In recent weeks, there has been a lot of attention for medicine residues in drinking water. According to Koos Brouwers, it is not enough about the size of the problem and what we can contribute to prevent this ‘contamination’.
With the help of laboratory research we are able to determine very low concentrations of medicines in our drinking water. For a long time we have been told that we have the best drinking water in the world. However, this should be related to the origin of our drinking water. An important part of our drinking water is (out of necessity) extracted from surface water, because pumping up large quantities of groundwater is undesirable. We need to find out how the ‘contaminants’ end up in our drinking water and how we can measure this.
The contamination of surface water is caused by discharges (industry) and via our sewage water (toilet). In sewage, we can quite easily measure the sources of contamination, such as cocaine or viruses such as covid. By tracing cocaine, we gain insight into drug use in certain regions. The amount of covid particles has proven to be a measure of the spread of the corona epidemic. According to the RIVM, tons of medicine residues end up in our surface water every year. How is that possible?
Harmful to the environment
When we take medicines, they are partly converted into breakdown products in our body and partly excreted unchanged with the stool (poo and urine). Both the drug residue itself and the breakdown product can be harmful to the environment. In fish in particular, harmful effects have been seen of painkillers (eg diclofenac), certain antidepressants (so-called TCAs), but also anticancer agents, such as platinum. Because not all residues can be removed from our drinking water, we are still exposed to low concentrations of medicines through drinking water.
What can we do ourselves to prevent contamination of surface water with pharmaceutical residues? Firstly: never throw (unnecessary) medicines with the residual waste and never flush them through the toilet, but hand them in at the pharmacy or designated depot.
Secondly: ask your doctor to prescribe medicines that have as little impact on the environment as possible, for example no anti-inflammatory painkillers, but preferably paracetamol if possible (this also applies to your self-care products at the pharmacy or drugstore).
Thirdly: support initiatives in the hospital where certain anti-cancer agents or contrast agents can be (temporarily) collected via a urine bag or container and can thus be disposed of and processed responsibly.
And finally: ask for a periodic MOT inspection of your medication use by doctors and pharmacists, so that you no longer use ‘unnecessary’ pills as much as possible.
Prevent wastage
Of course: if you are ill or have a deficiency, always take the necessary pills. By eliminating overuse, waste or incorrect choice of pills, we can expect to halve the problem of pharmaceutical residues in our drinking water. That’s where the fish are, you and the environment also benefits from that.
Koos Brouwers is emeritus professor of pharmacotherapy at the University of Groningen. He lives in Oranjewoud