Invisible pollution: the impact of pharmaceuticals in the water supply.

During the past decade, interest in the public and environmental health effects of trace levels of pharmaceuticals and personal care products in the water supply has evolved. Although most pharmaceuticals are tested for human safety and efficacy prior to marketing and distribution, the potential for adverse effects in nontarget populations exposed to minute environmental medication doses has not been established. Several recent studies have demonstrated adverse effects from longstanding, low-dose exposures in both aquatic and terrestrial wildlife, although human toxicity related to trace levels of pharmaceuticals in the water supply remains unknown. This article provides a brief overview of the routes through which pharmaceuticals are introduced into the environment; a description of the effects of longstanding, low-dose exposures in aquatic and terrestrial animals, including human health effects; an update on the current regulations and solutions regarding pharmaceutical disposal practices; and a discussion of implications for reducing pharmaceuticals in the environment for occupational health nurses and other allied health professionals.