BMJ highlights the problem of drugs residues in drinking water

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Back in February of this year, one of my blogposts focused on the fact that the UK Health Secretary was making noises about expanding water fluoridation, despite the fact that the evidence suggests that this practice is far from ‘evidence-based’. The title of this post was: UK health minister calls for mass medication through water supply which referred to the claim that fluoride is, essentially, a medication (i.e. one that can cut dental disease). However, reading today’s British Medical Journal made me realise that fluoride is not the only drug that might be being pumped into homes in the UK and elsewhere [1].

In the piece in question, freelance journalist Geoff Watts details reports of pharmaceutical drugs ending up in the water supply. He points out that after ingestion, drug residues can end up passing from our bodies into the sewage system via our urine. Sometimes individuals will ‘cut out the middle man’ by simply flushing medication down the toilet. Drugs that make their way into the sewage system may contaminate nature. However, we are not immune to the effects of such contamination because the purification of water before it appears in our kitchen taps may fail to rid it of all its pharmaceutical pollutants.

Mr Watts starts by citing an American press report from March of this year which claimed that that a wide spectrum of medications (including antibiotics, anticonvulsants, mood stabilizers and sex hormones) had been found in the drinking water supplies of more than 40 million Americans. In a subsequent senatorial hearing on the issue, the US Environmental Protection Agency was lambasted for its alleged complacency.

There have been problems on the other side of the pond too. For example. a researcher at the Technical University of Berlin’s Institute of Food Chemistry found drugs in samples of Berlin tap water. Italian researchers have found chemical and medicinal products in the drinking water from the Lake Maggiore area. Mr Watts also points to the work of a Hawii-based researcher who, last year, reviewed all the reports she could find regarding drug residues in water systems in Europe and America. Apparently, between them the reports identified 10 drugs in drinking water. As Mr Watts says: The amounts were low, but the findings undermine any comfortable assumption that water treatment plants can be counted on to remove all contaminants.

The body responsible for ensuring the purity and safety of our water supply in the UK is the Drinking Water Inspectorate. Mr Watts points that the Drinking Water Inspectorate is confident that the country’s “sophisticated treatment processes . . . installed to remove pesticides and other organic substances from source waters are equally effective at removing minute traces of pharmaceutical residues.” But, as Mr Watts goes on to point out, the reports of drug residues in water supplies make it clear that some systems are less than perfect for at least some drugs.

This BMJ piece has not done anything, obviously, to reassure me about the purity of drinking water, and my advice remains to avoid drinking it straight from the tap. One strategy might be to filter the water and relatively economical under-sink systems are available for this. I do not know how good they are at taking out specific drug residues. However, these filters will go at least some way to improving the purity of tap water, in a way which is quite environmentally friendly. One company in the UK that provides such filters is the Freshwater Filter company. You may like to look for comparable companies in your own country if appropriate.

Another option, of course, is to opt for bottled water that is likely to be far cleaner than tap water from a drug residue/chlorine/fluoride perspective, though may itself be tainted by residues from plastic bottles. Buying mineral water in glass gets around this, though it should also be borne in mind that bottled water may have a considerable environmental impact, especially if it is being drunk outside its country of origin.


Watts G. How clean is your water? BMJ 2008;337:a237

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