Leaky sewers are likely responsible for large amounts of medications in streams
acs.org
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Obviously, people shouldn't do that. But some antibiotics go through the body almost unchanged. When penicillin was first developed they used to recycle the antibiotic from the patient's urine over and over because they had so little of it.
Because of this so-called "first path" effect you end up taking enough that hopefully some (and enough) "gets to the required location" and not too much gets where it's not wanted (most of what counts as "side effects"). The approval process focuses on this and ignores anything excreted, which shouldn't be surprising: with few exceptions the process is #1 safety and #2 minimal clinically effective dosing.
* former pharmaceutical scientist; have designed protocols approved by the FDA.
I'm not sure this is obvious or even particularly well-publicized.
The "official recommendation" in the U.S. for many meds is that they be flushed down the toilet, especially scheduled/controlled substances. The FDA maintains a "flush list" [1] of medications that you are specifically instructed to dispose of by flushing. However, even for medications not on the official flush list, it's common to be informed by reasonable authorities that you should dispose of them by flushing -- e.g. I had to sign paperwork at my doctor's office affirming that I'd responsibly dispose of my unused ADHD meds by flushing them down the toilet before my dr would write the prescription. This was seconded by the drug/alcohol training I was given as a condition of attending college, which stated that you should flush all unused medication.
[1]: https://www.fda.gov/drugs/disposal-unused-medicines-what-you...
Back in Europe, you could just hand off your unused meds to the local pharmacy and rest assured they'll be handled more responsibly.
* Ignoring minute traces of minerals that are lost through transpiration
That's its whole purpose. Just look at the name "antibiotic"...
1. It doesn't say anything about whether the medications would have been removed if they went through a wastewater treatment facility.
2. It's basically saying we accidentally performed a tracking experiment by adding compounds that don't occur (in those levels) naturally to wastewater, and then seeing where we could find those chemicals unexpectedly -- it's like dumping fluorescent dye down your drains to see if you can find it spotting in the yard, but with pharmaceuticals.
https://www.semanticscholar.org/paper/Determination-of-caffe...
Shameless plug: We're a startup building AI to detect leakages in sewers and tell cities when to fix their underground pipes. If you want to help us solve this problem and make cities more sustainable, let me know at ew@hades.ai :)
This is a very difficult problem. If the sanitary sewers aren't in great condition, rising ground water levels can leak into the sanitary sewers. Sewers that were initially well made might be damaged over time by people digging, the ground shifting, or tree roots pushing things around. One way or the other, when high ground waters get into a sanitary sewer, you now have a situation where those sewers are overflowing. And what can be done with that overflow? Let it pool up in the streets? Sending it down the storm drains is about the best you can do at that point.
There is no easy solution to this. Building the sanitary sewers bigger is the obvious solution, except that costs more money and a lot of places don't have much money to spare (corruption, poverty, etc.) Furthermore, just how over-designed does a sanitary sewer have to be? Climate change makes this difficult to predict decades in advance.
BTW [intentionally] combined sewers are problematic even when they're not overflowing. Diluting sewage with a bunch of water increases the cost and decreases the efficacy of treatment.
Combined sewers are definitely problematic, but if diluting costs more depends on the inputs to the treatment plant. Some plants need to dilute with fresh water, and storm sewers are freshish, so it might reduce costs to use storm water rather than potable water.
If all else is equal, in my mind, I'd run the storm sewer to the treatment plant and treat it when there's capacity and let it flow when there isn't. Of course, most of the seasonal difference in sewage flow is from groundwater infiltration, so that probably doesn't make a lot of sense... Both systems will be at higher flows at the same time, for the most part.
This should be relatively straightforward to investigate.
It's an extremely reasonable hypothesis but you also have other factors to deal with (size of city resulting in more wear and tear on infrastructure, other environmental factors that could cause deterioration of pipes, water hard/softness, quality of wastewater processing facilities). Age would likely be a major factor but not the only factor.
Something I’d like to see more of is utility tunnels where all utilities are undergrounded in a single tunnel with with easy access. Yes it’s expensive, but could work out in the long run. Just look at how much utility relocation can drive up the cost for simple projects like BRT.
While disgusting...this would have the side effect of those being repaired very quickly I imagine.
You've just described the Paris sewer system, where the sewage tunels also house fresh water, power, comms…
https://lh3.googleusercontent.com/proxy/wRHK1kkKpNBXt4WWuCQW...
Trench and cover, probably with streets.
But it would create a lot of extra void to maintain that would need its own drainage, maintenance to keep it free of debris and pests, inspections to make sure they don't collapse, and security to keep people out. Feasibility is probably commensurate with urban density.
Also more accessible to damage from vandals and car crashes. And they would freeze in winter. And they would expand/contract with temperature changes, leading to increased cracking etc. The only places that use above ground water/sewer pipes are those with unsupportive soils such as permafrost or deep sand that would cause breaks.
Yes, maintenance gets more expensive, but that maintenance should be far less frequent. And hopefully more predictable (true maintenance vs emergency repair).
I'll take the odd risk of contamination and excavator-induced failure over fragile and inconsistent infrastructure every day.
I'd imagine a lot more problems would occur if pipes were exposed to the elements, for example.
And of course, the issue of where to put the pipes when they're above ground.
A parallel question is whether the body of a deceased patient should be treated as hazardous. We do tend to bury or cremate them without a thought towards whether these drugs will survive and impact the local environment.
So here's the bit that I don't get. When my friend had to get her cat a medical scan, the cat had to have radiactive contrast ingested/injected. She was then told to carefully, without touching it, collect all poop made by the cat in the next 7 days, put it in this special container, then bring it back to the vet for safe disposal.
However, when humans have the same procedure done....no one cares? You drink radioactive contrast, then pee and poop as normal, it all goes down our drains. How does that make any sense?
Cat shit stays intact when it goes to a landfill, and thus would cause a potential hot spot that humans would not.
Cat litter + indoor plumbing = not a good time.
I did think it seemed kind of silly though. Like the state is really gonna hunt down whoever threw away radioactive cat poop.
The whole thing was more about 9/11 / terrorism than environmental damage.
Not necessarily? My father had to collect his waste for disposal for a week following a scan where he had to drink the radioactive contrast stuff. Made easier by him being in the hospital for the duration and then some.
Well.. not usually. https://en.wikipedia.org/wiki/Bedpan
If it's actually not safe, then they are irradiating humans for fun.
I thought that was common for patients on chemotherapy drugs? I remember seeing some sign in a hospital room's bathroom about it, but the details escape me.
Not even drugs necessarily. The theory is out there that a hidden but significant influence on society is large-scale male consumption of estrogen via contamination from women's urine.
> Some research cited in the report suggests that animal manure accounts for 90 percent of estrogens in the environment. Other research estimates that if just 1 percent of the estrogens in livestock waste reached waterways, it would comprise 15 percent of the estrogens in the world's water supply.
1. How much estrogen gets into the water supply from birth control pills?
2. How much estrogen gets into the water supply from women's urine?
(There are other similar questions, of course.)
These two questions are related in that #1 is mostly a subset of #2. But concluding that #1 is an insignificant source of estrogen doesn't tell you much about #2. Women produce estrogen on their own.
It's actually a massive problem in the West, especially the US, that the average person is exposed to tons of endocrine disruptors in the food and water supply, everything from estrogens in the water to plasticizers in your food wrappings on your take out or in the store.
Poor fish downstream don’t stand a chance.
Except for fluoride and chlorine. Small amounts of those chemicals in water are a net health benefit. Society has to be careful about adding anything, but 100% pure water isn't the healthiest choice no matter what the commercials say.
Also iodine in salt.
I also wonder about fluoride's benefits if we use toothpaste and mouthwash that has it. For example, I know people on well water or city water without it that don't have teeth issues.
Also, they are generally using chloramine, not sodium hypochlorite.
That is - assuming the natural levels are healthy for us.
Perhaps we could build some sort of hyper loop to send them in bulk to speed up the process.
Diagram of the idea, reversed https://xkcd.com/1599/
Where did your conclusion come from? Why would adding extra waste (the bottles) to the equation result in less contamination? What about my statement made you think "this man wants people to bottle their waste, rather than maintaining/improving existing infrastructure that addresses the issue"?
"No, I shot him. The bullets and the fall killed him."
- Collateral (2004 film)
I didn't see a mention of an overall solution in the article. I see they mention that leaky pipes could be the cause for that stream. Is there evidence to suggest that the sewage treatment facility actually removes these chemicals?
No, of course not.
What I am saying is that our best shot at getting pharmaceuticals out of fresh water is better sewer & water treatment. We can control that. It is implausible to control people who are, within the privacy of their bathroom, chucking random things down the toilet. The only thing that would stop that behavior is immediate consequences to them personally.
Edit: And this assumes it is all people chucking drugs down the toilet. If it's coming through their urine, then we're definitely back to water treatment being the only plausible answer.