Transcript Refreshing Idea - State of Texas Alliance for Recycling

San Antonio’s Approach to
Emerging Containments:
MedDropSA - Residential
Pharmaceutical Drug
Disposal Program (October 3, 2011)
ANNUAL TEXAS RECYCLING AND
SUSTAINABILITY SUMMIT
Ken Diehl, Environmental Protection Specialist IV
San Antonio Water System
Page 2
What are Micro-constituents, Endocrine Disruptor
Compounds (EDCs), Pharmaceutical Personal Care
Products (PPCPs), or Emerging Contaminants?
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Antioxidants
Fire retardants
Disinfectants
Fumigants
Fragrances
Pesticides / Repellants
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October 3, 2011
Human Drugs
Veterinary Drugs
Antibiotics
Hormones
Steroids
Plastics
What Does this Mean?
Commonly Used Products
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Sunscreens
Cosmetics
Preservatives / Flavorings
Oral Contraceptives
Plastics
Detergents
Cleaning products
Nail polish
Perfumes
Skin moisturizers
Meat / growth hormones
Fragrants
Tobacco
October 3, 2011
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What EDCs Influence?
• Endocrine Systems Produce:
– hormones
– chemicals
– messengers
• Regulates:
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mood
growth & development
tissue function
metabolism
sexual function
reproductive processes
October 3, 2011
Source: University of Maryland Medical Center
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Catalyst for SAWS’ Activities
Media: Associated Press Release
• Reported that drugs have been
detected in the drinking water
supplies of 24 major metropolitan
areas.
• Focused on surface water
reservoirs, especially in New
York, Las Vegas, and California.
AP Probe Finds
Drugs in Drinking
Water
By JEFF DONN, MARTHA MENDOZA and
JUSTIN PRITCHARD – Mar 9, 2008
• Article initiated questions from
concerned customers.
A vast array of pharmaceuticals — including
antibiotics, anti-convulsants, mood stabilizers
and sex hormones — have been found in the
drinking water supplies of at least 41 million
Americans, an Associated Press investigation
shows.
• Anticipated long-term drinking
water and wastewater discharge
issue.
To be sure, the concentrations of these
pharmaceuticals are tiny, measured in quantities
of parts per billion or trillion, far below the levels
of a medical dose. Also, utilities insist their water
is safe…………..
October 3, 2011
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Current Findings
• Scientists have discovered a range of adverse effects in
wildlife exposed to pharmaceuticals and generally agree
that aquatic life is most at risk.
• Male fish feminization has been documented, creating
egg yolk proteins, a process usually restricted to
females.
- Colorado's Boulder Creek Study, 50 of the 60 (83%) white suckers
collected downstream of Boulder's wastewater treatment plant were
female, compared to about half of them upstream.
• Fish tissue tested positive for different pharmaceuticals.
• Arid regions of the West considered more vulnerable.
- Larger senior populations
- Streams predominantly effluent
October 3, 2011
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General EDC Information
• Primary concern is with surface drinking water
– Edwards Aquifer is recharged by storm water, not surface water
influenced by effluent
• Released for decades through human activities
– Long-term chronic exposure vs. periodic large doses (dose response)
– No demonstrated impact on human health.
• Our ability to measure contaminants currently
exceeds our understanding of their affects.
– ppb vs. ppt levels
• Very technically complex subject.
October 3, 2011
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General EDC Information
(continued)
• EPA Activity:
– Can risk of known or suspected EDCs be managed in a cost effective
manner and what new tools are needed?
– EPA uses a tiered screening and testing process to identify chemicals that
interact with the endocrine system.
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Amphibian Metamorphosis & Teratogenicity tests (frog embryo development assays) and
fish short-term reproduction assays as a good indicators.
– EPA has prepared a guidance document to help permit writers and
pretreatment coordinators develop wastewater discharge permits and
pretreatment requirements for pharmaceutical manufacturing facilities.
– The EPA regulates only one component of pharmaceuticals in drinking
water, Lindane, an ingredient in delousing shampoos.
– No regulatory standards or approved EPA testing methodologies.
October 3, 2011
SAWS’ Initial Activities
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Internal Meetings
• Monthly Meeting – Started in March, 2009.
• Involved Numerous Departments with-in SAWS,
collaborative effort.
• Goal: Identified strategies that are best for our
community.
• Phased two-fold approach:
1. Sampling
2. Drug Disposal Program
October 3, 2011
Two-Fold Approach
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1. Sampling
• Utilized USGS for sampling and testing protocols.
- Complex sampling and testing procedures
• Most recognized organization on the subject.
• Two of SAWS’ primary Edwards /pump stations
and raw wastewater from four sewersheds.
• Data interpretation could be difficult.
• Worked with Communications Department.
October 3, 2011
Two-Fold Approach
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2. Drug Disposal Program Consideration
• Internal monthly meetings investigated:
– How are other communities are handling the issue.
– Local, State and Federal regulations, handling, diversion &
disposal practices.
– Operational challenges.
– Partners and media message.
• Unused prescription drugs at home.
- Adolescent, adult and senior drug abuse.
• Pharmacies reluctant/unable to take unused
drugs.
• Complex regulations related to Drug handling.
October 3, 2011
Texas Legislative Initiative
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SB 1757 Studying Safe Handling
& Disposal of Medical Waste
• The commission reported their results of
the study to the legislature by December 1, 2010.
• TCEQ’s Water Supply Division, responsible for complying.
• SAWS was part of the Water Advisory Committee.
• The TCEQ recommended that a statewide education effort
be initiated to begin providing the most current information
to health-care providers, consumers and others on the topic
of unused pharmaceuticals and their proper disposal.
October 3, 2011
Federal Legislative Activities
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Proposed House Bills HR 1359 and SB 1292
• PASSED
• Amends the CSA to provide for take-back disposal of
controlled substances in certain instances.
• User may deliver controlled substance to authorized
person. Care facilities dispose of drugs in a specific
manner.
October 3, 2011
Federal Legislative Activities
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Proposed House Bill HR 553
• The Endocrine Disruptor Screening Enhancement Act of 2011 was
introduced on May 5, 2010.
• Directs EPA to establish a plan and schedule that tests chemicals
found in drinking water to determine whether they are endocrine
disruptors, their level of interference and with-in 4 year time frame.
Status:
• 2/8/2011
- Referred to the House Committee on Energy and Commerce
• 2/15/2011
- Referred to the Subcommittee on Environment and the Economy
October 3, 2011
Federal Legislative Activities
Proposed House Bill HR 2939
• Pharmaceutical Stewardship Act of 2011 was introduced on
Sept. 19, 2011.
• Congresswoman Louise Slaughter, Ranking Member of the
House Rules Committee announced that she has introduced
H.R. 2939, the Pharmaceutical Stewardship Act.
• The bill would require prescription drug manufacturers to
establish a national collection and disposal program with
oversight from the U.S. EPA.
October 3, 2011
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Results of Internal Meetings
• Involved numerous stakeholders for input.
- SAPD/Narcotics Division, HEB, CVS, Wal-greens, Bexar County,
COSA, TCEQ, Clean Harbors Environmental Services, Inc.,
Restorative Health Care, School of Pharmacy (UIW), Home Instead
Senior Care and AAGOG & CPS Energy
• Ever increasing trend in the abuse of controlled
prescription drugs.
• Law Enforcement needs to be the Lead Agency.
- DEA and Law enforcement dictates diversion process.
• Issues with Hospitals, State run facilities vs.
residential participants.
October 3, 2011
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Results of Internal Meetings
• Identified Advantages for Program Initiation:
– Reduces community abuse of prescription drugs.
– Aids TCEQ to comply with their Legislative directive.
– Environmental Protection, reduces EDC load into Water
Recycling Centers/WWTPs and landfills.
– Indicates positive collaboration between local agencies and
community.
– Important component:
» Educating the public on the proper disposal of drugs
that will have the greatest impact over time.
October 3, 2011
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Program Development - Pilot Program
• Expand COSA’s Single-Day Household Hazardous Waste Collection
Events to accept pharmaceuticals.
• San Antonio Police Dept. / Narcotics Division will:
− Handle, Transport, Store & Incinerate
• Develop media, educational and Press Release message (MedDropSA).
• Comply with TCEQ’s HHW Notification and
Operational Plan requirements.
• December 12, 2009 - Event Results:
– First Drug Disposal program initiated in a large Texas City.
– 171 pounds collected
– Incineration Cost: $180
• Identified items to resolve:
– Concern for chemically decomposing drugs, Sharp Collection, Drug
Categorization, Additional outreach (Hospice, Senior Care, Pharmacies)
October 3, 2011
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MedDropSA Pilot Program Results
October 3, 2011
MedDropSA Program Results
October 3, 2011
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MedDropSA Program Results
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October 3, 2011
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SAWS’ MedDropSA Participants
October 3, 2011
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Summary – MedDropSA & DEA Results
MedDropSA Results:
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December 12th, 2009 = 171 lbs. (Pilot Program)
June 5th, 2010 = 1,336 lbs.
September 11th, 2010 = 1,270 lbs.
March 5th, 2011 = 427 lbs.
June 4th, 2011 = 424 lbs.
September 10th, 2011 = 992 lbs.
Total to Date: 4,620 lbs.
DEA National Take-back Day Results:
• Sept. 25th - 10 Sites/Regional drop-off locations: 1,166 lbs.
• April 28th - 22 Sites/Regional drop-off locations: 2,465 lbs.
• October 29th, 2011 – To Be Determined
October 3, 2011
Next Steps – MedDropSA
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• Refine Program specifics for future.
• Involve Stakeholders in resolving identified
issues during the Pilot Program.
• Continue to comply with TCEQ’s SB 1757 results.
• Track State & Federal Legislative Bills that promote takeback/Drug Disposal Programs and EDC analysis of
environmental impacts.
• Continue to support SAWS’ Mission, Vision and Value
Statement.
October 3, 2011
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Partnership Growth
School of Pharmacy
October 3, 2011
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Additional Information
Web-site Link:
Meddropsa.com
Contact Information:
Ken Diehl
San Antonio Water System
(210) 233-3535
[email protected]
October 3, 2011
Emerging Containments:
San Antonio Residential
Pharmaceutical Drug
Disposal Program
ANNUAL TEXAS RECYCLING AND
SUSTAINABILITY SUMMIT
Ken Diehl, Environmental Protection Specialist IV
San Antonio Water System
Page 28
EDCs in Public Water Supply:
• Some existing removal technologies:
October 3, 2011