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Active and obsolete pharmaceuticals in the Baltic sea region

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Why bother? Background and Rationale.
Pharmaceuticals in the BSR: what do we know?
Proposal for the Baltic Priority List.
Measures available and applicable.
Pharmaceuticals: what we still need to know?

Publicado en: Medio ambiente
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Active and obsolete pharmaceuticals in the Baltic sea region

  1. 1. co-funded by EU LIFE Programme Active and obsolete pharmaceuticals in the Baltic Sea region Mikhail Durkin, Coalition Clean Baltic Secretariat, Sweden Действующие и устаревшие фармакопрепараты в Балтийском регионе Михаил Дуркин, Секретариат Колалиции Чистой Балтики, Швеция
  2. 2. • CCB: was established in 1990 • CCB: a network of grass-root environmental NGOs • CCB: cooperation of Environmental Citizens Organisations (ECO) • CCB: 19 member organizations and through them – over 800 000 individual members • CCB: works in the entire Baltic Sea catchment area, through organisations in Belarus, Denmark, Estonia, Finland, Germany, Latvia, Lithuania, Poland, Russia, Sweden and Ukraine • CCB: lobby at EU and HELCOM level, coordinated actions and field work, awareness raising and capacity building Network of grass-root environmental NGOs co-funded by EU LIFE Programme
  3. 3. Network covering the whole catchment Russia Friends of the Baltic, St. Petersburg Green World, St. Petersburg GUIDE Environmental Group, Kaliningrad Finland Finnish Association for Nature Conservation Finnish Society for Nature and Environment Sweden Swedish Society for Nature Conservation WWF-Sweden Denmark Danish Society for Nature Conservation Germany Bund für Umwelt und Naturschutz Deutschland / Friends of the Earth Germany Estonia Estonian Green Movement Latvia Environmental Protection Club of Latvia, VAK Latvian Green Movement Lithuania Lithuanian Fund for Nature Lithuanian Green Movement Poland Green Federation, GAJA, Szczecin Polish Ecological Club, PKE Belarus Ecohome IPO Ecoproject Ukraine The Western Centre of the Ukrainian Branch of the World Laboratory, Lviv, Ukraine co-funded by EU LIFE Programme
  4. 4. Water Protection in Agriculture River Basin and Wastewater Management Fisheries and Aquaculture Network working across sectors Hazardous Substances and Marine Litter Biodiversity and Nature Conservation Sustainable Development in Coastal and Marine Areas Harmful Installations and Maritime Transport co-funded by EU LIFE Programme
  5. 5. Why bother? Background and Rationale • Poor state of the Baltic with regards to chemical pollution status – Gap between HELCOM and EU • Focus on pharmaceuticals at EU level – EU WFD Watch List • Need to address the issue at HELCOM – Strategy for hazardous substances (1998) • Cessation target within 25 years – List of substances of specific concern (2007) – List of Priority Hazardous Substances (2010) + substances of possible concern – HELCOM Moscow Ministerial (2010) • Gather expertise and knowledge – HELCOM Copenhagen Ministerial (2013) • State-of-play report • Input to EU • Decide on measures co-funded by EU LIFE Programme
  6. 6. Pharmaceuticals in the BSR, state-of-play (2016) co-funded by EU LIFE Programme www.no-pills.eu • Human consumption and use in the countries • Pathways to the environment • Concentrations in WWTP influent and effluent as well as sewage sludge, and in river water • An estimate of the magnitude of inputs to the Baltic Sea • Information about the handling of pharmaceutical waste in countries
  7. 7. Pharmaceuticals in the BSR: what do we know? • ca. 2200 tAPI /yr enter annually through WWTPs • main loads: cardiovascular, central nervous system and anti-inflammatories and analgesics (diclofenac, ibuprofen and paracetamol most frequent) • main source - excretion by human and animals and incorrect disposal • vast observations (45000 source/path and 4600 sea/coastal samples) • data from 7 out of 9 coastal states • traced effects in biota (blue mussels accumulate most) • developed take-back but unknown efficiency? co-funded by EU LIFE Programme www.no-pills.eu
  8. 8. Waste water treatment co-funded by EU LIFE Programme www.no-pills.eu Is it safe to use sludge? • 26,500 kg/yr of 52 pharmaceuticals are retained to in WWTP sludge. • Of 52 the amounts of 6 pharmaceuticals in the sludge exceeded 1,000 kg/yr • amount of priority pharmaceuticals retained in sludge was estimated to be 22,500 kg/yr (85% of all) Is there treatment available? • Lack of wide-spread advanced WWTP technology applied across the region – only pilot plants (e.g. 2 in Sweden)
  9. 9. Waste management and take-back • Voluntary vs. obligatory • Lacking data on efficiency • Estonia – 89,190 kg collected • Finland – 185,000 kg returned – 33,000 kg disposed to waste – 28,000 kg disposed to sewers • Sweden – 1,500,000 kg covered by take-back – 800,000 kg returned – 250,000 kg to waste – 50,000 kg by pharmacies – 250,000 kg wholsale waste – 100,000 kg hospitals co-funded by EU LIFE Programme www.no-pills.eu
  10. 10. Proposal for the Baltic Priority List co-funded by EU LIFE Programme www.no-pills.eu • anti-inflammatory and analgesic • codeine, diclofenac, ibuprofen, irbesartan, ketoprofen, naxoproxen, paracetamol, and tramadol; • antimicrobial • ciprofloxacin, clarithromycin, fluconazole, sulfamethoxazole; • cardiovascular agents • atenolol, eprosartan, furosemide, metoprolol, sotalol; • antiepileptic • carbamazepine
  11. 11. Swedish watch list (MPA, 2015), 17 substances in addition to EU WFD ”Watch List” Name Justification by Swedish MPA Ciprofloxacin Persistent and demonstrated resistance development in the environment Citalopram Has been detected in fish and drinking water. PBT- properties. Relatively large usage. Fluconazol Has been detected in drinking water, surface water and sludge. Ibuprofen Large usage and has been detected in surface water Carbamazepin Has been detected in drinking water and surface water. Cetoconazol Has been detected in sludge Levonorgestrel PBT- properties Losartan Large usage Metoprolol Large usage and has been detected in drinking water, surface water and sludge. Metotrexat Unknown environmental effects and presence. A chemotherapy that is used by the households. Naproxen Has been detected in drinking water and surface water. Increased usage as it is often used as a replacer for diclofenac Oxazepam Has been detected in fish, surface water and drinking water. Toxic at environmental relevant concentration. Sertralin Has been detected in surface water, fish and sludge. Sulfametoxazol Has been detected in surface water, fish and sludge. Tramadol Has been detected in surface water and drinking water. Trimetroprim Large usage. Has been detected in drinking water, surface water and sludge Zolpidem Has been detected in drinking water, surface water and sludge
  12. 12. Measures available and applicable co-funded by EU LIFE Programme www.no-pills.eu • Measures to reduce the inputs should address all stages of the product lifecycle from manufacturing to consumption to waste management. • Technical solutions can be applied in WWTPs, mainly as tertiary treatment methods. • Oxidation, adsorption and filtration methods could also be used for the pre-treatment of hospital and production site wastewater prior to discharging to the sewer. • Take-back of unused medicines by pharmacies should be applied in countries where such systems are not yet in place, in order to reduce the disposal of unused medicines via solid waste or sewer. • Eco-labelling of pharmaceutical products can help doctors, pharmacists and consumers to consider environmental perspectives when choosing medication. • Decreasing the total consumption of pharmaceuticals
  13. 13. Pharmaceuticals: what we still need to know? co-funded by EU LIFE Programme www.no-pills.eu • Better and consistent consumption data • Concentrations of pharmaceuticals in WWTPs influent and effluent as well as rivers • Emissions of pharmaceuticals to environment • Occurrence and fate of metabolites • Concentrations in sewage sludge and soil • Consumption, sources, pathways and loads of veterinary pharmaceuticals to soils and the aquatic environment
  14. 14. Thank you for your attention! Östra Ågatan 53, SE-753 22 Uppsala, Sweden +46 73-977 07 93; mikhail.durkin@ccb.se www.ccb.se co-funded by EU LIFE Programme

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