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Something in the water

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d7236 (Published 07 November 2011) Cite this as: BMJ 2011;343:d7236
  1. Geoff Watts
  1. 1London

As chemists get better at measuring even the tiniest amounts of drugs in the environment, scientists are left with the problem of deciding whether these residues matter. Geoff Watts reports

The past decade has seen a steady accumulation of evidence that the residues of pharmaceutical products can be detected in the environment and even in drinking water. But the implications for human health of these nanogram measurements are still uncertain. While scientists debate the issue, the tectonic plates of regulation—within countries and in Europe as a whole—are undergoing small but discernible signs of movement.

The issue of drug residues was the subject of a meeting organised recently by the Royal Society of Medicine. Ecopharmacovigilance, as the study of medicinal drugs in the environment is now known, emerged as a discipline still characterised as much by speculation as by fact. But that is no criticism of the scientists involved; they face some tough challenges.

For a start, information is piecemeal—a study of fluoxetine in this river, another of antihypertensives in that lake—and often reflects local circumstances from which it’s hard to generalise. Harm to wildlife can sometimes be established: …

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