Pharmaceuticals in Rivers Threaten World Health
News article: "Pharmaceuticals in Rivers Threaten World Health - Study"
Scientific paper: "Pharmaceutical Pollution of the World's Rivers"
I chose a BBC news article from earlier this year that discusses the findings of a scientific paper published in PNAS, both discussing the presence of pharmaceuticals in rivers around the world. The scientific paper, entitled “Pharmaceutical Pollution of the World’s Rivers,” was published in February 2022 with 127 co-authors representing 86 different institutions, led by Dr. John Wilkinson at the University of York. This paper presents the results from an extensive global study of the concentrations of active pharmaceutical ingredients (APIs) in various rivers across the world.
Impressively, water samples were collected from 1,052 different sampling sites covering 104 countries across all 7 continents, and 61 different APIs were analyzed at each site. Additionally, 36 of these countries had never been monitored previously for APIs in water sources, therefore filling in a large gap in the current knowledge of global API pollution. The paper analyzes the cumulative pharmaceutical concentrations by location, the detection frequencies of various pharmaceuticals, the socioeconomic trends of API pollution, and the implications for ecological and human health.
The BBC article, which was published in February 2022 shortly after the PNAS paper, is entitled “Pharmaceuticals in rivers threaten world health - study.” Whereas the PNAS paper presents a large amount of data and analyzes the observed trends in pollution, it is worth noting that the BBC article instead focuses primarily on the potential environmental and health effects of API pollution. Overall, the article does a good job of conveying the major findings of this study to a general audience and raises awareness about pharmaceutical pollution, which many people may not be aware of.
The BBC article is very readable, and it defines important terms like API and “lifestyle consumable,” as well as explaining what each pharmaceutical drug is used for. Additionally, the article includes a direct link to the PNAS journal as well as direct quotes from Dr. Wilkinson, which is immediately a good sign. The article also includes insight from other experts in the field, which gives the article even more credibility. I also like that the news article starts by acknowledging that this study was “among the most extensive undertaken on a global scale,” therefore giving it instant credibility and not downplaying the major significance of these results. However, I do think that the article could’ve elaborated more on what they mean by “extensive,” especially given that the paper has an entire section on the global reach of this study. This could’ve been a good opportunity for the news article to include the following figure from the paper, that shows a map with all of the sampling sites marked. This would allow the reader to have a better appreciation of the breadth of this study, while also avoiding complicated data that would overwhelm a general audience.
Another general critique of the news article is that it lacks analysis of the data that is presented in the paper. For example, the first few paragraphs of the news article are simply reciting the findings of the paper in a very dry, unengaging way. For example, the article reports which rivers were found to be the most polluted and which were the cleanest, but with no subsequent analysis of the significance of these results. This information is useless to the reader without acknowledging its implications for global API pollution.
Additionally, there are a few spots in the article where the research findings could’ve been presented differently to be more thorough and in line with the actual findings of the paper. For example, the first sentence of the article states, “Paracetamol, nicotine, caffeine, and epilepsy and diabetes drugs were widely detected in a University of York study.” While these drugs were indeed widely detected, this statement neglects the numerous other pharmaceuticals that were detected in this study that also pose potential threats to human and environmental health (such as beta-blockers, antibiotics, and antidepressants).
Furthermore, the article reports that the most polluted sites were largely in low- to middle-income countries, but this doesn’t quite tell the whole story with regards to the socioeconomics of API pollution. Whereas one might expect that countries in the lowest income bracket would have the worst levels of pollution due to poor wastewater infrastructure, it is actually the lower-middle income bracket where API concentrations were the worst. This is because these countries typically have poor wastewater infrastructure, but have improved access to larger numbers of medicines relative to lower income countries.
With that being said, I appreciated how much the article emphasized the potential hazards associated with API water pollution - the issues of human contraceptives harming fish reproduction, antibiotics promoting the formation of resistant bacteria, as well as unseen impacts that require further studies to diagnose. They also discussed how drug accessibility and regulatory oversight factor into the problem - as the paper finds, countries where antibiotics are overprescribed or available over the counter have much larger antibiotic concentrations in their rivers. Overall, I think the news article did a good job of accurately conveying the paper findings, maintaining transparency, and avoiding misleading or sensationalized statements. There are definitely spots where the article could’ve been more thorough, but there were no glaring errors in the way the science was presented. With all of this in mind, I would give the article a 7/10.
Hi! Great work on summarizing your findings with the news article and scientific article. the one things that I think stuck out to me as a little extreme was the very last sentence of the new article that stated "That would mean making it harder to get hold of medicines like antibiotics, and tighter restrictions on doses." To end off this article with that statement I think would make the general public scared, and retaliate against such policies that would potentially do such a thing. This is not the message that you want people to resonate with since obviously pharmaceuticals are harming the ecosystem in various ways and clearly needs further mitigation. Especially with the way Western medicine is structured and spreading to other parts of the world, this seems frightening to people to potentially lose their lifelines of living (for those that depend on prescriptions to get by). How do you think they could have reworded this statement? Or do you think maybe they could just omit it all together?
ReplyDeleteHi Sofia, that's a really great point! I agree that the message of implementing tighter control over medicines might make people afraid, and thus hesitant to support measures to combat API pollution. I think one way that the BBC article could've avoided this is by being more specific about what areas of the globe are in need of more drug regulation. As the PNAS paper mentions, this is mostly relevant in countries where antibiotics and other drugs are available over the counter, for example - and not as much in the U.S. where there is tighter control over drug prescriptions and doses.
DeleteGreat critique of the article and paper! While I feel like this is something that a lot of people already knew/suspected, it's good to have it studied more empirically, since that's one of the first steps needed for change
ReplyDeleteI find this topic super interesting because I have a lot of strong feelings on pharmaceutical companies and their ethical practices, and this only adds to the list. Do you think that holding pharmaceutical companies accountable for issues like this would help bring the industry toward a healthier perspective overall? It seems this sort of thing is less based on how an individual views the company should approach drug ethics and more set-in-stone evidence that their practices are harmful.
ReplyDeleteHi Nathan - this is an interesting question! Although I think that pharmaceutical companies should, to some extent, be responsible for the pollution that results from drug manufacture, I think it's important to consider how much they can really do in countries that simply don't have proper water treatment infrastructure. This raises an interesting debate with regards to low/middle-income countries where the infrastructure is currently lagging behind the access to medicines. It is also important to note that a lot of APIs entering natural waterways are not coming directly from pharmaceutical production, but from drugs being excreted from people's bodies after consumption.
DeleteThank you for sharing these articles! I am curious if there are health impacts of API pollution in water on top of environmental damages? If there are, do you think the news article should have included them too to better drive home the message of concern regarding API release?
ReplyDeleteHi Mike - while the article does seem to focus more on environmental damages of API pollution, such as causing harm to aquatic organisms, it does address potential health implications for humans - namely, that the development of antibiotic resistant bacteria will ultimately limit the effectiveness of antibiotics.
DeleteI think that this is a really interesting and important subject that should be getting more attention for research. It got me thinking, if the APIs are getting through the waste management systems, would there be significant levels in the sludge that they produce? Would that mean that these APIs could be introduced into our food if the sludge was repurposed for farming purposes?
ReplyDeleteAlso, many drugs have very toxic effects if combined. For example, grapefruit juice combined with metformin or statin drugs have adverse and sometimes severe side effects. There are serious side effects between some of the listed drugs in the study, even. If APIs like these within the water mix together, could there be toxic effects effects when introduced to animals or humans?
Hi Monica - I really like the point you bring up about potential drug-drug interactions, and the threat of multiple APIs in natural waters having compounding effects. It really goes to show how much we still don't understand about the potential adverse effects of API pollution, and this is something the paper brings up as well. Each individual drug needs to be tested for its effects on aquatic systems, and this still doesn't account for how it could be interacting with other substances that are present in waterways.
DeleteGreat analysis! The connection between the lower-middle income bracket having access to larger amounts of pharmaceuticals but not wastewater treatment stuck out to me. I wonder what your thoughts are on ways to address this issue in an equitable way across global income brackets.
ReplyDeleteHi Katie, that's a really great question, and one that I'm sure there's no easy answer to. One idea - in countries where water treatment infrastructure lags behind pharmaceutical production, perhaps drug companies should be required to invest a certain amount of their profits into developing better water treatment systems and mitigating existing pollution.
DeleteReally interesting pick for the blog! One particular pharmaceutical drug I am interested in would be antibiotics such as amoxicillin. I know that in recent years there has been growing concern on the increased prevalence and strength of antibiotic-resistant bacteria. I am curious to see how increased exposure of trace amounts of these antibiotics would react with the environment and could potentially result in even more bacteria to become resistant -- I guess this could show that the side effects of pharmacological pollution is more numerous or severe than originally thought. Much like global warming caused by greenhouse gas pollution (aside from the initial effect of the changing climate), there seems to be a "snowball" effect that is a result of all different types of pollution.
ReplyDeleteThanks for the analysis! I hadn't really ever thought about the existence of APIs in rivers or the effects it can have on us and wildlife, so this was an interesting read. I agree with you that the beginning of the news article is extremely dry and boring, and I wonder if that may turn away a lot of readers, especially considering that these days you only have a few seconds to hook your potential audience in. There are definitely way more engaging ways to introduce prospective readers to these kinds of articles, maybe with a short anecdote for example. To be honest, it seems like would have been better than what they actually did.
ReplyDeleteHi Emily! Thanks for sharing these. It's a huge breath of fresh air to actually see research that's relevant to the global population instead of just those of developed countries. The article mentioned that the two most frequently detected pharmaceuticals were carbamazepine (used to treat epilepsy/nerve pain) and metformin (used to treat type 2 diabetes). I guess I'm just wondering why those? Like is there something about the way process chemists have chosen to make these that causes most of the desired product to end up in the waste? I guess to go a step further, I'm wondering if people could use the data from the scientific article to track how these are getting dumped into waterways.
ReplyDeleteHi Sabrina, that's a great point! The PNAS paper doesn't provide any analysis as to why carbamazepine and metformin are observed so widely, and I'm also curious to know why these two drugs are so prevalent. I wonder if it has more to do with consumption patterns of these drugs and how widely they're used, or if it has more to do with the production process. Or, maybe it has more to do with how persistent these drugs are in the environment / resistant to metabolism or decomposition.
DeleteWhile reading the BBC article, I felt like there was an underlying theme of trying to tackle the problem of API pollution in natural waterways by preventing human consumption, or perhaps over consumption, of medicinal products. For instance, the quote from Dr. Edmonds-Brown stating "This is only going to get worse as we are increasingly using pharmacological solutions to any illness whether physical or mental" and that from Dr. Wilkinson stating "One of the few things that could have an effect right now is the proper use of medicines" gives the impression that stricter regulations on drugs is the best, or perhaps only, way to address the issue. Do you feel that this is the case? Are there alternative measures to reduce this pollution that are not discussed in the BBC article?
ReplyDeleteHi Maddie, that's a really great point! That does seem to be one of the biggest inconsistencies with the BBC article - it mentions that some of the most polluted sites are those near pharmaceutical manufacturing, but then the only solutions that are provided are related to human consumption, not manufacturing. This seems to put an unfair amount of blame/responsibility on consumers who rely on pharmaceutical drugs for their health.
DeleteThis comment has been removed by the author.
ReplyDeleteThanks for sharing this paper and article! I agree with your assessment and critique about the paper, but I also think that even though the paper didn't discuss extensively on the actual health and impact to humans, the paper could've added more on this as the reader probably wants to know how the problems associated with pharmaceuticals in rivers impacts them. I was also wondering what your thoughts were on how this impacts drinking water, particularly in poorer regions?
ReplyDeleteThis is a super interesting topic! I hadn't even considered the fact that APIs were pollutants until reading these articles and some of the readings for class. I don't know how much further research you did on this topic, but I am interested in knowing how much of the pollution comes from the manufacturing of pharmaceuticals versus their usage. Like Sofia, I was somewhat offput by the statement at the end of the BBC article about making it harder to get ahold of medicines like antibiotics. Should more focus be put into limiting the pollution from manufacturing and disposal versus usage in order to ensure that people are still able to access medications that are sometimes necessary for survival?
ReplyDeleteHey Maddie,
ReplyDeleteVery interesting read, I had no idea this was an issue as I have never thought about accidental pharmaceuticals ending up in our water streams. My question that I feel was not addressed well in the scientific article is: how are all these pharmaceuticals ending up in these rivers? Is it from human waste or industrial waste? I ask this because if it is from human waste, then this would be an interesting result since I believe most pharmaceutical compounds are made to be biodegradable and able to break down once in the body, but perhaps this is the wrong assumption. Either way, it is clear that they are getting into our water supplies which definitely begs the question of how water treatment plants can handle this issue in the future.
Hello Emily,
ReplyDeleteGreat Review! First, I think you did a good job in summarizing both the articles and the scientific paper and analyzing them in details. I also agree you on maybe they should focus more on the drugs that will impact us more seriously. However, the public might not be aware of these drugs and maybe lack of context. To what extent do you think the author should elaborate?
Great review Emily! I agree with the statement you made about how the article reports that the most polluted sites were largely in low- to middle-income countries. It would be helpful for them to have some statistical analysis about that to better communicate why those communities are most effected by API pollution, leading to wrong assumptions. I also think what the scientific article could include how wastewater is treated in the first place in those global communities. Is it chemical or physical filtration? Do they treat the water with chemicals or flocculants? Is it regulated on a state or country basis? Were these things considered before they tested the water samples?
ReplyDeleteHey Emily! Great post! I really like how in this paper they focus on a more world wide approach and not just in one specific area. Since there was so many institutions across the world collaborating in this effort, did the paper mention any difficulties when having to communicating with so many different people?
ReplyDelete