Drugs on Tap:
What’s In Our Tap Water?
Here’s a question to ponder. What happens to the hundreds of millions of prescription
drugs and the over-the-counter medications that are swallowed daily?
The answer: they go out through the plumbing. Being flushed down the toilet and into the sewage system, 90
per cent of every drug swallowed is either excreted, totally unchanged, or is broken down into active metabo-
lites. They then continue on their way into your water supply to eventually return as a chemical cocktail flowing
In addition to pharmaceutical drugs, there’s another group of chemicals sneaking down the drain. More than
10,500 chemical ingredients are used to manufacture what is collectively known as personal care products.
These products include moisturisers, cleaners, bubble baths, shampoos, fragrances, deodorants, mouthwashes
and sunscreens etc. Research has shown that vast numbers of these chemicals can alter our endocrine, neuro-
logical, respiratory and immune systems.
This collection of chemical compounds has been officially classified as Pharmaceutical and Personal Care Pol-
lutants (PPCPs). PPCPs comprise a very broad, diverse collection of thousands of chemical substances, includ-
ing prescription and over-the-counter therapeutic drugs, fragrances, cosmetics, sun-screen agents, diagnostic
agents, nutraceuticals, biopharmaceuticals, and many others. This broad collection of substances refers, in
general, to any product used by individuals for personal health or cosmetic reasons. Until recently little if any
thought had been given to what may result from the staggering quantities of chemicals that are washed down the
It is estimated in the Environmental Health Perspectives Supplements, 1999, that ‘the amount of pharmaceu-
ticals and personal care products entering the environment annually is about equal to the amount of pesticides
Many pharmaceutical drugs and personal care products have persistent chemicals that remain biologically active
even after being relegated to landfills and water systems. Hospitals, doctors’ offices, veterinary clinics, farms
and even the average home are all contributors to the PCPP overload.
Other sources of PPCPs include unused medications (which are commonly flushed down the toilet), leaking
septic systems or discharge from wastewater treatment plants. It’s indeed a sobering thought to realise that our
personal grooming habits as well as our reliance on pharmaceutical drugs may, however unwittingly, contribute
The fact is no one really knows to what extent these chemical mixtures might be altering our health. Many
chemicals are designed to profoundly affect humans’ physiology. Unlike pesticides, drugs and personal care
products, these mixtures have not been examined for their effect on the environment. This is surprising, espe-
cially since certain pharmaceuticals are designed to modulate endocrine and immune systems.
In the 1980s the issue of PCPPs emerged as a serious area of investigation in Europe. A German study in Small
Flows Quarterly by Nikki Stiles, found PCPPs in treated and untreated sewage effluent, surface water, ground
water and drinking water. Most commonly found medications were anti-inflammatory and pain-killing drugs,
cholesterol-lowering drugs anti-convulsants and oral contraceptives. Samples from 40 German rivers and
streams turned up residues of 31 different PPCPs.
More recent findings in Berlin found significant amounts of antibiotics, ibuprofen, cholesterol-lowering drugs,
hormones (oestrogen), and chemotherapy agents in that city’s ware supply. British scientists estimate that more
than a ton of aspirin and a ton f morphine derivatives flow down just one small river in north east London every
Samples from 139 US streams showed detectable, although minute, quantities of PPCPs. The most frequent
were steroid hormones and non-prescription drugs. Antibiotics, prescription medications, detergents fire retar-
dants, pesticides and natural and synthetic hormones were also present.
Between 30 and 90 per cent of most antibiotics given to humans and animals is excreted with the urine. The
problem is particularly acute in the fish and farming industry where, according to an article in New Scientist,
1999, 70 to 80 per cent of antibiotics end up in the environment.
Would you like birth control pills with your coffee?
Synthetic steroid hormones are taken by one hundred million women wordwide as oral contraceptives or hor-
mone replacement therapy. Both natural and synthetic oestrogen as well as oestrogen-mimicking chemicals
from degradation of plasticizers enter sewage treatment plants.
A Canadian study provided concrete evidence of just what exposure to these chemicals portends. For three
years, Canadian scientists added birth-control pills into a pristine Ontario Lake set aside for research to measure
this impact. The results: all male fish in the lake – from tiny tadpoles to large trout – were feminized egg pro-
teins were growing abnormally in their bodies) This was an unmistakable sign of hormone disruption. Femi-
nized male fish have now been found in rivers and streams worldwide.
Theo Colborn, author of Our Stolen Future, is worried about pharmaceutical oestrogens mixing with chemicals
‘You can liken it to the side effects of a prescription drug – you don’t know how it’s going to interact with the
over –the-counter drugs that you’re taking. For example bisphenol A, a compound of plastic causes female mice
to reach puberty earlier than normal. Bisphenol A forms a weak bond with the body’s oestrogen receptors. It can
scramble a cell’s natural communication system and cause it to replicate too quickly That, in turn, raises con-
cerns about breast cancer in women. What happens if this compound, which is active at low levels of exposure,
combines with oestrogen from a birth control pill in the water? At this point, it’s still unclear. It cold have long-
Could oestrogen-laced water contribute to shaply falling human sperm counts? In Europe, researchers have tied
a decline in male sperm count to levels of oestrogenic hormones in the environment. Unfortunately, the ris-
ing numbers of breast and uterine cancers, early puberty, and hypospadias (a birth defect of the urethra and the
penis), reveal a most disturbing picture. It appears that this unnatural exposure to potent oestrogen hormones as
well as oestrogen mimics could be seriously and irrevocably altering critical hormonal signalling for adults as
well as vulnerable infants and children.
Antibiotics – too much of a good thing
Detection of antibiotics in drinking water is of particular concern. The presence of these chemicals in the envi-
ronment can lead to the development of resistant bacterial strains, contributing to antibiotic resistance. Some of
the antibiotics detected were Class 1 drugs, (the one used when other antibiotics don’t work).
A bacteria-phobic public now uses millions of pounds annually of triclosan, a broad-spectrum anti-microbial
agent. Triclosan is a derivative of the herbicide 2,4-D. It is the active ingredient found in a plethora of products
such as anti-bacterial soaps, deodorants, mouthwashes, sponges and household cleaners. Triclosan’s popularity
has contributed to the antibiotic resistance problem.
If triclosan-initiated antibiotic resistance wasn’t bad enough, researchers found that when triclosan in water was
exposed to sunlight, it converted into a dioxin. When first exposed to sunlight, triclosan becomes a mildly toxic
chemical. The problem occurs when it becomes treated with chlorine at water treatment plants; it then breaks
What is particularly ironic is that the use of triclosan-treated products has never been proven to be superior to
Just drink your prozac and call me in the morning
In 2004, major headlines in Britain announced that Prozac was found in drinking water. This situation has been
described as a ‘hidden mass medication of the unsuspecting public’. Since there is no way to monitor for levels
of Prozac or other PPCPs, a serious public health crisis is brewing. In the UK, there has been a 166 per cent
increase antidepressant prescriptions since 1991 – up to 24 millions prescriptions a year. The most popular kind
is the selective serotonin reuptake inhibitors (SSRIs), which include Prozac, Zoloft, Luvox, and Seroxat/Paxil.
What might result from Prozac-aced water? US researchers found traces of Prozac and antidepressants in the
livers, muscles, and brains of bluegill fish in Texas. In addition, they found traces of Prozac in Prozac-free
Low-level exposure to fluoxetine, the active ingredient of Prozac, delays both development in fish and metamor-
phosis in frogs. The researchers strongly suspect that results imply a disruption of thyroid function.
‘We know that the thyroid levels peak with metamorphic climax, when the legs and arms form and the tail re-
sorbs. We believe that fluoxetine inhibits the thyroid.’ (7)
When it comes to the possible side effects of PPCPs on humans and aquatic life, there are more questions than
answers. It is a truly daunting task to assess the possible harmful effects of just one PPCP much less the expo-
sure to thousands. And what might be the consequence of al those incalculable permutations of drug mixtures?
Where do we go from here?
The problem of pharmaceutical and personal care pollutants has been clearly identified; the tricky part is what
One obvious action would be to choose non-toxic alternatives. Choosing natural therapies replaces the depen-
dency on pharmaceutical drugs. Also find your political voice on a local and national level as well as supporting
One practical solution to the flush problem woud be a pharmaceutical take-back programme – like those imple-
mented in several European countries, Australia, and Canada.
What about water sewage plants?
It is a well-established fact that conventional sewage treatment technologies do not completely remove drug and
chemical residues. While other methods, such as activated carbon filtration or treatment with ultraviolet light,
could effectively remove PPCPs, they are costly approaches. So, if we can’t rely on the municipal water treat-
ment systems, it’s really up to each person to find their own solutions. It is not advisable to drink tap water, for
example – a much healthier choice would be a reputable brand of bottled spring water.
The most effective water purification system for removing PPCPs is an activated carbon filtration system.
Investing in a high quality whole-house water system using an activated carbon filtration method which puri-
fies all the water used in your home drinking, bathing, and washing, would be your best line of defence, if your
budget can manage it. At the very least use an activated carbon filter such as reverse osmosis.
[Editors Note: A water ionizer is considered by experts to be the very best water purification system - it filter
and ionizes the water to remove all pollutants and harmfull acid molecules from the water, but leaves all the
beneficial substances intact. A reverse osmosis or water distiller can leach essential minerals from the body. ]
The day may come will take responsibility for the life cycle of their products; when the Environmental Protec-
tion Agency and Food and Drug Administration will enact protective regulations for PPCPs; and new sewage
treatment technologies will be developed that safely remove PPCPs. But for fight now, it seems that we’re on
In a world of connectedness, we are again painfully reminded that nothing we do exists in isolation. Our most
ordinary choices, in this case the drugs we ingest and the personal care products we use, may have lifelong con-
sequences not just for us but also for all the unsuspecting people and wildlife downstream. Remember, everyone
Sherrill Sellman, N.D, is the author of Hormone Heresey and
What Women MUST Know To Protect Their Daughters From Breast Cancer.
DRIP RATE PROBLEMS Upon arriving at the emergency department the physician asks how much fluid you infused into your transport patient. Your total transport time was 40 minutes and you ran NS at 45 gtts/min through at 15 gtts/mL administration set. What would you report? The transferring physician requests that you infuse 750 mL of NS during your transport. Anticipated transport time is 3 hou
CURRICULUM VITAE Via V. Alfieri 27 Gioia del Colle ESPERIENZE IN UNIVERSITA’ ITALIANE E STRANIERE Laurea in Scienze Biologiche. Indirizzo Medico-Sanitario. Università degli Studi di Bari. Votazione finale 110/110 Tirocinio propedeutico all’esame di stato, presso il Dipartimento di Fisiologia Generale ed Ambientale e presso il Dipartimento di Chimica Biologica dell’Un