Page 66 - ITPS-8-3

INNOSC Theranostics and
Pharmacological Sciences Knowledge, perception, and practices of ecopharmacovigilance

1. Introduction antibiotics will be consumed worldwide. Pharmaceuticals
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were found in water bodies in previous investigations,
The modern world is experiencing an unprecedented most of which came from high-income nations. However,
increase in drug consumption and production due to one of the largest studies assessing the prevalence of
population growth, increased disease burden, and the drugs in 1,052 rivers across104 countries revealed that
rapid advancement of the pharmaceutical industry. As the most contaminated rivers were located in low- and
a result, pharmaceuticals have increasingly entered the middle-income nations in South America, South Asia,
environment. A wide range of medications, including and sub-Saharan Africa. Despite the growing importance
1,2
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antibiotics, steroid hormones, analgesics, anti-inflammatory of safe pharmaceutical disposal, both consumers and
drugs, anti-hypertensives, and anti-depressants, have been healthcare professionals remain largely unaware of this
detected in various environmental compartments, such as issue. In response, ecopharmacovigilance (EPV) has been
soil, sediments, groundwater, surface water, drinking water, introduced. EPV is defined as “the science and activities
and living organisms. Pharmaceuticals are commonly associated with the detection, evaluation, understanding,
3-6
referred to as pseudo-persistent pollutants due to their and prevention of adverse effects of pharmaceuticals in the
widespread use, continuous release into the environment, environment.” It aims to address important environmental
and the ineffective clearance of pharmaceutical residues. 7 problems associated with drugs and ensure that they are

These pollutants enter the environment through multiple effectively managed. 11,27,28
pathways, including pharmaceutical manufacturing, The main goal of EPV is to regulate the causes of
improper disposal by consumers, hospital waste, pharmacy pharmaceutical exposure. EPV monitors, assesses, and
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practices, veterinary use, and other sources. 8-11 Improper regulates pharmaceutical pollutants, taking into account
disposal of pharmaceuticals leads to the release of harmful elements including degradation, wastewater, and the
chemicals and various pollutants, which can pose risks to effectiveness of drinking water treatment plants. EPV
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human health. 12-14 At present, over 600 pharmaceuticals encourages the reduction of production leftovers, rational
have been detected in the environment worldwide. Given utilization, reliability, and the safe disposal of unwanted
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the widespread use of over-the-counter medications, it medications. EPV strategies should focus on drugs
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is essential to raise public awareness regarding proper known to have negative environmental consequences,
disposal procedures. Although pharmaceutical residues with emphasis to areas with elevated risks and significant
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are often found in small concentrations, their persistent pollution issues. To minimize the amount of medicinal
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release into the environment can have a negative impact products in the ecosystem, some EPV strategies have been
on the ecosystem, wildlife, and human health. 3,8,11,17 For proposed, including the development and production of
example, veterinary use of diclofenac has significantly green medications, carefully management of pollutants
endangered Asian Gyps vulture species, while antibiotic from drug production, the return and disposal of unused
8
residues contribute to the emergence of antibiotic medications, and the proper use of medicines. However,
resistance, which is a serious public health concern. 18-21 EPV has not yet established a formalized implementation
In addition, studies have shown that exposure to trace model. 3,8,11 Practical application of EPV is already
amounts of 17α-ethynylestradiol, an estrogen commonly underway. For instance, before a medication can be
found in birth control pills, at concentration of 5 – 6 ng/L marketed in the European Union (EU), an environmental
in lake water can cause feminization and near extinction risk assessment (ERA) must be completed. According to
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certain fish species. 22,23 In addition, exposure to animal regulations set by the European Medicines Agency (EMA),
antimicrobial residues in contaminated food or drinks every medication intended for human use undergo an
has been linked to a higher risk of overweight and obesity ERA before being marketed. In terms of EPV legislations,
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among school children. 18 the United States (US), EU, and Canada lead the world.
17
Despite being a major category of emerging pollutants, Pharmaceutical companies like Astra Zeneca have created
pharmaceuticals are not regulated under existing laws environmental risk management plans to simplify the
for detection, notification, or environmental control. monitoring of environmental impacts. According to the
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24
Furthermore, the removal of pharmaceuticals using Drug Enforcement Administration’s 2014 Finalized Rule
current sewage treatment systems is ineffective. 3,8,15 The on the Disposal of Controlled Pharmaceuticals, patients
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environmental effects of drugs have received insufficient can choose to mail leftover drugs to a registered collector
attention over time, with few studies examining their with proper labeling or return them during take-back
impact. Meanwhile, the use of pharmaceuticals in both program. To effectively address the issue of pharmaceutical
humans and animals continues to rise. According to one waste, EPV must be integrated with a medication take-back
study, by 2030, more than 100,000 tons of veterinary system, together with additional financial and logistical

Volume 8 Issue 3 (2025) 60 doi: 10.36922/itps.7678