- The Washington Times - Monday, January 26, 2009

PATANCHERU, India (AP) When researchers analyzed vials of treated wastewater taken from a plant where about 90 Indian drug factories dump their residues, they were shocked. Enough of a single, powerful antibiotic was being spewed into one stream each day to treat every person in a city of 90,000.

And it wasn’t just ciprofloxacin being detected. The supposedly cleaned water was a floating medicine cabinet a soup of 21 different active pharmaceutical ingredients, used in generics for treatment of hypertension, heart disease, chronic liver ailments, depression, gonorrhea, ulcers and other ailments. Half of the drugs measured at the highest levels of pharmaceuticals ever detected in the environment, researchers say.

Those Indian factories produce drugs for much of the world, including many Americans. The result: Some of India’s poor are unwittingly consuming an array of chemicals that may be harmful, and could lead to the proliferation of drug-resistant bacteria.

“If you take a bath there, then you have all the antibiotics you need for treatment,” said chemist Klaus Kuemmerer at the University of Freiburg Medical Center in Germany, an expert on drug resistance in the environment who did not participate in the research. “If you just swallow a few gasps of water, you’re treated for everything. The question is for how long?”


Last year, The Associated Press reported that trace concentrations of pharmaceuticals had been found in drinking water provided to at least 46 million Americans. But the wastewater downstream from the Indian plants contained 150 times the highest levels detected in the U.S.

At first, Joakim Larsson, an environmental scientist at the University of Gothenburg in Sweden, questioned whether 100 pounds a day of ciprofloxacin could really be running into the stream. The researcher was so baffled by the unprecedented results he sent the samples to a second lab for independent analysis.

When those reports came back with similarly record-high levels, Larsson knew he was looking at a potentially serious situation. After all, some villagers fish in the stream’s tributaries, while others drink from wells nearby. Livestock also depend on these watering holes.

Some locals long believed drugs were seeping into their drinking water, and new data from Larsson’s study presented at a U.S. scientific conference in November confirmed their suspicions. Ciprofloxacin, the antibiotic, and the popular antihistamine cetirizine had the highest levels in the wells of six villages tested. Both drugs measured far below a human dose, but the results were still alarming.

“We don’t have any other source, so we’re drinking it,” said R. Durgamma, a mother of four, sitting on the steps of her crude mud home in a bright flowered sari a few miles downstream from the treatment plant. High drug concentrations were recently found in her well water. “When the local leaders come, we offer them water and they won’t take it.”

Pharmaceutical contamination is an emerging concern worldwide. In its series of articles, AP documented the commonplace presence of minute concentrations of pharmaceuticals in U.S. drinking water supplies. The AP also found that trace concentrations of pharmaceuticals were almost ubiquitous in rivers, lakes and streams.

The medicines are excreted without being fully metabolized by people who take them, while hospitals and long-term care facilities annually flush millions of pounds of unused pills down the drain. Until Larsson’s research, there had been widespread consensus among researchers that drug makers were not a source.

The consequences of the India studies are worrisome.

As the AP reported last year, researchers are finding that human cells fail to grow normally in the laboratory when exposed to trace concentrations of certain pharmaceuticals. Some waterborne drugs also promote antibiotic-resistant germs, especially when as in India they are mixed with bacteria in human sewage. Even extremely diluted concentrations of drug residues harm the reproductive systems of fish, frogs and other aquatic species in the wild.

In the India research, tadpoles exposed to water from the treatment plant that had been diluted 500 times were nonetheless 40 percent smaller than those growing in clean water.

The discovery of this contamination raises two key issues for researchers and policy makers: the amount of pollution and its source. Experts say one of the biggest concerns for humans is whether the discharge from the wastewater treatment facility is spawning drug resistance.

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