Norman Leonard moved to Heritage Village, a sprawling retirement community in western Connecticut, 11 years ago. Its green-gabled condominiums and Capes were well maintained, and the landscapers hadn't skimped on the rhododendrons. A retired CPA, Leonard considers himself, at age 80, to be in pretty decent shape: He plays platform tennis on the grounds and hikes often in nearby forests and reserves. But still, he takes five different drugs a day to manage his blood pressure, acid reflux, and high cholesterol. Heritage Village is home to about 4,000 residents with similar medical profiles, who take an average of six drugs a day.
And that's a healthy population. In a convalescent home a few miles away, Patricia Reilly, age 88, wheels herself each morning toward a low shelf. With a glass of water and small cups of applesauce at the ready, she prepares to take her morning medicines: nine different types that treat heart disease, acid reflux, renal stones, a chronic urinary-tract infection, chronic constipation, migraine headaches, depression, allergic rhinitis, degenerative arthritis, and intermittent vertigo. The 120 residents of River Glen Health Care Center, where the average age is 90, take an average of eight drugs a day; the most common among them target high cholesterol, high blood pressure, depression, and diabetes. Once swallowed, Reilly's medications will bring her some relief, but their biological activity won't stop once they leave her body.
When residents of Heritage Village and two other nearby retirement communities flush their toilets, wastewater laced with traces of prescription drugs rushes through a series of pipes into the Heritage Village treatment plant. This flushing is the main pathway by which pharmaceuticals enter the environment. Hospitals and nursing homes routinely dump unused or expired pills down the toilet, and consumers have been advised to do the same; effluent from pharmaceutical manufacturers also ends up at municipal wastewater treatment plants. Through a process of settling and aeration, the Heritage Village plant separates liquids from solids, treats the liquid portion with disinfectant, and then discharges this effluent into a mini-creek that meanders between the third green and the seventh tee of the Heritage Village golf course. Making its way through a riparian band of oaks and maples, the creek fans out into the Pomperaug River, which loops without further interruption through the town of Southbury.
The Pomperaug looks no different upstream or down, but studies by the U.S. Geological Survey (USGS) on other rivers suggest that the Pomperaug below the effluent creek carries the signatures of drugs consumed by anyone plumbed into the Heritage Village system. The effect of those drugs on the environment, and possibly on those who drink water pumped from those streams, is only beginning to be understood.
We are a nation obsessed with pharmaceuticals. We spend vast sums to manage our health, and we pop pills to address every conceivable symptom. Some elderly Americans take as many as 30 drugs a day, some of them merely to counteract the effects of others. Prescription drug sales rose by an annual average of 11 percent between 2000 and 2005. Americans now fill more than three billion prescriptions a year; nationwide, more than 10 million women take birth-control pills, and about the same number are on hormone-replacement therapy.
The rate at which prescriptions are dispensed is only going up as the population ages. Already, those over 65 fill twice as many prescriptions per year as do younger Americans. Inevitably, more drugs will be headed into waterways like the Pomperaug. Our rivers -- already stressed by pollutants, groundwater pumping, reduced flows, and overburdened wastewater treatment plants that dump raw sewage -- will be ever less able to cope.
Alarmed by data that showed trace levels of pharmaceuticals in European streams, researchers in the United States have begun to survey our nation's waterways. In 2002, the USGS published the results of its first-ever reconnaissance of man-made contaminants. Using highly sensitive assays, the agency found traces of 82 different organic contaminants -- fertilizers and flame retardants as well as pharmaceuticals -- in surface waters across the nation. These drugs included natural and synthetic hormones, antibiotics, antihypertensives, painkillers, and antidepressants.
Now that science has documented the presence of free-flowing pharmaceuticals, researchers are faced with another, far more difficult, pair of questions: What does this mean for the environment, and what does it mean for us? Early evidence of harm to aquatic organisms is giving researchers grounds for real concern.
On a dull November morning, two graduate students from the University of Connecticut shiver on the steep banks of the Pomperaug. Monotonously, repetitively, they plunge plastic jars two feet down into the beer-colored water. Five-minute intervals tick away on a stopwatch. "Is it here yet?" asks Dan Seremet. He's now midstream, his fleece cuffs dripping onto his chest waders. Raquel Figueroa, squatting in a drift of crisp oak leaves, slips a vial of water into a portable fluorometer, closes the gizmo's cover, taps a button, and answers, "Point one nine."
So, no. It isn't here yet.
Five minutes pass, Raquel shouts in her tiny voice, "Go!" and Dan, maneuvering over slippery rocks, dips his jar again. Two hours pass, in five-minute chunks, and the fluorometer, which detects and measures specific particles in the water, rises only to 0.65 parts per billion (ppb).
"Maybe we're in the wrong river," Dan sighs. Raquel doesn't bother to answer. She logs the time and the concentrations. She dumps out samples. She painstakingly removes a bittersweet vine holding her leg prisoner. "Next time we should bring pruners," she says to no one in particular. Then, "Go!" Dan dips.