Alternative Strategies for Managing Pharmaceutical and Personal Care Products in Water Resources

In recent decades, concern has grown over the presence of pharmaceutical and personal care products (PPCPs) in water. This concern stems from the possibility that the presence of PPCPs in water supplies may pose a threat to both human and environmental health. Such threats may be both direct (e.g., exposure to endocrine disrupting compounds) and indirect (e.g., emergence of antibiotic resistant bacteria). The water treatment and wastewater treatment community has been especially concerned over PPCPs because of PPCPs ubiquitous nature and their ability to persist or only partially degrade in water and during wastewater treatment. Studies done over the past several decades have indicated that wastewater contaminants including antibiotics, other prescription drugs, non-prescription drugs, steroids, reproductive hormones, and personal care products have been found in both surface water and ground water in the United States.Sources of PPCPs include human & animal feces and urine, hospital/medical wastes, wastes from industrial and agricultural processes, pharmaceuticals and personal care products that are disposed of inappropriately, urban runoff, and leachate from landfills. These contaminants are rarely treated or removed in the wastewater treatment process and typically remain in waters discharged from wastewater treatment plants into receiving streams and lakes, as well as in solid and liquid wastes applied to lands designated as application sites.Various common law remedies, such as trespass, nuisance, negligence, and strict liability, may be relevant to concerns over PPCPs in water supplies. However, these remedies rely on success in litigation. Litigation is often expensive, time consuming, and very case specific. Additionally, success in litigation requires plaintiffs to prove causation – which manufacturer produced the PPCP involved in the suit, and which PPCPs resulted in the harm alleged in the suit e hurdles that may be difficult to overcome.An alternative to common law remedies may be found under federal, state, and tribal laws and regulations where a number of agencies and statutes may be relevant. Federal agencies that have the potential to be involved in various aspects of the management of PPCPs include the Environmental Protection Agency (EPA), the Food and Drug Administration (FDA), the U.S. Department of Agriculture (USDA), the U.S. Geological Survey (USGS), and the Centers for Disease Control and Prevention (CDC). In addition, numerous units of state, tribal, and local governments may be involved in implementing environmental programs that are relevant to the management of PPCPs. Existing federal statutory regimes that may be relevant to PPCPs include: Clean Water Act; Safe Drinking Water Act; Resource Conservation and Recovery Act; Toxic Substance Control Act; and Endangered Species Act (ESA). States and tribes have enacted similar legislation. While these strategies may prove to be important, their implementation can be expensive and politically unpopular.A more effective route for responding to PPCPs in drinking water supplies may be to focus on alternative strategies that focus on removing PPCPs from the source. These alternative strategies include designing drugs and personal care products that minimize the human and animal excretion of wastes, which would then minimize the volume of PPCPs that enter the water system. Changing the delivery mechanisms may also be successful in addressing PPCPs in water systems. This strategy relies on better informing doctors and patients about the effects of PPCPs on the environment, and educating doctors and other professionals on how to individualize or tailor doses to the individual user rather than prescribing the manufacturers’ recommended dose. Informing users on how to dispose of unused drugs and personal care products and producing a variety of package sizes to reduce the amount of unused drugs could also be an essential PPCP reducing mechanism.In addition, encouraging states or manufacturers of pharmaceuticals and personal care products to develop take-back programs could also lead to the reduction of PPCPs in the water supplies. Unfortunately, institutional and financial barriers may make implementing of many of these programs difficult. For take-back programs to be successful, these institutional barriers need to be revised. Nutrition and health maintenance programs that reduce illness and the need for PPCPs, as well as the use of alternative products that do not contain PPCPs, such as probiotics, also could reduce the amount of PPCPs entering the water supply. This alternative, however, could also be costly to the patient.The issue of PPCPs in water supplies is a complex problem that will require more than one simple solution. It will require reducing the source of PPCPs and monitoring and regulating the PPCPs that enter the water supply. New monitoring, detection, and analysis methods are needed. New drinking water treatment processes will need to be developed. Regulatory and statutory approaches need to be tailored to reducing the amount of PPCPs in water supplies. The alternative strategies discussed here will be needed to protect human and environmental health.