Pharmaceutical Pollution from Human Use and the Polluter Pays Principle

Journey of a pill

OBJECTIVE

To estimate the global journey of a generic clonazepam pill to map steps of production, distribution, and disposal.

DATA SOURCES

PubMed; Google Scholar; industry and market reports; gray literature; pharmaceutical databases (eg, PharmaCompass); export records; pharmacies in Hamilton, Ont; industry professionals and leaders such as pharmaceutical company vice presidents, professors, a supply chain insurance company, and sustainable procurement consulting companies; and an international not-for-profit company.

STUDY SELECTION

Data related to clonazepam's standard pharmaceutical production process, life cycle system boundaries, and most probable production locations were included in this review.

SYNTHESIS

This study depicts the estimated journey of a clonazepam pill's production and distribution, with the prescription being filled in Vancouver, BC. It begins with the extraction of salts to produce the active pharmaceutical ingredient. The main centres for clonazepam's active pharmaceutical ingredient and excipient salt extraction and production are in India and China. Quality testing and stocking occur elsewhere, such as within the European Union. The product is then shipped back to India for the next manufacturing stages. Excipients are shipped from China to India and are incorporated into formulation and tableting. The product is then sent to global markets for the final stages of pill formation and regional distribution. After shipment through Europe and Asia, the journey continues through several locations within the United States, specifically New Jersey, for the final stages of manufacturing. Once manufacturing is finalized in New Jersey, the pill is shipped to and repackaged in Tennessee for distribution and then sent to Canadian industry clusters, typically within the greater Toronto area in Ontario. Pills are then shipped to pharmacies and hospitals in Vancouver, BC, for consumer use. The total distance travelled in this scenario is approximately 63,162 km, not including the entire process of producing and shipping excipients or local retailer shipments.

CONCLUSION

Health care prescribing practices have tangible environmental impacts and manufacturers should continue to invest in operational streamlining to reduce greenhouse gas emissions.

Challenges and Current Trends in Preventing Antimicrobial Resistance in EU Water Law Context

The increasing consumption of pharmaceuticals, including antibiotics, and their improper disposal have resulted in both pharmaceuticals and their metabolites being released into the environment, where they pose a risk to both ecosystems and human health. One of the most serious threats to public health associated with the presence of antibiotics in the environment is antimicrobial resistance (AMR). In order to combat AMR, the legal aspect of water protection becomes a critical area of action. This article analyzes the current challenges and legislative developments in the European Union (EU) aimed at mitigating pharmaceutical contamination in aquatic environments, particularly with regard to AMR. It traces the evolution of EU water protection policies from the initial surface and groundwater directives to the recent updates of the Water Framework Directive, Groundwater Directive and Environmental Quality Standards Directive, focusing on the integration of pharmaceutical contaminants into the regulatory framework. In addition, these changes include the update of the Watch List system for monitoring emerging contaminants, the adoption of effects-based methods (EBMs) in the assessment of water status and the streamlining of the legislative process to respond more quickly to emerging threats in the aquatic environment. The EU's strategic approach to pharmaceuticals in the environment is emphasized as a key framework for harmonizing the environmental standards and addressing the problem of AMR through more sustainable pharmaceutical practices. This study advocates for a proactive, integrated approach to water policy that aligns regulatory actions with scientific advancements to protect public health and ecosystem integrity.

Tackling Pharmaceutical Pollution Along the Product Lifecycle: Roles and Responsibilities for Producers, Regulators and Prescribers

Pharmaceuticals produce considerable environmental harm. The industry's resource-intensive nature, coupled with high energy costs for manufacturing and transportation, contribute to the "upstream" harms from greenhouse gas emissions and ecosystem pollution, while factors such as overprescription, overuse, and pharmaceutical waste contribute to the "downstream" harms. Effectively addressing pharmaceutical pollution requires an understanding of the key roles and responsibilities along the product lifecycle. In this commentary, we argue that three actors-producers, regulators, and prescribers-have unique and interdependent responsibilities to address these issues. Producers and market access regulators are upstream actors who can manage and mitigate harms by both shifting manufacturing, business practices, and regulatory requirements and producing transparent, robust data on environmental harms. By contrast, prescribers are downstream actors whose capacity to reduce environmental harms arises principally as a "co-benefit" of reducing inappropriate prescribing and overuse. Potentially complicating the prescriber's role are the calls for prescribers to recommend "environmentally preferable medicines". These calls continue to increase, even with the sparsity of transparent and robust data on the impact of pharmaceuticals on the environment. Recognizing the interdependencies among actors, we argue that, rather than being ineffectual, these calls draw needed attention to the critical responsibility for upstream actors to prioritize data production, reporting standards and public transparency to facilitate future downstream efforts to tackle pharmaceutical pollution.

Fluorometric and colorimetric platforms for rapid and sensitive hydroxychloroquine detection in aqueous samples

The detection of pharmaceuticals has been an active area of research with numerous application areas ranging from therapeutic and environmental monitoring to pharmaceutical manufacturing and diagnostics. And, the emergence of COVID-19 pandemic has increased the demand for detection of certain active pharmaceutical ingredients such as Hydroxychloroquine (HCQ) mainly due to their increased manufacturing and usage. In this study, we present two optical, fluorometric and colorimetric, detection platforms for the rapid and sensitive detection of HCQ. These platforms take advantage of the interactions between the highly fluorescent dye Thioflavin T (ThT) and Tel24 G-quadruplex (G4) DNA structure, as well as the salt-induced aggregation behavior of negatively charged citrate-capped silver nanoparticles (Cit-AgNPs) in the presence of HCQ. In the fluorometric method, the addition of HCQ led to a significant and rapid decrease in the fluorescence signal of the ThT + Tel24 probe. In the colorimetric method, HCQ induced the aggregation of Cit-AgNPs in the presence of NaCl, resulting in a noticeable color change from yellowish-gray to colorless. Under the optimized conditions, the colorimetric platform exhibited a linear range of 18.0-240.0 nM and a detection limit of 9.2 nM, while the fluorometric platform showed a linear range of 0.24-5.17 μM and a detection limit of 120 nM. The selectivity of the proposed optical methods towards the target analyte was demonstrated by evaluating the response to other structurally similar small molecules. Finally, the practical applicability of both detection systems was confirmed by analyzing HCQ-spiked human urine samples that yielded average recoveries ranging from 75.4 to 110.2 % for the fluorometric platform and 86.9-98.2 % for the colorimetric platform. These results indicate the potential of the developed methods for HCQ detection in complex matrices.

Antimicrobial Resistance, One Health Interventions and the Least Restrictive Alternative Principle

Antimicrobial resistance (AMR) is increasingly recognised as a threat to human, animal and environmental health. In an effort to counter this threat, several intervention plans have been proposed and implemented by states and organisations such as the WHO. A One Health policy approach, which targets multiple domains (healthcare, animal husbandry and the environment), has been identified as useful for curbing AMR. Johnson and Matlock have recently argued that One Health policies in the AMR context require special ethical justification because of the so-called least restrictive alternative principle. This article analyses and rejects two assumptions that this argument relies on. The first assumption is that One Health policies are generally more restrictive than their alternatives because they target more domains and impact more people. The second assumption is that the least restrictive alternative principle has a special normative importance in that it establishes a systematic presumption in favour of the least restrictive policy options. Once these assumptions are rejected, the use of One Health policies on AMR can be justified more easily than Johnson and Matlock argue.

A review on takeaway packaging waste: Types, ecological impact, and disposal route

Rapid economic growth and urbanization have led to significant changes in the world's consumption patterns. Accelerated urbanization, the spread of the mobile Internet, and the increasing pace of work globally have all contributed to the demand for the food takeaway industry. The rapid development of the takeaway industry inevitably brings convenience to life, and with it comes great environmental pressure from waste packaging materials. While maintaining the convenience of people's lives, further reducing the environmental pollution caused by takeaway packaging materials and promoting the recycling and reuse of takeaway packaging waste need to attract the attention and concern of the whole society. This review systematically and comprehensively introduces common takeaway food types and commonly used packaging materials, analyzes the impacts of discarded takeaway packaging materials on human health and the ecological environment, summarizes the formulation and implementation of relevant policies and regulations, proposes treatment methods and resourceful reuse pathways for discarded takeaway packaging, and also provides an outlook on the development of green takeaway packaging. Currently, only 20% of waste packaging materials are recycled worldwide, and there is still a need to develop more green takeaway packaging materials and continuously improve relevant policies and regulations to promote the sustainable development of the takeaway industry. The review is conducive to further optimizing the takeaway packaging management system, alleviating the environmental pollution problem, and providing feasible solutions and technical guidance for further optimizing takeaway food packaging materials and comprehensive utilization of resources.