This is the fourth in a series of occasional articles about water.

New testing methods are enabling scientists to detect trace amounts of pharmaceuticals and other bioactive chemicals in the water supply. These are referred to collectively as pharmaceuticals and personal care products (PPCPs) and include prescription and over-the-counter medicines, veterinary drugs, fragrances, cosmetics, sunscreen products, and vitamins.

A 2002 U.S. Geological Survey (USGS) report documented the presence of a broad range of PPCPs and other contaminants in water samples from 30 states. Locally, a 2008 Illinois EPA analysis of raw and finished drinking water for Chicago found minute amounts of four PPCP compounds, including a nicotine byproduct (continine) and a cholesterol-modifying drug (gemfibrozil). The Evanston Water Utility also reported trace amounts of continine in Evanston’s finished drinking water in 2009.

Of note: The 2008 Illinois EPA study found more types of PPCPs in river water downstream from wastewater treatment facilities. Moreover, the analytical methods used in this study were not capable of detecting a number of high-use pharmaceuticals.

Risks and Concerns

Scientists, to date, have found no evidence of harmful effects to human health from PPCPs in the environment. But little is known about the human health consequences of long-term, low-level exposure to pharmaceuticals.

The impact of PPCPs on aquatic life is of particular concern because the exposure risks for aquatic species are much greater than for humans. Aquatic organisms are continually exposed to contaminants in the water, generation after generation, and may be affected by very low concentrations.

Adding to the concerns —

• Medicines are produced and prescribed in increasing volumes every year.

• Wastewater treatment plants are not designed to remove dissolved medicines from water.

• Some pharmaceutical chemicals remain in the environment for a long time.

• Small amounts of different chemicals can add up or interact. 

Sources of PPCPs

Patient use is the primary source of pharmaceuticals in the water supply. A portion of the medication is absorbed, but the rest passes through the body and is flushed down the toilet. A second source is the disposal of unused medications by flushing them down the sink or toilet. In addition, externally applied personal care products enter the environment during bathing, shaving, and swimming.

Many leftover medications are thrown in the trash. This can be dangerous since they could end up in the mouths of children or pets. In addition, medicines thrown out in containers with original labels intact can result in identity theft and medicine theft.

Proper Medicine Disposal

Evanstonians can help prevent pharmaceuticals from entering the environment by disposing of them properly through the City’s collection/disposal program for unused and expired medications and sharps. The program is sponsored by the Solid Waste Agency of Northern Cook County (SWANCC).

Residents can bring their items to the Evanston Health Department, Division of Environmental Health, at the Evanston Civic Center, between 9 a.m. and 4 p.m., Mondays through Fridays. 

• Medicines must be in their original containers with labels to identify the contents.

• Personal information on the labels should be marked out with a black felt
tip pen.

• Sharps (needles and syringes used to manage medical conditions at home) must be placed in a SWANCC-provided container, which can be picked up at the collection site.

The program does not accept any prescription drugs that are considered controlled substances. (A list of these substances is available at swancc.org.) According to federal guidelines for proper disposal of prescription drugs —

• The drugs should be removed from their original containers, mixed with an undesirable substance (such as kitty litter or used coffee grounds), and placed in a disposable container with a lid or into a sealable bag.

• All personal information, including the Rx number, on the empty drug container should be concealed or removed.

There is a very small set of medicines that may be flushed down the toilet or sink. These are medicines that could be especially harmful, or even fatal, if used by someone other than the person for whom they were prescribed. The label on the container or accompanying patient information will include specific instructions for proper disposal.

Residents may also dispose of their mercury-containing thermometers, thermostats, and wall switches at the Evanston Health Department. Mercury thermometers may be exchanged for new, mercury-free oral thermometers at no cost.