The Scottish Government will consider the extent to which the recast Urban Wastewater Treatment Directive (rUWWTD) should be incorporated into Scottish legislation. Article 8 of the rUWWTD requires a subset of substances from 12 identified to have an 80% load reduction at some of the larger wastewater treatment works over a phased period – 10 of these substances are pharmaceuticals.
Scottish Water and the University of the Highlands and Islands are undertaking this project to explore whether it is possible for this 80% load reduction to be achieved through a One Health approach combining healthcare interventions together with wastewater treatment.
Approach:
This 12 month project aims to identify up-stream, source-directed and user-oriented interventions which may support the 80% load reductions of target pharmaceuticals. The project will involve review of literature and Scottish initiatives/policies, considering e.g., safe disposal, awareness activity, alternatives/substitutions, de-prescribing, health promotion, medicine compliance, and prescribing guidance such as Realistic Medicines and Antimicrobial Stewardship.
The targeted pharmaceuticals include those listed in Article 8 and previously identified compounds of environmental and regulatory concern in Scotland.
Principal research questions:
- What are the inputs of the targeted pharmaceuticals into the wastewater system from community and hospital prescribing?
- What factors contribute to the inputs of the pharmaceuticals into the wastewater system?
- Which pharmaceuticals could be targeted by up-stream, source-directed and user-oriented interventions to reduce loads entering the wastewater systems?
- What up-stream, source-directed and user-oriented interventions have been applied in Scotland which may support the 80% load reductions of targeted pharmaceuticals?
- What potential interventions could be designed to support the 80% load reductions of targeted pharmaceuticals, in combination with the current treatment processes?
This is a primarily a desk-based study undertaken through prescription analysis (using the Pharmaceuticals in the Environment SpotFire tool), literature review, and stakeholder workshops. The output is envisioned to detail potential targeted actions at different stages of the pharmaceutical life-cycle (e.g., prescription, use, and disposal) to guide future activity which could reduce pharmaceuticals entering the environment, in combination with the current wastewater treatment processes.
Running in parallel with this desk-based study is a sampling programme that will determine the loading reductions achieved through the current treatment process at selected wastewater treatment works.
Additional information:
Scottish Water and UHI are steering group members of the One Health Breakthrough Partnership, and are committed to working together to explore potential solutions to pharmaceutical pollution in the water environment through cross-sector engagement and knowledge exchange. The tool “Pharmaceuticals in the Environment” developed by SEPA on behalf of the OHBP overlays data on pharmaceuticals detected in the Scottish water environment and NHS Scotland prescribing data, including pharmaceuticals listed in the rUWWTD Article 8. The tool was designed by the OHBP to help develop a better understanding of the link between prescription and pharmaceutical pollution in the environment.
This project is funded by Scottish Water, and runs for approximately 12 months aiming for completion in December 2026.
