1. Pharmaceuticals in the Environment Pharmaceuticals are increasingly being designed to have higher potency, bioavailability and degradation resistance. Concentration in environment will increase o Inverted age structure o Medical advancements o Increased per capita consumption o Increased spending on health care o Increasing population o Chemical persistence

2. Ethinylestradiol (EE2) EE2 is a synthetic estrogen used in OCs 9 in 10 municipal waste water effluents in Canada were found to contain >1ng/L Documented negative effects on aquatic organisms, e.g. fish populations experience skewed sex ratio, demasculinization, decreased egg fertilization, vitellogenin production in males Potential effects on humans?

3. Challenges Test for acute vs. chronic toxicity tests Limited ability to detect and remove chemicals in water Effects of chemical “cocktails” unknown Challenge to regulate because source is so diffuse Accountability/liability Pitting the need for clean water against our use of modern medicine – how do we weight the costs and benefits when there are so many unknowns?

4. Root of the problem ! Encourage use of other contraceptives, take less drugs, disease prevention, education, population control Change the drug Design more environmentally benign and efficient products (green chemistry) EOP Improve detection methods and wastewater treatment, establish disposal programs, further research, rating systems