1. What’s in our water? The disposal of drugs in our drinking water system Amber L. Ross Dr. R. Thron PUBH 8165 May 5, 2011 Environmental Health Project

2. Objectives Understand the modes of disposal concerning drugs in our drinking water systems. Understand the rate of disease cases, deaths and carcinogenic risks related to contaminated drinking water in the U.S. and other countries Demonstrate the need for tougher laws and penalties toward improper disposal of medications.

3. Understand the modes of disposal concerning drugs in our drinking water systems Rivers – rivers are evident by the remains on the surface moving from higher to lower altitudes in respect to gravity. Rivers Streams – stream flow refers to the amount of water flowing in a river. Streams Lakes – lake is where surface-water runoff (and maybe some ground- water seepage) have accumulated in a low spot, relative to the surrounding countryside. Lakesrunoff Toilets – has been a source used to dispense expired or unused medications which travels back to our main water source. Toilets

4. Antibiotic resistant medicines in the river (2009) http://cogtoronto.wordpress.com/2009/07/21/super-bacteria-in-fertilizer-breeding-more- super-bugs/ http://cogtoronto.wordpress.com/2009/07/21/super-bacteria-in-fertilizer-breeding-more- super-bugs/

5. Unwanted prescribed antibiotics in the stream. (2009). http://www.targethealthglobal.com/http://www.targethealthglobal.com/

6. Duane Moser, an assistant research professor with Desert Research Institute, collects water samples from the Las Vegas Wash in Henderson, Nevada Donn, J., Mendoza, M., Pritchard, J. (2008) http://www.msnbc.msn.com/id/23503485/ns/health-health_care http://www.msnbc.msn.com/id/23503485/ns/health-health_care

7. Discarding unwanted antibiotics and liquid medicines in the toilet. (2007). http://www.charlottechd.com/EH/MedDisposal.htmlhttp://www.charlottechd.com/EH/MedDisposal.html

8. Understand the rate of disease occurrences, deaths and carcinogenic risks related to contaminated drinking water in the U.S. and other countries Just 10 years ago, reports show that 39 outbreaks occurred here in the U.S., and previous to that 59 outbreaks occurred involving recreational water. (Moeller, D. 2005) In the U.S., two deaths were reported between 1997 and 1998 due contaminated drinking water. (Moeller, D. 2005) Treatment plants do not test pharmaceuticals on a regular basis because no Environmental Protection Agency regulations required it to do so. (Van Dyke, A. 2009)

9. A girl waits to collect drinking water from a water tanker in New Delhi, (2007) Credit: Reuters/Parth Sanyal http://www.reuters.com/article/2011/04/07/us-bacteria- superbugs-india-idUSTRE7357W920110407http://www.reuters.com/article/2011/04/07/us-bacteria- superbugs-india-idUSTRE7357W920110407

10. Antibiotic resistance genes have been found in bacteria in drinking water and sewage, far the hospitals the usually haunt.Gurinder Osan / AP Photo http://www.nature.com/news/2011/110407/full/news.2011.218.html?s=n ews_rss http://www.nature.com/news/2011/110407/full/news.2011.218.html?s=n ews_rss

11. Demonstrate the need for tougher laws and penalties toward improper disposal of medications Currently, there are no safety limits on drugs in drinking water. (Snyder, E. 2008) U.S. officials are uneasy discussing these dangers. So are water utilities. For now, nothing is being done to limit drugs in the water supply. (Uehling, M. 2001)water utilities. Treatment plants do not test pharmaceuticals on a regular basis because no Environmental Protection Agency regulations required it to do so. (Van Dyke, A. 2009)

12. Further Reading Online Sources http://water.epa.gov/drink/contaminants/index.cfm http://www.govtrack.us/congress/bill.xpd?bill=s111- 3397&tab=related http://www.govtrack.us/congress/bill.xpd?bill=s111- 3397&tab=related http://www.waterindustry.org/Water-Facts/new- pollutants.htm http://www.waterindustry.org/Water-Facts/new- pollutants.htm http://waterfilterauthority.com/ http://water.epa.gov/lawsregs/rulesregs/sdwa/gwr/index.cfm http://water.epa.gov/lawsregs/rulesregs/sdwa/gwr/index.cfm http://www.allthingshealing.com/Organic-Living/Are- There-Drugs-in-Our-Water-Supply/6340 http://www.allthingshealing.com/Organic-Living/Are- There-Drugs-in-Our-Water-Supply/6340

13. Reference Bynum, J. (2008). Dental diseases by bacteria in drinking water. The Watchers. [Online]. Retrieved on April 15, 2011 from http://thewatchers.us/dental_disease.html http://thewatchers.us/dental_disease.html Chuanwu, X., Zhang, Y., Marrs, C. et. al. (2009). Prevalence of Antibiotic Resistance in Drinking Water Treatment and Distribution Systems. Applied and Environmental Microbiology. [Online]. Retrieved on April15, 2011 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2737933/ Gleick, P. (2002). Dirty Water:Estimated Deaths from Water-Related Diseases 2000-2020. Pacific Institute Research Report. [Online]. Retrieved on April 18, 2011 from http://pacinst.org/reports/water_related_deaths/water_related_deaths_report.pdf http://pacinst.org/reports/water_related_deaths/water_related_deaths_report.pdf

14. Reference King, T. (2000). Antibiotics in your drinking water. [Online]. Retrieved on April 15, 2011 fromhttp://www.suite101.com/article.cfm/food_safety/49083http://www.suite101.com/article.cfm/food_safety/49083 Lubick, N. (2011). Antibiotic resistance shows up in India’s drinking water. Nature. [Online]. Retrieved on April 15, 2011 from http://www.nature.com/news/2011/110407/full/news.2011.218.html http://www.nature.com/news/2011/110407/full/news.2011.218.html Moeller, D. (2005). Environmental Health. Harvard University Press. Cambridge, Massachusetts

15. Reference Perlman, H. (2011). Earth’s Water: Rivers and Streams. U.S. G. S. [Online]. Retrieved on April 15, 2011 from http://ga.water.usgs.gov/edu/earthrivers.html http://ga.water.usgs.gov/edu/earthrivers.html Pioneering study finds small amounts of dairy antibiotics in groundwater. (2010). UC Davis. [Online]. Retrieved on April 15, 2011 from http://news.ucdavis.edu/search/news_detail.lasso?id=9582 http://news.ucdavis.edu/search/news_detail.lasso?id=9582 Rastogi, N. Should you flush your drugs down the toilet. (2009). The Green Lantern. [Online]. Retrieved on April 28, 2011 from http://www.slate.com/id/2236431 / http://www.slate.com/id/2236431 /

16. Reference Recommendations for clean and safe water for the 21 st century. (n. d.). Water Infrastructure Network. [Online]. Retrieved on April 15, 2011 from http://win-water.org/reports/winow.pdf http://win-water.org/reports/winow.pdf S. 3397:Secure and Responsible Drug Disposal Act of 2010. (2010). Gov Track. [Online]. Retrieved on April 15, 2011 from http://www.govtrack.us/congress/bill.xpd?bill=s111-3397&tab=related http://www.govtrack.us/congress/bill.xpd?bill=s111-3397&tab=related Schaaf, B. (2010). Cholera, Water, and Recovery in Haiti. Haiti Innovation. [Online]. Retrieved on April 15, 2011 from http://www.haitiinnovation.org/en/2010/10/29/cholera-water-and-recovery- haiti

17. Reference Stranahan, S. (2009). Drugs in our drinking water. AARP Bulletin Today. [Online]. Retrieved on April 15, 2011 from http://www.safemeddisposal.com/documents/AARPFeb2709.pdf http://www.safemeddisposal.com/documents/AARPFeb2709.pdf The Health Effects Of Drinking Water Contamination. (2005). The Ralph Nader Institute. Belkraft. [Online]. Retrieved on April 15, 2011 from http://www.belkraft.com/DrinkingWaterContamination.htmhttp://www.belkraft.com/DrinkingWaterContamination.htm Typhoid Fever in the United States. (2001). National Institutes of Health. [Online]. Retrieved on April 15, 2011 from http://www.nichd.nih.gov/news/releases/typhoid_background.cfm http://www.nichd.nih.gov/news/releases/typhoid_background.cfm

18. Reference Uehling, M. (2001). Free drugs from your faucet. Salon. [Online]. Retrieved on April 15, 2011 from http://www.salon.com/technology/feature/2001/10/25/drugs_water http://www.salon.com/technology/feature/2001/10/25/drugs_water Van Dyke, A. (2009). Dirty mouth: Water may not be clean. Kansan. [Online]. Retrieved on April 15, 2011 from http://www.kansan.com/news/2009/sep/14/tap_water http://www.kansan.com/news/2009/sep/14/tap_water Wallinga, D. (2004). Concentrated animal feeding operations: Health risks from water pollution. Institute for agriculture and trade policy. [Online]. Retrieved on April 15, 2011 from http://www.healthobservatory.org/library.cfm?refID=37390 http://www.healthobservatory.org/library.cfm?refID=37390

19. Reference Water related Diseases. (2001). World Health Organization. [Online]. Retrieved on April 15, 2011 from http://www.who.int/water_sanitation_health/diseases/en http://www.who.int/water_sanitation_health/diseases/en Xi, C., Zhang, Y., Marrs, C., Ye, W., Simon, C., Foxman, B., Nriagu, J. (2009). Prevalence of Antibiotic Resistance in Drinking Water Treatment and Distribution Systems Appl. Environ. Microbiol. Retrieved on April 15, 2011 from http://aem.asm.org/cgi/reprint/AEM.00382-09v1 http://aem.asm.org/cgi/reprint/AEM.00382-09v1