PharmEcovigilance and the Environmental Footprint of Pharmaceuticals

The prescribing of medications have ramifications extending far beyond conventional medical care. The healthcare industry has an environmental footprint because the active ingredients from pharmaceuticals enter the environment as pollutants, primarily from excretion, bathing, and disposal. This presentation presents an examination of secondary routes of API release to the environment and for direct but unintentional human exposure. These routes include: (a) bathing, washing, and laundering, and (b) disposal of unused and partially used high-content medical devices. Understanding these secondary routes is important from the perspective of pollution prevention, as well as for reducing the incidence of unintentional and purposeful poisonings of humans and pets, and for improving the quality and cost-effectiveness of healthcare.

A broad spectrum of actions can be taken by physicians and the healthcare community at large to reduce the release and introduction of medication ingredients to the environment. Most significantly, however, nearly any action taken to reduce their introduction to the environment can also have collateral benefits regarding the cost and quality of healthcare and therapeutic outcomes. Existing pharmacovigilance monitoring programs designed to detect and prevent adverse drug reactions could be expanded to also focus on the adverse impacts from drugs in the environment. Such a program has been termed pharmEcovigilance (doi: 10.2165/0002018-200831120-00004). A major reason for the medical community to implement a pharmEcovigilance program - - beyond reducing its environmental footprint - - could be the previously unforeseen benefits in optimization of delivery, effectiveness, and cost of healthcare.