|
 
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| REVIEW ARTICLE |
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| Year : 2022 | Volume
: 7
| Issue : 2 | Page : 192-197 |
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Effect of expired pharmaceutical dumping on ecological community
Dipanshu Kumar Vishwas
Department of Botany, Brahmananda Keshab Chandra College, Kolkata, West Bengal, India
| Date of Submission | 14-Jan-2022 |
| Date of Decision | 24-May-2022 |
| Date of Acceptance | 02-Jun-2022 |
| Date of Web Publication | 09-Sep-2022 |
Correspondence Address:
Dipanshu Kumar Vishwas
Department of Botany, Brahmananda Keshab Chandra College, 111/2 B. T. Road, Bon-Hooghly, Kolkata - 700 108, West Bengal
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/bjhs.bjhs_8_22
Most people usually throw unused or expired medicines at open landfill sites or isolated locations completely inadvertently due to the consequences and lack of drug disposal facilities. Thus, our field of investigation focuses on whether disposal medicine has any direct effect on various life forms, including humans. This investigation describes how medicinal metabolites develop through wastewater that continuously enters the aquifer and soil environment. Since the discharge of toxic drugs has antibacterial activity, loss of soil fertility, aquatic species have a feminizing effect in males, and bioaccumulation affects inland animals including humans promote global consequences, and thus food affects the chain. Thus, a review of this study might furnish a good conception on the issue of lapsed pharmaceutical wastage and its effect on biological networks. The work concludes with better knowledge about the current conditions of drug wastage around the world, including India, and how biologically active ingredients can have devastating effects on the metabolism of various life forms in the ecological community. This article can also be very useful for understanding, aware and cautioning about the future consequences of drugs by people carelessly in the environment, and turning the brain to the urgent need for a strict and complete proof policy on its safe dumping so that its harmful effects on the environment can be minimized.
Keywords: Ecological community, environmental hazards, expired medicine, pharmaceutical waste
How to cite this article:
Vishwas DK. Effect of expired pharmaceutical dumping on ecological community. BLDE Univ J Health Sci 2022;7:192-7 |
Therapeutic products are additionally designated as pharmaceuticals or drugs, which may be in the form of any active drug ingredients, metabolites, transformation products, and prodrugs.[1] The progress made by clinical science and its positive effects on society is remarkable. The nature of medicines unexpectedly affects animals and microorganisms in the environment.[2] This is an area that we need to see and understand the world over. Pharmaceutical products assure the potency and safety of the drug contained until the expiration mentioned on the medicine pack. The expiration date does not mean that the drug will completely lose its potency and will no longer be effective after the expiration date.[3] Typically, the expiry date of drugs is 2–5 years from the date of production.[4] If the drugs are stored in optimal conditions, drugs retain 90% potency up to 5 years after their expiration period, and in some cases longer. In fact, even 10 years after the expiration date, some drugs have their original potential.[5] The termination date is that the day of judgment the company assures the complete efficiency and safety of a drug.[6] The lapsed drug cannot be suggested for human use as there will be no legal support for compensation for any side effects or adverse drug reactions as the manufacturer cannot be accused of it.[7]
Due to a lack of awareness and disorganization about the method of disposal, a large proportion of individuals usually disposed of these expired meds.[8] Investigations about the disposal of currently expired and unused drugs emerge that have an immediate impact on various ecological life forms, including humans. Thus, the purpose of this study is to furnish a well conception on the issue of lapsed pharmaceutical wastage and its effect on biological networks. In this specific situation, our regions can be articulated with an inquiry into understanding the current conditions of drug wastage around the world, including India, and how their biologically active elements on the metabolism of life forms present in various ecological networks may be affected, discussing this. In this sense, first, we have reviewed ongoing writing on existing disposal practices, and then finally, we have built a new understanding of the concept of termination of drugs over time and its devastating effect on ecological networks, which might be very useful, understanding, aware, and cautious about the future consequences of careless throwing of drugs into the environment.
| Concept of Disposal of Medicine around the World | |  |
The life cycle of medicinal products includes all pharmacological processes from discovery to access.[9] According to the German Federal Ministry for the Environment, pharmaceutical organizations are producing a variety of manufactured synthetic substances at a speed of 100,000 tons per year.[10] This would result in a significant portion of the drug volume being used or potentially lapsed, while a fraction of it is being only used. In addition, a cross-sectional investigation reported that the value of unused meds produced by many senior citizens in the US alone is over the US $1 billion per year.[11] A similar situation has occurred in other developed nations. In Australia, the monetary estimate of drug waste per patient and during the year is up to 1280 USD.[12] Pharmaceutical wastes contain many biologically active and toxic substances, which can pose a risk to the aquatic environment, especially if disposed of improperly. The US Geological Survey reported that there are intersex fish in the Potomac River due to estrogen contamination,[13] and small concentrations of 25 antibiotics in drinking water have been found in Canada.[14] Despite this, the waste disposal practice of unused medicine among people in Asia, Africa, Europe, and South and North America was briefly described by Alnahas et al.[15]
In addition, the presence of a very minute concentration of dynamic drug material in the dirt and streams then enters the natural way of life and accordingly get back to people unexpectedly.[16] In addition, the WHO created a depository for clear meds, while a donation program to redistribute unused medicine in developing countries may be a decent activity to address drug abuse. However, the WHO also distributed a guideline in 1999 and suggested that lapsed or unused drugs should not be reused.[17] Disposal of expired and unused medicine has become an ulcer worldwide. The wastage of meds by garbage and sewer is by far the most well-known practice in various countries by patients.[18]
| Performance of Medicine in India Concluded | | |
In India, common unused and premature pharmaceutical disposal practices include direct waste into the environment such as at an open landfill site or isolated location or from burning. The issue of unused or expired meds can occur at homes, clinics, wholesalers, retail medical stores, or construction sites. Many metropolitan corporations are not aware of the aftermath of the wastage results and therefore require conscious and drug dumping facilities. Individuals are completely unaware of the consequences of unsafe wastage of meds. In fact, even medical professionals are very casual about pharmaceutical wastage.[19] In India, addiction to drugs under the control of narcotics is preferably due to drug abuse, although such expired and unused drug wastage is not their priority. In addition, unused and lapsed meds are considered metropolitan solid waste. Bundling is seen as the consumption of plastic waste because of its physical presence of bundling.[7] Thus, this review article might curb the minds of highly educated people who can apply their basic level of thinking about the harmful consequences and making reliable policy for safe drug disposal practices.
| Pathways to Entering the Environment | | |
The nature of drug waste is progressively impacting, as unused medicines are improperly discarded or disposed of.[20] Drugs have been found essentially in lakes, rivers, groundwater, soil, manure, and potable water.[21] Dynamic drug constituents enter the vicinity through two main routes through human and veterinary treatments. First, when medicines taken are discharged into urine or feces, and second, when unused medicines are disposed of under latrine or sink and open landfill. Subsequently, the abandonment of unused and expired medication on open land or sewage by the vast majority of the unaware individual, releases the results of the drug content and eventually enters the surface water,[22] and then enters the aquatic ecosystem.[23] However, the impact of these multidrugs on the physiology of fishes, amphibians, and other aquatic species is still a question. In addition, these pharmaceuticals enter the soil environment by application of sewage biosolids, and further consequences on various ecological life forms need to be known.
| Drug Molecules in the Environment | | |
At the beginning of the twenty-first century, the European Environment Agency was concerned with the natural impact of expired or unused medicines as an important emerging issue.[24] Recent literature detailed that a total of 631 drugs were detected out of a total of 713 drugs for testing in the environment.[25] In Germany, a total of ~ 14,000 tons of drugs were discarded annually from human medicine, and 60%–80% of these drugs flowed into the toilet or sink or were disposed of in the ordinary household waste.[26] A similar situation is expected in different countries including India. Besides, a wide range of drugs including hormones, steroids, antibiotics, and parasites have been detected at low levels in soil and surface water.[27],[28]
| Environmental Hazards for the Environment | | |
Organisms present in the environment have not been widely studied due to open, landfill, or dumping of expired drugs. If drug disposal practices are inappropriate, the health of the exposed population is definitely at risk.
Effect of drugs on bacterial community structure
In most homes around the world, there are packs of medicines stored in containers and eventually exhausted, which flows into the sink or landfill,[29] and can lead to the accumulation of large amounts of drugs in the wastewater. The hospital flow is also full of antibiotics, steroids, etc., in high concentrations.[30] The abundance of toxic drugs, including antibiotics in wastewater, might affect microbial community structure as a bactericidal effect.[31] Further, it promotes the development of drug-resistant microorganisms having sewage-containing drugs, yet may have global consequences.[32] Clean, fresh drinking water is one of the most important natural resources in the world. In India, anti-ciprofloxacin bacteria have been discovered downstream of a pharmaceutical manufacturing plant, and genes for antimicrobial multi-drug resistance have been observed in drinking water.[33] Besides, multidrug-resistant Salmonella has been reported on vegetables sprayed with drinking water.[34]
Effects of drugs on earthworms
Drugs that enter the soil environment by animal slaughter and the application of biosolids to the ground with contaminated water for irrigation.[35] These drugs are assimilated by soil organisms cause toxic effects, contaminate the food chain, and provide a path of launching into earthy environment.[36] Earthworms, as engineers of ecosystems,[37] have an impact on soil structure, as their bubbling activities are accompanied by ingestion of soil and their production.[38] Uptake of medication associated with anticonvulsant, anti-inflammatory, antidepressant, and antiobesity, etc., in earthworms affected its physiology; therefore, soil matrices modified soil pH scale over time.[39] The intrinsic hydrogen ion concentration of the earthworm is additionally altered because of supplementation with medicinally edged soils. Thus, the physicochemical properties of the drug could alter the soil and intrinsic earthworm alchemy,[35] which might have a fatal effect on the growth of herbs or shrubs.
It is also known that earthworms are prey to birds and small mammals. Therefore, they have an important role in the food chain and can overtake drugs in their tissues. Consequently, some concentrations of these pharmaceuticals can be transferred from insects to terrestrial vertebrate species.
Effect of medicines on fish
Unusable drug waste dumping and ineffective treatment of wastewater pollute the freshwater that contaminates the environment.[40] Studies on the effects of drug contamination on wildlife are scarce, but some published work on an antidepressant reduces feeding in starlings,[41] and a contraceptive drug reduces fish populations in lakes.[42] Synthetic estrogen used in birth control pills eradicated the fathead minnows in lakes and disrupted the entire ecosystem. Furthermore, residues of these drugs in freshwater habitats lost 75% of the population of fish and amphibians. In addition, drug contamination of synthetic hormones caused male fish to become feminized. Besides, estradiol concentrations in surface water caused vitellogenin production in male fishes and structural changes of the sex organs.[43] Another antidiabetic drug, metformin, observed that there was no metabolic change in the fish under laboratory conditions, but a gene related to egg production was expressed in male fish due to hormonal imbalances in the male confirms a feminizing effect on fish.[44] Moreover, the drug propranolol was reported to cause a significant decrease in egg production in Medaka fish,[45] and gemfibrozil reduced testosterone levels in fish,[46] whereas in shellfish, swimming activity was affected by fluoxetine.[47]
Effect of drugs on frogs
Progestogens are hormones used in contraceptives, cancer treatment, and hormone replacement therapy for a menopausal crisis. Various progestogens (norethindrone, levonorgestrel, and progesterone) have been recognized in aquatic ecosystems,[48] of various nations including India. Environmental exposure to these progestogens is targeted at oogenesis, showing a threat for adverse effects on fertility in exposed wild amphibians.[49] Levonorgestrel can cause sterility in female frogs at a little higher concentration than those in the environment. Female tadpoles swimming in water with low concentrations of levonorgestrel reported the absence of juvenile ovarian egg cells and oviducts that perceived sterility. In addition, environmental concentrations at 1.8 ng/L of estrogen ethinylestradiol cause impaired spermatogenesis-related developmental reproductive toxicity in frogs.[49] Moreover, hermaphrodite frogs were reported in metropolitan lakes polluted by wastewater.[50] Various dynamic drugs might cause reproductive damage in amphibians at concentrations occurring in natural waters.[51] Consequently, the writing overview suggests that drugs other than estrogen might cause permanent damage to aquatic animals during early life stages.
Effect of drugs on phytoplankton
However, pharmaceuticals with animal slaughter, sewage biosolids, and contaminated water are applied to the soil as fertilizers. The drug material may then be available for the phytoplankton already present in the soil and affect its growth. Growth of six blue-green algal species is prevented by streptomycin from concentrations of 0.09 to 0.86 mg/L which are supported by published literature.[52] In addition, Chlorella vulgaris, Scenedesmus obliquus, and Ulothrix were resistant to growth when supplemented with streptomycin at < 21 mg/L, while 0.66 mg/L were toxic for Chlamydomonas reinhardtii.[52]
Effect of drugs on insects
The uptake of diphenhydramine, oxazepam, trimethoprim, diclofenac, and hydroxyzine has been known to bioaccumulate in four aquatic invertebrates, namely, damselfly larvae, mayfly larvae, water louse, and ramshorn snail.[53] However, a remarkable toxic effect was detected on wrigglers by furazolidone.[54] In addition, ivermectin is an antiparasitic drug for the treatment of cattle which has a pesticide effect on dung pests.[55]
Effect of drugs on vultures
Diclofenac is well known for an anti-inflammatory and arthritis drug used in human and livestock medication. It is available in the market with numerous distinct trade names. The decade from 1990s, Indian formers began to use this drug for their cattle to relieve from pain, which diminishes the ability of cow milking or plough with bollocks as aftereffect. Soon, more or less 300 μg of diclofenac was deposited in the liver of around 10% of Indian livestock. Once they died, their body was disposed of at peculiar scrapyard and cleansed by a drove of vultures. However, the vultures feeding the treated carcasses and earned an amount of 100 μg diclofenac/Kg body weight, was sufficient for kidney failure, and eventually led to death.[56] In addition, ketoprofen, another arthritis drug, is equally fatal for birds.[57]
Effects of drugs on humans
Very small amounts of medicinal products are exposed to humans involuntarily through everyday consumption of leafy vegetables, tuber crops, dairy farm items, potable water, fishes, and meat.[58] Indirect environmental exposure of medicinal products may cause antimicrobial or antiviral resistance in the human intestine, which is less effective with these drugs in the future.[59] Through crops grown on drug-contaminated soil, humans might come in contact with such plant-derived foods.[60],[61] Further, humans might be exposed to pollutants that dissolve in drinking water.[62] The level of drug molecules in drinkable water made of surface water is usually higher in comparison from groundwater.[63] Moreover, the World Health Organization had altered a report and declared that human health is at risk due to presence of trace amounts of drug molecules in drinkable water worldwide.[64] Drug molecules will bioaccumulate in livestock and fishes, either through direct medical treatments or through the presence of drug residues in the surface water. However, the humans might be unmasked unintentionally due to consumption of drug contaminated vegetarian and nonvegetarian items.[65],[66] It has also been well reported that the intake of meals having multiple antibiotics might affect the intestinal bacteria[67] of an individual and later became resistant to antibiotic treatment.
| Conclusion | | |
Most people usually dump unused or expired medicines at open landfill sites or isolated locations completely inadvertently due to the consequences and lack of drug disposal facilities. Thus, our field of investigation focuses on whether disposal medicine has any direct effect on ecological life forms, including humans. However, medicinal metabolites continuously enter the aquatic environment through wastewater. Thus, the health of populations exposed to surface water, groundwater, soil, compost, and even drinking water is definitely at risk. Discharge of toxic drugs, including antibiotics, has bactericidal activity on the microbial community structure, which can promote global outcomes by developing drug-resistant microorganisms. In addition, these medicines are taken by soil organisms such as earthworms, causing toxic effects on the fertility power of the soil. Because earthworms and other pests are prey to birds and small mammals, which may expose by other organisms, are parts of the food chain. In this way, some concentration of the drug can be transferred from insects to terrestrial vertebrate species and may be responsible for the extinction of a particular community in the near future. Further, this might result in a destructive impact on the ecosystem.
It was also clearly known that drug residues in freshwater habitats dramatically affected populations of fish and frogs. Some synthetic hormones, such as progestogen, have a risk of female effects on male fish, and infertility in wild amphibians. It was further observed that pharmaceuticals such as diphenhydramine, oxazepam, trimethoprim, diclofenac, and hydroxyzine are bioactive in aquatic invertebrates and may affect the food chain. In addition, in the early 1990s, Indian farmers began using the anti-inflammatory and arthritis drugs diclofenac and/or ketoprofen to cows and bulls to relieve inflammation, and the accumulation of diclofenac in the liver results weak ability to give milk or draw animals as a side effect. When they died, their treated carcasses were cleaned by a flock of vultures, earned a dose of diclofenac that causes kidney failure, and these birds eventually died.
Similarly, humans are contaminated spontaneously with trace amount of drug residues through everyday intake of potable water, vegetables, grains, fish, dairy products, and meat. Thus, it can be concluded that indirect environmental exposure to medicinal products can cause antimicrobial or antiviral resistance in humans, with these drugs becoming less effective in the coming days. It can also be understood that consumption of accumulated drugs in cattle and fishes may produce a major consequence in human health shortly. Therefore, a focus of the government is the need to formulate strict, consistent, and reliable rules on the safe disposal of unused or expired medicine, so that its harmful effects on the ecological community can be minimized.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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