NRDC testifies in the US Senate on the impacts of pharmaceuticals and antibiotics contaminating our waterways

Kudos to Senators Boxer and Lautenberg, and the US Senate Committee on Environment and Public Works, Subcommittee on transportation, infrastructure, security, and water quality (Chairman Lautenberg and Ranking Member Vitter). I am very pleased to testify at hearings entitled: Pharmaceuticals in the Nation's Water: Assessing potential risks and actions to address the issue. This is an important issue, albeit not a new one. But, it's big, and getting bigger. The EPA website and its science experts have some good information for the public.

Some elements from my testimony below:

Compounds such as nicotine, caffeine, and aspirin that are designed to influence our body’s normal chemistry have been identified as environmental contaminants since the 1980s, moving from sewage and human waste into waterways. As our use of pharmaceuticals increases, it is logical to expect them to turn up in our environment. Although the levels reported to contaminate our waterways are much lower than therapeutic doses, it would be naïve to think of this as ‘safe’, knowing that the agents are chemically reactive in our bodies, and that we are exposed daily over a life-time to multiple compounds in unknown combinations.

When a medical professional prescribes a drug, they are considering the patient’s health status, age, gender, nutritional status, and any other drugs that may cross-react. For example, a pregnant woman would not knowingly expose her fetus to chemicals that cause birth defects such as anti-seizure drugs. A doctor would not knowingly prescribe toxic chemotherapy agents to a healthy person. Yet, all these things and more are in our Nation’s drinking water. The Associated Press reported that pharmaceutical residues were detected in the drinking water of 24 major metropolitan areas across the country serving 41 million people. Detected drugs included antibiotics, anti-convulsants, and mood stabilizer drugs. These results were supported by findings of the U.S. Geological Survey that reported organic wastewater contaminants and pharmaceuticals in 80% of sampled streams- including antibiotics, hypertensive and cholesterol-lowering drugs, antidepressants, analgesics, steroids, caffeine, and reproductive hormones.

Pharmaceuticals and personal care products (PPCPs) may end up in the environment through waste from human or animal excretion, improper disposal such as flushing down a toilet, runoff from animal feeding operations, or leaching from municipal landfills. However they get there, they are contaminating our waterways and tap water systems.

Large animal feeding operations generate a large amount of antibiotic-contaminated waste that contaminates waterways and contributes to antibiotic resistant pathogens. Because many of the same antibiotics are used in both human and veterinary medicine, almost every bacteria that can cause infections in humans has developed resistance to at least one antibiotic, and some are resistant to multiple antibiotics. This means that when a person gets sick, the antibiotic that the health care provider may reach for, may not work. To tackle this problem, Environmental Defense Fund, American Academy of Pediatrics, and other health advocates petitioned the Food and Drug Administration in 2005 to prevent the use of important human antibiotics to be used in agriculture, so as to limit the risk of developing resistent pathogens that could infect humans.

The traditional toxicology dogma has been “the dose makes the poison” but when considering the toxicity from exposures to endocrine disrupting chemicals, the timing of exposure maybe more important than the dose. Exposures to endocrine disrupting chemicals during critical windows of development have been shown to have permanent effects such as infertility or cancer that may not arise until adulthood even though the exposure occurred during fetal or neonatal life. Yet, pharmaceuticals that mimic estrogen are excreted as waste by-products from the use of birth-control pills, menopause treatments, and cancer therapy.

In addition to human uses, endocrine disrupting steroids used in livestock operations contribute to widespread environmental contamination. Research by the US Geological Survey reported a high incidence of intersex fish in the Potomac watershed associated with sites of intense farming and high human population density; 75% of male smallmouth bass in the most densely populated heavily farmed Potomac basin had eggs in their testicles.

Despite the various safeguards and processes that EPA could have taken to develop a robust picture of the scope of the problem, the Agency has taken advantage of none of them.

• The Safe Drinking Water Act requires EPA every five years to publish a list of currently unregulated contaminants that should be considered for potential regulation.  For these lists EPA has identified 130 potential chemicals for regulation – none of which are pharmaceuticals or personal care products. 

• In 1999 EPA promulgated an unregulated contaminant monitoring rule that imposed various monitoring requirements on community water systems for a list of unregulated contaminants; there are no pharmaceuticals or personal care products identified for which water systems must monitor and report results to their customers.

• The Safe Drinking Water Act requires community water systems to mail to each of their customers an annual report on the level of contaminants in the drinking water that they supply; there are no mandates to inform customers when pharmaceutical or personal care products are identified.

• Congress mandated that EPA must address endocrine disrupting chemicals in drinking water; it has now been 12 years since this mandate and the Endocrine Disruptor Screening Program has failed to even start testing chemical contaminants.

The proposed FY09 funding for the USGS Toxics Program reflects a nearly $3 M cut; this will significantly reduce research capacity on new and understudied environmental contaminants, including pharmaceuticals and personal care products.

In addition to rectifying the above failures of EPA, some additional elements of a solution may include reducing the unnecessary prophylactic uses of antibiotics and steroid hormones in agriculture, and excessive uses in humans, to tackle the problem at its source. There is no question that we will also need to invest in our waste water and drinking water infrastructure, and to monitor and treat for the chemical contaminants that present the biggest health risks, and that can be removed or reduced using cost-effective methods.

Bottom line: our tap water is the still the safest choice of drinking water available, but this problem won't fix itself.