药物试剂的不正当暴露与生态系统（英文ppt）protectingthe ecosystem from improperly disposed

Protecting the Ecosystem from Improperly Disposed Pharmaceuticals John M. Polimeni Assistant Professor of Economics Albany College of Pharmacy 1 What do all these products have in common? 2 Outline n Purpose n Overview of PPCPs and veterinary medicines in the water supply n Possible solutions n Discussion and questions 3 Purpose n Fate of PPCPs and veterinary medicines in the environment n Prevalence of PPCPs and veterinary medicines in the environment n Human and environmental health implications n To identify possible solutions 4 The Problem n Pharmaceutical & Personal Care Products (PPCPs) and Veterinary Medicines are in our groundwater supply 5 History n 1977 - first identification of drugs in the water system in a Missouri Sewage Treatment Plant (STP) n 1990s - researchers in the US and Europe started to investigate problem n 1998 - medias discovery of topic 6 Pharmaceuticals and Personal Care Products Pharmaceuticals Personal CareProducts Cosmetics Shampoo Detergent Others Prescription Drugs Over The CounterDrugs Antibiotics Hormones Others 7 Modes of Entry 8 Prevalence in the Environment n As shown on the previous diagram effluents eventually make it into the groundwater n Global problem n High percentages of pharmaceuticals can be excreted without being metabolized 9 Triclosan n One of the most frequently found compounds in USGS stream reconnaissance n An antimicrobial preservative found in: Hand soap Dish-washing products Laundry detergents and softeners Plastics (e.g., toys, cutting boards) Toothpaste Deodorants and antiperspirants Cosmetics Hair conditioners Pesticides 10 Impacts of Triclosan n Affects algae colonies n Bioaccumulates in fish at levels thousands times greater than levels found in water n Swiss study found it in breast milk n Degrades to harmful compounds like methyl triclosan, dioxins, chloroform, and other chlorinated compounds. n City of Palo Alto, CA has a ban Triclosan free soaps in all city soap dispensers n Pushes in San Jose and Denver for same ban 11 Whats the Big Deal? n Only traces were found in these samples, so why is this a concern? n Properties of PPCPs and veterinary medicines n Antibiotic Resistance n Hormones and hormone-regulators n Genotoxins 12 Antibiotics n A unique case n Resistance does not require large dosages n A natural function of the environment n Increased use has led to more harmful and stronger bacteria n Serious public health threat - MRSA 13 Antibiotic Resistance n Found in River and coastal areas Domestic sewage Surface water and sediments Lakes Sewage polluted ocean water Drinking water 14 Concentration vs Time Dependant n Shortening the duration of antibiotic therapy will decrease resistance Some antibiotics concentration dependant Some antibiotics time dependant n Shortening duration MAY decrease contamination in the environment and therefore decrease resistance there n If make duration too short in humans you WILL increase resistance in those patients n This is why the pharmacist always says to finish taking your antibiotics until they are gone, even if you start to feel better! 15 Hormones and Hormone-Regulating Drugs n Can cause major environmental damage n Need only a few nanograms per liter 1,000 times less concentrated than the g/l that has been found in samples n Estradiol alters reproductive tissues in fish n Endocrine disruptors 16 n Reports focus on substances known or suspected to act on sex hormone receptors and pathways Estrogen receptor most studied n Estrogen receptor agonists Methoxychlor (pesticide) PCBs Bisphenol A (from polycarbonate plastic production) Pharmaceutical estrogens Phytoestrogens from plants n Estrogen receptor antagonists Vinclozolin (fungicide) DDT metabolites Phthalates (found in makeup, shampoo, soaps, plastics, paints, and some pesticides) Endocrine Disrupting Chemicals 17 n Daily articles about environmental impacts n Reproductive and developmental abnormalities found in birds, frogs, seals, polar bears, marine mollusks, alligators, fish, and DOZENS more species n Report in Pure and Applied Chemistry from 2003 suggested over 200 species of animals have been / suspected affected by these chemicals n Current testing methods Hard to decipher the different EDC from one another Hard to pinpoint what is actually there Endocrine Disrupting Chemicals 18 Pharmaceutical Estrogens n All hormonal therapies are FDA Category X in pregnancy Evidence of fetal risk in humans, no benefit from use can be identified Other substances in Category X for pregnancy Alcohol Tobacco n Risks of estrogen exposure Congenital heart defects Limb malformations Virilization = male characteristics 19 Genotoxicity n Correlated to Cancer n Highly toxic n Damages cellular DNA n Antineoplastics carcinogenic, mutagenic, embryotoxic, or teratogenic 20 PPCPs and the Environment? n Yes! Remember, where do many PPCPs come from? n Perhaps no greater illustration of the connection between the environment and human health 21 What Can Be Done? n Let the market solve the problem n Upgrade sewage treatment plants n Use regulatory oversight 22 Regulatory Alternatives n Day Program n Mail Program n Take-back Program 23 Take-back Program n Arguably the most successful initiative n Voluntary program n 1st one November 1996 in British Columbia n Only for retail customers n Huge Success 24 Take-Back Program n The Australian RUM n July 1998 n Community pharmacies n Consumer awareness programs n $750,000 annual cost 25 Take-Back Program n The EU 11 countries involved n 5 are sponsored by the pharmaceutical industry n 6 are community pharmacies collaborating with waste collection companies 26 Take-Back Program n The United States n Vary in use n No permanent programs 27 Other Solutions? n Deposit program 28 Deposit Program n Medication deposit system: Consumers pay deposit on medication container Receive deposit refund upon containers return Returned medications collected for disposal as hazardous waste Medication container recycled n Venue: Community Pharmaci