Elsevier

Science of The Total Environment

Volume 671, 25 June 2019, Pages 505-509
Science of The Total Environment

Short Communication
Investigation of medicines consumption and disposal in Brazil: A study case in a developing country

https://doi.org/10.1016/j.scitotenv.2019.03.334Get rights and content

Highlights

  • The incorrect disposal of medicines may represent a risk to the environment.

  • Investigate how people are disposing unused medicines is crucial.

  • Online questionnaires were spread out in Brazil.

  • 66% of the respondents discard unused or expired medicines in common garbage.

  • Environmental education may help to mitigate pharmaceuticals pollution.

Abstract

The incorrect disposal of medicines can be harmful to the environment. Here, we aim to understand the consumption and disposal of medicines in Brazil using online forms. 64% of the respondents have the habit to self-medicate. 66% of respondents dispose the disused or expired medicines in the garbage. 71.9% of respondents never receive any information about correct disposal of medicines. 95.2% of respondents believe that residues of medicines can be harmful to the environment. Environmental education can provide information to the population and help to mitigate pharmaceuticals pollution.

Graphical abstract

The most important pathways for pharmaceuticals to the environment considering human disposal in the present study case.

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Introduction

The pharmaceutical industry produces thousands of different compounds and its importance to the world economy and health is unquestionable. However, the increase in production, prescription and use of pharmaceuticals have an environmental cost. The entire range of synthetic compounds produced by the pharmaceutical industry has the potential to enter and contaminate the ecosystems. Then, pharmaceutical waste has been part of ecosystems, especially in environments close to urbanized regions. Therefore, the environmental concern regarding pharmaceutical pollution has been increasing.

Many factors push the pharmaceutical industry, such as the increase of world population, self-medication and the inversion of the population pyramid (An and Jeon, 2006; Daughton and Ruhoy, 2013; Quadra et al., 2017). There are many pathways of medicines to reach the environment, especially through incorrect disposal and excretion by human and veterinary uses and also untreated industrial waste (Bila and Dezotti, 2003). When pharmaceuticals – active principles from medicines – reach the water and sewage treatment plants, these compounds are not completely removed (Petrović et al., 2005; Suárez et al., 2008; Tambosi et al., 2010). In this way, pharmaceuticals reach the water bodies and drinking water (Halling-Sørensen et al., 1998; Loos et al., 2013; Liu and Wong, 2013; Kostich et al., 2014). In Germany, for example, 156 pharmaceuticals were detected in surface water, groundwater and drinking water (Küster and Adler, 2014).

Currently, the concern has been raised regarding the occurrence of pharmaceuticals on the environment since the discovery of adverse effects on organisms, ranging from acute intoxication to endocrine and ecological disruption (Rosi-Marshall and Royer, 2012; Rosi-Marshall et al., 2013). Environmental variables added to the natural degradation processes modulate effects in these pharmaceutical compounds, generating metabolites with ecotoxicological potential (Pfluger and Dietrich, 2001; Ferrari et al., 2003). Moreover, the complexity of pharmaceuticals in the environment can lead to poorly know mixtures effects (Cleuvers, 2003, Cleuvers, 2004; WHO-UNEP, 2012).

The incorrect disposal of medicines by the population is an essential pathway for pharmaceuticals to reach the environment and many countries still lack effective regulation. Brazilian laws, for example, regulate the industrial production of medicines, however, do not include adequate disposal by the final consumer (Ueda et al., 2009). Therefore, bringing information about the consequences of incorrect disposal of medicines to the population is crucial. Then, this research aim was to investigate the habits of consumption and disposal of medicines by citizens in Brazil. Moreover, this study also aims to bring knowledge to the population, as well as generate awareness about the consumption and disposal of medicines.

Section snippets

Methods

Data collection was performed through wide dissemination of questionnaires, via Google Forms (online and free platform). The exploratory study was carried out with a varied population in Brazil, and the distribution was through electronic media, such as social media, e-mail, and websites. Therefore, anyone with internet access was able to answer the questionnaire. There was no direct interference in the population. In the questionnaire, general questions about residence localization, age and

Results and discussion

In 2018, approximately 70% of the Brazilian population was composed of individuals over 18 years old (IBGE, 2018). Therefore, based on Eq. (2), a 4% margin of error was estimated under such criteria. According to Eq. (1), a minimum sample size of 421 respondents was then calculated and would be representative of the Brazilian population.

In total, 540 forms were answered, and the majority was in the Southeastern region (88.3%), followed by Central-West (6.1%), South (3%), Northeast (1.5%), North

Conclusion

Although many countries still do not have adequate protocols for unused medicines disposal, it is essential that the population is aware of the incorrect forms and consequences for the environment. This study emphasizes the need for greater incentive in environmental education and public policies related to pharmaceuticals use and disposal. Furthermore, we believe that the conscious consumption of medicines, the medical treatments correct accomplishment, the reduction of self-medication, and

Acknowledgments

We are grateful for all the participants that answered the survey. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

References (37)

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  • Promoting unused medicine pro-environmental disposal: Characterization of consumer behavior and strategic propositions

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    Recent research indicates that household waste continues to be the predominant practice of medicine disposal (Alhomoud et al., 2021; Kusturica et al., 2020; Quadra et al., 2019). Furthermore, consumers' insufficient knowledge about proper disposal methods is a common justification for storing medicines at home, which also encourages self-medication (Chung and Brooks, 2019; Quadra et al., 2019). Additionally, although the delivery of expired and unused medicines at collection points is common in developed economies, it is still a distant reality for emerging economies (Bouzon et al., 2018; De Campos et al., 2017, 2021).

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