Sludge Watch ==> Drugs in the Drinking Water

[Maureen Reilly]

DRUGS IN DRINKING WATER


Remember, that with hormones and
hormone-mimicking compounds small doses may be
more dangerous than large because of the way the
bioactive chemical and the cells interact.  Then
there are the x-way synergisms....


http://ap.google.com/article/ALeqM5hGsoyElv4ZL879LW6z2aZS0Pix7AD8VA14500




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AP Probe Finds Drugs in Drinking Water


By JEFF DONN, MARTHA MENDOZA and JUSTIN PRITCHARD ­ 1 day ago


A vast array of pharmaceuticals — including
antibiotics, anti-convulsants, mood stabilizers
and sex hormones — have been found in the
drinking water supplies of at least 41 million
Americans, an Associated Press investigation shows.


To be sure, the concentrations of these
pharmaceuticals are tiny, measured in quantities
of parts per billion or trillion, far below the
levels of a medical dose. Also, utilities insist their water is safe.


But the presence of so many prescription drugs —
and over-the-counter medicines like acetaminophen
and ibuprofen — in so much of our drinking water
is heightening worries among scientists of
long-term consequences to human health.


In the course of a five-month inquiry, the AP
discovered that drugs have been detected in the
drinking water supplies of 24 major metropolitan
areas — from Southern California to Northern New
Jersey, from Detroit to Louisville, Ky.


Water providers rarely disclose results of
pharmaceutical screenings, unless pressed, the AP
found. For example, the head of a group
representing major California suppliers said the
public "doesn't know how to interpret the
information" and might be unduly alarmed.


How do the drugs get into the water?


People take pills. Their bodies absorb some of
the medication, but the rest of it passes through
and is flushed down the toilet. The wastewater is
treated before it is discharged into reservoirs,
rivers or lakes. Then, some of the water is
cleansed again at drinking water treatment plants
and piped to consumers. But most treatments do not remove all drug residue.


And while researchers do not yet understand the
exact risks from decades of persistent exposure
to random combinations of low levels of
pharmaceuticals, recent studies — which have gone
virtually unnoticed by the general public — have
found alarming effects on human cells and wildlife.


"We recognize it is a growing concern and we're
taking it very seriously," said Benjamin H.
Grumbles, assistant administrator for water at
the U.S. Environmental Protection Agency.


Members of the AP National Investigative Team
reviewed hundreds of scientific reports, analyzed
federal drinking water databases, visited
environmental study sites and treatment plants
and interviewed more than 230 officials,
academics and scientists. They also surveyed the
nation's 50 largest cities and a dozen other
major water providers, as well as smaller
community water providers in all 50 states.


Here are some of the key test results obtained by the AP:


_Officials in Philadelphia said testing there
discovered 56 pharmaceuticals or byproducts in
treated drinking water, including medicines for
pain, infection, high cholesterol, asthma,
epilepsy, mental illness and heart problems.
Sixty-three pharmaceuticals or byproducts were found in the city's 
watersheds.


_Anti-epileptic and anti-anxiety medications were
detected in a portion of the treated drinking
water for 18.5 million people in Southern California.


_Researchers at the U.S. Geological Survey
analyzed a Passaic Valley Water Commission
drinking water treatment plant, which serves
850,000 people in Northern New Jersey, and found
a metabolized angina medicine and the
mood-stabilizing carbamazepine in drinking water.


_A sex hormone was detected in San Francisco's drinking water.


_The drinking water for Washington, D.C., and
surrounding areas tested positive for six pharmaceuticals.


_Three medications, including an antibiotic, were
found in drinking water supplied to Tucson, Ariz.


The situation is undoubtedly worse than suggested
by the positive test results in the major
population centers documented by the AP.


The federal government doesn't require any
testing and hasn't set safety limits for drugs in
water. Of the 62 major water providers contacted,
the drinking water for only 28 was tested. Among
the 34 that haven't: Houston, Chicago, Miami,
Baltimore, Phoenix, Boston and New York City's
Department of Environmental Protection, which
delivers water to 9 million people.


Some providers screen only for one or two
pharmaceuticals, leaving open the possibility that others are present.


The AP's investigation also indicates that
watersheds, the natural sources of most of the
nation's water supply, also are contaminated.
Tests were conducted in the watersheds of 35 of
the 62 major providers surveyed by the AP, and
pharmaceuticals were detected in 28.


Yet officials in six of those 28 metropolitan
areas said they did not go on to test their
drinking water — Fairfax, Va.; Montgomery County
in Maryland; Omaha, Neb.; Oklahoma City; Santa
Clara, Calif., and New York City.


The New York state health department and the USGS
tested the source of the city's water, upstate.
They found trace concentrations of heart
medicine, infection fighters, estrogen,
anti-convulsants, a mood stabilizer and a tranquilizer.


City water officials declined repeated requests
for an interview. In a statement, they insisted
that "New York City's drinking water continues to
meet all federal and state regulations regarding
drinking water quality in the watershed and the
distribution system" — regulations that do not address trace 
pharmaceuticals.


In several cases, officials at municipal or
regional water providers told the AP that
pharmaceuticals had not been detected, but the AP
obtained the results of tests conducted by
independent researchers that showed otherwise.
For example, water department officials in New
Orleans said their water had not been tested for
pharmaceuticals, but a Tulane University
researcher and his students have published a
study that found the pain reliever naproxen, the
sex hormone estrone and the anti-cholesterol drug
byproduct clofibric acid in treated drinking water.


Of the 28 major metropolitan areas where tests
were performed on drinking water supplies, only
Albuquerque; Austin, Texas; and Virginia Beach,
Va.; said tests were negative. The drinking water
in Dallas has been tested, but officials are
awaiting results. Arlington, Texas, acknowledged
that traces of a pharmaceutical were detected in
its drinking water but cited post-9/11 security
concerns in refusing to identify the drug.


The AP also contacted 52 small water providers —
one in each state, and two each in Missouri and
Texas — that serve communities with populations
around 25,000. All but one said their drinking
water had not been screened for pharmaceuticals;
officials in Emporia, Kan., refused to answer
AP's questions, also citing post-9/11 issues.


Rural consumers who draw water from their own
wells aren't in the clear either, experts say.


The Stroud Water Research Center, in Avondale,
Pa., has measured water samples from New York
City's upstate watershed for caffeine, a common
contaminant that scientists often look for as a
possible signal for the presence of other
pharmaceuticals. Though more caffeine was
detected at suburban sites, researcher Anthony
Aufdenkampe was struck by the relatively high
levels even in less populated areas.


He suspects it escapes from failed septic tanks,
maybe with other drugs. "Septic systems are
essentially small treatment plants that are
essentially unmanaged and therefore tend to fail," Aufdenkampe said.


Even users of bottled water and home filtration
systems don't necessarily avoid exposure.
Bottlers, some of which simply repackage tap
water, do not typically treat or test for
pharmaceuticals, according to the industry's main
trade group. The same goes for the makers of home filtration systems.


Contamination is not confined to the United
States. More than 100 different pharmaceuticals
have been detected in lakes, rivers, reservoirs
and streams throughout the world. Studies have
detected pharmaceuticals in waters throughout
Asia, Australia, Canada and Europe — even in Swiss lakes and the North Sea.


For example, in Canada, a study of 20 Ontario
drinking water treatment plants by a national
research institute found nine different drugs in
water samples. Japanese health officials in
December called for human health impact studies
after detecting prescription drugs in drinking water at seven different 
sites.


In the United States, the problem isn't confined
to surface waters. Pharmaceuticals also permeate
aquifers deep underground, source of 40 percent
of the nation's water supply. Federal scientists
who drew water in 24 states from aquifers near
contaminant sources such as landfills and animal
feed lots found minuscule levels of hormones, antibiotics and other drugs.


Perhaps it's because Americans have been taking
drugs — and flushing them unmetabolized or unused
— in growing amounts. Over the past five years,
the number of U.S. prescriptions rose 12 percent
to a record 3.7 billion, while nonprescription
drug purchases held steady around 3.3 billion,
according to IMS Health and The Nielsen Co.


"People think that if they take a medication,
their body absorbs it and it disappears, but of
course that's not the case," said EPA scientist
Christian Daughton, one of the first to draw
attention to the issue of pharmaceuticals in water in the United States.


Some drugs, including widely used cholesterol
fighters, tranquilizers and anti-epileptic
medications, resist modern drinking water and
wastewater treatment processes. Plus, the EPA
says there are no sewage treatment systems
specifically engineered to remove pharmaceuticals.


One technology, reverse osmosis, removes
virtually all pharmaceutical contaminants but is
very expensive for large-scale use and leaves
several gallons of polluted water for every one that is made drinkable.


Another issue: There's evidence that adding
chlorine, a common process in conventional
drinking water treatment plants, makes some pharmaceuticals more toxic.


Human waste isn't the only source of
contamination. Cattle, for example, are given ear
implants that provide a slow release of
trenbolone, an anabolic steroid used by some
bodybuilders, which causes cattle to bulk up. But
not all the trenbolone circulating in a steer is
metabolized. A German study showed 10 percent of
the steroid passed right through the animals.


Water sampled downstream of a Nebraska feedlot
had steroid levels four times as high as the
water taken upstream. Male fathead minnows living
in that downstream area had low testosterone levels and small heads.


Other veterinary drugs also play a role. Pets are
now treated for arthritis, cancer, heart disease,
diabetes, allergies, dementia, and even obesity —
sometimes with the same drugs as humans. The
inflation-adjusted value of veterinary drugs rose
by 8 percent, to $5.2 billion, over the past five
years, according to an analysis of data from the Animal Health Institute.


Ask the pharmaceutical industry whether the
contamination of water supplies is a problem, and
officials will tell you no. "Based on what we now
know, I would say we find there's little or no
risk from pharmaceuticals in the environment to
human health," said microbiologist Thomas White,
a consultant for the Pharmaceutical Research and Manufacturers of America.


But at a conference last summer, Mary Buzby —
director of environmental technology for drug
maker Merck & Co. Inc. — said: "There's no doubt
about it, pharmaceuticals are being detected in
the environment and there is genuine concern that
these compounds, in the small concentrations that
they're at, could be causing impacts to human health or to aquatic 
organisms."


Recent laboratory research has found that small
amounts of medication have affected human
embryonic kidney cells, human blood cells and
human breast cancer cells. The cancer cells
proliferated too quickly; the kidney cells grew
too slowly; and the blood cells showed biological
activity associated with inflammation.


Also, pharmaceuticals in waterways are damaging
wildlife across the nation and around the globe,
research shows. Notably, male fish are being
feminized, creating egg yolk proteins, a process
usually restricted to females. Pharmaceuticals
also are affecting sentinel species at the
foundation of the pyramid of life — such as earth
worms in the wild and zooplankton in the laboratory, studies show.


Some scientists stress that the research is
extremely limited, and there are too many
unknowns. They say, though, that the documented
health problems in wildlife are disconcerting.


"It brings a question to people's minds that if
the fish were affected ... might there be a
potential problem for humans?" EPA research
biologist Vickie Wilson told the AP. "It could be
that the fish are just exquisitely sensitive
because of their physiology or something. We haven't gotten far enough 
along."


With limited research funds, said Shane Snyder,
research and development project manager at the
Southern Nevada Water Authority, a greater
emphasis should be put on studying the effects of drugs in water.


"I think it's a shame that so much money is going
into monitoring to figure out if these things are
out there, and so little is being spent on human
health," said Snyder. "They need to just accept
that these things are everywhere — every chemical
and pharmaceutical could be there. It's time for
the EPA to step up to the plate and make a
statement about the need to study effects, both human and environmental."


To the degree that the EPA is focused on the
issue, it appears to be looking at detection.
Grumbles acknowledged that just late last year
the agency developed three new methods to "detect
and quantify pharmaceuticals" in wastewater. "We
realize that we have a limited amount of data on
the concentrations," he said. "We're going to be able to learn a lot more."


While Grumbles said the EPA had analyzed 287
pharmaceuticals for possible inclusion on a draft
list of candidates for regulation under the Safe
Drinking Water Act, he said only one,
nitroglycerin, was on the list. Nitroglycerin can
be used as a drug for heart problems, but the key
reason it's being considered is its widespread use in making explosives.


So much is unknown. Many independent scientists
are skeptical that trace concentrations will
ultimately prove to be harmful to humans.
Confidence about human safety is based largely on
studies that poison lab animals with much higher amounts.


There's growing concern in the scientific
community, meanwhile, that certain drugs — or
combinations of drugs — may harm humans over
decades because water, unlike most specific
foods, is consumed in sizable amounts every day.


Our bodies may shrug off a relatively big
one-time dose, yet suffer from a smaller amount
delivered continuously over a half century,
perhaps subtly stirring allergies or nerve
damage. Pregnant women, the elderly and the very ill might be more 
sensitive.


Many concerns about chronic low-level exposure
focus on certain drug classes: chemotherapy that
can act as a powerful poison; hormones that can
hamper reproduction or development; medicines for
depression and epilepsy that can damage the brain
or change behavior; antibiotics that can allow
human germs to mutate into more dangerous forms;
pain relievers and blood-pressure diuretics.


For several decades, federal environmental
officials and nonprofit watchdog environmental
groups have focused on regulated contaminants —
pesticides, lead, PCBs — which are present in
higher concentrations and clearly pose a health risk.


However, some experts say medications may pose a
unique danger because, unlike most pollutants,
they were crafted to act on the human body.


"These are chemicals that are designed to have
very specific effects at very low concentrations.
That's what pharmaceuticals do. So when they get
out to the environment, it should not be a shock
to people that they have effects," says zoologist
John Sumpter at Brunel University in London, who
has studied trace hormones, heart medicine and other drugs.


And while drugs are tested to be safe for humans,
the timeframe is usually over a matter of months,
not a lifetime. Pharmaceuticals also can produce
side effects and interact with other drugs at
normal medical doses. That's why — aside from
therapeutic doses of fluoride injected into
potable water supplies — pharmaceuticals are
prescribed to people who need them, not delivered
to everyone in their drinking water.


"We know we are being exposed to other people's
drugs through our drinking water, and that can't
be good," says Dr. David Carpenter, who directs
the Institute for Health and the Environment of
the State University of New York at Albany.


The AP National Investigative Team can be reached at investigate (at) ap.org