The environment and pharmaceuticals and personal care products: What are the big questions?

Researchers at the University of York headed a major international review aimed at enhancing efforts to better understand the impacts of chemicals used in pharmaceuticals or in personal care products, such as cosmetics, soaps, perfumes, deodorants and toothpastes (PPCPs), on the natural environment.

Over the last two decades, scientists and regulators have raised concerns over the potential environmental effects and risks of the 4,000 pharmaceuticals and substantial number of personal care products that are used by society.

Following use, these substances can be released to the sewer system and can end up in rivers, aquifers and soils. Many PPCPs have been detected in the natural environment across the world. Though reported concentrations are generally low, some people are worried that, due to the biological activity of these substances, they could be adversely affecting the health of the environment and may also be getting into drinking water supplies.

The researchers in the University of York's Environment Department, working with academic, government and industry colleagues in the USA, Canada, Germany, Sweden, Switzerland, S. Korea and Argentina identified key outstanding issues regarding the effects on human and ecological health in order that future resources will be focused on the most important areas. Their findings are published in the latest issue of Environmental Health Perspectives.

They developed a 'Top 20' list of questions about issues that need to be addressed to better understand and manage the risks of PPCPs in the environment. An international expert workshop reduced an initial list of 101 potential questions to a final 20 ranked by importance.

The top 20 questions fell into seven categories:

• Identification of PPCPs and situations that research should be focussed on
• Understanding how PPCPs get into the natural environment
• Uptake of PPCPs from the environment into organisms
• Assessment of effects on organisms
• Assessment of risks to people and the environment
• Antibiotic resistance
• Management of risks

Professor Alistair Boxall, of the Environment Department at York, who led the review, said: "A large body of information is now available on PPCPs in the environment. This exercise has prioritised the most critical questions to aid in development of future research programmes and policy development on this important topic The development of the 'top 20 list' should mean that researchers, regulators and industry can begin to work more closely together to answer the most pressing questions in a coordinated and timely manner."

The Top 20 Questions are :

1. What approaches should be used to prioritize PPCPs for research on environmental and human health exposure and effects?
2. What are the environmental exposure pathways for organisms (including humans) to PPCPs in the environment and are any of these missed in current risk assessment approaches?
3. How can the uptake of ionizable PPCPs into aquatic and terrestrial organisms and through food chains be predicted?
4. What is the bioavailability of non-extractable residues of PPCPs?
5. How can pharmaceutical preclinical and clinical information be used to assess the potential for adverse environmental impacts of pharmaceuticals?
6. What can be learned about the evolutionary conservation of PPCP targets across species and life stages in the context of potential adverse outcomes and effects?
7. How can ecotoxicological responses, such as histological and molecular-level responses, observed for PPCPs, be translated to traditional ecologically important endpoints such as survival, growth and reproduction of a species?
8. How can ecotoxicity test methods, which reflect the different modes of actions of active PPCPs, be developed and implemented in customized risk assessment strategies?
9. How can effects from long-term exposure to low concentrations of PPCP mixtures on non-target organisms be assessed?
10. Can non-animal testing methods be developed that will provide equivalent or better hazard data compared to current in vivo methods?
11. How can regions where PPCPs pose the greatest risk to environmental and human health, either now or in the future, be identified?
12. How important are PPCPs relative to other chemicals and non-chemical stressors in terms of biological impacts in the natural environment?
13. Do PPCPs pose a risk to wildlife such as mammals, birds, reptiles and amphibians?
14. How can the environmental risks of metabolites and environmental transformation products of PPCPs be assessed?
15. How can data on the occurrence of PPCPs in the environment and on quality of ecosystems exposed to PPCPs be used to determine whether current regulatory risk assessment schemes are effective?
16. Does environmental exposure to PPCP residues result in the selection of antimicrobial resistant micro-organisms and is this important in terms of human health outcomes?
17. How can the risks to human health, arising from antibiotic resistance selection by PPCPs in the natural environment, be assessed?
18. If a PPCP has an adverse environmental risk profile what can be done to manage and mitigate the risks?
19. What effluent treatment methods are effective in reducing the effects of PPCPs in the environment while at the same time not increasing the toxicity of whole effluents?
20. How can the efficacy of risk management approaches be assessed?