This week, we will take a short detour from our shorter articles to contemplate upon a key medeconomics issue: Is the discarding of medical waste into the sink a big enough deal to warrant significant economic action?
The wind screams in your ears like a banshee as you trudge forward in the desolate landscape; puddles of water smear the bottom of your shoes from the incessant rains that seem ceaseless in their fervour; an siren rings the air as you are made aware of another hurricane making its way to your area, threatening to undo all the construction work made since the area had been ravaged forty-six days back: You wonder, “Will this ever end? How could I have prevented this?”
Climate change and the healthcare service are often regarded as mutually exclusive areas. How can that vaccine you received a few days back have contributed to the detriment of our planet? How can the dental appointment you recently scheduled destroy our planet and make it uninhabitable for future generations? Let us explore all this in this season’s edition by looking at just one cog in this giant machinery: the discarding of unused medicines into rivers and its environmental and economic impact.
Why Do Medicines End Up in Water Bodies?
The development of medicines is not exactly a linear process: failures are met, drugs fail in their trials and the drug turns out to not meet certain regulations: what happens to medicines that do meet fulfil a set of fixed criteria? They are discarded. What does a common household do if a medicine has gone past its expiry date unused? They discard it. You may have just dumped that medicine down the drain, but where will the medicine go after that? Water providers into the UK try their best to filter out medical waste, but as Liv Garfield, CEO of Severn Trent an FTSE 100 water utilities company, has repeatedly stated, not everything can be removed a hundred percent every single time. These discarded medicines often find themselves with other sewage materials into water bodies. In one of its reports, the BBC reported a large residue of these drugs in the Thames River and the Eden River. The Guardian, on the other hand, reported that water companies may be unlawfully discharging raw sewage at a volume almost ten times greater than the Environment Agency Guidelines recommend; a sizeable but unreported percentage of this is comprised of pharmaceutical discharge.
How Do These Discarded Drugs Affect the Environment?
When these drugs are ingested by wildlife creatures, they invariably get affected adversely and die. When a huge number of aquatic organisms are missing from the food chain, the entire ecosystem of these areas if affected. These could be species responsible for the dispersal of plant seeds as is the case with trout and salmon, or these species could be the ones preying on algae like snails and freshwater crabs. When a plant seed is not dispersed or when the growth of one plant is stifled by an alga hogging up the nutrients, that is one fewer plant involved in removing carbon dioxide from the atmosphere. All the carbon dioxide that could have been absorbed by the plant as part of the carbon cycle is no longer absorbed and is involved in trapping infrared radiation on earth and making it a hotter place every day, contributing to climate change. The World Economic Forum, in one of its reports dated to June 2021 warned of this matter specifically while observing how the world economy could lose 10% of its total economic value in the form of decreased agricultural productivity because of the hotter climate and predicted natural calamities by 2050 if this issue is not combated.
The ingestion of these discarded drugs into aquatic bodies also poses the problem to the fisheries industry in the United Kingdom. Ibuprofen, one of the most prescribed NSAIDS (Non-Steroidal Anti-Inflammatory Drugs) in the UK. It is also one of the most prevalent drugs found dumped into rivers. A study conducted in May 2019 on the Humber Estuary in the UK found that 66% of its samples contained pharmaceutical drugs and 97% of these samples contained ibuprofen as a major contaminant. This ibuprofen has been shown to cause stomach and intestinal ulcers in fishes alongside kidney failures when ingested. Benzodiazepines like Xanax and Klonopin have been linked to causing a slowed breathing rate in fishes alongside liver failure and acetaminophens like Tylenol have been linked to decreasing a fish’s ability to carry out aerobic respiration. All these drugs have been found int the Hull estuary as well, albeit in smaller doses than ibuprofen. The 12,000 fishers working on UK registered ships brought in 622,000 tonnes of fish from rivers and seas around the UK. The Marine Stewardship Council predicts that fisheries globally and in the United Kingdom could lose up to 40% of their catch by 2050 because of these drugs. That would amount to damages worth almost £50 million. One can only speculate how many job losses could be amounted to by these losses.
The most concerning aspect though, is the rise of resistant strains of bacteria that will inevitably arise because of the dumping of antibiotics into water bodies. When antibiotics make their way into the water, most bacteria in their immediate vicinity are killed. Those that are not get free reign to spread due to the absence of competition for resources around them and eventually become the dominant strain. When humans enter these water bodies, the bacteria infect them. Imagine now what would happen if many antibiotics were dumped into the same water body; What if a strain of bacteria arises that is resistant to every strain of antibiotic known to medicine? How would we combat this superbug? The UK lost £5.6 billion in 2019 as a result of illnesses: this number will only rise if such a strain comes into existence.
What Can Be Done to Stop This?
Having read about the impact of discarding medical waste into water bodies, the onus is now on you. Consider the question and answer the question posed- How would you combat the discarding of medical waste into water bodies?
Type in your answers into the comments section! Also, do not forget to answer the question posed in the poll on the right!
Bibliography:
1. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/viewer.html?pdfurl=https%3A%2F%2Fwww.england.nhs.uk%2Fgreenernhs%2Fwp-content%2Fuploads%2Fsites%2F51%2F2020%2F10%2Fdelivering-a-net-zero-national-health-service.pdf&clen=1566465&chunk=true
13. Hulme, Mike, and John Turnpenny. “Understanding and Managing Climate Change: The UK Experience.” The Geographical Journal, vol. 170, no. 2, [Wiley, Royal Geographical Society (with the Institute of British Geographers)], 2004, pp. 105–15, http://www.jstor.org/stable/3451587.
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