Worldwide, pharmaceuticals save millions of lives by preventing and treating diseases, and improve the quality of life for those with a chronic condition. But these lifesaving properties come with an environmental downside. Recent widespread detection of pharmaceuticals in our waterways has generated publicconcern over the potential environmental and human health impacts associated with exposure. The unintended movement of biologically active, toxic, and hormone-disrupting compounds from pharmaceuticals to wastewater effluents and drinking water sources is an international problem that has been documented and publicly reported by government experts and academic researchers for nearly two decades.
Health Care Without Harm, an international nonprofit coalition with more than 450 member organizations,is the leader in effecting environmentally responsible
changes in health care through waste minimization, safer products, and green building. The purposes of this report from the Health Care Research Collaborative are to provide an overview of known information about the life cycle of exposure pathways of pharmaceuticals in the environment, to identifythe gaps in our knowledge, and to make a series of recommendations for further research, policy discussion, and action along the pipeline of exposure pathways.
The management of pharmaceuticals throughout their life cycle is a global issue. Most of the studies reported in this paper were conducted in countries other than the United States, such as Sweden, France, Germany, Italy, Canada, and China, although some studies are drawn from the United States, reflecting the global nature of this issue. This paper builds on the Natural Resources Defense Council’s review of the literature, Dosed Without Prescription, and explores additional ideas put forth by other countries that have successfully grappled with this issue.
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