Massachusetts Water Resources AuthorityMassachusetts Water Resources Authority

There’s What in My Water??

Pharmaceuticals, Hormones and Endocrine Disrupters in Wastewater and

Drinking Water

Stephen Estes-Smargiassi

Director of PlanningNovember 20, 2008

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So Why Do We Care About Drugs in Our Water?

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So Why Do We Care About Drugs in Our Water?

Sex Drug Found in San Fran WaterA sex hormone was detected in San Francisco’s drinking water. Officials in Philadelphia said testing there discovered 56 pharmaceuticals or byproducts in treated drinking water, including medicines for pain, infection ….

The situation is undoubtedly worse than suggested by the positive test results in the major population centers documented by the AP.

The federal government doesn’t require any testing and hasn’t set safety limits for drugs in water. Of the 62 major water providers contacted, the drinking water for only 28 was tested. Among the 34

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From The Boston Globe

Pharmaceuticals found in US drinking waterTrace quantities could endanger wildlife, humansBy Jeff Donn, Associated Press | March 10, 2008

NEW YORK - An array of pharmaceuticals - including antibiotics, anticonvulsants, mood stabilizers, and sex hormones - have been found in the drinking water supplies of at least 41 million Americans, an Associated Press investigation found.The concentrations of these pharmaceuticals are tiny, measured in quantities of parts per billion or trillion, far below the levels of a medical dose. And utilities insist that their water is safe.But the presence of so many prescription drugs - and over-the-counter medicines like acetaminophen and ibuprofen - in so much of our drinking water is heightening worries among scientists of long-term consequences to human health.

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Best Known for the “Boston Harbor Cleanup”

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And Quabbin Reservoir

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MWRA’s Water System

• From the shores of the Connecticut River to Boston Harbor

• 50 Cities and Towns – 2.5 million users• 220 million gallons per day

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The source – 400 square miles of protected lands

• $118 Million invested in land preservation

• So well protected, the Safe Drinking Water Act requires only disinfection

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No Pharmaceuticals In MWRA Water Supply

• After AP story broke last March, MWRA tested for 31 pharmaceutical compounds

• No traces were found!

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Associated Press: Pharmaceuticals in Tap Water

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MWRA Tested For and Did Not Detect

PHARMACEUTICALS:AcetaminophenCaffeineCarbamazepineFluoxetineGemfibrozilIbuprofenIopromideSulfamethoxazoleTrimethoprim

HORMONES:EstradiolEstroneEthyl EstradiolProgesteroneTestoserone

ENDOCRINE DISRUPTORS:2, 6-Di-tert-butylphenol4-Methylphenol4-NonylphenolAlpha ChloradaneBis Phenol A (BPA)CarbarylChlorpyrifosDEETDiazinonDieldrinMethylparathonPhenolTDCPPTriclosanTriphenyl PhosphateTris (2-Butoxyethyl) Phosphate*Tris (2-Chloroethyl) Phosphate

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So Are Pristine Sources the Only Answer?

• No!• Absolutely Pristine Sources Represent Only a Small Fraction of

Systems

• Most Large Cities - Rivers and Lakes with Development Upstream• Smaller Cities (and Some Large) - Groundwater with Human

Activity• Agricultural Sources are Prevalent

• It May Not Be “Toilet To Tap”, But Most Water Is “Used” By The Time It Gets to a Water Treatment Plant

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A Bit of History

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Early Papers on Estrogenic Effect

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Early Paper: Natural and Synthetic Hormones

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Early Paper: Pharmaceuticals in Wastewater

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Turning to the Key Question

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Four Parallel and Complementary Paths

• How Do We Effectively Communicate about This Issue with the Public?

• What is their Occurrence in the Environment and in Drinking Water?

• What is the Toxicological Relevance of Pharmaceuticals, Hormones and EDCs?

• How Can We Reduce the Risk?– Treatment

• Wastewater, Water – Source Reduction

• Homes, Businesses, Health Care Facilities

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Pharmaceuticals - Why?

• On one level it doesn’t make sense

• Low levels, only detected through better technology• No documented health effects• Modern water treatment has improved public health

• Competing concerns of infrastructure, known health effects, new regulations

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Risk Perception Factors Drive Outrage

• Voluntariness – involuntary or imposed risk• Controllability – risks under the control of others• Familiarity – risk perceived to be unfamiliar• Understanding – is the risk poorly understood• Uncertainty – does it have highly uncertain

dimensions• Dread – evokes fear, terror or anxiety• Trust in Institutions – does the institution have

credibility?• Personal stake – personally and directly at risk?• Human vs. natural origin – risk of human origin less

readily accepted

After – P. Sandman

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Risk Communication Perspective

Perceptions are valid and must be addressed equally in relation to scientific data

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What Worked with Local Media

• Openness about uncertainty and results

• Trust within the community

• Proactive strategy

• Clear message

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What Didn’t Work

• “The public won’t understand”

• Citing regulations

• Lack of empathy with consumer worry

• “The water is absolutely safe”

• Reactive testing

• “I can’t tell your for security reasons”

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What Didn’t Work

Water providers rarely disclose results of pharmaceutical screenings, unless pressed… (the spokesman) said the public "doesn't know how to interpret the information" and might be unduly alarmed.”

"It would be irresponsible to communicate to the public about this issue, as doing so would only generate questions that scientific research has not yet answered. We don't want to create the perception where people would be alarmed."

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What Didn’t Work

(City) leaders are convinced you should drink tap water…But the city doesn't test the tap water you drink for pharmaceuticals -- a growing area of concern…

"We perform all the tests asked for by the [U.S.] Environmental Protection Agency," said a(a city) spokesman for Department of Water. "We are confident our purified water is safe."

He said revealing the name in the post-9/11 world could cause a terrorist to intentionally release more of the drug, causing harm to residents.

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The Water Industry Has Been Out in Front

• American Waterworks Association Research Foundation (AwwaRF)• Water Environment Research Foundation (WERF)

– Methods Development

– Occurrence Monitoring

– Treatment Effectiveness

– Review of Toxicological Knowledge Base

• AwwaRF Board of Trustees approved a multi-year, $1 million per year Strategic Initiative

– Integrative Frameworks to Assess and Communicate Risk.

– Analytical Methods to Support EDC/PPCP Research Objectives.

– Assess Watershed and Treatment Impact on EDC/PPCP Exposure at the Tap

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Review of Recent Occurrence Data

• AwwaRF Funded Study• Principle Investigator - Shane Synder of Southern Nevada Water

Authority

• Nationwide Screening Study• Identify Compounds of Interest• Assess Frequency and Concentrations• Comparative Estrogenicity and Toxicology• Communication Guidance

• Over 300 samples from 17 water systems• Completed this past spring

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Screening List of Pharmaceuticals

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Screening List of Potential Endocrine Disrupting Compounds

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Screening List of Steroids and Phytoestrogens

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Analytical Methods

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Isotope Dilution – Pretty Cool!

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Results

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A Quick Aside: Food and Beverages

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E-Screen Assay

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Conclusions of the AwwaRF Screening Study

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Real World Water Cycle

• Away Does Not Mean Away• What Goes Down the Drain Shows Up Again

Drinking Water

Wastewater

• It May Not Be “Toilet To Tap”, But Most Water Is “Used” By The Time It Gets to a Water Treatment Plant

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Sources in Wastewater and the Environment

• Wastewater– Consumer Disposal of Drugs and Other Products– Health Care Facilities– Excretion of Natural and Artificial Compounds

• Agricultural and Veterinary Sources

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Removal by Wastewater Treatment Plants?

• Not Expressly Regulated by EPA

• Neither Monitoring nor Removal Required

• Still at the learning stage

• Conventional Biological Wastewater Treatment Reduces Some Compounds

• Nutrient Removal Plants Can Reduce Further

• Advanced Plants – Activated Carbon, Membrane, Reverse Osmosis – demonstrate even greater reductions

• Water Reuse Plants at high end of scale

• Resource Allocation Question Remains – How much is enough reduction, and how to achieve it?

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Removal by Water Treatment Plants

• Not Expressly Regulated by EPA

• Neither Monitoring nor Removal Required

• Still at the learning stage

• Conventional Filtration Plants – Relatively low reductions

• Advance Filtration – carbon or membranes – Fairly high reductions

• Advanced disinfection – ozone and UV – Fairly high reductions

• Depends on the nature of the compound as well

• Resource Allocation Question Remains – How much is enough reduction, and how to achieve it?

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What Can We Do at the Source?

• Consumer Take Back Programs• Improved Disposal at Health Care Facilities• Improved (reduced) use in veterinary and agricultural use

• Is this enough?• Why bother?

• Largest Source In Many Places May be Excretion

• Clear case of “ If you are not part of the solution, you are part of the problem.”

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A Few Closing Thoughts

• Will This Go Away? NO!– Consumer concern– The detection paradox

• Even if Not a Human Health Concern, it is an Environmental Concern

• We need data about human and environmental impacts, not just about occurrence

• We need to work at effectively communicating about real and perceived risk

• Consumers expect us to be knowledgeable, and to do the right thing

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No One Wants Drugs in Their Water

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Questions or Comments?

• Stephen Estes-Smargiassi• smargias@mwra.state.ma.us• 617-788-4303• www.mwra.com