Probe
Finds Drugs in Drinking Water
AP
Posted:
2008-03-09 20:06:02
(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.
Philadelphia: 56
pharmaceuticals or pharmaceutical byproducts, including medicines used to treat
pain, infection, high cholesterol, asthma, epilepsy, mental illness and heart
problems
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.