Stewardship approaches to reducing healthcare contaminants

This chapter explores the role of stewardship in the reduction of environmental and human health risks from health-care-specific contaminants in the environment, focusing in particular on pharmaceuticals. In the absence of a full understanding of environmental effects, stewardship approaches have much to offer and can be applied along the entire life cycle of a drug, from design to its release into the environment. While “green pharmacy” appears a worthwhile pursuit in the long term and advanced wastewater treatment technologies are increasingly being considered, it is in particular in the health-care domain that stewardship—both as stewardship toward one's own health and through discerning use of pharmaceuticals—has the potential to deliver positive environmental, health, and financial outcomes. While environmental stewardship of pharmaceuticals can be driven by policy, education, and facilitation, a reexamination of our attitude to health and our relationship with pharmaceuticals is required to curb the trend of ever-increasing use of medicines.