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      Attitudes and Practice Regarding Disposal for Unwanted Medications among Young Adults and Elderly People in China from an Ecopharmacovigilance Perspective

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          Abstract

          Due to the expensive cost and uncertain effectiveness of environmental management options in eliminating pharmaceutical residues, recently, decreasing the emission of pharmaceutical pollutants from a drug administration perspective has been considered a hot area of research. As a kind of drug administration for the environment, ecopharmacovigilance (EPV) emphasizes the source control of pharmaceutical pollutants. Disposal of unwanted medicines has been considered as the easiest target for source control of pharmaceutical contamination. Here, we focused on public attitudes and practice regarding disposal of unwanted medicines from the EPV perspective among 365 Chinese university young adults and 206 elderly retirement home residents. The results showed that the majority of respondents had positive attitudes, but exhibited inadequate awareness and poor practice. In addition, the young-adult respondents were found to pay more attention to the environmental problems posed by pharmaceutical residues, and be more supportive of the EPV intervention predominantly performed by pharmaceutical industries and pharmacists. Therefore, it is urgent to establish the standard medicine disposal protocols and educate the general public on the best way for medication disposal under the principle of EPV in China, and efforts on environmentally-preferred drug disposal under EPV should target for the specific demographics.

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          Most cited references31

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          Collapse of a fish population after exposure to a synthetic estrogen.

          Municipal wastewaters are a complex mixture containing estrogens and estrogen mimics that are known to affect the reproductive health of wild fishes. Male fishes downstream of some wastewater outfalls produce vitellogenin (VTG) (a protein normally synthesized by females during oocyte maturation) and early-stage eggs in their testes, and this feminization has been attributed to the presence of estrogenic substances such as natural estrogens [estrone or 17beta-estradiol (E2)], the synthetic estrogen used in birth-control pills [17 alpha-ethynylestradiol (EE2)], or weaker estrogen mimics such as nonylphenol in the water. Despite widespread evidence that male fishes are being feminized, it is not known whether these low-level, chronic exposures adversely impact the sustainability of wild populations. We conducted a 7-year, whole-lake experiment at the Experimental Lakes Area (ELA) in northwestern Ontario, Canada, and showed that chronic exposure of fathead minnow (Pimephales promelas) to low concentrations (5-6 ng x L(-1)) of the potent 17 alpha-ethynylestradiol led to feminization of males through the production of vitellogenin mRNA and protein, impacts on gonadal development as evidenced by intersex in males and altered oogenesis in females, and, ultimately, a near extinction of this species from the lake. Our observations demonstrate that the concentrations of estrogens and their mimics observed in freshwaters can impact the sustainability of wild fish populations.
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            Disposal practices for unused medications around the world.

            Pharmaceuticals have been detected throughout the environment where at least in some cases, they have been shown to have a detrimental effect. Many result from improper patient disposal of unused pharmaceuticals via environmentally-unfriendly routes, such as the sink, toilet or rubbish bin. This review surveys the current peer-reviewed literature on attitudes and practices to medicine disposal methods as reported by patients and the various medication disposal and destruction systems around the world. A literature search was carried out using the keywords 'medicines disposal', 'unused medicines', 'medicines wastage', and 'medication disposal' in the PubMed TM, ISI Web of Knowledge TM, Google Scholar TM, Medline TM, Scopus TM and International Pharmaceuticals Abstracts TM up to the end of May 2010. Twelve peer-reviewed articles with specified sample sizes were selected. The most popular methods for medication disposal were in the garbage, toilet or sink. Liquid medications were more likely to be rinsed down the sink, as opposed to solid tablets and capsules which were more likely deposited in the rubbish bin. Much confusion exists about the 'proper' way of medication disposal as many countries do not have standard medication disposal protocols. Furthermore, some pharmacies around the world refused to accept unused medications or discouraged the practice. Patients with knowledge about the impact of pharmaceuticals in the environment were more likely to return medications for proper disposal and destruction. It is concluded that it is of paramount importance that a formalized protocol for patient disposal and destruction of pharmaceuticals be implemented around the world. Copyright © 2010 Elsevier Ltd. All rights reserved.
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              Occurrence and ecotoxicological assessment of pharmaceuticals: Is there a risk for the Mediterranean aquatic environment?

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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                25 April 2019
                April 2019
                : 16
                : 8
                : 1463
                Affiliations
                [1 ]New Medicine Innovation and Development Institute, Department of Pharmacy, College of Medicine, Wuhan University of Science and Technology, Wuhan 430065, China; yuxiaotan123@ 123456gmail.com (X.Y.); huxianmin@ 123456wust.edu.cn (X.H.); lishulan971204@ 123456outlook.com (S.L.); zhangmengya0703@ 123456163.com (M.Z.)
                [2 ]Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China
                Author notes
                [* ]Correspondence: wangjun@ 123456wust.edu.cn
                Author information
                https://orcid.org/0000-0003-0343-1407
                Article
                ijerph-16-01463
                10.3390/ijerph16081463
                6518121
                31027160
                51cba409-f794-40f8-90ff-8cbaec3e084a
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 11 March 2019
                : 24 April 2019
                Categories
                Article

                Public health
                ecopharmacovigilance,disposal of unwanted medicines,pharmaceutical,environment,young adults,elder people

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