Consumption of medicinal products
Some persistent pharmaceuticals pass continuously through the treatment plants into surface waters, where they can cause chronic stress to aquatic organisms. For instance, in watercourses receiving high quantities of treated wastewater, diclofenac concentrations reach levels that are possibly damaging to brown trout – diclofenac is an active ingredient contained in painkillers that are in widespread use. The medicinal product consumption therefore gives information about the pollution of surface waters by pharmaceuticals.
The consumption of medicinal products has not changed significantly since the mid-1990s. For this reason the trend is assessed as neutral.
With the demographic changes (due to an ageing population) and the rise in population numbers, consumption of medicinal products will probably increase longer term.
Adverse effects on surface waters can be limited by upgrading municipal wastewater treatment plants (WWTP). By introducing additional treatment steps, many organic trace substances can be eliminated. Upgrading of about 100 out of 700 WWTP in Switzerland would be sufficient to significantly improve water quality. Environmentally unsound compounds should also be replaced by less problematic alternatives. Efforts on the part of industry are yielding results. Another approach is to give greater weight to environmental impact assessments in the registration and regulation of substances.
Three biologically active compounds are monitored to represent the consumption of medicinal products: Carbamazepine (an anti-epileptic), diclofenac and sulfomethoxazole (an antibiotic). In a full survey in 2006, the wholesalers recorded all the sales and distribution of pharmaceutical specialities to pharmacies, primary care practitioners and drugstores. Data on annual quantities consumed were recorded once again in 2010.