Brave New World - The Ripple Effect: The Fate of Freshwater in the Twenty-First Century - page 55

New technologies—such as using microwaves, electrical arcs, or caustic chemicals to
destroy old medications—might help ease the strain.
Occasionally, when public ire grows loud enough, politicians and medical profes-
sionals have suggested that the pharmaceutical industry—which, after all, profits hand-
somely from drug manufacturing—should bear some responsibility and help to under-
write the disposal of drug waste. Some legislators have even called for fining companies
that refuse to take back old drugs. The industry has stonewalled these efforts, replying
that “without suicient evidence of harm” the cost of drug disposal outweighs the po-
tential benefits.
HIGH WATER
In the mid-1990s, Dr. Ettore Zuccato and his colleagues at the Mario Negri Institute
for Pharmacological Research, in Milan, wondered if the Po, Italy's largest river, would
be filled with pharmaceuticals. Zuccato had come across a scientific paper by Thomas
Ternes, a young German researcher at the University of Mainz, who had discovered
clofibric acid, a cholesterol-lowering drug, in groundwater beneath a water-treatment
plant. Other European researchers had found traces of ibuprofen, antibiotics, and
chemotherapy drugs in drinking-water sources. “Whatever people ingest, they excrete,
and that ends up in the water,” said Zuccato. Because commonly used therapeutic drugs
are hardy and metabolize through the body in specific ways, Zuccato figured he would
have a good chance of identifying them in river water.
To test his idea, Zuccato and his team took samples from a number of sites along
the Po and passed them through a mass spectrometer, a long cylindrical instrument
that can detect billionths of a gram of a substance per liter of water. When they
tested the river for thirteen known drugs—such as erythromycin, naproxen, and sulfas-
alazine—they identified trace elements of all of them. The results were also consistent
with known prescribing patterns (meaning the ratio of drugs in the water reflected the
frequency with which each was prescribed) and were considered an accurate and ob-
jective record. They also identified metabolites of clofibrate, a powerful drug that had
been withdrawn from the market years earlier yet still lingered in the ecosystem. After
further study, the Negri team concluded that even trace elements of pharmaceuticals in
drinking water—present at only a few parts per trillion—“can significantly inhibit em-
bryonic cell growth in vitro.” This was a worrisome finding and caused a stir: the Italian
study was published in the Lancetand picked up by other media around the world. Yet
it would prove to be a mere preview to a far more sensational story.