Paper published in the Lancet Planetary Health

Screenshot taken from the Lancet Planetary Health.

Academics from across the University of Exeter have joined forces with thought leaders from other universities, industry, government and non-profit organisations, to call for societal-wide action on reducing pharmaceutical pollution from human healthcare.

In a paper published in the Lancet Planetary Health, the diverse team illustrates how pharmaceutical pollution is an overlooked but urgent issue that needs co-ordinated action from across the pharmaceutical, healthcare and environmental sectors.

Lead author, Dr Kelly Thornber, said: “At the moment many people don’t think about where our medicines come from or what happens to them after we swallow them. Medicines are a vital part of our healthcare system, so we need to find ways to use them without harming the environment at the same time.”

Senior author Professor Charles Tyler, who has been researching pharmaceuticals in the environment for almost four decades, said: “We’ve known for a long time that the medicines we take can have adverse impacts on wildlife, but little progress has been made in reducing environmental pollution levels. As a population, we are using increasing amounts of medicines and many of these directly enter the aquatic environment through our urine and faeces.

“Many people also dispose of unused drugs down the sink or toilet rather than returning them to pharmacies. Our wastewater treatment plants remove variable amounts of these pollutants from our sewage, and for some drugs very little of them. As a consequence, drug pollution levels are rising in waterways across the UK and globally.  This is an environmental cost of our healthcare which needs to be better addressed.”

The project team includes external partners from across the NHS, AstraZeneca, the Environment Agency, the One Health Breakthrough Partnership, the Sustainable Healthcare Coalition and Healthcare Ocean, as well as academics from University College Dublin, the University of Plymouth and the University of the Highlands and Islands. Together, they have mapped out the UK healthcare pharmaceutical system to try to better understand the issue and pave the way for identifying solutions that consider the needs and interests of everyone involved. 

This system map follows the flow of pharmaceuticals (the stock) through their life cycle, from design (left) to environmental contamination (bottom right). Read the full caption here.

Dr Thornber explained: “Possibly the most exciting part of this project has been seeing such high levels of enthusiasm from all sectors. All the people and organisations involved are keen to do what they can to protect the environment. But the issue is very complex and there are many different factors influencing how successful solutions are likely to be. This means we need as many perspectives and ideas as possible to allow us to collectively identify the most appropriate and effective way forward.

“We know that the scale of change required here is such that organisations will need support in identifying and implementing solutions. Universities are in a great position to support this through collaborative research programmes, and that’s what we want to create through our network.” 

The team now hopes to expand their network of interested parties from across the pharmaceutical, healthcare and environmental sectors, to further develop the Pharmaceutical Pollution Hub, to promote shared dialogue, understanding and collaboration.

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Article in Health Europa Quarterly by Kelly Thornber