194842 Expert judgment of pharmaceutical and over-the-counter drugs present in recycled water for indirect potable reuse

Wednesday, November 11, 2009: 12:48 PM

Louisa Flander, Ph D , School of Population Health, University of Melbourne, Carlton VIC 3053, Australia
Andew Speirs-Bridge, BBSc (Hons) , University of Melbourne, Parkville VIC 3010, Australia
Fiona Fidler, PhD , LaTrobe University, Bundoora VIC 3086, Australia
Marissa McBride, BSc (Hons) , University of Melbourne, Parkville VIC 3010, Australia
Mark Burgman, PhD , University of Melbourne, Parkville VIC 3010, Australia
Peter Fox, PhD , Department of Civil and Environmental Engineering, Arizona State University, Tempe, AZ
Grant Skrepnek, PhD , Department of Pharmacy Practice and Science, University of Arizona, Tucson, AZ
Jeffrey Soller, MS , Soller Environmental, Berkeley, CA
Margaret H. Nellor, MS , Nellor Environmental Associates Inc., Austin, TX
We demonstrate the application of a novel four-step elicitation technique for generating expert predictions of the concentration of pharmaceutical and over-the-counter drugs expected to be present in recycled water used for supplementing drinking water over the next twenty years (indirect potable reuse or IPR). This work is part of a larger project that is assessing the risks of IPR projects using relative risk assessments and developing “safe” concentration levels for drugs and other non-regulated chemicals. The project is also predicting contaminants that may be of future concern based on pharmaceutical production trends and use, their fate during water reclamation treatment processes, and testing expert judgment of future exposures against these predictions. The method is a structured elicitation of expert judgment and offers an alternative to other methods for examining risks and providing transparent risk assessment where data may be lacking. In such instances as environmental health hazards with low probability and potentially catastrophic outcomes, data for risk estimates must be inferred from alternative sources such as expert opinions. These opinions are often elicited in the form of subjective confidence intervals; however the judgments are prone to cognitive biases such as overconfidence. In this study, predictions of chemical exposures are elicited by means of an expert judgment instrument for predicting distributions and assigning credible subjective estimates. The predicted compounds provide crucial information about future pharmaceutical trends as well as benchmarks for use by the recycled water industry, public health regulatory agencies and consumer advocacy networks.

Learning Objectives:
1. Describe a novel expert elicitation method. 2. List at least three pharmaceutical compounds predicted to be present in drinking water over the next 20 years.

Keywords: Environmental Exposures, Water Quality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Senior Research Fellow on the Australian Research Council funded grant that contributes to this research report, as well as co-investigator on the Water ReUse Foundation funded grant that contributes to this research. I have designed and conducted this and related research projects over the past five years, including grants, conference presentations and articles submitted to referreed journals.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.