What it is:

• Pharmaceuticals and Personal Care Products (PPCPs) are any product used for personal health or cosmetic reasons.

• Pharmaceuticals are synthetic or natural chemicals found in prescription medicines, over the counter therapeutic drugs and veterinary drugs. Some very common examples include aspirin, ibuprophen and caffeine. For perspective, one cup of coffee contains about one million times the amount of caffeine that has been detected in some waters.

• They also include natural and synthetic hormones and antibiotics. Humans and animals also excrete natural hormones, which function physiologically at low concentrations, so they would be of greatest interest if they were found in drinking water. Fortunately, they are readily removed by conventional treatment processes.

• Personal care products include detergents/surfactants, cleaning agents, insect repellants, biocides and many other common components of over the counter consumer products.


In the news:

          • Veolia Water North America announced study findings that showed the successful removal of pharmaceuticals and phosphorus from wastewater using its Actiflo Carb technology. Over the course of an 8-week study, the presence of phosphorus and a variety of pharmaceuticals and personal care products (PPCPs), ranging from ointments to medications, were monitored after adding Actiflo Carb to the traditional wastewater treatment process. With the use of Actiflo Carb, 75 percent of the selected PPCPs were removed from the wastewater. Additionally, phosphorus was reduced to a concentration of 0.05 mg/L or less, well below the EPA's regulatory limit set at 1.0 mg/L.

• A new $8 million solar-powered plant being built in Cottonwood, Ariz. will help in the removal of pharmaceuticals in the city’s reclaimed water. The plant will break apart many trace synthetic compounds by blasting them with ozone and hydrogen peroxide. The city is hoping this process will help clean their water supply.



• Recent advances in analytical chemistry has allowed detections of many of these chemicals at parts per trillion (ppt) in water; however, it is likely that many of them have been present to some extent for many years and probably at higher levels because sewage treatment is more widely practiced now.

• Microgram and nanogram amounts of PPCPs have been found in surface waters, wastewater, groundwater and, to a lesser extent, in drinking water. Most of them originate from sewage entering the environment.

• They occur in sewage or ambient waters from bathing, shaving, swimming, illicit drugs, veterinary drug use, agribusiness, residues from pharmaceutical manufacturing, residues from hospitals, etc.

• Most PPCPs appear in sewage from their normal uses, although a small amount of pharmaceuticals may be in sewage from inappropriate disposal of unused medicines by consumers.

• Depending upon the chemical type, some removal occurs during sewage treatment, natural sedimentation, solar exposure and hydrolysis and biodegradation in the environment as well as dilution.


Health effects:

• There has been no evidence of human health effects from PPCPs in the environment.

• When they are detected in drinking water the concentrations are usually in parts per trillion. Frequently, the margins of exposure will be less than one millionth of a therapeutic dose, so it is very unlikely that there would be health impacts on humans who drink water containing small traces of PPCPs.


Environmental effects:

• The main concern for PPCPs is probably the effects they could have on the environment. While studies are still ongoing to find out the extent of the concerns, research suggests there may be some ecological harm when certain drugs/hormones are present. Instances of feminization of male fish near sewage outfalls have been reported.


Water treatment:

• PPCPs represent a wide range of chemical types so they are treatable to a greater or lesser degree by the standard technologies depending upon their chemical and physical characteristics. Chlorine and ozone will oxidize several types of these chemicals, granular carbon will adsorb many and reverse osmosis is effective at removing many whose molecular weights exceed about 100 daltons. Advanced oxidation processes involving formation of hydroxyl radicals are effective for the traces that may survive more traditional treatments, but they are expensive.

• In 2007, the White House of National Drug Control Policy issued a set of guidelines on the proper disposal of prescription drugs. However, by far, the principle source of pharmaceuticals in sewage is excretion by humans after normal use.



• The Resource Conservation and Recovery Act (RCRA) was established to control the management and disposal of solid and hazardous waste produced by a wide variety of industries and sources, including the disposal of hazardous pharmaceutical wastes produced by pharmaceutical manufacturers.

• The Clean Water Act includes provisions for effluent guidelines for the pharmaceutical industry.

• The World Health Organization (WHO) has recently reviewed issues on pharmaceuticals in drinking water and has concluded that trace quantities of pharmaceuticals found in drinking water are unlikely to pose risks to humans. They also stated that development of formal guideline levels for pharmaceuticals in drinking water is unwarranted. In addition, WHO stated that routine monitoring and installation of specialized drinking water treatment was not necessary.


Sources: Environmental Protection Agency, World Health Organization.

Dr. Joseph Cotruvo is president of Joseph Cotruvo and Associates, LLC, Water, Environment and Public Health Consultants. He is a former director of the U.S. EPA Drinking Water Standards Division.