Hospital disposal of medications into the sewage system is liable to constitute
a serious health and environmental danger, according to experts who spoke at an
unprecedented special session of the Knesset Environmental Protection and Labor,
Social Affairs and Health Committees on Monday.
The MKs were provided
with background material collected by Shiri Bass Spector of the Knesset’s
research and information center. She noted that organic micro-pollutants, some
of which do not disintegrate, have biological effects. These come from
cosmetics, drugs and hormones that affect the endocrine system.
products taken by people and animals are not fully absorbed by the body; 90
percent of them are eliminated in urine and stool and enter the civil and
agricultural sewage systems. They reach sewage treatment plants, says the
document, but these are not built to treat organic micro-pollutants. As Israel
is one of the world’s leaders in water treatment, in 2009, 84% of treated sewage
is used for irrigation, and in four years, it will reach 100%. But using sewage
water for irrigating plants exposes the public to health dangers, said Bass
Hospitals contribute between 5% and 30% of all
medical materials that reach urban waste-treatment plants. They are treated like
industrial waste, but as there is no standard for organic micro-pollutants; they
are not monitored or specially treated.
One way to deal with this
potential danger is the precautionary principle – not to allow these pollutants
to reach the sewage plants. Patients can also be encouraged to return unused
drugs, she said, recommending that official standards be set.
University’s Dr. Dror Avissar said that the country constantly discusses the
water shortage but not water quality.
He bemoaned the fact that there are
no serious Israeli epidemiological studies in the field, but he said
prescription drugs should not be in the drinking water.
have shown that one to five nanograms/liter of estrogens in the water can cause
an increase in breast cancer and reduce sperm counts. The presence of
antibiotics in the environment can also increase resistance of bacteria to these
The Health Ministry’s national environmental quality expert,
engineer Shalom Goldberger, welcomed the growing awareness of organic
His ministry has begun to study it, he said, noting
that there is no standard for these anywhere in the world.
limitations prevent separation of drug wastes from other wastes in hospitals,
said Dr. Eyran Halperin, the new chairman of the Union of Hospital directors and
the director of the Rabin Medical Center. At present, cytotoxic and radioactive
materials are separated and sent to the Ramat Hovav dump, while polluted medical
waste is sterilized. He agreed that patients’ urine and stools do pose a
MK Dov Khenin, who chaired the meeting, said it was clear that
there remain troubling unanswered questions.
He called for research into
the problem, for pharmaceutical companies to meet advanced standards and for
increasing awareness in hospitals about problems posed by their sewage and
He said he intended to prepare legislation that would
require the collection of unused drugs to reduce the amount of organic
micro-pollutants in the environment.