environmental impact of pharmaceuticals and personal care products environmental impact of pharmaceuticals and personal care products the environmental effect of pharmaceuticals and personal care products (ppcps) is being investigated since at least the 1990s. ppcps include substances used by individuals for personal health or cosmetic reasons and the products used by agribusiness to boost growth or health of livestock. more than twenty million tons of ppcps are produced every year. the european union has declared pharmaceutical residues with the potential of contamination of water and soil to be "priority substances". part of a series onpollutionmethods of ppcp entry into the environment from residential homes via septic and sewage systems air acid rain air quality index atmospheric dispersion modeling chlorofluorocarbon exhaust gas haze indoor air internal combustion engine global dimming global distillation ozone depletion particulates persistent organic pollutant smog aerosol soot volatile organic compound biological biological hazard genetic introduced species (invasive species) digital information electromagnetic light ecological overillumination radio spectrum natural ozone radium and radon in the environment volcanic ash wildfire noise transportation land water air rail sustainable transport urban sonar marine mammals and sonar industrial military abstract noise control radiation actinides bioremediation depleted uranium nuclear fission nuclear fallout plutonium poisoning radioactivity uranium electromagnetic radiation and health radioactive waste soil agricultural herbicides manure waste pesticides land degradation bioremediation defecation electrical resistance heating soil guideline values phytoremediation solid waste biodegradable waste brown waste electronic waste battery recycling food waste green waste hazardous waste biomedical waste chemical waste construction waste lead poisoning mercury poisoning toxic waste international waste industrial waste lead smelting litter mining coal mining gold mining surface mining deep sea mining mining waste uranium mining municipal solid waste garbage nanomaterials plastic microplastics packaging waste post-consumer waste waste management landfill thermal treatment space satellite thermal urban heat island visual air travel advertising clutter overhead power lines traffic signs vandalism war chemical warfare herbicidal warfare (agent orange) nuclear holocaust (nuclear fallout - nuclear famine - nuclear winter) scorched earth unexploded ordnance war and environmental law water agricultural wastewater diseases eutrophication firewater freshwater groundwater hypoxia industrial wastewater marine debris monitoring nonpoint source see misc section nutrient ocean acidification oil spill pharmaceuticals freshwater salinization septic tanks sewage septic tanks pit latrine shipping stagnation sulfur water surface runoff turbidity urban runoff water quality misc point source area source legacy pollution lists diseases law by country most polluted cities least polluted cities by pm2.5 treaties categories by country environment portal ecology portal ppcps have been detected in water bodies throughout the world more research is needed to evaluate the risks of toxicity, persistence, and bioaccumulation, but the current state of research shows that personal care products impact over the environment and other species, such as coral reefs and fish. ppcps encompass environmental persistent pharmaceutical pollutants (eppps) and are one type of persistent organic pollutants. they are not removed in conventional sewage treatment plants but require a fourth treatment stage which not many plants have. in 2022, the most comprehensive study of pharmaceutical pollution of the world's rivers found that it threatens "environmental and/or human health in more than a quarter of the studied locations". it investigated 1,052 sampling sites along 258 rivers in 104 countries, representing the river pollution of 470 million people. it found that "the most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing" and lists the most frequently detected and concentrated pharmaceuticals. overview since the 1990s, water pollution by pharmaceuticals has been an environmental issue of concern. many public health professionals in the united states began writing reports of pharmaceutical contamination in waterways in the 1970s." most pharmaceuticals are deposited in the environment through human consumption and excretion, and are often filtered ineffectively by municipal sewage treatment plants which are not designed to manage them. once in the water, they can have diverse, subtle effects on organisms, although research is still limited. pharmaceuticals may also be deposited in the environment through improper disposal, runoff from sludge fertilizer and reclaimed wastewater irrigation, and leaky sewer pipes. in 2009, an investigative report by associated press concluded that u.s. manufacturers had legally released 271 million pounds of compounds used as drugs into the environment, 92% of which was the industrial chemicals phenol and hydrogen peroxide, which are also used as antiseptics. it could not distinguish between drugs released by manufacturers as opposed to the pharmaceutical industry. it also found that an estimated 250 million pounds of pharmaceuticals and contaminated packaging were discarded by hospitals and long-term care facilities. the series of articles led to a hearing conducted by the u.s. senate subcommittee on transportation safety, infrastructure security, and water quality. this hearing was designed to address the levels of pharmaceutical contaminants in u.s. drinking water. this was the first time that pharmaceutical companies were questioned about their waste disposal methods. "no federal regulations or laws were created as a result of the hearing." "between the years of 1970-2018 more than 3000 pharmaceutical chemicals were manufactured, but only 17 are screened or tested for in waterways." alternately, "there are no studies designed to examine the effects of pharmaceutical contaminated drinking water on human health." in parallel, the european union is the second biggest consumer in the world (24% of the world total) after the usa and in the majority of eu member states, around 50% of unused human medicinal products is not collected to be disposed of properly. in the eu, between 30 and 90% of the orally administered doses are estimated to be excreted as the active substances in the urine. the term environmental persistent pharmaceutical pollutants (eppp) was suggested in the 2010 nomination of pharmaceuticals and environment as an emerging issue to strategic approach to international chemicals management (saicm) by the international society of doctors for the environment (isde). safe disposal depending on the sources and ingredients, there are various ways in which the public can dispose of pharmaceutical and personal care products in acceptable ways. the most environmentally safe disposal method is to take advantage of a community drug take-back programs that collect drugs at a central location for proper disposal. several local public health departments in the united states have initiated these programs. in addition, the united states drug enforcement administration (dea) periodically promotes local take-back programs, as well as the national take back initiative. take-back programs in the us are funded by state or local health departments or are volunteer programs through pharmacies or health care providers. in recent years, the proposition that pharmaceutical manufacturers should be responsible for their products "from the cradle to the grave" has been gaining attention. where there is no local take-back program, the u.s. environmental protection agency (epa) and the office of national drug control policy suggested in a 2009 guidance that consumers do the following: take the prescription drugs out of their original containers mix drugs with cat litter or used coffee grounds place the mixture into a disposable container with a lid, such as a sealable bag cover up any personal identification with a black marker that is on the original pill containers place these containers in the bag with the mixture, seal them, and place them in the trash. the intent of the recommended practices is that the chemicals would be separated from the open environment, especially water bodies, long enough for them to naturally break down. when these substances find their way into water, it is much more difficult to deal with them. water treatment facilities use different processes in order to minimize or fully eliminate these pollutants. this is done by using sorption where suspended solids are removed by sedimentation. another method used is biodegradation, and through this method microorganisms, such as bacteria and fungi, feed on or break down these pollutants thus eliminating them from the contaminated media. types illicit drugs such as ecstasy (above) can be found in waterways. pharmaceuticals, or prescription and over-the-counter medications made for human use or veterinary or agribusiness purposes, are common ppcps found in the environment. there are nine classes of pharmaceuticals included in ppcps: hormones, antibiotics, lipid regulators, nonsteroidal anti-inflammatory drugs, beta-blockers, antidepressants, anticonvulsants, antineoplastics, and diagnostic contrast media. personal care products have four classes: fragrances, preservatives, disinfectants, and sunscreen agents. these products may be found in cosmetics, perfumes, menstrual care products, lotions, shampoos, soaps, toothpastes, and sunscreen. these products typically enter the environment when passed through or washed off the body and into the ground or sewer lines, or when disposed of in the trash, septic tank, or sewage system. traces of illicit drugs can be found in waterways and may even be carried by money. routes into the environment more attention has been devoted since 2016 to ppcps in the environment. two causes may contribute to this: ppcps are actually increasing in the environment due to widespread use and/or analytical technology is better able to detect ppcps in the environment. these substances enter the environment directly or indirectly. direct methods include contamination of surface water by hospitals, households, industries, or sewage treatment plants. direct contamination can also affect the sediment and soil. it is generally assumed (albeit hardly verified) that the production of pharmaceuticals in industrialised countries is well controlled and unharmful to the environment, due to the local legal restrictions usually required to permit production. however, a substantial fraction of the global production of pharmaceuticals takes place in low-cost production countries like india and china. recent reports from india demonstrate that such production sites may emit very large quantities of e.g. antibiotics, yielding levels of the drugs in local surface waters higher than those found in the blood of patients under treatment. the major route for pharmaceutical residues to reach the aquatic environment is most probably by excretion from patients undergoing pharma treatment. since many pharmaceutical substances are not metabolized in the body they may be excreted in biologically active form, usually via the urine. furthermore, many pharmaceutical substances are not fully taken up from the intestine (following oral administration in patients) into their blood stream. the fraction not taken up into the blood stream will remain in the gut and eventually be excreted via the feces. hence, both urine and feces from treated patients contain pharmaceutical residues. between 30 and 90% of the orally administered dose is generally excreted as active substance in the urine. an additional source to environmental pollution with pharmaceuticals is improper disposal of unused or expired drug residues. in european countries take-back systems for such residues are usually in place (although not always utilized to full extent) while in e.g. the us only voluntary initiatives on a local basis exist. though most of the waste goes to incineration and people are asked to throw unused or expired pharmaceuticals into the household waste investigations in germany showed that up to 24% of liquid pharmaceuticals and 7% of tablets or ointments are disposed always or at least "rarely" via the toilet or sink. proper destruction of pharma residues should yield rest products without any pharmaceutical or ecotoxic activity. furthermore, the residues should not act as components in the environmental formation of new such products. incineration at a high temperature (>1000 degrees celsius) is considered to fulfill the requirements, but even following such incineration residual ashes from the incineration should be properly taken care of. pharmaceuticals used in veterinary medicine, or as additives to animal food, pose a different problem, since they are excreted into soil or possibly open surface waters. it is well known that such excretions may affect terrestrial organisms directly, leading to extinction of exposed species (e.g. dung-beetles). lipid-soluble pharma residues from veterinary use may bind strongly to soil particles, with little tendency to leak out to ground water or to local surface waters. more water-soluble residues may be washed out with rain or melting snow and reach both ground water and surface water streams. presence in the environment the use of pharmaceuticals and personal care products (ppcps) is on the rise with an estimated increase from 2 billion to 3.9 billion annual prescriptions between 1999 and 2009 in the united states alone. ppcps enter into the environment through individual human activity and as residues from manufacturing, agribusiness, veterinary use, and hospital and community use. in europe, the input of pharmaceutical residues via domestic waste water is estimated to