Understanding the Environmental Impact of Pharmaceutical Use – New published research in Sweden

As our society becomes increasingly reliant on pharmaceuticals, it is essential to recognise the potential risks they pose to the environment. A recent cross-sectional study conducted in the region surrounding Sweden’s largest drinking water source, Lake Mälaren, has shed light on the drug utilisation patterns of analgesics and their environmental impact. The findings of this study, titled “Estimating environmental exposure to analgesic drugs: A cross-sectional study of drug utilization patterns in the area surrounding Sweden’s largest drinking water source,” emphasise the importance of understanding and addressing the environmental consequences of pharmaceutical use. This research is highly relevant to the work conducted by the One Health Breakthrough Partnership and its partners.

The study analysed sales data on analgesics, including non-steroidal anti-inflammatory drugs, paracetamol, other non-opioid analgesics, and opioids, from the years 2016 to 2020. It revealed that the three most commonly sold active pharmaceutical ingredients (APIs) were classified as low-environmental hazard compounds. These included paracetamol, ibuprofen, and acetylsalicylic acid. However, the study also highlighted the persistent use of diclofenac, a pharmaceutical classified as high-hazard, despite efforts by stakeholders to mitigate its environmental impact.

One crucial finding of the study was that the majority of the sold analgesics originated from dispensed prescriptions for human use in urban areas. This emphasises the significance of engaging prescribing physicians in urban settings to reduce the environmental burden of pharmaceuticals. Targeted interventions and education programs aimed at healthcare professionals can play a pivotal role in promoting responsible prescribing practices and raising awareness about the environmental implications of certain drugs.

The study underscored the need for additional measures to tackle the high over-the-counter use of diclofenac. Despite various countermeasures taken in Sweden, diclofenac continued to be widely used, posing a significant risk to the environment. Campaigns targeted at raising awareness among consumers, encouraging responsible medication disposal, and promoting alternative pain management options can contribute to reducing diclofenac usage and its associated environmental impact.

The work presented in this study aligns closely with the objectives and initiatives of the One Health Breakthrough Partnership (OHBP) and its partners. The Partnership recognises the interconnectedness of human, animal, and environmental health and strives to address complex challenges through collaborative efforts. Understanding and mitigating the environmental impact of pharmaceutical use is a shared concern and an area where OHBP can contribute significantly.

By leveraging the expertise and resources of its diverse partners, OHBP can play a pivotal role in promoting responsible pharmaceutical use and raising awareness about the environmental consequences. The study’s findings provide valuable insights that can inform the OHBP’s strategies and interventions, enabling the development of evidence-based approaches to safeguard water resources and protect ecosystems.

The study on estimating environmental exposure to analgesic drugs provides valuable insights into the drug utilisation patterns and their environmental impact around Lake Mälaren. By recognising the potential risks associated with pharmaceutical use and taking proactive measures, we can protect our precious water resources. Engaging prescribing physicians, targeting over-the-counter sales, and promoting responsible medication disposal are key steps towards minimising the environmental burden.

OHBP and its partners are well-positioned to address the challenges posed by pharmaceuticals’ environmental impact. Through collaboration, research, and education, the Partnership can contribute to sustainable practices that promote both human and environmental health. By working together, we can drive positive change and create a healthier and more sustainable future for all.

The research involved researchers at Uppsala University in Sweden, including Johanna Villén, Marmar Nekoro, and Björn Wettermark, who are also collaborating with OHBP on the Medical Research Council project Developing frameworks for eco-directed sustainable prescribing: Towards reducing environmental pollution from healthcare practices. The paper is published in the journal Environmental Advances and can be accessed here: https://www.sciencedirect.com/science/article/pii/S2666765723000443

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