Section 2: Scientific Explanation of Pharmaceutical Contamination

A.   Human Impact

              Most pharmaceuticals in the water occur in concentrations far below prescribed dosages.  Nevertheless, micro-dose exposure to many drugs over a long period poses great human health risk.[8] Pharmaceuticals are designed to effect biological change, and thus these compounds pose a greater risk to human health than other anthropogenically- originating chemicals in the environment.[9] Additionally, human exposure to pharmaceuticals in water is not limited to the water humans consume.  Exposure also occurs through the consumption of fish and shellfish that have bioaccumulated pharmaceuticals or have been in contact with contaminated water.[10] The most studied side effect of consuming pharmaceutically contaminated water is endocrine system disruption.[11]  Endocrine resistance occurs when drugs that mimic naturally occurring hormones or drugs that are exogenous forms of hormones produced in the body are consumed and cause the endocrine system to stop producing its own hormones.[12] Such endocrine disrupting affects can “include breast cancer and endometriosis in women, testicular and prostate cancers in men, abnormal sexual development, reduced male fertility, alteration in pituitary and thyroid gland functions, immune suppression and neurobehavioral effects.”[13]  There is a direct relationship between the generational decline in men’s testosterone and luteinizing hormone levels and the amount of birth control prescribed for and consumed by women.[14]

              Pharmaceuticals in the water also contribute to antimicrobial resistance, which occurs when microbes that adapt to antimicrobial agents reproduce and then pass on that resistance gene.[15] Such resistance poses serious public health risks, such as the need for\multiple rounds of antibiotics to kill bacteria or the inability to fight infections altogether.[16]

              While antimicrobial resistance of the endocrine system and to antibiotics is an indisputable effect of consuming pharmaceutically contaminated water, some scientists argue that there are few other side effects to human consumption of such water.[17] This camp believes that new sewage treatment mechanisms are not necessary. But there is a large group of scientists who disagree. They argue that there have not been enough studies conducted and that presently there are inefficient means to detect the threats that long term, low dose consumption of many pharmaceuticals pose.[18]

              Despite the lack of human studies, there have been many studies on how pharmaceutically contaminated water impacts individual human cells. In one study, scientists exposed healthy cells to a dosage of pharmaceuticals similar to that found in Italian rivers – the result was that cells grew a third as fast as they did prior to exposure.[19] Another study found that breast cancer cells exposed to estrogens taken fromfish that were caught near sewage plants grew twice as quickly as unexposed cells.[20]  Other studies have found that individual drugs can cause cell growth, but when drugs that cause growth are combined with other drugs, growth can actually be slowed.[21] Such effects prove that pharmaceuticals have synergistic effects. Yet in the lab and in testing for humans, such effects are not studied because most drugs are not designed to be stacked with other compounds.[22]

[8] Kolpin, supra note 1.

[9] Halford, supra note 2.

[10] GLOBAL WATER RESEARCH COALITION, OCCURRENCE AND POTENTIAL FOR HUMAN HEALTH IMPACTS OF PHARMACEUTICALS IN THE WATER SYSTEM 2 (2009).

[11] Karyn Feiden, Pharmaceuticals Are in the Drinking Water: What Does It Mean?, Rapid Pub. Health Pol’y Response Project: Geo. Wash. Sch. of Pub. Health & Health Serv., 3 (April 2008)

[12] Thomas M. Crisp et al., Environmental Endocrine Disruption: An Effects Assessment and Analysis, 106 Envtl. Health Persp. 11, 11 (Supp. 1998).

[13] Tanya Tillett, Summit Focuses on Pharmaceuticals in Drinking Water, 117 Envtl. Health Persp. A16, A16 (2009).

[14] Id.

[15] Antimicrobial Resistance, World Health Org. (Mar. 2016), http:// www.who.int/ mediacentre/factsheets/fs194/en/.

[16] Christopher T. Nidel, Regulating the Fate of Pharmaceutical Drugs: A New Prescription for the Environment, 58 Food & Drug L.J. 81, 83-84 (2003).

[17] Halford, supra note ii.

[18] Id.

[19] How Meds in Water Could Impact Human Cells, MSNBC (Feb. 16, 2010), http:// www.msnbc.msn.com/id/23558785.

[20] Id.

[21] Id.

[22] Francisco Pomati et al., Effects and Interactions in an Environmentally Relevant Mixture of Pharmaceuticals, 102 Toxicology Sci. 129, 129 (2008).

‍