Where do our prescribed drugs end up?

Member blog | Bertil Hagström, General practitioner, PhD - Swedish Doctors for the Environment

After passing through sewage treatment plants, approximately 40 tonnes of antibiotics and other drug residues can be found in Sweden’s sewage sludge, along with a variety of other hazardous chemicals. Even larger quantities find their way into our lakes and seas.

As healthcare professionals, we have a responsibility to the health of our patients and communities. Whilst we must carefully consider the full impact of our prescribing practices and our own contribution to this growing issue, we cannot ignore regulatory and policy solutions – we must act as advocates for more sustainable sewage management.

The health and environmental effects of sewage sludge

Many pharmaceutical residues, pollutants, and industrial chemicals, produced both inside and outside our country end up in sewage sludge systems through household sewage and wastewater, but also from small and large local industries, roads, hospitals, and street drains. Pollution from all forms of consumables comes from global production and trade and there are hundreds of thousands of foreign substances in sewage sludge.

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Drugs used to treat HIV and flu can have detrimental impact on crops

by University of Plymouth

Credit: CC0 Public Domain

The increased global use of antiviral and antiretroviral medication could have a detrimental impact on crops and potentially heighten resistance to their effects, new research has suggested.

Scientists from the UK and Kenya found that lettuce plants exposed to a higher concentration of four commonly-used drugs could be more than a third smaller in biomass than those grown in a drug-free environment.

They also examined how the chemicals transferred throughout the crop and found that, in some cases, concentrations were as strong in the leaves as they were in the roots.

The study—published in Science of the Total Environment—was conducted by environmental chemists from the University of Plymouth (UK), Kisii University (Kenya) and Jomo Kenyatta University of Agriculture and Technology (Kenya).

It is one of the first worldwide to examine the impact of pharmaceutical compounds on agriculture, and to consider the subsequent risks for consumers.

For it, scientists focused on the drugs nevirapine, lamivudine and efavirenz—which are used to treat and prevent HIV/AIDS—and oseltamivir, which stops the spread of the flu virus in the body.

However, they say it is also relevant in light of the current COVID-19 pandemic, with antiviral medications having been approved for use to treat those affected by the virus.

Such compounds get into soils when they are irrigated with contaminated surface water, treated or untreated waste water, sewage sludge and biosolids.
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There is an Alarming Amount of Microplastics in Farm Soil and Our Food Supply

More microplastics are contaminating agricultural lands than oceans, impacting plant development and ending up in produce and people.


Mary Beth Kirkham hadn’t studied microplastics when she was invited to co-edit a new book about microplastics in the environment—but something stood out to her about the existing research.

“I had read in the literature that . . . cadmium and other toxic trace elements [are] increased when we have these particulate plastics in the soil. So, that was of concern to me,” said Kirkham, a plant physiologist and distinguished professor of agronomy at Kansas State University.

Kirkham’s expertise is in water and plant relations and heavy metal uptake, so she decided to conduct her own research in which she cultivated wheat plants exposed to microplastics, cadmium, and both microplastics and cadmium. Then she compared these plants to those grown without either additive.

read full article at Civil Eats


A Danish study found that people with elevated levels of a compound called PFBA were more than twice as likely to have a severe form of Covid-19.

by Sharon Lerner
December 7 2020, 10:53 a.m.

ELEVATED LEVELS OF a PFAS compound were associated with more severe forms of Covid-19, according to a Danish study now undergoing peer review. The research, which involved 323 patients infected with the coronavirus, found that those who had elevated levels of a chemical called PFBA were more than twice as likely to have a severe form of the disease.

PFBA is one of a class of industrial compounds, often called “forever chemicals,” that has come to contaminate soil, water, and food around the world. It has been presented as relatively safe because it stays in human blood for much less time than some of the other compounds in the class and is a shorter molecule. Both traits are thought to be indications of its innocuousness. PFBA, which was created by 3M, is based on a four-carbon chain and is gone from human blood in a matter of days. It is still in use, while PFOA, which is based on eight carbons and stays in the human blood for years, has been phased out since 2015.

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Plastic Pollution in Soils: Governance Approaches to Foster Soil Health and Closed Nutrient Cycles

Stubenrauch, J.; Ekardt, F. Plastic Pollution in Soils: Governance Approaches to Foster Soil Health and Closed Nutrient Cycles. Environments 2020, 7, 38.


Plastic pollution in soils pose a major threat to soil health and soil fertility that are directly linked to food security and human health. In contrast to marine plastic pollution, this ubiquitous problem is thus far scientifically poorly understood and policy approaches that tackle plastic pollution in soils comprehensively do not exist. In this article, we apply a qualitative governance analysis to assess the effectiveness of existing policy instruments to avoid harmful plastic pollution in (agricultural) soils against the background of international environmental agreements. In particular, environmental and fertiliser legislation relevant to soil protection in the European Union and in Germany are assessed. Regulatory weaknesses and gaps of the respective legislation are identified, and proposals for enhanced command-and-control provisions developed. However, the legal analysis furthermore shows that plastic pollution ecologically is also a problem of quantity, which is difficult to solve exclusively through command-and-control legislation. Instead, comprehensive quantity-control instruments to phase out fossil fuels (worldwide and in all sectors) as required by climate protection law can be effective approaches to tackle plastic pollution in environmental media like agricultural soils as well.

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The Autism Biosolids Conundrum

by David L. Lewis
Retired, U.S. EPA Office of Research and Development, National Exposure Research Laboratory (1968-2003), Athens, Georgia USA

Despite overwhelming evidence that certain heavy metals, toxic organic chemicals and infectious agents play an important role in triggering autism and other environmental health problems, the U.S. Environmental Protection Agency supports land application of largely unmonitored concentrations of these contaminants in biosolids.


Before Congress passed the Clean Water Act of 1972, municipalities throughout the United States discharged hazardous municipal and industrial wastes directly into rivers and other waterways. Every chemical and biological agent linked to neurodevelopmental disorders, including those linked to “autism spectrum disorders” (ASDs), spilled into coastal waters and settled on the bottoms of the oceans. The solution to pollution was dilution. To comply with the Clean Water Act of 1972, President Carter created wastewater treatment plants throughout the United States to extract heavy metals and toxic organic chemicals from water and concentrate them in sewage sludges that were dumped offshore and buried in landfills. In 1988, Congress banned ocean dumping of sewage sludges because of their potential for causing vaccine-derived polio epidemics. Suddenly, high concentrations of every heavy metal, toxic organic chemical and vaccine-derived viruses linked to autism, including rubella and cytomegalovirus, had no place to go but land. The solution to pollution shifted from diluting pollutants in water to concentrating them on land at hundreds of thousands to millions of times higher concentrations, including on commercial farms that produce our nation’s food supplies. Now, all of the most dangerous pollutants regulated by EPA no longer require biomagnification up the food chain to harm public health. Promoted by EPA and the USDA as safe and environmentally beneficial, land application practices quickly spread worldwide. Here, the author relies largely, albeit not exclusively, on EPA’s own research to address the implications. As a whole, it indicates that the global shift that EPA’s 503 Sludge Rule created in the accumulation of pollutants from ocean sediments to populated land surfaces is causally related to sharp increases in the incidence of neurodevelopmental disorders worldwide. Autism in its severe infantile form is more or less at the center of this entire class of disorders that appears to have become epidemic beginning in late 1988. EPA dismissed controversial claims linking MMR vaccination to autism, but never addressed the role that widespread land application of sewage sludges (a.k.a. biosolids), which contain highly virulent strains of vaccine-derived measles, rubella and other viruses, may play in autism. Notwithstanding this glaring omission, the global shift that EPA policies on biosolids created in human exposures to complex mixtures of measles, rubella and other viruses derived from live vaccines, combined with high concentrations of potentially every heavy metal and chemical pollutant linked to autism, could explain sharp increases in the incidences of autism and other ASDs that began in 1988.

Lewis, D. (2020). The Autism Biosolids Conundrum. International Journal of Vaccine Theory, Practice, and Research. Vol. 1 No. 1 (2020): Inaugural Issue. Published 2020-07-15.