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Drug Disposal: Ramifications for the Environment and Human Health
Project Purpose:
Provide technical guidance for a doctoral dissertation whose objective is to: (i) Define the scope of the scientific issues surrounding the disposal of pharmaceuticals to the environment; (ii) Identify all sources and routes leading to drug accumulation and disposal; (iii) Identify and quantify all the drug active ingredients accumulated by a particular sub-population in a defined locale; (iv) Using these collected data and pharmacokinetic data, predict which drugs hold the greatest potential for disposal and entry to the environment; (v) Compare these findings with actual field monitoring data published in the literature; (vi) Make recommendations regarding those changes in health care practices that would lessen the accumulation of drugs leading to disposal.
Project Description(s):
A doctoral dissertation forms the basis for this project. An EPA Student Volunteer (Dr. Ilene Ruhoy) engaged in research towards a PhD in Environmental Studies at the University of Nevada, Las Vegas, is working under the technical guidance of Dr. Christian Daughton. The graduate student, who also holds an MD, brings knowledge and perspective from the medical community - - an expertise generally lacking among environmental scientists. Dr. Ruhoy's dissertation will advance the state of knowledge with regard to the many facets of drug disposal. Dr. Ruhoy is also providing advice and assistance to a number of other organizations that are actively engaged with drug disposal.
This project will: (i) Contribute original data and information on the factors contributing to drug disposal; (ii) Propose solutions for reducing the need for disposal, (iii) Communicate these findings to the scientific community, medical and healthcare communities, regulators, and certain federal agencies (e.g., DEA, ONDCP, FDA) by way of peer-reviewed publications, conference presentations, and the Internet.
Project Outcomes:
Drug disposal and its attendant pollution of the environment occupies the interface between the practice of medicine and our environment. As such, its study involves an understanding of both healthcare practices and environmental science.
The ultimate outcome being sought in this project is to catalyze a dialog, and the beginning of change, among the medical and health care communities in altering how medications are prescribed, thereby reducing the need for drug disposal.
Another objective being sought is to determine whether the accumulation of drugs awaiting disposal is a significant factor in two key, unanswered questions. First, do drugs awaiting disposal contribute significantly to diversion and/or abuse of unused drugs? Second, do these drugs, once disposed of, make a significant contribution to the overall load of drug residues existing in the environment?
The following products have been completed as of February 2008:
Ruhoy, I.S. and Daughton, C.G. "Types and Quantities of Leftover Drugs Entering the Environment via Disposal to Sewage - Revealed by Coroner Records," Sci. Total Environ., 2007, 388(1-3):137-148; doi 10.1016/j.scitotenv.2007.08.013.
Daughton, C.G. and Ruhoy, I.S. "PharmEcovigilance: Aligning Pharmacovigilance with Environmental Protection," Introductory Overview (invited) for the Proceedings of 7th Annual Conference of Society of Pharmacovigilance - India (SoPI), Rajasthan, Jaipur, India (http://www.freewebs.com/sopi2007/), in press.
Daughton, C.G. and Ruhoy, I.S. "Accumulation and Disposal of Leftover Medications: A Key Aspect of PharmEcovigilance," invited paper for the Proceedings of 7th Annual Conference of Society of Pharmacovigilance - India (SoPI), Rajasthan, Jaipur, India (http://www.freewebs.com/sopi2007/), in press.
Daughton, C.G. and Ruhoy, I.S. "Pharmaceuticals in the Environment - - Why Should Anyone Care?" guest editorial, KNAPPE Newsletter No. 2, Knowledge and Need Assessment on Pharmaceutical Products in Environmental Waters, p 1-6, October 2007.
Ruhoy IS and Daughton CG "Pharmaceutical Disposal and the Environment," U.S. EPA, Las Vegas, NV; illustrated poster, December 2007, NERL-LV-ESD-07-132.
Ruhoy IS and Daughton CG "Disposal as a Source of Pharmaceuticals in the Environment," U.S. EPA, Las Vegas, NV; illustrated poster, December 2007; NERL-LV-ESD-07-129.
Contact
Christian Daughton at daughton.christian@epa.gov