Blyshchyk NatalliaCenter for Environmental Solutions, Belarus

blyshchik@ecoidea.by

OUR COMMON BALTIC

PHARMACEUTICAL POLLUTION

Hel Marine Station, Poland, 4 July 2017

Routes of a medicinal products in the Environment

The UBA database is free to access and can be used by many different stakeholders with an interest in the topic of pharmaceuticals in the environment. It allows users to search for data pertaining to their particular region or the pharmaceutical substance of interest to themhttps://www.umweltbundesamt.de/en/database-pharmaceuticals-in-the- environment-0

Tools for use:

http://maps.helcom.fi/website/mapservice/index.html

Some data (georeferenced measurements in the marine envi-

ronment) has been prepared via the map service and as shape files.

Learn how you can contribute to the work and be a part of the policy development in the region to reduce the emission of pharmaceuticals to the Baltic. And spread the word to anyone interested!

http://www.swedishepa.se/hazards/pharmaceuticals

Highest diclofenac concentration

in surface waters

Baltic Sea Region countries

Highest 17-alpha-Ethinylestradiol

concentration in surface

waters BSR-countries

Pharmaceuticals in surface water,

Belarus, 2016-2017The Lake which locates in a protected wildlife sanctuary — no exceedances

The Lake is experiencing a significant load associated with the intensive

economic activity of people in the catchment area. The lake is a major

recreational center, a water intake of the meliorative network, and intensive

industrial fishing is conducted on it — Synthetic hormone drug

ethinylestradiol (in water) and an anti-inflammatory drug ketoprofen (in silt)

are found in it.

The third reservoir is formed in the lower reaches of the City River, including

for fish farming needs. And it is subject of the greatest strain. Hormonal

preparations have been found in water, and in the sludge were found

antibacterial drug ciprofloxacin, spasmolytic drotaverin and hormone 17b-

estradiol.The highest ethinylestradiol concentrationin river sediment — 71 µg/g dry weight

Pharmaceutical production\ hospitals

old|\unused

medicines

free

Liquid medicines

2 $ / kg

Dangerous medicines

0.13 $ / kg

Other medicines

Health facilities present a good platform for informing the public

• Promoting the rational use of

pharmaceuticals and reducing

inadequate prophylactic use of

pharmaceuticals

• Usage more environmentally

benign medicines

• Educating the general public on

how to dispose of unused

medicines

• Educating on the risks of

pharmaceuticals transfer into

the environment

Consumption data show that the following groups are the most widely used in all Baltic countries:

(С) Cardiovascular agents: on the first place –blood pressure lowering drugs

(enalapril, ramipril) and statins. Finland is the leader.

(N) Central nervous system agents: on the first place – Analgesics (Denmark is

the leader), Antiepileptics (in Sweden, Denmark and Finland 2 times more than

in Latvia, Lithuania and Estonia), Psycholeptics (Finland is the leader),

Antidepressants (Sweden is the leader).

(B) Drugs affecting the blood and blood forming organs: on the first place –acetylsalicylic acid.

(A) Alimentary tract and metabolism: drugs for acid related disorders (Sweden

is the leader), on the first place – omeprazole, pantoprazole.

(R) Respiratory system: (drugs for obstructive airway diseases); Antihistamines

(in Sweden, Denmark and Finland 2-4 times more than in Latvia, Lithuania and

Estonia); nasal preparations.

(G) Genito urinary system and sex hormones and especially (G03A) Hormonal

contraceptives for systemic use: in Sweden 3-10 times more, than in other

countries.

(M) Analgesics and drugs affecting the musculoskeletal system especially

painkillers diclofenac, propionic acid derivatives and ibuprofen.

Collection system the old/unused medicines from the population

92% of people

8% of people

65% of Belarusiansbuy more medicines than they need

36 packs of medicinesper person per year

900 people, 2015

Country Mandatory or

voluntary

collecting system

Collection points Amounts of pharmaceutical

waste collected

Denmark M - All pharmacies,

- recycling centersNo data

Sweden M - All pharmacies,

- recycling centers

- on-line pharmacies

In 2011:

- 800 tons by pharmacies;

- 10 tons by the recycling center

Finland V - Сommunity pharmacy

- Mobile collecting point

In 2006:

-185 tons by pharmacies

Russia V - Mobile collecting point

- recycling centers

about 4 tons every year

Estonia M - All pharmacies,

-hazardous waste

collection points

in 2014:

about 89 tons

Latvia V - Some pharmacies,

- hazardous waste

collection points

About 60 pharmacies:

collect only around 200 kilograms

per year

Lithania M - All pharmacies No data

Poland V - Some pharmacies,

- special hazardous waste

collection points

in 2007, in the city of Krakow,

Poland:

about 5 tons

Germany V - Some pharmacies;

- local recycling center

1 400 of 4 000-7 000 tons not used

each year

Veterinary medicinal products

Antimicrobial resistance

The European Commission adopted a new action plan to tackle

antimicrobial resistance (AMR), described as "the greatest single

challenge in infectious diseases today”.

BUT this action plan does not address pharmaceutical discharges

in the environment. Unlike the previous action plan (2011-2016),

this new plan opens the discussion about AMR in the

environment, however the only action proposed on this issue is to

close knowledge gaps (i.e. the link between the release of

antimicrobials in the environment and the threats and risks this

poses to human and animal health).“

"This alone will not be enough to tackle the problem of

pharmaceuticals in the environment.

What we can to do:

• To identify the hot spots for each territory.

• We need further data on pharmaceutical pollution from

rivers.

• Make the stress on pollution prevention.

• Conduct information company with different target groups.

• Share the best practices.

Not have (working)

pharmaceutical

collection system

from population

- Initiation of legislativechanges- make working meetings- preparation of the report and recommendations-adaptation of the best international experience

Not have enough

information on the scale and

consequences of the

problem of contamination

with environmental

medicines

Issues: Our activities:

-Initiation of analytical research-information company with health institutions

-accumulation of internationalexperience

-Information company with apopulation

-make sociological studies

Work with stakeholders

Pharmaceutical producers: Healthcare sector: Pharmacies:

Policy makers: Patients, consumers:

The report contains available

information on the problem in the

countries of the Baltic region:

- review of monitoring data

-review of medicine consumption

-description of collection system

unused medicine from population

We are looking for support from

BSR-countries in the

implementation of information

about the problem in your country

www.ecoidea.by