BY JASON LOH

AND

reproductive capacity , etc . For instance , based on a study , birth control pills have a high level of progestogens to which frogs are very sensitive . Female tadpoles that inhabit polluted areas are subjected to reproduction issues resulting from infertility ( see , “ Sterility in frogs caused by environmental pharmaceutical progestogens , study finds ”, Science Daily , Feb 16 , 2011 ).

JACHINTHA JOYCE

For example , according to the Cary Institute of Ecosystem Studies , “ pharmaceutical pollution in freshwater [ among others ] is largely unstudied ”.

Covid-19 has provided the impetus and catalyst for further acceleration in the growth of pharmaceutical industries leading to high-risk pollution across the world ( see , e . g .,“ A critical review on the environmental presence of pharmaceutical drugs tested for the Covid-19 treatment ”).

Worldwide revenue of the pharmaceutical industry reached US $ 1.4 trillion in 2021 , according to ResearchandMarkets . com ( see “ Analyzing the US $ 1.4 trillion Global Pharmaceutical Industry 2022 ”, Business Wire , Nov 30 , 2022 ).

But the tide is shifting and the “ crustal displacement ” in the policy discourse is that there ’ s been growing awareness and consciousness regarding the ecological impact of pharmaceutical and what ’ s known as active pharmaceutical ingredients ’ ( API ) disposal , discharge and release over the years now . This is due to the global reconnaissance and findings precipitated by the off-shoring , outsourcing , and relocation of the pharmaceutical industries ’ production networks to the so-called “ Third World ” countries .

APIs are any substances or compounds that are designed to be utilised in the production of a pharmaceutical dosage form and , when so used , becomes an active component that helps to diagnose , treat or prevent different diseases ( World Health Organisation / WHO Technical Report Series No . 970,2012 , as

quoted by the National Pharmaceutical Regulatory Agency / NPRA , Ministry of Health / MoH , Malaysia ).

In addition to freshwater sources , APIs and finished pharmaceutical products ( FPPs ) infiltrate / enter the environment via ocean , underground water , and landfills .

CONTAMINANTS OF EMERGING CONCERN

Due to the nature of the role that they play , wastewater and sewage treatment plants ( STPs ) host pharmaceutical pollutants via urine , faeces and wastes from body wash ( see , “ A critical review on environmental presence of pharmaceutical drugs tested for the Covid-19 treatment ”, Process Safety and Environmental Protection , Vol . 152 , August 2021 ).

Besides medical and drug products , personal care products ( PCPs ) – such as toothpastes and shampoos – are counterpart elements that contribute to pharmaceutical pollution .

The Fourth Session of the International Conference on Chemicals Management ( ICCM 4 ) nominated what ’ s termed as , “ environmentally persistent pharmaceutical products ” ( EPPP ) – which contain APIs – as an emerging policy issue at 2015 . These pollutants

are also classified as contaminants of emerging concern ( CECs ).

Even where the concentration is low , APIs / EPPPs / CECs can cause an inimical effect on living organisms and don ’ t degrade easily , and persist for longer periods in the environment due to their stable structure (“ Pharmaceutical Wastewater as Emerging Contaminants ( EC ): Treatment technologies , impact on environment and human health ”, Energy Nexus , Volume 6 , June 2022 ).

Traces of pharmaceutical components from antidepressants , antibiotics , painkillers and birth control pills are some of the common pollutants found in freshwater sources , and considered as the leading environmentally dangerous drugs ( see , “ Drugs flushed into the environment could be cause of wildlife decline , The Guardian , Oct 13 , 2014 ).

Additionally , pharmaceutical pollution is highly associated with risks in human and aquatic organisms ’ endocrine ( or hormonal ) systems – as endocrine disrupting chemicals ( EDCs ).

Endocrine systems release hormones into the bloodstreams of humans and animals , which is critical in controlling mood , physical growth and development , energy level ,

PHARMACEUTICAL POLLUTION IN RIVERS

Globally , 25 per cent of the rivers are impacted whereby this is inclusive of not only urban but also remote areas ( see , “ 25 per cent of global rivers have significant pharmaceutical pollution ”, Open Access Government , Feb 17 , 2022 ).

Developing and less developing countries are more exposed ( to pharmaceutical pollution ) – reflecting the wider disparities arising from the North-South divide .

A study published by the Proceedings of the National Academy of Science / PNAS – “ Pharmaceutical Pollution of the World ’ s Rivers ” ( Feb 14 , 2022 ) – shows that parts of South America , sub-Saharan Africa and South Asia are highly rated pharmaceutical pollutant hubs (“ Global study finds the extent of pharmaceutical pollution in the world ’ s rivers ”, University of York , 2022 ). The study “ monitored 1,052 sampling sites along 258 rivers in 104 countries of all continents , thus representing the pharmaceutical fingerprint of 471.4 million people ” to “ measure the presence of 61 pharmaceuticals .

In turn , these pharmaceuticals such as carbamazepine ( a highly teratogenic substance , i . e ., causing congenital disorders in a developing embryo or foetus and life-threatening allergic reactions such as Stevens- Johnson Syndrome / SJS ) or toxic epidermal necrolysis / TEN ), metformin and caffeine [ as the three most frequently detected APIs ]”.

It ’ s found ( among other things ) that :

• There ’ re strong correlations between the levels of socioeconomic inequality of a country and higher pollution of pharmaceuticals in the rivers ;

• high levels of pharmaceutical pollution were most positively associated with regions of high local unemployment and poverty rates ;

• the most pharmaceutically polluted countries and regions of the world are the ones that have been researched the least in the past – as alluded to , namely parts of sub-Saharan Africa , South America and South Asia . These regions have a high presence of multinational pharmaceutical