Probe Finds Drugs in Drinking Water

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Probe Finds Drugs in Drinking Water

AP

Posted: 2008-03-09 21:42:14

Filed Under: Health News, Nation News, Science News

(March 9) - 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 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 land; 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

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 White, a consultant for the Pharmaceutical

Research and Manufacturers of America.

But at a conference last summer, 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 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 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. Carpenter,

who directs the Institute for Health and the Environment of the State

University of New York at Albany.

Copyright 2008 The Associated Press. The information contained in the

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2008-03-09 18:50:12