An AP investigation found that our nation's drinking water supplies for at least 41 million Americans are contaminated with pharmaceuticals that had been initially provided to people, pets and cows. Some of the drugs are absorbed by the body while the remainder ends up in wastewater. The contamination extends to drinking water supplies, watersheds and groundwater basins. Some of the drugs will not even be removed by modern drinking water and wastewater treatment processes and no sewage treatment systems are specifically engineered to remove pharmaceuticals. There really are no cost effective alternative options because private drinking water wells are affected, water bottlers often use tap water and home filtration system makers do not usually treat the water or test for drugs. Only the reverse osmosis technology removes virtually all pharmaceutical contaminants but is very expensive for large-scale use.
While it is shocking to find out that we may be involuntarily ingesting unknown quantities of a variety of drugs, this really is business as usual.
The investigation found water supplies contaminated by prescription drugs, like "antibiotics, anti-convulsants, mood stabilizers and sex hormones" as well as over-the-counter medicines (e.g., acetaminophen and ibuprofen) and "medicines for pain, infection, high cholesterol, asthma, epilepsy, mental illness and heart problems." While the concentrations of drugs in our drinking water supplies are "tiny, measured in quantities of parts per billion or trillion, far below the levels of a medical dose," low detection levels do not equal the absence of harm.
Not all water providers screen for pharmaceuticals and those that do screen rarely report their findings publicly because the public "doesn't know how to interpret the information" and "might be unduly alarmed." In one water system where drugs were detected, the water provider would not identify the drug based on "9/11 security concerns."
The central problem is that the federal government has not established safety limits for drugs in water or mandated testing. While the AP contacted 62 major water providers, only 28 have tested their drinking water supplies. Moreover, given that we don't have federal standards, if water utilities screen for drugs, the scope of the screening may be limited to one or two drugs, which means there are a number of drugs which are not even screened.
The water utilities claim the "water is safe," and others state that their drinking water supply complies with all state and federal regulations governing water quality. However, these regulations do not govern trace pharmaceuticals. Moreover, the addition of chlorine is a "common process in conventional drinking water treatment plants," and the chlorine can enhance the toxicity of some pharmaceuticals.
The AP probe focused on pharmaceuticals, and did not mention any studies on whether harm may be caused by low levels of chronic exposure. However, in the case of pollutants generally, there are few studies which address what damage is caused by "chronic low-level exposure to the pollutants." Our government permits a specified quantity of a particular chemical to be released into our environment under the assumption that the particular chemical is not harmful unless we are exposed to a higher dosage. This ignores the fact that chronic exposure to low levels of pollutants can be just as harmful as a one-time exposure to the same pollutant at a higher dosage. One study suggested that "day-to-day exposure to relatively low levels of pollution can cause permanent damage."
The pharmaceutical industry generally claim there is very little or no risk. However, Merck admits the problem: "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."
Scientists are also worried about the long-term consequences to our health. Researchers don't know all the risks from "decades of persistent exposure to random combinations of low levels of pharmaceuticals." However, recent studies revealed "alarming effects on human cells and wildlife."
In one case, water samples taken downstream from a livestock feedlot showed steroid levels 4 times higher than upstream. "Male fathead minnows living in that downstream area had low testosterone levels and small heads."
Indeed, research showed that small amounts of drugs can affect growth rates of cells and produce biological activity:
"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."
The canaries for water contamination are our wildlife:
[P]harmaceuticals 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.
Many Americans have chemicals and pollutants in their bodies from eating contaminated food. This is also an issue with water supplies contaminated by pharmaceuticals:
"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."
Many scientists are "skeptical that trace concentrations will ultimately prove to be harmful to humans" because studies test lab animals with much higher amounts of the drugs. However, these studies don't evaluate the impact of certain drugs or combination of drugs interacting and perhaps harming people over decades.
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.
Another concern is that medications may present a "unique danger" to people, as compared with pesticides and toxic metals or chemicals, because they are designed 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.
Moreover, drug safety tests for people are based on a timeframe of months, not a lifetime of daily consumption. There is also the issue of drug interactions:
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.
Another problem is that the EPA is focused on creating methods to detect drug contamination rather than admitting a problem exists.
"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."
Even when the EPA works on developing standards to regulate drugs, it moves at a snail's pace. Of the 287 pharmaceuticals analyzed by the EPA for possible regulation, only one drug made the list of potential drugs to be regulated, and it was nitroglycerin, which was included because of its use to make explosives.
This is a common governmental response to delay detection that would then cost government and private water suppliers millions in order to provide effective treatment of our water supplies as well as settlements for lawsuits filed. For example, in addition to the AP disclosure of pharmaceutical contamination, our water supplies are also contaminated by a variety of chemicals and pollutants. One particularly disturbing case involves massive underground plumes of TCE, an industrial chemical that the public is exposed to when they drink water, shower or breathe air in their homes from in their homes from TCE vapors intruding from the soil. After 4 years of study, senior EPA scientists issued a risk assessment in 2001 that TCE was 40 times more likely to cause cancer than previously believed. The data show that detectable levels of TCE exist in 9-34% of the nation's drinking water sources and 1 in 10 Americans may have detectable levels of TCE in their blood.
Instead of imposing tough standards to limit public exposure to TCE, Bush used his corporate bean-counter mentality to delay for years. For 2 years, the EPA battled the Pentagon, Energy Dept. and NASA which appealed directly to the White House for protection because each agency had contaminated sites. So, the White House had its anti-EPA "working group" -- comprised of officials from Pentagon, Energy Dept. and NASA -- review the issue and decide that another study was needed.
The Pentagon demanded more proof that TCE causes cancer even though 6 state, federal and international agencies classified TCE as a "probable carcinogen" and California classified as a "known carcinogen." In the summer of 2006, the new study concluded that the EPA was correct and that "evidence on cancer and other health risks from TCE exposure has strengthened since 2001," when the EPA issued its assessment.
So, during the 5 year delay alone Americans were further exposed to a carcinogen simply because limiting public exposure would have required treatment facilities costing billions of dollars. The Pentagon alone has 1,400 sites contaminated with TCE. One such contaminated site is at Camp Lejeune in California:
"Tens of thousands of Marine families were exposed to TCE in the base's drinking water supply. A preliminary study has found elevated rates of leukemia among children conceived at the base. The TCE was discovered in 1980 but not disclosed until 1985."
In 2006, a U.S. Geological Survey study concluded that most of our rivers and streams – and the fish – are "contaminated with pesticides linked to cancer, birth defects and neurological disorders, but not at levels that can harm humans." We've heard this refrain before that we need not worry if the pollutant is at a low level:
"The classic example is lead. In 1971 the U.S. Surgeon General declared that lead levels of 40 micrograms per deciliter of blood were safe. It's now known that any detectable lead can cause neurological damage in children, shaving off IQ points. From DDT to PCBs, the chemical industry has released compounds first and discovered damaging health effects later. Regulators have often allowed a standard of innocent until proven guilty in what Leo Trasande, a pediatrician and environmental health specialist at Mount Sinai Hospital in New York City, calls 'an uncontrolled experiment on America's children.'"