Project: start – Management Strategies for Pharmaceuticals in Drinking Water

Project Head: Florian Keil Project Consortium: Institute for Social Ecological Research (ISOE) GmbH, Frankfurt Institute for Technology Assessment and Systems Analysis (ITAS), Research Centre Karlsruhe, University Hospital Freiburg, Institute for Environmental Medicine and Hospital Epidemiology, Applied Environmental Research Section J. W. Goethe University Frankfurt on the Main, Institute for Physical Geography, Section Hydrology J. W. Goethe University Frankfurt on the Main, Institute for Atmosphere and Environment, Section Environmental Analysis J. W. Goethe University Frankfurt on the Main, Institute for Ecology, Evolution and Diversity, Section Ecotoxicology Funding: Federal Ministry of Research and Technology Funding programme Social-Ecological Research Duration: 10/2005 – 03/2008 Project-Website: http://www.start-project.de/english.htm   Field of research Research Area: Transdisciplinary Concepts and Methods   about the Institute

A Research Project of the Network of Competence MOMUS Pharmaceutical Agents in the Water Cycle 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 pro-cedures (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

Date 2007-10-09