does not mean the water is safe from pharmaceutical contamination. This section is dedicated to the WWTP and DWTP processes, and proving these processes are not sufficient enough to eliminate potential risk regarding pharmaceutical presence in our water. The drinking water treatment process can be categorized into three different steps: (1) physical separation/adsorption, (2) chemical disinfection, and (3) physical disinfection. Physical separation and adsorption uses coagulation and flocculation methods to remove suspended solids and natural organic matter from source water. Substances such as copper, mercury, arsenic and fluoride are removed at this level of treatment. This process only resulted in a maximum removal of 20% of pharmaceuticals such as naproxen, ibuprofen, ketoprofen, and diclofenac. A very persistent pharmaceutical (anticonvulsant carbamazepine) was not affected by these processes (Jelic, Petrovic & Barcelo, 2012). The next step is chemical disinfection. This process aims to deactivate pathogenic microbes such as bacteria, algae, spores and viruses through

Bewley 8 Pharmaceuticals in the Water Supply oxidation. Chloride dioxide is a strong, effective oxidant used in this process. Chemicals used in this process have the ability to transform/remove some of the pharmaceuticals, but only 22 compounds out of 98 were effectively removed in this process, and still the risks of disinfection bi-products (DBPs) pose an equally significant threat (Jelic, et al, 2012). The third and final process is physical disinfection, which is mainly carried out through photo degradation by ultraviolet radiation. The typical low energy doses of UV radiation are ineffective for the removal of most target pharmaceutical compounds. Although higher doses of UV radiation can be more efficient, this increases the risk of inducing radicals into the water (Jelic, et al, 2012). After testing post-treatment water from DWTPs, one of the most studied and detected pharmaceuticals, anti-epileptic carbamazepine, has been found to have little to no degradation during treatment. Phenytoin (anti-epileptic), psycholeptic and meprobamate have also been detected in treated tap water. Out of the 19 U.S. DWTPs tested from 2006-2007, results showed that 13 of 15 distribution systems contained detectable concentrations of at least one major targeted compound. The only systems that showed no signs of detectable pharmaceutical concentrations had no direct input of wastewaters (Jelic, et al, 2012). All purification processes are effective in some way or another, but the treatment of pharmaceuticals poses new difficulties in the process. Pharmaceuticals have been designed to be biologically stable. The sorption depends not only on the type and properties of the organic contaminant, but the also the suspended solids. Even if the compounds targeted to remove are photoactive (susceptible to UV treatment) or easily oxidized, the risk of by-products are also of concern. No treatment is completely effective or able to completely purify water from pharmaceutical contaminants, but only multistep processes and physiochemical processes can provide better removal (Jelic, et al, 2012). The failure of our DWTP to provide Americans with pharmaceutical free water suggests that we are still exposed to these compounds and are vulnerable to potential risks associated with them.

Bewley 9 Pharmaceuticals in the Water Supply The following paper advocating the proposition that pharmaceutical drugs are found in the United States drinking water supply has done the following: given background to public water distribution, the most common pharmaceuticals detected in water supplies and presented the methods of entry of these pharmaceuticals into the water supply. I have also provided supported contentions that pharmaceuticals are indeed present in our water and that our current government regulated water treatment processes fail to remove these pharmaceuticals. With new technology comes new risk. The benefits of pharmaceuticals have in no doubt been large steps for humanity and our society, but risks posed by these steps need to be factored in to the big picture. The drugs which lurk in our drinking water introduce us to constant, long-term exposure to these pharmaceuticals, and like many inventions of modern technology, only time will tell the long-term effects of our rapidly developing society.

Bewley 10 Pharmaceuticals in the Water Supply Works Cited

Bachman, S. (2010). Groundwater Management Plan: Goleta Groundwater Basin. Goleta Water District Headquarters. Retrieved at http://www.goletawater.com/assets/documents/groundwatermanagement/Groundwater_Management_Plan_Final_05-11-10.pdf. Benotti, M.J., Trenholm, R.A., Vanderford, B.J., Holady, J.C., Stanford, B.D., and Snyder, S.A. (2009). Pharmaceuticals and Endocrine Disrupting Compounds in U.S. Drinking Water. Environmental Science and Technology, 43(3), 597-603.

BRAD, M. (2011). GAO ISSUES REPORT ON PHARMACEUTICALS IN U.S. DRINKING WATER. FDCH Press Releases. Retrieved from: http://libproxy.sbcc.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&d b=mth&AN=32X1713162535&site=ehost-live&scope=site. Donn, J., Mendoza, M., Pritchard, J. (2008, March 10). Pharmaceuticals lurking in U.S. drinking water. AP probe found traces of meds in water supplies of 41 million Americans. MSNBC. Retrieved from http://www.msnbc.msn.com/id/23503485/ns/health-health_care/t/pharmaceuticals-lurking-usdrinking-water/#.T0mVaPI8WmE on 2012, February 24. Donn, J., Mendoza, M., Pritchard, J. (20 April, 2009). US Water Contaminated by Pharmaceutical Companies, Hospitals, Consumers. Huff Post Green. Retrieved from http://www.huffingtonpost.com/2009/04/20/us-water-contaminated-by-_n_188852.html Fatta-Kassinos, D., Meric S., Nikolaou, A. (2010, July 30). Pharmaceutical Residues in Environmental Waters and Wastewater: Current State of Knowledge and Future Research. Analytical & Bioanalytical Chemistry, 399 (1), 251-275. Guox, C., Y., Krasner, S., W. (2010). Source, Fate, and Transport of Endocrine Disruptors, Pharmaceuticals, and Personal Care Products in Drinking Water Sources in California. National Water Research Institute, Fountain Valley, California. Jelic, A., Petrovic, M., Barcelo, D. (2012) Pharmaceuticals in Drinking Water. Emerging Organic Contaminants and Human Health, Handbook of Environmental Chemistry, DOI 10.1007/698_2011_133, # Springer-Verlag Berlin Heidelberg. National Center for Health Statistics.(2010). NCHS Data Brief, No. 42. Retrieved from ://www.webmd.com/news/20100902/prescription-drug-use-on-the-rise-in-the-u-s Reynolds, A. K., (2003, March). Pharmaceuticals in Drinking Water Supplies. Water Purification and Conditioning Magazine, 45. Retrieved from http://www.wcponline.com/NewsView.cfm?ID=2199. Royte, E. (2006, October 26). How Prescription Drugs Are Poisoning Our Waters: An aging population

Bewley 11 Pharmaceuticals in the Water Supply and our growing addiction to pharmaceuticals may have disastrous consequences for our water supply. OnEarth Magazine. Retrieved from http://www.alternet.org/environment/43242. Trimble, D. (2011, August). ENVIRONMENTAL HEALTH: Action Needed to Sustain Agencies Collaboration on Pharmaceuticals in Drinking Water. (GAO Publication Number 11-346) Song, W., Ding, Y., Chiou, C., Li, H. (2010). Selected Veterinary, Pharmaceuticals in Agricultural Water and Soil from Land Application of Animal Manure. Journal of Environmental Quality, 39(4). 1211-1217.