Pol­lu­tion caused by drug dump­ing can’t be ig­nored

Add flushed meds—and per­haps recluse rep­tiles—to your list of con­cerns

Modern Healthcare - - Editorial - NEIL MCLAUGH­LIN Man­ag­ing Edi­tor

Notes on the news:

■ Years ago, one of the more pop­u­lar ur­ban leg­ends concerned the New York sewer sys­tem. Ac­cord­ing to this myth, pet al­li­ga­tors aban­doned in the sys­tem prowled the tun­nels and had be­come ad­dicted to the nar­cotics city dwellers flushed down their toi­lets dur­ing po­lice raids. The drug-crazed crea­tures had evolved into al­bino preda­tors who munched on sewer work­ers.

This leg­end surely will be up­dated soon, if it hasn’t al­ready. In the new telling, the ga­tors will be mu­tants cre­ated by a del­uge of pre­scrip­tion drugs flushed into the sew­ers.

As re­porter Gregg Blesch noted in our May 24 Cover Story (p. 6), govern­ment of­fi­cials are be­com­ing in­creas­ingly concerned by haz­ardous prod­ucts turn­ing up in the nation’s wa­ter, and they are look­ing to hos­pi­tals as one of the sources of that pol­lu­tion. In 2008, a Se­nate sub­com­mit­tee held a hear­ing on phar­ma­ceu­ti­cals in drink­ing wa­ter af­ter the As­so­ci­ated Press pub­lished a se­ries of sto­ries out­lin­ing the prob­lem.

The is­sue also has at­tracted the at­ten­tion of state of­fi­cials, in­clud­ing New York At­tor­ney Gen­eral An­drew Cuomo. That in­ves­ti­ga­tion into the dis­posal prac­tices of hos­pi­tals and nurs­ing homes led to set­tle­ments with two crit­i­cal-ac­cess hos­pi­tals and three nurs­ing homes. Cuomo’s of­fice al­leged the dumped drugs were flow­ing into the reser­voirs and lakes that pro­vide wa­ter to 9 mil­lion res­i­dents of the New York metropoli­tan area.

And as Blesch points out, En­vi­ron­men­tal Pro­tec­tion Agency records show 244 hos­pi­tals have been found in vi­o­la­tion of a key haz­ardous ma­te­ri­als statute over the past five years for mis­han­dling drugs and other toxic sub­stances.

Many hos­pi­tals and in­dus­try groups are work­ing to rem­edy the pol­lu­tion, and that’s good. While the ul­ti­mate ef­fect of these drugs on the en­vi­ron­ment and hu­man health are un­known, ev­i­dence so far is not en­cour­ag­ing. Stud­ies have shown, for in­stance, that male fish are fem­i­ninized by very low lev­els of en­docrine dis­rupt­ing chem­i­cals, in­clud­ing phar­ma­ceu­ti­cal hor­mones as well as chem­i­cals in pes­ti­cides and de­ter­gents found in treated waste­water.

There are plenty of prob­lems that health­care ex­ec­u­tives have to con­tend with in the 21st cen­tury. Un­for­tu­nately, this is an­other one that shouldn’t be rel­e­gated to the back Bun­sen burner.

■ A sign of things to come came last week when Gen­tiva Health Ser­vices agreed to ac­quire hospice provider Odyssey Health­Care for about $1 bil­lion. The ac­qui­si­tion would com­bine Gen­tiva’s nurs­ing-home op­er­a­tions with the hospice busi­ness, shar­ing re­fer­rals and a va­ri­ety of staffing re­sources.

The deal re­flects grow­ing in­ter­est in the post-acute in­dus­try fu­eled by the ag­ing of the pop­u­la­tion. An­a­lysts say we can ex­pect to see more con­sol­i­da­tion in the home-health, nurs­ing home and hospice sec­tors as the baby boomers turn grayer.

■ On the sub­ject of ag­ing, the Washington Post last week pub­lished a guest com­men­tary by author Fred Pearce. He ar­gued that as longevity grows around the world, so­ci­ety will ben­e­fit from an older, wiser work­force and an en­light­ened cit­i­zenry.

We hope so. But look­ing at the cur­rent state of the planet, in­clud­ing an oil-in­fused Gulf of Mex­ico, it’s hard to em­brace the no­tion that age brings wis­dom. Nearly 40 years af­ter the oil shocks of the 1970s, to­day’s el­ders clearly haven’t learned much about petroleum ad­dic­tion or other en­vi­ron­men­tal dangers.

The fight for clean air and wa­ter is among the most im­por­tant pub­lic health is­sues of our time. Health­care ex­ec­u­tives and pro­fes­sion­als ought to be lead­ing ad­vo­cates for and guardians of the en­vi­ron­ment — prefer­ably be­fore we’re de­voured by sex­u­ally dis­rupted, oil-black­ened al­li­ga­tors high on mood-al­ter­ing drugs.

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