Just when you thought,what else can go wrong

[Alfred E. Newman]

Prescription drugs found in drinking water across U.S.Story
Highlights
Investigation finds pharmaceuticals in drinking water of 41 million
Americans

Concentrations are minute; utilities say water is safe


Low-level drug combinations found to impact human cells, wildlife


Bottlers, some of who repackage tap water, do not typically treat,
test for drugs


(AP) -- A vast array of pharmaceuticals -- including antibiotics,
anti-
convulsants, mood stabilizers and sex hormones -- have been found in
the drinking water supplies of at least 41 million Americans, an
Associated Press investigation shows.


Officials in Philadelphia say testing there discovered 56
pharmaceuticals or byproducts in treated drinking water.


To be sure, the concentrations of these pharmaceuticals are tiny,
measured in quantities of parts per billion or trillion, far below
the
levels of a medical dose. Also, utilities insist their water is safe.


But the presence of so many prescription drugs -- and over-the-
counter
medicines like acetaminophen and ibuprofen -- in so much of our
drinking water is heightening worries among scientists of long-term
consequences to human health.


In the course of a five-month inquiry, the AP discovered that drugs
have been detected in the drinking water supplies of 24 major
metropolitan areas -- from Southern California to Northern New
Jersey,
from Detroit, Michigan, to Louisville, Kentucky. Map: See the cities
where drugs were found in drinking water >>


Water providers rarely disclose results of pharmaceutical screenings,
unless pressed, the AP found. For example, the head of a group
representing major California suppliers said the public "doesn't know
how to interpret the information" and might be unduly alarmed.


How do the drugs get into the water?


People take pills. Their bodies absorb some of the medication, but
the
rest of it passes through and is flushed down the toilet. The
wastewater is treated before it is discharged into reservoirs, rivers
or lakes. Then, some of the water is cleansed again at drinking water
treatment plants and piped to consumers. But most treatments do not
remove all drug residue.


And while researchers do not yet understand the exact risks from
decades of persistent exposure to random combinations of low levels
of
pharmaceuticals, recent studies -- which have gone virtually
unnoticed
by the general public -- have found alarming effects on human cells
and wildlife.


A 'growing concern'


"We recognize it is a growing concern and we're taking it very
seriously," said Benjamin H. Grumbles, assistant administrator for
water at the U.S. Environmental Protection Agency.


Members of the AP National Investigative Team reviewed hundreds of
scientific reports, analyzed federal drinking water databases,
visited
environmental study sites and treatment plants and interviewed more
than 230 officials, academics and scientists.


They also surveyed the nation's 50 largest cities and a dozen other
major water providers, as well as smaller community water providers
in
all 50 states.


Here are some of the key test results obtained by the AP:


* Officials in Philadelphia, Pennsylvania, said testing there
discovered 56 pharmaceuticals or byproducts in treated drinking
water,
including medicines for pain, infection, high cholesterol, asthma,
epilepsy, mental illness and heart problems. Sixty-three
pharmaceuticals or byproducts were found in the city's watersheds.


* Anti-epileptic and anti-anxiety medications were detected in a
portion of the treated drinking water for 18.5 million people in
Southern California.


* Researchers at the U.S. Geological Survey analyzed a Passaic Valley
Water Commission drinking water treatment plant, which serves 850,000
people in Northern New Jersey, and found a metabolized angina
medicine
and the mood-stabilizing carbamazepine in drinking water.


* A sex hormone was detected in the drinking water of San Francisco,
California.


* The drinking water for Washington, D.C., and surrounding areas
tested positive for six pharmaceuticals.


The situation is undoubtedly worse than suggested by the positive
test
results in the major population centers documented by the AP.


Testing not required


The federal government doesn't require any testing and hasn't set
safety limits for drugs in water.


Of the 62 major water providers contacted, the drinking water for
only
28 was tested. Among the 34 that haven't: Houston, Texas; Chicago,
Illinois; Miami, Florida; Baltimore, Maryland; Phoenix, Arizona;
Boston, Massachusetts; and New York City's Department of
Environmental
Protection, which delivers water to 9 million people.


Some providers screen for only one or two pharmaceuticals, leaving
open the possibility that others are present.


The AP's investigation also indicates that watersheds, the natural
sources of most of the nation's water supply, also are contaminated.
Tests were conducted in the watersheds of 35 of the 62 major
providers
surveyed by the AP, and pharmaceuticals were detected in 28.


Yet officials in six of those 28 metropolitan areas said they did not
go on to test their drinking water -- Fairfax, Virginia; Montgomery
County in Maryland; Omaha, Nebraska; Oklahoma City, Oklahoma; Santa
Clara, California; and New York City.


The New York state health department and the USGS tested the source
of
the city's water, upstate. They found trace concentrations of heart
medicine, infection fighters, estrogen, anti-convulsants, a mood
stabilizer and a tranquilizer.


City water officials declined repeated requests for an interview. In
a
statement, they insisted that "New York City's drinking water
continues to meet all federal and state regulations regarding
drinking
water quality in the watershed and the distribution system" --
regulations that do not address trace pharmaceuticals.


In several cases, officials at municipal or regional water providers
told the AP that pharmaceuticals had not been detected, but the AP
obtained the results of tests conducted by independent researchers
that showed otherwise.


Of the 28 major metropolitan areas where tests were performed on
drinking water supplies, only Albuquerque, New Mexico; Austin, Texas;
and Virginia Beach, Virginia, said tests were negative. The drinking
water in Dallas, Texas, has been tested, but officials are awaiting
results. Arlington, Texas, acknowledged that traces of a
pharmaceutical were detected in its drinking water but cited
post-9/11
security concerns in refusing to identify the drug.


The AP also contacted 52 small water providers -- one in each state,
and two each in Missouri and Texas -- that serve communities with
populations around 25,000. All but one said their drinking water had
not been screened for pharmaceuticals; officials in Emporia, Kansas,
refused to answer AP's questions, also citing post-9/11 issues.


Rural, bottled water also unchecked


Rural consumers who draw water from their own wells aren't in the
clear either, experts say.


Even users of bottled water and home filtration systems don't
necessarily avoid exposure. Bottlers, some of which simply repackage
tap water, do not typically treat or test for pharmaceuticals,
according to the industry's main trade group. The same goes for the
makers of home filtration systems.


Contamination is not confined to the United States. More than 100
different pharmaceuticals have been detected in lakes, rivers,
reservoirs and streams throughout the world. Studies have detected
pharmaceuticals in waters throughout Asia, Australia, Canada and
Europe -- even in Swiss lakes and the North Sea.


In the United States, the problem isn't confined to surface waters.
Pharmaceuticals also permeate aquifers deep underground, the source
of
40 percent of the nation's water supply. Federal scientists who drew
water in 24 states from aquifers near contaminant sources such as
landfills and animal feed lots found minuscule levels of hormones,
antibiotics and other drugs.


Perhaps it's because Americans have been taking drugs -- and flushing
them unmetabolized or unused -- in growing amounts. Over the past
five
years, the number of U.S. drug prescriptions rose 12 percent to a
record 3.7 billion, while nonprescription drug purchases held steady
around 3.3 billion, according to IMS Health and The Nielsen Co.


Medications not all absorbed


"People think that if they take a medication, their body absorbs it
and it disappears, but of course that's not the case," said EPA
scientist Christian Daughton, one of the first to draw attention to
the issue of pharmaceuticals in water in the United States.


Some drugs, including widely used cholesterol fighters, tranquilizers
and anti-epileptic medications, resist modern drinking water and
wastewater treatment processes. Plus, the EPA says there are no
sewage
treatment systems specifically engineered to remove pharmaceuticals.


Veterinary drugs also play a role. Pets are now treated for a wide
range of ailments -- sometimes with the same drugs as humans. The
inflation-adjusted value of veterinary drugs rose by 8 percent, to
$5.2 billion, over the past five years, according to an analysis of
data from the Animal Health Institute.


Ask the pharmaceutical industry whether the contamination of water
supplies is a problem, and officials will tell you no.


"Based on what we now know, I would say we find there's little or no
risk from pharmaceuticals in the environment to human health," said
microbiologist Thomas White, a consultant for the Pharmaceutical
Research and Manufacturers of America.


But at a conference last summer, Mary Buzby -- director of
environmental technology for drug maker Merck & Co. Inc. -- said:
"There's no doubt about it, pharmaceuticals are being detected in the
environment and there is genuine concern that these compounds, in the
small concentrations that they're at, could be causing impacts to
human health or to aquatic organisms."


Recent laboratory research has found that small amounts of medication
have affected human embryonic kidney cells, human blood cells and
human breast cancer cells. The cancer cells proliferated too quickly;
the kidney cells grew too slowly; and the blood cells showed
biological activity associated with inflammation.


Also, pharmaceuticals in waterways are damaging wildlife across the
nation and around the globe, research shows. Notably, male fish are
being feminized, creating egg yolk proteins, a process usually
restricted to females. Pharmaceuticals also are affecting sentinel
species at the foundation of the pyramid of life -- such as
earthworms
in the wild and zooplankton in the laboratory, studies show.


Wildlife problems troubling


Some scientists stress that the research is extremely limited, and
there are too many unknowns. They say, though, that the documented
health problems in wildlife are disconcerting.


Health Library
MayoClinic.com: Health Library
To the degree that the EPA is focused on the issue, it appears to be
looking at detection. Grumbles acknowledged that just late last year
the agency developed three new methods to "detect and quantify
pharmaceuticals" in wastewater.


"We realize that we have a limited amount of data on the
concentrations," he said. "We're going to be able to learn a lot
more."


So much is unknown. Many independent scientists are skeptical that
trace concentrations will ultimately prove to be harmful to humans.
There's growing concern in the scientific community, though, that
certain drugs -- or combinations of drugs -- may harm humans over
decades because water, unlike most specific foods, is consumed in
sizable amounts every day.


Our bodies may shrug off a relatively big one-time dose, yet suffer
from a smaller amount delivered continuously over a half century,
perhaps subtly stirring allergies or nerve damage. Pregnant women,
the
elderly and the very ill might be more sensitive.


"We know we are being exposed to other people's drugs through our
drinking water, and that can't be good," says Dr. David Carpenter,
who
directs the Institute for Health and the Environment of the State
University of New York at Albany.