Great Lakes Article:

Is our water hooked on drugs?
Article courtesy of the Windsor Star
December 8, 2001

Medicines to dull our pain, cosmetics to make us more attractive and drugs to speed the growth of livestock might all be coming back to haunt our health.

Commonly used pharmaceuticals, ingested and applied to treat everything from head-aches and painful joints to epileptic seizures and high cholesterol, are starting to be found in measurable quantities in the Great Lakes and elsewhere.

"We weren't expecting to find this in our water ... (but) we're finding concentrations in the environment that are approaching concentrations we expect to see having an effect," said Mark Servos, an Environment Canada toxicologist who is heading up an effort by the federal government to understand the potential threat.

Research into the growing amount of drug wastes entering our waters and what harm it might be doing is in its infancy. But there is growing concern as Canadians steadily increase their intake of pharmaceuticals, only to see much of it discharged into the sewage system.

"I'm not going to ring any alarm bells ... (but) in North America, it's generated a lot of interest lately," said Trent University research dean Chris Metcalfe, one of the first Canadian scientists to recognize and begin researching the potential threat posed by drug wastes.

"It's a difficult, enormous story ... even the scientists are surprised at what they're finding," said Mike Gilbertson, a biologist with the International Joint Commission, a binational agency concerned with environmental issues affecting Canada and the U.S.

What Metcalfe found last year in the treated effluent leaving Windsor's Little River sewage plant were traces of aspirin and ibuprofen, as well as prescription medications such as naproxen, an anti-inflammatory drug and carbamazepine, used to treat epilepsy and depression.

Across the Detroit River, Michigan researchers sampling treated sewage are detecting small amounts of everything from diet pills, caffeine and contraceptives to household cleansers that can break down into compounds that behave like hormones, including the female sex hormone estrogen. Hormones are the body's chemical messengers that can trigger changes in the body, particularly during fetal development.

Some researchers suspect pharmaceutical wastes flushed into the lakes could be linked to such disturbing discoveries as male fish turning into females. It may help explain the trend of boys' and girls' bodies maturing into adulthood at an ever younger age.

"When fish are exposed to estrogen ... young males will start feminization. We know those chemicals are there and fish can respond to them," said Servos. "We're still working on the question of whether it's a serious problem."

Trace amounts of estrogen were detected in residential sections of Windsor's sewage system three years ago when Metcalfe and the Great Lakes Institute for Environmental Research did a test for the city.

"There are definitely hormonal effects happening in wildlife in the Great Lakes ... you have to wonder what else might be happening," said Julia Langer, a director with World Wildlife Fund Canada. "How do pharmaceuticals fit into that?"

Less understood is how pharmaceuticals have infiltrated drinking water.

"That's the $60,000 question," said Metcalfe. Scientists in Germany have discovered traces of some drugs in tap water there, but in Canada, he said, "we don't have any data."

The Windsor Utilities Commission, which taps the Detroit River for the city's drinking water supply, will start this month testing for pharmaceuticals.

"I'm sure we're going to see some, but how much, that's the question," said Saad Jasim, WUC's superintendent of water production.

Windsor is the only city in Ontario that treats its drinking water with ozone, which some studies identify as effective in getting rid of some pharmaceutical remnants.

Admitting to "growing concerns" stemming from its own research, Health Canada announced in September new regulations requiring companies that bring in or manufacture new drugs to have them screened under the Environmental Protection Act to assess their ecological impact.

Environment Canada and Health Canada teamed up in October to study the environmental effects of pharmaceuticals. Servos, who co-chairs the effort, said looking into the safety of drinking water is at the top of their agenda.

So far, said Servos, Canada is not seeing the same "dramatic effects" as in Europe, where male fish downstream of sewage outfalls are becoming feminized or undergoing complete sex reversal.

The U.S. Geological Survey is expected before year's end to reveal initial results of a first-ever nationwide survey of U.S. water sources that looked at 94 target chemicals, including human and veterinary antibiotics, prescription drugs and reproductive and steroidal hormones.

Pain drug shows up in sewage

Pharmaceutical use soaring

I should have quit hockey at 35." Instead, University of Windsor biologist Doug Haffner was held captive to Canada's national pastime for another five years.

The result? A creaky knee and the need for pain relief in the form of the prescription medication Naprosyn.

Haffner, a research scientist who makes his living tracking toxic contaminants in the Great Lakes, recently made the stunning discovery that he and his knee might be part of that pollution problem.

Recent water samples taken downstream of Windsor's Little River sewage treatment plant for a Health Canada study uncovered detectable levels of a number of pharmaceuticals, including naproxen. Marketed under the brand name Naprosyn, the anti-inflammatory is used to treat the ailing joints of many pain sufferers, including aging hockey players.

"I didn't realize I'm peeing this stuff (into the Great Lakes)," said Haffner.

He's not alone.

Last year, Canadian pharmacists dispensed 405,000 prescriptions of Naprosyn.

According to IMS Health Canada Ltd., a private company that tracks health care statistics, Canadian doctors wrote almost 2.5 million naproxen prescriptions in 2000.

It's part of a growing trend that has seen pharmaceutical consumption soar the past several years, with Canadians spending $9.5 billion on prescription drugs in 2000, up 72 per cent from 1995.

Other drugs found at detectable levels in the Little River last year included aspirin, ibuprofen and carbamazepine, a widely prescribed medication used to treat epilepsy and depression.

"How hazardous is it? To me, not much, at least not here," said Haffner. Compared to Europe, where some rivers consist entirely of treated effluent, he and others say our much larger water bodies serving a much smaller population should sufficiently dilute the problem.

But environmentalists argue dilution shouldn't be seen as the solution to pollution.

"I do think there is a concern," said Tracey Easthope, a director with the Ecology Centre in Ann Arbor, Mich.

"Wildlife are the sentinel species for us. I think we should take note when there are changes, when we see effects in wildlife ... caged studies show there is an impact."

On the subject of harmful chemicals in the water, Haffner admitted to being "biased" in favour of targeting such persistent and proven toxic and carcinogenic environmental poisons as PCBs, PAHs, dioxins and other industrial wastes.

'Superbugs' feared

The exception, said Haffner, is antibiotics and the threat that, flushed into the environment, they may lead to the creation of "superbugs" -- new strains of bacteria resistant to antibiotics.

Said Trent University's Chris Metcalfe, one of the first in North America to study the issue: "Antibiotics is certainly one to keep an eye on ... if they're getting into the water, is there a potential for antibiotic resistance?"

Metcalfe is concerned over the widespread use of antibiotics and growth hormones in increasingly larger and more concentrated livestock feedlots, not to treat sick animals but used to prevent illness and promote growth. A report this fall estimated livestock operations in Ontario and Quebec generate manure equivalent to the sewage of 100 million people, none of it treated.

But even sewage plants leave a lot to be desired, according to Metcalfe, who said his European colleagues are "absolutely flabbergasted" when they hear what level of treatment is offered in Canada, with cities like Victoria, Montreal and Halifax literally filtering out only unsightly solids and Windsor's main plant offering only slightly better technology.

Andrew Swift, a Health Canada spokesman, said that up to 80 per cent of a drug can pass through the body and be excreted.

Said Metcalfe: "When you're taking an aspirin, you're probably only absorbing about 30 per cent of it, the rest is excreted and gets into our sewage plants."

There, Windsor pollution control director Kit Woods said, "anything organic and dissolved in the influent will essentially go into the plant and out."

Woods said there's "no way of quantifying" the pharmaceuticals and other drugs flushing through the system and into the Great Lakes.

"I don't think people need to panic," he said, adding the "jury is still out" on whether traces of pharmaceuticals in sewage effluent can be directly tied to damage in the environment.

He agreed the issue needs further investigation. "We are baby boomers, we're getting older and we're going to use more and more drugs," said Metcalfe.

"No, none of this stuff kills you dead, but if your brain function is altered, in the wildlife kingdom, that's of very big concern -- come to think of it, it should be in the human kingdom as well," said Julia Langer, a director with World Wildlife Fund Canada.

Drugs and our Water

Gender morphing

A big worry about drugs in our water is how they might affect the body's endocrine system, which regulates hormones.

Hormones are the body's chemical messengers, triggering everything from sexual development to emotional responses and exerting enormous control over fetal development -- the growth of skin, the nervous system and some brain cells.

Molecules of some chemical pollutants, from pesticides and polychlorinated biphenyls (PCBs) to dioxins and additives in some plastics and industrial detergents, can behave like hormones in the bodies of animals and humans. They can mimic natural hormones -- or block, amplify or otherwise disrupt them -- triggering "fake" messages.

Synthetic chemicals in laboratory rodents and Great Lakes fish and herring gulls have been shown to act like natural estrogen and testosterone sex hormones. Some studies have shown sex reversals in male fish.

The same chemicals are found in the fatty tissues of most humans and might explain, for instance, soaring rates of breast and testicular cancers, or why male sperm counts in the industrialized world, according to some studies, have plummeted 50 per cent since the chemical revolution began after the Second World War.

What's being done

¥ Windsor Utilities Commission, which uses the Detroit River as the city's tap water source, starts a pilot project this month to, for the first time, measure for pharmaceuticals and test how successful ozone treatment is in getting rid of them in drinking water.

¥ The city public works department, which already uses live trout and mussels to monitor for pollutants in treated sewage, will soon add medaka, a highly sensitive Japanese fish, to test for endocrine disrupting chemicals in effluent.