Pharmaceuticals in Sewage Treatment: Causes, Effects, and Solutions

Pharmaceuticals in Sewage Treatment: Causes, Effects, and Solutions

Written by Jason Brashear

Jason has been a software engineer for more than 20 years. He is now working with engineering team at Manning Environmental working on sampler development and design.

March 22, 2023

Definition of pharmaceuticals in sewage treatment

Pharmaceuticals in sewage treatment refer to the presence of various pharmaceutical compounds, such as prescription and over-the-counter drugs, hormones, and personal care products, in municipal wastewater systems. These substances make their way into sewage systems through human and animal excretion, improper disposal of medications, and industrial waste and runoff.

Importance of the issue

The presence of pharmaceuticals in sewage treatment is a growing concern due to the potential adverse effects on both the environment and public health. These substances can contaminate water sources, leading to ecosystem disruption and health risks for humans and animals, as well as contribute to the development of antibiotic-resistant bacteria.

Pharmaceuticals in sewage treatment causes and solutions

This paper aims to discuss the causes of pharmaceuticals in sewage treatment, their effects on the environment and public health, and explore potential solutions to mitigate these issues.

Causes of Pharmaceuticals in Sewage Treatment

Disposal of unused medications

One of the primary causes of pharmaceuticals in sewage treatment is the improper disposal of unused medications. A lack of awareness about the appropriate methods for disposing of unused or expired drugs often leads to people resorting to flushing them down the toilet or sink. This practice introduces a variety of pharmaceutical compounds, including antibiotics, painkillers, hormones, and other medications, directly into the wastewater system. Since conventional sewage treatment plants are not designed to remove these substances effectively, they can ultimately end up in rivers, lakes, and oceans, posing risks to aquatic life and contaminating drinking water sources.

In addition to flushing, another common method of disposing of unused medications is throwing them in the trash. While this may seem like a safer alternative, it can still contribute to the presence of pharmaceuticals in the environment. When medications are discarded in household trash, they often end up in landfills, where they can leach into the surrounding soil and groundwater. Over time, these substances can migrate into nearby surface waters, further exacerbating the problem of pharmaceutical pollution.

The improper disposal of unused medications not only increases the concentration of pharmaceutical compounds in wastewater systems but also contributes to the inefficiency of sewage treatment processes. The presence of these substances can interfere with the biological treatment of wastewater, potentially reducing the overall effectiveness of the treatment process.

Public awareness and education campaigns are essential in addressing this issue. By informing the public about the environmental and health risks associated with improper disposal of medications and providing guidelines for safe and responsible disposal methods, people can be encouraged to change their behavior and reduce the introduction of pharmaceuticals into wastewater systems. Some of these methods include participating in drug take-back programs, using designated medication disposal drop-off locations, and following the instructions provided by pharmacists and healthcare professionals.

The improper disposal of unused medications is a significant contributor to the presence of pharmaceuticals in sewage treatment systems. Tackling this issue requires a concerted effort from individuals, healthcare providers, and regulatory authorities to promote responsible disposal practices and raise public awareness about the potential consequences of improper disposal on the environment and public health.

Excretion of drugs by humans and animals

The excretion of drugs by humans and animals is a significant contributor to the presence of pharmaceuticals in sewage treatment systems. When medications are taken, they undergo a series of complex processes within the body, including absorption, distribution, metabolism, and excretion. These processes result in the breakdown of the active pharmaceutical ingredients, as well as the formation of various metabolites, some of which can still exhibit biological activity.

After these metabolic processes, a significant portion of the ingested drugs, along with their metabolites, are excreted through urine and feces. These waste products, containing a mixture of unmetabolized parent compounds and active metabolites, eventually enter wastewater systems through household, commercial, and industrial sewage lines. As a result, sewage treatment plants receive a continuous influx of pharmaceutical compounds and their metabolites from various sources.

Livestock production plays a notable role in contributing to the presence of pharmaceuticals in wastewater systems. Veterinary drugs, such as antibiotics, hormones, and anti-parasitic agents, are routinely administered to animals for the prevention and treatment of diseases and to promote growth. Similar to humans, animals also metabolize and excrete these drugs, leading to the presence of pharmaceutical residues in their waste.

Manure from livestock operations is often used as fertilizer in agricultural fields, and when it rains or during irrigation, these pharmaceutical residues can be washed off and make their way into nearby surface waters and groundwater systems. Additionally, livestock operations that utilize lagoons or other waste storage systems can potentially release pharmaceuticals into the environment through leakage or overflow incidents.

The excretion of drugs by humans and animals, coupled with the widespread use of veterinary drugs in livestock production, contributes significantly to the presence of pharmaceuticals in sewage treatment systems. This complex issue requires a multifaceted approach to address the various sources of pharmaceutical pollution and their potential impact on the environment and public health.

Industrial waste and runoff

Industrial waste and runoff from pharmaceutical manufacturing facilities can be a major contributor to the presence of pharmaceuticals in wastewater systems. These facilities produce a variety of pharmaceutical compounds and, during the manufacturing process, generate waste streams that contain residues of active ingredients, intermediates, solvents, and other chemical byproducts. The disposal and management of this waste are critical to minimizing the release of pharmaceuticals into the environment.

In some cases, inadequate regulation and oversight of the pharmaceutical industry can exacerbate the issue of pharmaceutical pollution. In the absence of strict environmental regulations, companies may not properly treat their waste before discharging it into wastewater systems or surface waters, leading to the contamination of aquatic ecosystems and downstream water sources. Furthermore, the lack of stringent monitoring and enforcement can result in facilities not being held accountable for their environmental impact, reducing the incentive to invest in more sustainable waste management practices.

Another factor contributing to the presence of pharmaceuticals in wastewater systems is the potential for accidental spills and leaks during the manufacturing, storage, and transportation of pharmaceutical compounds. These incidents can lead to the release of large quantities of drugs and their byproducts into the environment, further highlighting the need for proper oversight and regulation of the industry.

To address this issue, governments and regulatory agencies must work together to develop and enforce comprehensive environmental regulations specifically tailored to the pharmaceutical industry. These regulations should focus on the proper treatment and disposal of industrial waste, as well as the implementation of best management practices to minimize the risk of accidental spills and leaks. Additionally, incentives can be provided to encourage pharmaceutical companies to invest in cleaner production technologies and to adopt environmentally friendly manufacturing practices.

The industrial waste and runoff from pharmaceutical manufacturing facilities pose a significant risk to wastewater systems and the environment. Addressing this issue requires a combination of strong regulations, effective oversight, and industry cooperation to minimize the release of pharmaceuticals into the environment and safeguard the health of aquatic ecosystems and the public.

Effects of Pharmaceuticals in Sewage Treatment

Environmental impact

The presence of pharmaceuticals in sewage treatment poses considerable risks to the environment, with aquatic ecosystems being particularly susceptible to the adverse effects of these contaminants. The introduction of pharmaceutical residues into water bodies can disrupt the delicate balance of aquatic ecosystems and lead to a cascade of negative consequences.

One significant impact of pharmaceuticals on aquatic ecosystems is the disruption of endocrine systems in fish and other aquatic organisms. Many pharmaceuticals, such as hormones and hormone-mimicking compounds, can interfere with the normal functioning of endocrine systems, which regulate vital physiological processes like growth, metabolism, and reproduction. Exposure to these substances, even at low concentrations, can result in a range of abnormalities, including altered reproductive behavior, reduced fertility, and developmental defects.

Behavioral changes in aquatic organisms due to pharmaceutical exposure can also have broader ecosystem-level implications. For instance, changes in feeding habits, mating behaviors, and predator-prey dynamics can disrupt the overall balance of the ecosystem and lead to population declines or the loss of biodiversity. Additionally, the bioaccumulation of pharmaceuticals in aquatic food chains can lead to higher concentrations of these compounds in organisms higher up the food chain, posing risks to predators, including humans who consume contaminated fish and seafood.

Pharmaceuticals in water sources can also contribute to the degradation of water quality. They can alter the chemical composition of water, which can have adverse effects on aquatic plant life. Plants play a crucial role in maintaining the health and stability of aquatic ecosystems by providing food, oxygen, and habitat for various organisms. The presence of pharmaceuticals in water can inhibit the growth and reproduction of aquatic plants, leading to a reduction in the overall productivity and biodiversity of the ecosystem.

Furthermore, the presence of pharmaceuticals in water bodies can exacerbate other environmental issues, such as eutrophication and the proliferation of harmful algal blooms. Eutrophication, the excessive growth of algae and other aquatic plants due to nutrient enrichment, can lead to oxygen depletion, the loss of biodiversity, and the deterioration of water quality. The presence of pharmaceuticals in water bodies can interact with other pollutants, making it challenging to predict and manage the potential environmental impacts.

The environmental impact of pharmaceuticals in sewage treatment is a significant concern that requires urgent attention. The adverse effects on aquatic ecosystems, water quality, and biodiversity highlight the need for more effective wastewater treatment technologies and improved management practices to minimize the release of these compounds into the environment.

Health risks to humans and animals

Pharmaceuticals in sewage treatment pose potential health risks to both humans and animals due to their presence in water sources. The increasing detection of pharmaceutical residues in drinking water, surface water, and groundwater raises concerns about the potential consequences of exposure to these contaminants for humans, wildlife, and aquatic organisms.

Human health risks associated with exposure to pharmaceutical-contaminated water sources can vary depending on the specific compounds, their concentrations, and the duration of exposure. However, potential health issues may include hormonal imbalances, allergic reactions, and developmental problems. Hormonal imbalances can result from exposure to endocrine-disrupting chemicals, such as synthetic hormones and hormone-mimicking compounds found in some pharmaceuticals. These imbalances can lead to reproductive issues, developmental abnormalities, and increased susceptibility to certain diseases, such as cancer.

Allergic reactions may occur when individuals are exposed to trace amounts of pharmaceuticals, to which they are sensitive, through drinking water or recreational water activities. These reactions can range from mild skin irritations to severe anaphylactic responses, depending on the individual’s sensitivity and the specific pharmaceutical compound involved.

Developmental problems may arise from prenatal and early-life exposure to pharmaceuticals in contaminated water sources. Early-life exposure to certain pharmaceuticals has been associated with developmental delays, cognitive impairments, and behavioral issues in children. Furthermore, the long-term health risks associated with chronic exposure to low levels of pharmaceuticals are not yet fully understood but warrant further investigation.

In addition to human health risks, animals are also vulnerable to the adverse effects of pharmaceuticals in the environment. Wildlife and aquatic organisms may experience similar health issues as humans, such as endocrine disruption, reproductive issues, and developmental abnormalities. Moreover, the bioaccumulation of pharmaceuticals in the tissues of animals can lead to increased exposure and heightened health risks for predators higher up the food chain, including humans who consume contaminated fish and seafood.

The presence of pharmaceuticals in sewage treatment and their subsequent contamination of water sources pose significant health risks to both humans and animals. Addressing this issue requires a combination of improved wastewater treatment technologies, responsible drug disposal practices, and enhanced monitoring of water sources to minimize exposure and protect the health of humans, wildlife, and aquatic ecosystems.

Development of antibiotic-resistant bacteria

The presence of antibiotics in sewage treatment contributes to the development of antibiotic-resistant bacteria, a growing public health concern. As these bacteria evolve and become resistant to common antibiotics, treating infections becomes increasingly difficult, leading to higher healthcare costs and a greater risk of complications and mortality. The spread of antibiotic-resistant bacteria in the environment can also result in the transmission of these bacteria to humans and animals, exacerbating the issue further.

Solutions to Pharmaceuticals in Sewage Treatment

Proper disposal of unused medications

One crucial solution to addressing pharmaceuticals in sewage treatment is to encourage and facilitate the proper disposal of unused medications. Implementing drug take-back programs and providing easily accessible drop-off locations can help prevent the flushing or discarding of unused drugs. Additionally, raising public awareness about the environmental and health risks associated with improper disposal can further motivate individuals to dispose of their medications responsibly.

Improved sewage treatment methods

Improving sewage treatment methods is crucial for mitigating the impact of pharmaceuticals on the environment and public health. By implementing advanced treatment technologies, a significant portion of pharmaceuticals can be removed from wastewater before it is discharged into natural water bodies. Several promising technologies have demonstrated their efficacy in removing pharmaceuticals from wastewater, and investing in research and development to refine and expand these methods can lead to a substantial reduction in pharmaceutical pollution.

Activated carbon: Activated carbon is a highly porous material with a large surface area that can effectively adsorb a wide range of organic compounds, including pharmaceuticals. By integrating activated carbon treatment into existing wastewater treatment processes, pharmaceuticals can be adsorbed onto the carbon surface and effectively removed from the water. Further research into the optimization of activated carbon properties, such as pore size and surface chemistry, can enhance the removal efficiency for a broader range of pharmaceutical compounds.

Ozonation: Ozonation is a powerful oxidation process that involves the use of ozone gas to break down organic contaminants, including pharmaceuticals. The high reactivity of ozone allows it to oxidize and transform pharmaceutical compounds into less harmful byproducts, which can be more easily removed in subsequent treatment stages. Research into the optimization of ozone dose, contact time, and pH conditions can help improve the removal efficiency and minimize the formation of potentially harmful oxidation byproducts.

Membrane filtration: Membrane filtration technologies, such as ultrafiltration, nanofiltration, and reverse osmosis, employ semi-permeable membranes to separate and remove contaminants from wastewater. These processes can effectively remove a wide range of pharmaceutical compounds based on their size, charge, and hydrophobicity. Ongoing research in membrane material development and process optimization can lead to improved removal efficiency and reduced fouling, enhancing the overall performance and cost-effectiveness of membrane-based treatment technologies.

Biological treatment: Biological treatment methods, such as aerobic and anaerobic biodegradation, rely on the action of microorganisms to break down and remove organic contaminants, including pharmaceuticals. Enhancing the capacity of microorganisms to degrade pharmaceutical compounds can be achieved through the optimization of operational conditions, such as temperature, pH, and nutrient availability, as well as the development of specialized microbial communities capable of breaking down recalcitrant pharmaceuticals.

Hybrid treatment systems: Combining different treatment technologies can result in synergistic effects, improving the overall removal efficiency of pharmaceuticals from wastewater. Hybrid treatment systems, such as combining advanced oxidation processes with biological treatments or membrane filtration, can target a broader range of pharmaceutical compounds and minimize the formation of harmful byproducts. Research into the design and optimization of hybrid treatment systems can help identify the most effective combinations of technologies for specific wastewater treatment scenarios.

Improving sewage treatment methods and processes through the implementation of advanced treatment technologies and the development of hybrid systems can significantly reduce the presence of pharmaceuticals in wastewater. Investing in research and development to optimize and expand these methods is essential for mitigating the environmental and public health risks associated with pharmaceutical pollution.

Public education and awareness

Public education and awareness play a pivotal role in addressing the issue of pharmaceuticals in sewage treatment. By raising awareness about the potential risks associated with pharmaceutical pollution and promoting responsible drug use and disposal, behavioral changes can be encouraged that reduce the release of these substances into wastewater systems. A multi-faceted approach targeting different stakeholders, including the general public, healthcare professionals, veterinarians, and the pharmaceutical industry, can contribute to a more sustainable and environmentally responsible approach to managing pharmaceuticals.

General public: Educating the general public about the environmental and health risks associated with improper disposal of medications is crucial in promoting responsible disposal practices. Public awareness campaigns can emphasize the importance of not flushing unused or expired drugs down the toilet or sink and provide information on safe disposal options, such as drug take-back programs and designated medication disposal drop-off locations. Additionally, raising awareness about the importance of adhering to prescribed dosages can help minimize the amount of pharmaceuticals excreted into wastewater systems.

Healthcare professionals: Healthcare professionals, such as doctors, nurses, and pharmacists, play a key role in prescribing and dispensing medications. Educating these professionals about the environmental impacts of pharmaceutical pollution can encourage more responsible prescribing practices, such as considering the environmental persistence and potential risks of specific medications. Furthermore, healthcare professionals can serve as valuable sources of information for patients, advising them on proper drug use and disposal practices.

Veterinarians: Similar to healthcare professionals, veterinarians prescribe medications for animals, which can also contribute to pharmaceutical pollution. Education campaigns targeting veterinarians can emphasize the importance of considering the environmental impacts of veterinary drugs and promote responsible prescribing practices. Veterinarians can also inform pet owners about proper drug use and disposal, helping to reduce the release of veterinary pharmaceuticals into wastewater systems.

Pharmaceutical industry: Engaging with the pharmaceutical industry is essential in promoting the development of environmentally friendly drug formulations and waste management practices. Public awareness campaigns can encourage industry stakeholders to prioritize the environmental impacts of their products throughout the entire lifecycle, from research and development to manufacturing and disposal. By fostering a culture of environmental responsibility within the industry, more sustainable practices can be adopted, such as investing in cleaner production technologies and implementing waste reduction strategies.

Educational institutions: Integrating information about pharmaceutical pollution and responsible drug use and disposal into school curricula can help raise awareness among younger generations. By incorporating this topic into subjects such as biology, chemistry, and environmental science, students can develop a deeper understanding of the issue and its potential consequences, fostering a sense of environmental responsibility that can last a lifetime.

Public education and awareness are vital in addressing the issue of pharmaceuticals in sewage treatment. By targeting different stakeholders and promoting responsible drug use, disposal, and management practices, it is possible to achieve significant progress in reducing the environmental and health risks associated with pharmaceutical pollution.


Pharmaceuticals in sewage treatment pose significant environmental and public health risks, including ecosystem disruption, health issues for humans and animals, and the development of antibiotic-resistant bacteria. Addressing this issue requires a multifaceted approach, including proper disposal of unused medications, improved sewage treatment methods, and increased public education and awareness. By investing in research, infrastructure, and educational campaigns, society can work towards mitigating the negative effects of pharmaceuticals in sewage treatment and safeguarding the health of both the environment and the public.

While substantial progress has been made in identifying the causes and effects of pharmaceuticals in sewage treatment, there is still much work to be done. Governments, the pharmaceutical industry, and individuals all have roles to play in implementing and supporting solutions to this problem.

Policy makers should consider enacting stricter regulations for the disposal of pharmaceutical waste, as well as enforcing higher treatment standards for wastewater facilities. They can also provide incentives for research into new drug formulations with reduced environmental impact and promote the adoption of advanced wastewater treatment technologies.

The pharmaceutical industry can contribute by taking greater responsibility for the lifecycle of their products, prioritizing eco-friendly manufacturing processes, and working with healthcare providers to minimize drug waste. They can also collaborate with governments and researchers to develop innovative solutions and technologies that minimize the release of pharmaceuticals into the environment.

Individuals play a crucial role in reducing pharmaceutical pollution by being conscious of their consumption and disposal habits. By being aware of the issue, adhering to proper disposal guidelines, and advocating for better waste management and treatment practices, individuals can make a significant impact on mitigating the harmful effects of pharmaceuticals in sewage treatment.

In conclusion, addressing the issue of pharmaceuticals in sewage treatment is a shared responsibility that requires a collective effort from all stakeholders. By working together, we can ensure a healthier, more sustainable environment for future generations.

Manning Environmental’s state-of-the-art water sampling equipment plays a crucial role in detecting pharmaceuticals in the wastewater industry. By employing their advanced and reliable samplers, municipalities can accurately and efficiently monitor the levels of pharmaceutical compounds in their sewage systems. This monitoring is essential for assessing the extent of pharmaceutical pollution and identifying areas where improvements in waste management and treatment processes are needed.

Manning’s water samplers are designed to provide precise, representative samples of wastewater, ensuring that the collected data accurately reflects the presence of pharmaceuticals in the system. Their equipment’s robust construction and user-friendly interface make it a reliable and practical choice for wastewater operators. By using Manning Environmental’s water samplers, municipalities can obtain the data necessary to make informed decisions about addressing the issue of pharmaceuticals in their sewage treatment processes.

To all concerned municipalities:

We invite you to partner with Manning Environmental in our mission to safeguard the environment and public health from the detrimental effects of pharmaceuticals in wastewater systems. Our state-of-the-art water sampling equipment will enable your municipality to effectively monitor and manage pharmaceutical contamination in your sewage treatment processes. By collaborating with us, you will not only have access to cutting-edge technology but also to our team of experts, who can provide guidance and support tailored to your specific needs.

Together, we can work towards a cleaner, healthier, and more sustainable future for our communities. Don’t wait to address this growing concern; contact Manning Environmental today and let us help you take proactive steps in mitigating pharmaceutical pollution in your wastewater systems. Our commitment to innovation, quality, and customer satisfaction makes us the ideal partner for municipalities seeking to improve their wastewater management practices and protect the well-being of their citizens and the environment.

By joining forces with Manning Environmental, your municipality will be at the forefront of addressing this critical issue and demonstrating your commitment to environmental stewardship. We understand the unique challenges faced by municipalities and are dedicated to providing tailored solutions that fit your specific needs and budget constraints.

Investing in Manning Environmental’s water sampling equipment and expertise is an investment in the health of your community and the preservation of our precious water resources. Together, we can make a lasting impact on the quality of our water and the future of our planet.

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