Probe Finds Drugs in Drinking  Water

(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.

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.  




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