Water and Sustainable Environmental Planning
Project Results
Keil,
Florian (2008): Pharmaceuticals for Human Use: Options
of Action for Reducing the Contamination of Water Bodies - A Practical
Guide
(download)
Overview about the project -
project flyer
Project
Management Strategies for Pharmaceuticals in Drinking Water - start
Project head:
Duration :
10/2005 – 05/2008
Project partner:
- Researchszentrum Karlsruhe GmbH,
- Institut für Technikfolgenab-schätzung und Systemanalyse (ITAS)
- Universitätsklinikum Freiburg,
- Institut für Umweltmedizin und Krankenhaushygiene, Sektion Angewandte UmweltResearch
- J. W. Goethe-Universität Frankfurt am Main: Institut für Physische Geografie, Institut für Atmosphäre und Umwelt, Institut für Ökologie, Evolution und Diversität
Practice partner:
- Arzneimittelkommission der Deutschen Apotheker, Eschborn
- Arzneimittelkommission der Deutschen Ärzteschaft, Berlin
- badenova AG & Co. KG, Freiburg
- Barmer Ersatzkasse, Landesgeschäftsstelle Hessen, Frankfurt am Main
- Bayer HealthCare AG, Wuppertal
- Bundesverband Verbraucher-zentralen e.V., Berlin
- Deutsche Vereinigung des Gas- und Wasserfachs e. V. (DVGW)
- Deutscher Berufsverband der Umweltmediziner, Würzburg
- Emschergenossenschaft/ Lippeverband, Essen- F.
- Hoffmann-La Roche Ltd, Basel, Schweiz
- genanet/ Life e. V., Frankfurt am Main
- Novartis Pharma AG, Basel, Schweiz
- Rheingütestation Worms
- Stockholm City Council, Stockholm, Schweden
- Umweltbundesamt Dessau
Funding:
Federal Ministry of Education and Research
funding
programme Social Ecological Research
International
Conference Sustainable Pharmacy, 24-25 April 2008
Publications
Keil, F./G. Bechmann/K. Kümmerer/E. Schramm (008): Systemic Risk Governance for Pharmaceuticals in the Water Cycle. GAIA 4/2008
Strengthening the Coping Capacity for Pharmaceuticals in Drinking Water - Poster
Management Strategies for Pharmaceuticals in Drinking Water - start
The presence of pharmaceutical agents in the water cycle poses an unpredictable and only partly controllable risk for drinking water supply systems. The conditions for the emergence and the dynamics of this systemic risk are as yet unidentified. Of particular interest are the roles and perspectives of the different actors: How do they perceive the risk and how does this perception influence the recognition of need for action and the implementation of management strategies? The research project »Management Strate-gies for Pharmaceuticals in Drinking Water (start)« addresses this problem with the aim to integrate different sectoral measures for the reduction of emissions of pharmaceuti-cals into a systemic management strategy.
Environmental Relevance and Drinking Water Exposure
Health protection and environmental protection are societal aims which usually accom-pany each other. However, the recently boosted discussion on the environmental rele-vance of pharmaceuticals shows that both aims can become mutually inconsistent. After the intake pharmaceutical agents are excreted partly unchanged with urine and can be emitted into the environment via municipal sewage. Today they are, in fact, detected with significant concentration in many surface waters within Germany and across Euro-pe as well as in ground waters, which are influenced by bank filtration. Even in drinking water individual agents are found at trace levels.
Limits to Knowledge
It is difficult to ascertain if, according to these results, a hazard for humans and the envi-ronment has to be expected, since the problem is characterised by a high degree of un-certainty and nescience: Long-term effects of a continuous exposure to pharmaceutical agents in sub-therapeutic doses are as unexplored as the impacts of their numerous me-tabolites. At the same time one can safely assume that problem specific knowledge defi-cits will basically persist both practically due to the large amount of pharmaceuticals already on the market and fundamentally due to the inherent complexity of the problem.
Complex Risk Dynamics
From this, an unpredictable systemic risk emerges for the safeguarding of the drinking water supply. Actual hazards for human health – e.g. as a consequence of the occur-rence of resistant germs due to antibiotics in waters – and fundamental conflicts of in-terest along the question of an effective supply with pharmaceuticals and the provision of hygienically unobjectionable drinking water combine with the population’s subjec-tive perception of hazards to a complex risk dynamic. In a situation where risks as a consequence of limited knowledge are hard to assess the precautionary principle calls for action.
Strategy Approaches
Preventive management strategies for pharmaceutical agents in drinking water can act on three individual sectors each with different time horizons:
- Technical Approach (short- to mid-term): Conventional procedures for sewage treatment and drinking water processing are largely replaced by innovative procedures (e.g. membrane filtration, reversed osmosis).
- Conduct Approach (mid- to long-term): Present prescription practices, use and disposal patterns of pharmaceuticals change towards a higher environmental sensibility.
- Agent Approach (long-term): Innovations in sustainable pharmacy lead to the substitution of problematic agents by those which are simultaneously optimised for activity in humans and degradability in the environment.
Integrated Strategy Development
The basis of the research work in start is the formulation of a common understanding of the emergence and dynamics of a systemic risk for the drinking water supply as a con-sequence of pharmaceuticals in the water cycle. The development of integrated strate-gies is carried out in several transdisciplinary entwined natural and social sciences work packages:
- Definition of the three sectoral strategy approaches
- Socio-empirical surveys for strategy acceptances
- Actor analysis, systemic analysis and strategy integration
- Development of different scenarios for the implementation of the systemic strat-egy
- Development of target group specific instruments of risk communication
- Presentation of results at corporations, health care facilities and organisations