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A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: 26 Mar 2009
Source: Health. Day News [edited]
Fish from 5 U.S. rivers were found to be tainted with traces of
medications and common chemicals, according to a new study from the
U.S. Environmental Protection Agency and Baylor University.
The common antihistamine diphenhydramine (Benadryl), an
anticonvulsant and 2 types of antidepressants were among the 7 types
of pharmaceuticals found in the tissue and livers of fish from
waterways in or near Chicago, Dallas, Philadelphia, Phoenix and
Orlando, Florida. Each river is considered "effluent-dominated,"
because they receive large amounts of wastewater discharge from
nearby sewage treatment plants.
While federal standards exist for treated wastewater, they do not
address pharmaceuticals or most personal care products, and little is
known about the effects they have on the environment and wildlife.
This study is part of a federal strategy to address the issue.
Previous research has concluded that behavior vital for fish
survival, such as mating and fighting, can be affected if too much
antidepressant residue collects in their systems.
While other studies have found pharmaceuticals and personal care
products in wild river fish, this is the 1st time multiple compounds
have been found in fish from several different locations, co-lead
investigator Bryan Brooks, an associate professor of environmental
sciences at Baylor, said in a news release issued by the Texas-based
university.
The medications and chemicals found from among the 36 tested for
were, aside from diphenhydramine: the cholesterol drug gemfibrozil
(Lopid), which researchers say had never before been found in wild
fish; diltiazem (Cardizem), a medication that helps control high
blood pressure; carbamazepine (Tegretol), a drug used for epilepsy
and bipolar disorder; norfluoxetine, an active ingredient in the
antidepressant fluoxetine (Prozac); the antidepressant sertraline
(Zoloft); galaxolide and tonalide, common odor-enhancing ingredients
in soap and other hygiene products. Galaxolide and tonalide were
found in the highest concentrations in the fish tissue, while the
others were more concentrated in the liver, which processes foreign
substances that enter the body.
The study was presented Wednesday [25 Mar 2009] at the American
Chemical Society annual meeting in Salt Lake City, while the results
also are to be published in a special online edition of Environmental
Toxicology and Chemistry.
The U.S. Geologic Survey has more about toxins in wastewater.
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
[There have been numerous more localized studies of waterways that
have found similar results: multiple drugs in the water system that
fish and other aquatic animals are exposed to, and subsequently in
many cases, those animals or the water are consumed by humans. So, it
is a recycling of the drugs.
Pharmaceutical agents are molecularly designed to do a particular job
within the body. The US Food and Drug Agency looks at what the target
level is at the target organ; does the drug cause any other side
effects. The agency typically does not look at how much is expelled
in the urine or feces of those patients treated with the
pharmaceutical agent, and it certainly does not examine the sewer
systems in the USA to determine whether these molecules will pass
through the sewer purifying system.
I am not sure, but I don't think the sewer systems were ever designed
to filter out molecules of pharmaceutical agents. Further, I would
suspect that most of these sewer systems have never been checked to
see what drugs pass through the system and are recycled into the
environment or the soil or even eventually into our drinking water.
There is much blame being placed on animal agriculture because of
feeding of antibiotics. However, this study demonstrates that if you
look for various pharmaceutical agents, antibiotics, anti-allergens
or any other substances, you may find them. An absence of
surveillance is not an absence of evidence. How many other products
that were not tested for in this study of fish would be found? How
many antibiotics that are no longer used in animal agriculture but
are still used in human medicine would be found if they were looked
for?
While this study is fascinating and horrifying all at the same time,
I think it provides insight into the old adage, "seek and ye shall
find." - Mod.TG
The risk seems to be to the fish and their reproductive behavior;
there is no suggestion that the concentrations in fish tissue are high
enough to affect people who might eat the fish, and cooking could
eliminate most of that. The fish species are not stated, but as they
are living in highly polluted water they are unlikely to be palatable.
However, immigrants around the Great Lakes are know to catch and eat
species that are not sold in stores, and this practice might occur
elsewhere. - Mod.JW]
UPDATE: April 1, 2009
DRUGS, FISH, CONTAMINATED WATERWAYS - USA (02)
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A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Wed 1 Apr 2009
From: Corey Green
In response to: Drugs, fish, contaminated waterways - USA 20090331.1246
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It is certainly concerning to find fish and water sources
contaminated with pharaceutically active compounds (PhACs). While
numerous studies out of Canada, USA and Germany have identified such
compounds (lipid regulating drugs, anti-convulsants,
anti-depressants, analgesics, and estrogens) contaminating surface
waters such as rivers, lakes, and streams, as well as groundwater
sources, the concentrations are typically low (e.g., mcg/L, ng/L) and
tend to decrease depending on river flow, size of the water source
sampled, and proximity to water treatment facilities. Some of these
compounds also undergo reactions when they reach water sources that
can render them inactive (or active).
Although bioaccumulation is a concern, there is little evidence
currently available that these compounds pose any risk to human
health. There is also the concern about the potential health impact
of these compounds when they interact together in our body, even in
trace quantities. There is only a handful of studies that actually
look at the levels of these PhACs, personal care products, and
endocrine-regulating compounds that actually make it to into
municipal drinking water. Only one study that I'm aware of has
actually attempted to determine the human health impact associated
with certain compounds (ASA, clofibrate, cyclophosphamide, indomethacin)
found in water supplies (Schulman et al., 2002 [1]).
And the moderator's note is worth repeating -- there could be so much
more that we're missing just because we haven't looked for it. These
compounds exist and are accumulating in our environment, but there is
little evidence that PhACs actually make it into drinking water
sources or that they have a negative impact on human health.
[1] Schulman et al. (2002). A human health risk assessment of
pharmaceuticals in the aquatic environment. In Human and Ecological
Risk Assessment. Vol 8. Issue 4. pp. 657-680. Abstract available at:
--
Corey Green, RN, BScN, MHSc(c)
Regional Epidemiologist
First Nations and Inuit Health
Health Canada - Ontario Region
180 Queen Street West, 9th Floor, Rm. 9-152
Toronto, ON M5B 3L7
[On the contrary, there are studies regarding feminization of
populations because of hormones and estrogens from pharmaceutical
agents that have reached our water sources. And there are documented
cases of this in fish as well --see ProMED 2004 archive below. - Mod.TG]
[see also:
Drugs, fish, contaminated waterways - USA 20090331.1246
2004
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Breeding disturbance, fish - UK 20040711.1859]
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