RIVM investigates how the impact of pharmaceutical residues on the environment may be reduced. If certain drugs can be substituted by treatments that are less harmful to the environment, this would be advantageous for the environment . However, this has proved to be difficult.

Pharmaceutical residues end up in surface water after use, via urine and faeces. In the current situation, sewage treatment plants are unable to remove all pharmaceutical residues. These residues may have harmful effects on organisms in the aquatic environment, such as behavioral changes, tissue damage and reproductive effects. The drinking water quality is not affected, but this may become a problem in the future. We interviewed professionals from the medicinal product chain, such as policy makers, manufacturers, assessors, health care providers, pharmacists and water managers. They were all willing to consider solutions such as adjusting treatments.

Equally safe and effective

The main requirement to be met is that the patient's treatment is equally effective and safe. In practice, for many pharmaceuticals this proves not yet possible.

Substantiate environmental benefits

The environmental benefits must be adequately substantiated. For many pharmaceuticals, data on environmental effects is lacking. There is a need for a framework to compare effectivity, safety and environmental effects of pharmaceuticals.

The study was performed on behalf of the Ministry of Infrastructure and Environment and is part of the chain approach ‘Pharmaceutical residues in Water’.