Medicines sold in Sweden cause serious environmental harm in India

Many of the substances in our most common medicines are manufactured in India and China.

Some of these factories release large quantities of antibiotics and other pharmaceutical substances to the environment. There is an obvious risk of these releases leading to resistant bacteria.

Research from the Sahlgrenska Academy at University of Gothenburg, Sweden, shows that Sweden is a major consumer of pharmaceutical substances from factories that fail to adequately treat their wastewater. As it is difficult to find out where the pharmaceutical substances are manufactured and how much is released, it is impossible at present for consumers to avoid contributing to this environmental harm.

These findings are presented in the medical journal Regulatory Toxicology and Pharmacology and are highlighted today in a news article in Nature. Last week the research of the Swedish group became headline news in New York Times, Washington Post and Times of India.

"We used to think that pharmaceuticals that ended up in the environment mostly came from the use of the medicines and that the substances were dispersed through wastewater. We now know that certain factories that manufacture substances release very large quantities of active substances," says associate professor Joakim Larsson of the Sahlgrenska Academy in Gothenburg,Sweden, one of the research scientists behind the studies.

The water from the pharmaceutical industries is highly toxic

Joakim Larsson has visited the industrial zone near Hyderabad, India, an important centre for the manufacturing of pharmaceutical substances. Here his research team has taken samples of the water discharged from a treatment plant that treats wastewater from around 90 pharmaceutical factories before it is released.

"We have previously shown that the "treated" water contained exceptionally high levels of various pharmaceutical substances, including several broad-spectrum antibiotics. We estimated that the treatment plant released 45 kilograms of the antibiotic ciprofloxacin in one day, which is equivalent to five times the daily consumption of Sweden," says Larsson.

Such high levels of antibiotics in the water are a cause for alarm as there is an increased risk of spawning resistant bacteria, an issue of global concern. This can lead to those antibiotics that are invaluable today becoming ineffective sooner and not killing the bacteria of tomorrow. In addition, the environment is affected locally by the pollution; In another study by Larsson's team, published this week in Environmental Toxicology and Chemistry, they show that effluent diluted as much as 500 times strongly inhibit the growth of frog tadpoles.

The substances manufactured in Hyderabad are sold in Sweden

Where the active substance in a pharmaceutical product is manufactured is not public information, but the Swedish Medical Products Agency can grant exemptions for research purposes. The researchers analyzed data from the Medical Products Agency for all 242 products on the Swedish market that contained any of nine specific substances*. They found that 123 products contained substances from India and for 74 of the products, 31 per cent, the active substance was manufactured by one of the factories that send their wastewater to the treatment plant outside Hyderabad that was studied.

"The analysis shows quite clearly that a large number of medicinal products on the Swedish market is made by manufacturers that send their effluent to a treatment plant that does not treat their water satisfactorily," says Larsson.

We bear part of the responsibility

"Sweden, which is reputed to have some of the strictest environmental legislation in the world, like other western countries therefore bears a shared responsibility for the environmental problems the medicines we consume cause in India, for example," says Larsson.

But it is impossible for the individual consumer to know today whether a substance in a medicine he or she needs to take may have caused environmental problems in manufacturing.

"It is therefore important that the production chain is made transparent. If consumers are given an opportunity to choose pharmaceutical products they know to be produced in an environmentally friendly way, this could encourage manufacturers to become more environmentally friendly," says Larsson.

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