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.

Medical 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 Spector’s document.

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.

Tel Aviv 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.

Foreign studies 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 drugs.

The Health Ministry’s national environmental quality expert, engineer Shalom Goldberger, welcomed the growing awareness of organic micro-pollutants.

His ministry has begun to study it, he said, noting that there is no standard for these anywhere in the world.

Financial 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 problem.

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 disposal systems.

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.

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