Endocrine disruptors are of special concern.

Pharmaceuticals and Personal Care Products (PPCPs) are a growing concern for clean-water and drinking-water programs.

While the drinking-water and wastewater-treatment industries are not the causes of this problem, they have become responsible for the solution.

Wastewater and drinking water treatment processes have not been designed to address pharmaceuticals, but officials are working to increase PPCP removal rates.

Communication strategies and public outreach programs can inform the public about what the scientific community is learning about PPCP effects. These efforts can tell the public how state and federal officials are responding, and how citizens can help. Researchers and scientists studying the issue need better ways to share their findings with those who will benefit from the research.

For NEIWPCC, tracking and monitoring these issues is of high priority. We will continue to apprise our members of all activities in this area and will coordinate regional PPCP-related initiatives. NEIWPCC has hosted multiple conferences on PPCPs.


Though PPCPs are not new, the implications of their presence in the environment is only now a focus of our attention and research. These compounds include:

  • prescription and over-the-counter drugs
  • veterinary drugs
  • nutritional supplements
  • fragrances
  • cosmetics
  • sun-screen agents

The paths these compounds travel that ultimately deliver them to the waters of our environment can be generalized into three segments:

Wastewater Influent

  • Metabolic excretion (unmetabolized parent drug, parent-drug conjugates, and bioactive metabolites) by humans and pets
  • Release to sewage systems, including both treatment plants and septic systems
  • Disposal of unused/expired medication to sewage systems
  • Release of treated/untreated hospital wastes to domestic sewage systems (weighted toward acutely toxic drugs and diagnostic agents, as opposed to long-term medications)
  • Disposal by pharmacies, physicians, humanitarian drug surplus
  • Discharge of regulated/controlled industrial manufacturing waste streams
  • Disposal/release from clandestine drug labs and illicit drug usage

Wastewater Effluent

  • Treated effluent from domestic sewage treatment plants
  • Release from private septic/leach fields
  • Discharged to surface waters
  • Injected into aquifers (recharge)
  • Recycled/reused (irrigation or domestic uses)
  • Transfer of sewage solids (“biosolids”) to land (e.g., soil amendment/fertilization)
  • Manure from medicated domestic animals (e.g., feed) – CAFOs (confined animal feeding operations)

Direct Release

  • Direct release to open waters via washing/bathing/swimming
  • Release to open waters from aquaculture (medicated feed and resulting excreta)
  • Underground leakage from sewage system infrastructure
  • Overflow of untreated sewage from storm events and system failures directly to surface waters
  • “Straight-piping” from homes (untreated sewage discharged directly to surface waters)

Contributions to the environment from some of these sources remain poorly characterized in both quantity and quality today. There are other sources that have yet to be identified.

Do Not Flush!

Many states and local governments as well as water organizations advise citizens to refrain from flushing pharmaceuticals. Instead, health agencies promote the use of takeback programs and trash as the proper disposal methods of unused or unwanted medicines.

A takeback event is a service in which unused pharmaceuticals are collected and disposed of properly (generally by incineration). Takebacks are provided by a local organization or municipality,

Takeback program and event organizers must adhere to various federal and state laws and regulations regarding drug collection and transportation. Alternatives to takeback events are mail-in programs by which patients can send their unused pharmaceuticals by mail to be properly disposed.

If a takeback even is not available, people should dispose of unused or unwanted pharmaceuticals in the trash.

Patients should remove prescription drugs from their original containers and, in a nondescript container, mix them with some undesirable substance such as used coffee grounds, kitty litter, dirt, or sawdust to further discourage their use before throwing the mixture away in the trash.