noPILLS in waters

Pharmaceuticals in the Environment (PiE) are an increasingly recognised risk to the quality of surface water and groundwater. The noPILLS project contributed towards a better understanding of the complex system of processes and – probably more importantly – actors that influence the presence of pharmaceutical micropollutants in waste water and, ultimately, receiving waters.
Clearly, a problem as complex and wide-ranging as that of pharmaceuticals in the aquatic environment cannot be comprehensively explored by a single project. However, noPILLS aimed to provide a unique insight into the problem by first defining the range of factors affecting pharmaceuticals in the environment, together with related points for intervention, and then investigating these interventions in a multi- and inter-disciplinary fashion.
In developing the concept of a “medicinal product chain” (of processes and actors), noPILLS identified potential “levers for intervention” towards the reduction of pharmaceutical ingress into the aquatic environment.
This report describes a series of case studies of applied investigative nature along the medicinal product chain, which explored and evaluated a range of levers for intervention for their underlying efficacy, efficiency, barriers and challenges.
In summary, the noPILLS project has shown that:
• Pharmaceutical micropollutants are ubiquitous in the aquatic environment in the project areas, and contribute to environmental effects;
• Regional differences exist in environmental conditions, as can be expected due to macro-geographical influences (landscape, climate etc), but conditions can also vary within regions and in time, with the biggest factors being influx of effluents and dilution in the environment;
• A risk highlighted by noPILLS is that of antibiotic resistance developing in - or being introduced into - the aquatic environment via the sewerage network;
• People, acting both as consumers/patients and as professionals, play an important role in the medicinal product chain and need to be involved more in intervention activities;
• Strong regional differences exist in factors that are influenced by human behaviour, attitudes, and awareness; most likely this is primarily a result of regional differences in systems (e.g. health system, funding, waste management);
• There appears to be a relatively high level of underlying willingness to ‘do the right thing’ both by the general public and professionals, which is largely under-utilized due to lack of information, support or means to change behaviour;
• Technological interventions are effective in reducing some pharmaceutical micropollutants but present their own challenges in terms of monetary and energy costs;
• Training, education and awareness raising, together with good stakeholder management and effective communication, are crucial for the success of all forms of intervention.
• There appears to be no single ‘silver bullet’ intervention point, and the whole medicinal product chain needs to be considered for multi-point, targeted intervention.