7 PM I Antibiotics are contaminating rivers and posing health risks I November 28th, 2019

Context: Water contamination due to pharmaceuticals and its effects on human health.

More in news:

• Recently in Hyderabad, researchers from Sweden found a multitude of pharmaceutical residues in water bodies in the city.
• They made a pill called ‘Sordidum Pharmacum’ out of the pharmaceutical pollutants found in Hyderabad’s waters as a commentary on just what people are exposed to on a daily basis while using these water resources.

Relationship between Biome, Microbiome and Human health:

Biomes are very large ecological areas on the earth’s surface, with fauna and flora (animals and plants) adapting to their environment. Biomes are often defined by abiotic factors such as temperature, climate, relief, geology, soils and vegetation. Biomes play a crucial role in sustaining life on earth.

A microbiome is the community of micro-organisms living together in a particular habitat. Humans, animals and plants have their own unique microbiomes, but so do soils, oceans and even buildings.

Both biome and microbiome share an intimate relationship that affects human health. The increasing water pollution changes the microbiology affecting directly on human health making diseases antibiotic resistant.

Water pollution:

Water pollution happens when toxic substances enter water bodies such as lakes, rivers, oceans and so on, getting dissolved in them, lying suspended in the water or depositing on the bed. This degrades the quality of water.

Sources water pollution:

Water pollution can be caused in a number of ways, one of the most polluting being city sewage and industrial waste discharge. Indirect sources of water pollution include contaminants that enter the water supply from soils or groundwater systems and from the atmosphere via rain.

• Sewage and Waste Water: Sewage, garbage and liquid waste of households, agricultural lands and factories are discharged into lakes and rivers. These wastes contain harmful chemicals and toxins which make the water poisonous for aquatic animals and plants.
• Dumping: Dumping of solid wastes and litters in water bodies causes huge problems. Litters include glass, plastic, aluminum, styrofoam etc. Different things take different amount of time to degrade in water. They affect aquatic plants and animals.
• Industrial Waste: Industrial waste contains pollutants like asbestos, lead, mercury and petrochemicals which are extremely harmful to both people and environment. Industrial waste is discharged into lakes and rivers by using fresh water making the water contaminated.
• Oil Pollution: Sea water gets polluted due to oil spilled from ships and tankers while traveling. The spilled oil does not dissolve in water and forms a thick sludge polluting the water.
• Acid Rain: Acid rain is pollution of water caused by air pollution. When the acidic particles caused by air pollution in the atmosphere mix with water vapor, it results in acid rain.
• Global Warming: Due to global warming, there is an increase in water temperature. This increase in temperature results in death of aquatic plants and animals. This also results in bleaching of coral reefs in water.
• Pharmaceuticals are an important element of medical and veterinary practice, and their beneficial effects on human and animal health, food production and economic welfare have been widely accepted. However, an area which is lacking an understanding is what happens when these pharmaceuticals are constantly discharged into the environment, through pharmaceutical manufacturing, consumption and excretion, and improper disposal of unused or expired products.

Effects of water pollution on human health:

• According to a study published in ‘The Lancet’, water pollution caused 1.8 million deaths in 2015.
• Contaminated water can also make us ill. Every year, unsafe water sickens about 1 billion people. And low-income communities are disproportionately at risk because their homes are often closest to the most polluting industries.
• Diseases spread by unsafe water include cholera, giardia, and typhoid. Even in wealthy nations, accidental or illegal releases from sewage treatment facilities, as well as runoff from farms and urban areas, contribute harmful pathogens to waterways.
• In 2011, a report found that pregnant women being exposed to a 10% increase in agrichemical levels in Indian rivers during their first month of conception was associated with an 11% increase in the likelihood of one-year mortality among newborns. It has been found that the average effect of a 1% increase in faecal coliforms is an additional 3-5 deaths per 100,000 births in a given month.

Highlights of OECD report “Pharmaceutical Residues in Freshwater: Hazards and Policy Responses”

• About 2 000 active pharmaceutical ingredients (APIs) are being administered worldwide in prescription medicines, non-prescription drugs and veterinary drugs, the residues of which are of increasing environmental concern as the number and density of humans and livestock requiring healthcare escalates.
• Active pharmaceutical ingredients are found in surface waters, groundwater, drinking water, soil, manure, biota, sediment and the food chain. Although the contribution of each emission source varies across regions and types, the dominant sources of pharmaceuticals in the environment stem from untreated household wastewater and effluent from municipal wastewater treatment plants. 
• Because pharmaceuticals are intentionally designed to interact with living organisms at low doses, even low concentrations in the environment can have unintended, negative impacts on freshwater ecosystems. For example, active substances in oral contraceptives have caused the feminisation of fish and amphibians; psychiatric drugs, such as fluoxetine, alter fish behaviour making them less risk-averse and vulnerable to predators; and the over-use and discharge of antibiotics to water bodies exacerbates the problem of antimicrobial resistance 
• The report estimates that 10% of pharmaceuticals have the potential to cause environmental harm. Those of greatest concern include hormones, painkillers and antidepressants. Concern over rising antibiotic content in wastewater fuelling the spread of drug-resistant microbes has been raised at G20 level.

Steps taken by government to clean the rivers:

• The First River Action Plan i.e. the Ganga Action Plan was taken up by the Ministry of Environment & Forests in 1985.  
• Since then its scope has increased to all the major rivers of the country and the programme was further extended to other major rivers of the country in 1995 under the National River Conservation Plan – NRCP.
• The main objective of these action plans is pollution abatement, to improve the water quality by Interception, Diversion and treatment of domestic sewage and present toxic and industrial chemical wastes from identified grossly polluting units entering in to the river.
• The pollution abatement works taken up under the NRCP include: 
  • Interception and diversion works/ laying of sewerage systems to capture raw sewage flowing into the rivers through open drains and diverting them for  treatment.   
  • Setting up of Sewage Treatment Plants (STPs) for treating the diverted  sewage   
  • Construction of Low Cost Sanitation Toilets to prevent open defecation on river banks;   
  • Construction of Electric Crematoria and Improved Wood Crematoria to conserve the use of wood;     
  • River Front Development works, such as improvement of bathing ghats
  • Public participation &  awareness and capacity building, etc.
• ‘Namami Gange Programme’, is an Integrated Conservation Mission, approved as ‘Flagship Programme’ by the Union Government in June 2014 with budget outlay of Rs.20,000 Crore to accomplish the twin objectives of effective abatement of pollution, conservation and rejuvenation of National River Ganga.

The aims and objectives of NMCG is to accomplish the mandate of National Ganga River Basin Authority (NGRBA) are:

• To ensure effective abatement of pollution and rejuvenation of the river Ganga by adopting a river basin approach to promote inter-sectoral co-ordination for comprehensive planning and management
• To maintain minimum ecological flows in the river Ganga with the aim of ensuring water quality and environmentally sustainable development.

Recommendations for management of pharmaceuticals in freshwater:

Policies that cost-effectively manage pharmaceuticals for the protection of water quality and freshwater ecosystems rest on five strategies:

1. Reporting on the occurrence, fate, and risks of pharmaceutical residues in water bodies, consideration of environmental risks in the risk-benefit analysis pre-authorisation of new pharmaceuticals, and continued monitoring of high-risk pharmaceuticals post-authorisation (including of those already approved on the market).
2. Source-directed approaches to impose, incentivise or encourage measures in order to prevent the release of pharmaceuticals into water bodies;
3. Use-orientated approaches to impose, incentivise or encourage reductions in the inappropriate and excessive consumption of pharmaceuticals;
4. End-of-pipe measures that impose, incentivise or encourage improved waste and wastewater treatment to remove pharmaceutical residues after their use or release into the aquatic environment; and
5. A collaborative life cycle approach, combining the four strategies above and involving several policy sectors.

Regulatory, economic and voluntary policy instruments are all part of the toolkit that is needed to manage multiple sources of pollution from different stakeholders at different stages of the pharmaceutical life cycle. Stakeholder engagement through inclusive water governance and information is increasingly recognised as critical to secure support for reforms, raise awareness about water risks and costs, increase users’ willingness to pay, and to handle conflicts.

Conclusion:

Current policy approaches to manage pharmaceutical residues are inadequate for the protection of water quality and freshwater ecosystems upon which healthy lives depend. They are often reactive and resource intensive and diffuse pollution, particularly from livestock and aquaculture, remains largely unmonitored and unregulated.

All stakeholders along the pharmaceutical chain have a critical role to play in the transition to more effective management of pharmaceutical pollution. Voluntary participation alone will not deliver; economic and regulatory drivers from central government are needed.

Source: https://www.livemint.com/opinion/columns/opinion-antibiotics-are-contaminating-rivers-and-posing-health-risks-11574878217623.html