Impacts of pharmaceutical pollution on communities and environment in India

World Environment Day, celebrated annually, is a global initiative to encourage awareness and action for the protection of our environment. While much attention is rightly given to issues like climate change, deforestation, and plastic pollution, one critical and often overlooked concern is pharmaceutical pollution.

Pharmaceutical pollution, originating from both drug excretion and industrial activities, poses significant risks to human health and ecosystems. These risks are evidenced in various ecological domains like water contamination. Pharmaceuticals enter our water systems through improper disposal, excretion, and agricultural runoff. These substances can persist in the water supply, affecting aquatic life and potentially entering the drinking water we consume. Although less commonly discussed, pharmaceutical compounds can also become airborne. This can occur through the evaporation of volatile substances or the incineration of pharmaceutical waste, potentially affecting air quality and contributing to broader environmental pollution.

Other risks include the near extinction of certain species, the feminisation of fish due to contraceptive pollution in water bodies. Such that synthetic estrogens from birth control pills disrupt fish endocrine systems, leading to reproductive issues. Also, the proliferation of antimicrobial resistance (AMR), where overuse of antibiotics leads to resistant bacteria, making infections harder to treat Additionally, pharmaceutical manufacturing consumes substantial amounts of solvents, which are typically highly toxic chemicals, as well as heavy metals. The enduring harmful effects of these substances on human health are well-documented, leading to regulatory controls in numerous countries. 

Pharmaceutical products enter the environment at various stages, particularly during production. Discharging antibiotics can promote antibiotic-resistant pathogens. According to WHO, in India over 56,000 newborns die yearly from sepsis by first-line antibiotic-resistant organisms. To address this, the Delhi Declaration during India’s G20 presidency committed to prioritising AMR antimicrobial stewardship in National Action Plans. 

Ironically, the components that make medicines effective—Active Pharmaceutical Ingredients (APIs)—are particularly harmful to the environment, causing issues like contaminated water, dead crops, health issues etc.  When the environment’s self-purification ability is insufficient to eliminate new pollutants, such as the active ingredients of antibiotics, it can lead to an ecological phenomenon where drug-resistant strains increase rapidly, which raise the risk of infections in other organisms.  

A recent study on the availability of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) (1) harmful to vultures in six districts of the Nilgiri Biosphere Reserve (NBR) revealed that approximately 50 per cent of the surveyed pharmacies were selling these NSAIDs.  Furthermore, impacts on public health and ecology like maternal morbidity, antibiotic resistance, metabolic disorders, ecosystem disruptions, plant contamination, heat stress, and harm to pollinators etc.

To address pharmaceutical pollution, several initiatives have been introduced. The National Action Plan for Antimicrobial Resistance 2017 aims to limit antibiotics in industrial waste. Additionally, the Central Pollution Control Board (CPCB) has issued guidelines for achieving zero liquid discharge in the industry. Future sustainability efforts must also focus on public education, awareness, and perceptions regarding pharmaceutical pollution. 

Perhaps, the sustainability of the pharmaceutical industry remains underexplored, presenting opportunities for future research in areas such as waste management, the economic impact of new drugs, and the role of pharmaceutical companies in the economic sustainability of health systems. However, the pharmaceutical industry can contribute to a substantial environment by embracing sustainable strategies like ‘Green chemistry’ which aims to create chemical products and processes that minimise or eliminate the use and production of hazardous substances. Other strategies can be waste minimisation, green packaging, energy efficiency and sustainable sourcing. 

On this World Environment Day, let us broaden our horizons to include the hidden yet pervasive issue of pharmaceutical pollution. By doing so, we can take a meaningful step towards a ‘Journey to Greener Future.’  

References:

1. https://www.researchgate.net/publication/371563918_How_Availability_of_NSAIDs_and_Public_Perception_matters_in_Vulture_conservation_in_the_Nilgiri_Biosphere_Reserve_South_India_An_overt_and_covert_Survey_Approach