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'Ecological sacrifice zone' in India

Water in a town with pharmaceutical plants that supply the U.S. is

February 08, 2009|Margie Mason | Mason writes for the Associated Press.

PATANCHERU, INDIA — When researchers analyzed vials of treated wastewater 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 liquid 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 Kummerer 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."

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

When those reports came back with similarly record 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 data from Larsson's study presented at a U.S. scientific conference in November confirmed their suspicions. Ciprofloxacin and the popular antihistamine cetirizine, the ingredient in Zyrtec, 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 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. Trace concentrations are common in U.S. water supplies.

The medicines get into the water system when patients excrete amounts that there were not fully metabolized, and 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.

Researchers are finding that human cells fail to grow normally in the lab when exposed to trace concentrations of certain pharmaceuticals.

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% smaller than those growing in clean water.

Some waterborne drugs also promote antibiotic-resistant germs, especially when -- as in India -- they are mixed with bacteria in human sewage.

"Not only is there the danger of antibiotic-resistant bacteria evolving; the entire biological food web could be affected," said Stan Cox, senior scientist at the Land Institute, a nonprofit agriculture research center in Kansas. Cox has studied and written about pharmaceutical pollution in Patancheru, in India's Andhra Pradesh state. "If Cipro is so widespread, it is likely that other drugs are out in the environment and getting into people's bodies."

Before Larsson's team tested the water at the Patancheru Enviro Tech Ltd. plant, researchers largely attributed the source of drugs in water to patient use, rather than manufacture.

In the U.S., the EPA says there are "well defined and controlled" limits to the amount of pharmaceutical waste emitted by drug makers.

India's environmental protections are being met at Patancheru, says Rajeshwar Tiwari, who heads the area's pollution control board. And while he says regulations have tightened since Larsson's initial research, screening for pharmaceutical residue at the end of the treatment process is not required. But even in the U.S., drug makers are only required to test their wastewater for three specific pharmaceutical compounds, not the myriad discovered in domestic drinking water.

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