Great Lakes Article:

Common drugs seeping into lakes, fish and water supply
By Susanne Quick
Milwaukee Journal Sentinel
Posted on the Ledger-Enquirer June 3, 2005

MILWAUKEE - (KRT) - It was barely a drop, but the effect of the drug was astonishing.

Pointing to a digital recording of fathead minnows gasping for breath in a milky, murky stew, researcher Rebecca Klaper said: "We had planned to keep them in there for a week, but we had to pull them the next day. They were going to die."

Klaper, of the University of Wisconsin-Milwaukee's Great Lakes WATER Institute, is investigating the effects of common drugs, such as pain relievers, anti-depressants and lipid regulators, on lake fish and invertebrates. Many of these medications pass through the body, into the sewer system and out to the environment largely unaltered.

And because they are designed to affect the biology of a living organism - to reduce headaches, control seizures or suppress coughs - she and other researchers think they could have an impact on fish and other wildlife.

Standing in her lab at the WATER Institute, an old tile warehouse on the banks of the Kinnickinnic River, Klaper reviewed the minnow experiment. She pointed to the fishes' gills, which were straining open and shut in a desperate attempt to filter oxygen in the deadly murk surrounding them.

"The water was cloudy by the time we got in the next morning," said Chris Rees, a research assistant, recalling the day after a lipid regulator was introduced into their tank.

But the milkiness wasn't from the drug itself, Klaper said. It was the physical manifestation of the stressed and dying fish - a cloudy stew of mucous and other piscine secretions.

It wasn't as if Klaper had heavily dosed the fish. She had diluted the drug to one part per billion, or the equivalent of a drop in a railroad tanker. That's a concentration that has been detected in waters from Europe to South America, and as close to home as Lake Ontario and the Detroit River.

It is estimated that more than 1,000 tons of active pharmaceutical products are manufactured each year. Pharmaceutical sales are increasing 7 percent to 8 percent annually, and nearly 45 percent of all sales in 2004 were in North America.

The U.S. Food and Drug Administration requires environmental impact statements under some circumstances, but the circumstances are so unusual that pharmaceutical companies essentially don't have to worry about them.

Researchers say two primary and related concerns exist when it comes to these drugs. First, the drugs going into the water might affect the environment, particularly the biological food chain. Second, the drugs could come back to people in drinking water.

In both cases, "the big unknown" is what effect these products might have on chronically exposed plants, animals and people, said Christian Daughton, chief of the environmental chemistry branch at the Environmental Protection Agency's National Exposure Research Laboratory in Las Vegas.

Because the concentrations are so small, the immediate effects might be too subtle to notice, Daughton said. But because the exposure is constant, the "long-term cumulative consequences could be insidious."

Klaper and other researchers, such as Stanley Dodson and Joel Pedersen at the University of Wisconsin-Madison, are trying to sort it out.

Dodson has been focusing on biological food chain-aspect, by looking at a small, shrimp-like organism called daphnia - what he calls an environmental "keystone" species.

"They're like canaries in a mine shaft," he said. If you see something start to go wrong with them, it's a warning.

Preliminary studies have shown that commonly used drugs can skew their sex ratios and slow their feeding behavior. That's a problem not just for daphnia, but potentially for animals, such as fish, that rely on them.

But Dodson realizes what might appear initially as a recreational issue - a crash in fish populations - also could develop into a human health issue.

Unlike other pollutants, these products have "enjoyed several decades of unrestricted discharge into the environment," Daughton said. And very little is known about their long-term effects on chronically exposed organisms.

Public awareness about the potential harm these compounds could cause started in the 1980s when researchers noticed that items such as antibiotics and hormones were making their way into the environment.

From Seattle to Berlin, researchers were finding genetically male fish that could produce eggs and egg proteins. Concerned that birth control pills, hormone replacement therapies and other chemicals that mimic hormones were causing this wave of "she-male" fish, researchers began investigating.

While scientists had data showing compounds such as aspirin, nicotine and caffeine also were leaching into wastewater at this time, the implications didn't hit until the early 1990s.

At this point, German researchers discovered the presence of these more common drugs in treated and untreated sewage, surface water, ground water and drinking water. Alarmed, North American researchers started looking for them, too.

Chris Metcalfe, of Trent University in Peterborough, Ontario, discovered them in both treated and untreated samples of wastewater in eastern Ontario. He has found them by treatment plants and more remote areas of the Lake Ontario.

And Glen Boyd, a researcher at Tulane University in New Orleans, has found them in the Mississippi River, Lake Pontchartrain and the Detroit River.

The drugs are so ubiquitous and pervasive, even researchers not looking for them have stumbled upon them.

Pedersen, a soil scientist at UW-Madison, said that as a graduate student in the late '90s, he studied runoff from fields irrigated with treated wastewater, a method commonly used in more arid areas. He was looking for pesticides and other agricultural chemicals. But he found dozens of these personal care products.

Since then, he's examined the fate of drugs, primarily antibiotics, as they seep through soil, potentially leaching their way into the groundwater below. He's now collaborating with other UW scientists to investigate the fate of pharmaceuticals that leach from septic systems.

"We're really just starting to understand the fate of pharmaceuticals in the environment," he said. "We have much to learn."

Admittedly, for people on the larger Great Lakes, the concerns are not as great as elsewhere because the concentrations here are so diluted. But as levels of common pharmaceuticals increase, the possibility these compounds could work their way back into drinking water magnifies.

"By their nature, pharmaceuticals are designed to be highly bioactive - many exquisitely so," Daughton wrote in a 1999 review for an EPA Web site. "Most, however, also have numerous unintended effects."

For water headed out to Lake Michigan, the Milwaukee Metropolitan Sewerage District is not treating sewage effluent with these products in mind. The cost, they say, to remove these drugs would be prohibitive. And although they acknowledge the research is still "out" on these drugs, they say current data doesn't warrant an overhaul of the system.

As for water coming back in, officials at Milwaukee Water Works, the largest provider of tap water in the area, say they haven't looked for these compounds in the past but will start this year.

Lon Couillard, water quality manager for Milwaukee Water Works, is not concerned. He's convinced the city's water treatment process will remove these products. If ozone oxidation - a chemical filtration method the city set up in 1998 - doesn't do it, other treatment processes, such as filtration, will.

"If you've got a group of soldiers and you surround them with a strip of raw razor wire, followed by land mines, a water-filled moat, a trench and sand bags, the enemy isn't going to be able to penetrate," Couillard said.

The problem, to borrow Couillard's analogy, is that if the enemy arrives in helicopters, those conventional methods don't add up to a pile of beans. That's what is so worrisome to researchers. Pharmaceutical products aren't the traditional enemy that water systems were designed to combat.

Chemical oxidation - the method Couillard cites as the city's best line of defense - works by breaking up molecules, encouraging compounds to convert into smaller components.

"These 'by-products' are generally smaller in size, more polar (water soluble) and often pose less hazard" than the original, Daughton said. "But sometimes they might pose more hazard," altering the molecules by making them even more biologically active.

"It is highly unlikely that any water-oxidation process would prove 100 percent efficient for all organic chemicals." And even though reverse-osmosis - a physical system for filtering out chemicals - is probably the most effective method, it, too, can't rid water of everything.

Even if it could, there's the question of what to do with the waste particles filtered out. Where would they go? Into landfills, where they could leach into groundwater?

The answer is not clear. And researchers are not sure what the future holds.

Klaper and her colleagues at the WATER Institute plan to head out this summer to test animals at the receiving end of wastewater outflows. She's interested in examining the effect these chemicals might have on gene expression in minnows and daphnia.

"We're really just at the beginning" of understanding the effects of these drugs on wildlife, she said.

But if her drug-exposed fathead minnows are any indicator of the future, it's not looking good.