JANUARY-FEBRUARY , 2023 | THE HEALTH

For example , “ the highest mean cumulative concentration was observed in Lahore , Pakistan at 70.8 µ g / L , with one sampling site reaching a maximum cumulative concentration of 189 µ g / L … This was followed by La Paz , Bolivia ( 68.9 µ g / L mean , 297 µ g / L maximum ) and Addis Ababa , Ethiopia ( 51.3 µ g / L mean , 74.2 µ g / L maximum ).

“ The most polluted sampling site was located in the Rio Seke ( La Paz , Bolivia ) and had a cumulative API concentration of 297 µ g / L … This sampling site was associated with both untreated sewage discharge and disposal of rubbish along the bank of the river ”.

Unlike North America and the Western hemisphere , lack of sophisticated waste removal technologies ( natural , e . g ., via micro-organisms and industrial via , e . g ., peracetic acid ) and lax enforcement of regulations to mitigate pharmaceutical pollution are common in developing and less developing countries , particularly in the regions concerned .

In conclusion , we need to be more aware and mindful of the harm from pharmaceutical pollution and go the extra mile in tackling these emerging challenges . – The Health

Jason Loh and Jachintha Joyce are part of the research team at EMIR Research , an independent think tank focused on strategic policy recommendations based on rigorous research .

IN MALAYSIA , the focus on pharmaceutical pollution has often been neglected .

The pharmaceutical industry here is controlled by the Drug Control Authority ( DCA ) of the Ministry of Health ( MoH ) with the NPRA as the secretariat and technical body . The DCA ’ s executive and legal role ( as delineated / provided for under the Control of Drugs and Cosmetics Regulation , 1984 ) is to ensure that every pharmaceutical product marketed in the country is safe and of sound quality .

The National Pharmaceutical Regulatory Agency ( NPRA ) provides technical support by testing the pharmaceutical products ’ quality and safety ( quality control ( QC ) and performance evaluation .

Currently , Malaysia ’ s core legislation on the environment is the Environmental Quality Act ( 1974 ). No laws specifically target pharmaceutical pollution as a discrete category in its own right .

Many Malaysians in less developed states source water from groundwater sources . Kelantan , Terengganu , Kedah , Perlis , Pahang , Sabah and Sarawak are the highest users of groundwater as a source of drinking water .

But the federal government has been keen to tap into groundwater as a viable alternative source for the nation as a whole ( see , “ Tapping into groundwater is the way forward , says PM , New Straits Times , March 26 , 2022 ).

If this is implemented , Malaysians might be at a heightened risk of groundwater contamination if pharmaceutical pollution isn ’ t definitively tackled .

Already in what could be deemed as a “ rare ” finding as contained in “ Detecting Human Pharmaceutical Pollutants in Malaysian Aquatic Environment : A new challenge for water quality management ” ( chapter in Contemporary environmental quality management in Malaysia and selected countries , UPM Press , 2011 ), results show that the Hulu Langat River has been polluted by APIs , and sewage treatment don ’ t totally remove these pollutants .

Mefenamic acid , salicylic acid and glibenclamide are the most common pharmaceutical residues found in the Hulu Langat River (“ The occurrence of human pharmaceuticals in wastewater effluents and surface water of Langat River and its tributaries , Malaysia ”, International Journal of Environmental Analytical Chemistry ,

93 ( 3 ), 2011 ). The ineffectiveness of our conventional sewage treatment plants ( STPs ) is confirmed by Dr Nurfaizah Abu Tahrim from Universiti Kebangsaan Malaysia ( UKM ) – which aren ’ t designed to treat pharmaceutical waste ( See “ Environmental implications of pharmaceutical waste , Borneo Post Online , Jan 27 , 2021 ).

REGULAR INSPECTIONS AND AUDITS IMPORTANT

EMIR Research would like to recommend that due attention be afforded to upgrading our STPs to ensure that they deploy the latest waste removal technology – natural and industrial – such as solar photolysis ( conversion of photon energy comprising of waves of electromagnetic radiation by which the contaminants are exposed – process of irradiation ) and advanced oxidation processes / AOPs ( e . g ., thermal plasma – increasing reactive oxygen and nitrogen species to dissolve in water and break down contaminants ), respectively , which specifically targets at pharmaceuticalbased / driven pollution .

The government at all three levels ( federal , state , local ) should be more committed to tackling river and landfill pollution by rigorously and uncompromisingly enforcing the legislation ( primary ) and regulations ( secondary ) on the pharmaceutical industries .

Regular inspections and audits should be carried out at all three levels and these activities should be coordinated and synchronised , accordingly . At the same time , the pharmaceutical industries should be assessed by private auditors in compliance to the ESG ( environmental , social and governance ) due diligence . Independent , non-executive directors should be empowered and trained to scrutinise and monitor pharmaceutical polluting activities .

At the micro-level , every pharmacist , medicine administrator in hospitals and clinics , and pharmacies should educate and inform patients to dispose of expired or unused drugs properly . This will prevent patients from disposing of the prescribed and non-prescribed ( i . e ., “ over the counter or OTC ) drugs improperly ( e . g ., flushing down the toilet bowl ). This is to ensure pharmaceutical wastes from contaminating the STPs – as pre-emptive and precautionary measures .

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