Date:
03/10/2008 08:01 AM AP INVESTIGATION: Pharmaceuticals found in drinking
water, affecting wildlife and maybe humans
EDITOR'S NOTE —The nation's drinking
water supplies are not as pristine as might be expected —
traces of pharmaceuticals are all too common, an Associated
Press investigation finds. First of a three-part series.
byline(By
JEFF DONN, MARTHA MENDOZA and JUSTIN PRITCHARD%)
bytitle(Associated
Press Writers%)
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.
————
The AP National Investigative Team can be
reached at investigate@ap.org
