Boys Will Be Girls:The Life-Altering Effects Of PPCPs In Drinking Water
Are man-made chemicals unmaking man?Studies suggest action may not only be needed, but overdue.By Kevin Westerling It has long been known that there are trace amounts of PPCPs (pharmaceutical and personal care products) that escape our wastewater treatment plants and end up in water - ways, including drinking water sources. However, they appear in such trace amounts — parts per billion (ppb) or parts per trillion (ppt) — that they have thus far been considered essentially harmless and therefore unregulated by the U.S. EPA. But something fishy is going on in the water, and not just with the fish. Recent research suggests that exposure to PPCPs in drinking water may subject humans, particularly males, to gender-morphing and other reproductive system alterations. Though unregulated, PPCPs are on the EPA’s radar via the Third Contaminant Candidate List (CCL3) and the Unregulated Contaminant Monitoring Rule (UCMR) — precursors to possible regulatory action. The EPA defines PPCPs as “any product used by individuals for personal health or cosmetic reasons or used by agribusiness to enhance growth or health of livestock. PPCPs comprise a diverse collection of thousands of chemical substances, including prescription and over-the-counter therapeutic drugs, veterinary drugs, fragrances, lotions, and cosmetics.” When you consider that chemicals are used to produce 96 percent of manufactured consumer goods and that there are more than 85,000 chemicals on the market, 1 wastewater and drinking water facilities do a tremendous job in keeping all but those miniscule amounts of them out of our water. Unfortunately, with PPCPs so ubiquitous, and with treatment systems not designed to handle them, they do creep into the environment. The resulting chemical cocktail makes analysis difficult, especially when trying to determine specific cause and effect for statistical oddities in PPCP-laden water — like why is the male birthrate dropping? Startling Statistics Fish being as small as they are, and therefore more susceptible to even tiny doses of PPCPs, it stands to reason that the PPCP-related statistical anomalies will first show up in aquatic pop - ulations. A 2008 study conducted by researchers from the University of Calgary indicated that male longnose dace were disappearing from the Oldman and Bow Rivers in Alberta, Canada. Since these same waters are a source of drinking water, the focus turned to human birth ratios. The findings were revealed in the book Down the Drain: How We Are Failing To Protect Our Water , published in May 2013 and co-authored by the acting chair of the Canadian Water Issues Council at the University of Toronto, Ralph Pentland. According to the book, researchers noticed a shift in the sex ratio starting in 1970, with male births in the Atlantic provinces of Canada dropping 5.6 per 1,000 live births over 25 years. For the year 2010, it was estimated that 850 Canadian boys went “missing” from the population. 2 Looking at a roughly 30-year timeframe in the U.S. and Japan, the journal Environmental Health Perspectives reported that a quarter of a million boys went missing compared to the number that would have been born if the birth ratio in 1970 remained unchanged. 3
Recent studies, as well as observations in the wild, can serve as
the
proverbial canary in the coal mine in warning us of a developing and
disturbing worldwide trend.
Casting the net wider, a Canadian Broadcasting Company documentary, The Disappearing Male , cites the following statistics: • The birthrate for boys has declined every year for the past 30 years in more than 20 heavily industrialized nations — amounting to 3 million fewer males born. • The number of boys born with penis abnormalities such as cryptorchidism (undescended testicle) and hypospadias (abnormal location of the urethra) has risen 200 percent in the past 20 years. • The average sperm count of North American college students has declined more than 50 percent over 50 years. • Up to 85 percent of the sperm in a healthy male is DNA-damaged. • There has been a 300 percent increase in testicular cancer, which is linked to damaged sperm, in the past half-century.
The Smoking PPCP If PPCPs are to blame for such trends, it is likely due to the endocrine disrupting compounds (EDCs) among them. Though the quantities (per compound) in drink - ing water are slight, the impact of endocrine disruptors is significant by their very definition: compounds that mimic hormones or disrupt hormone regulation. 5 In some cases, as with birth control pills, hormone manipulation is precisely the point. More than 100 million women world - wide take the pill, which contains the female hormone estrogen. That’s a logical place to start when considering female-skewing alterations of gene expression. Like other pharmaceuticals, the pill is not completely absorbed by the body and thus ends up in wastewa - ter. But it is far from the only source of estrogen in the water supply; in fact, it contributes very little to the total amount of estrogen in drinking water. According to a 2010 Environmental Science & Technology report, animal waste is a far greater contributor of natural and pharma - ceutical hormones. Livestock produce 13 times more solid waste than humans, and the excretions often enter the waterways without treatment. 6 The agriculture industry also uses pesticides with EDCs that mimic estrogen, as many chemicals do. Phthalates, for instance — found in soap, shampoo, deodorants, fragrances, hair spray, and nail polish — are among the most potent and worrisome EDCs. The incidence of these raging hormone-disruptors is linked to “feminiza - tion” within the animal kingdom. In 2008, the Associated Press conducted an investigative report on pharmaceuti - cals acknowledging that “Pharmaceuticals in waterways are damaging wildlife across the nation and around the globe.” 7 Examples include hermaphroditic “male” cane toads and polar bears; abnormal testes in bears, panthers, turtles, sea lions, whales, and birds; genitalia deformities in alligators and otters; and egg-yolk proteins in male fish, amphibians, and birds. 2 There’s also that extremely lop - sided sex ratio of longnose dace in Canada to consider. “It brings a question to people’s minds that if the fish were affected ... might there be a potential problem for humans?” said Vickie Wilson, an EPA research biologist interviewed by the AP. Strong evidence of the effect of EDCs on birth ratios comes from the Aamjiwnaang First Nation. This community of about 850 Chippewa (Ojibwe) aboriginal peoples lives in southwestern Ontario, Canada, just across the U.S. border from Port Huron, MI — and downstream from a number of chemical plants. Environmental Health Perspectives notes that while the normal birthrate percentages for boys and girls break roughly 50/50, the birth ratio between 1999 and 2003 for the Aamjiwnaang was dramatically altered to 33 percent boys and 67 percent girls. 8 The Aamjiwnaang is the first community on record with more than two girls to every boy, a fact that undoubt - edly points to the volume of EDCs to which they were exposed. But what about the more common scenario of low-dose exposure to PPCPs and EDCs? That is the ques - tion and the debate for scientists, and ultimately for water and wastewater treatment professionals. Low-Dose Impact A fundamental tenet of toxicology states that “the dose makes the poison” — in other words, as the dose increases, so does the effect. For many, this tenet trans - lates that PPCPs in the parts-per-billion range have little to no effect. Disputing this is a 2012 paper, “Hormones and Endocrine-Disrupting Chemicals: Low-Dose Effects and Nonmonotonic Dose Responses ,” written by 12 scientists and based on a review of 800 scientific studies, conclud - ing that it is “remarkably common” for extremely small amounts of hormone-disrupting compounds to have sig - nificant and adverse human-health effects. 9 The U.S. EPA remains wary but unconvinced, at least not enough to enact regulations. Benjamin H. Grumbles, the agency’s assistant administrator for water at the time of the report, told AP investigators, “We recognize it is a growing concern and we’re taking it very seriously.” 7 Meanwhile, the EPA website currently states, “To date, scientists have found no evidence of adverse human health effects from PPCPs in the environment.” That’s not exactly true. After reviewing hundreds of scientific reports, analyzing federal drinking water databases, and interviewing more than 230 officials, academics, and scientists, the AP com - mented that “Emerging scientific studies indicate that over time, humans could be harmed by ingesting drinking water contaminated with tiny amounts of pharmaceuticals.”
When it comes to human birth ratios, the impact is not immediately apparent, because the end result is a healthy bundle of joy — albeit a girl that might have otherwise, without hormone disruption in utero, been a boy. Recent studies, as well as observations in the wild, can serve as the proverbial canary in the coal mine in warning us of a developing and disturb - ing worldwide trend. Theo Colborn, a professor of zoology at the University of Florida and a lead - ing voice on EDCs (in fact, she coined the term “endocrine disruptor” in 1991), noted the correlation between animals and humans: “In the animals, it was at the population level that we really began to realize what was going on. If we’re going to wait to see population effects for all of these concerns that we have in the human population, it’s going to be too late.” 2 What’s A Water Treatment Professional To Do? While awaiting consensus from the scien - tific community or regulations from the EPA, there are steps that drinking water treatment facilities can take to protect their customers from dangerous PPCPs. The AP notes in its report that, “One technology, reverse osmosis, removes virtually all pharmaceutical contami - nants.” A 2009 report published by the University of New Mexico (UNM) echoed the endorsement of reverse osmo - sis, while also finding that activated carbon (both powder and granular) is “highly effective in removing most targeted compounds to a high degree.” 10 The UNM study further acknowledged the ability of advanced oxidation processes (AOPs) such as ozone and UV/H2O2 (ultraviolet radiation in the presence of hydrogen peroxide) to completely oxi - dize many targeted PPCPs and EDCs. On the flipside, UNM reported that most conven - tional oxidants, namely chlorine, are not very effective at degrading PPCP compounds. The AP goes one step farther, warning, “There’s evidence that adding chlorine, a common process in conventional drinking water treat - ment plants, makes some pharmaceuticals more toxic.” Because PPCPs are so pervasive, with different properties that may require different treatment strategies, it’s unrealistic to expect to completely eliminate them from our environ - ment and drinking water any time soon. The focus, then, should be on identifying and removing the most harmful among them. Water utilities should urge the EPA to not only consider the latest studies, but also to conduct many more in determining a strategy for the mitigation of PPCPs. If high occurrence of PPCPs is already suspected or known by local officials, utilities may want to preempt regulatory actions by the EPA and adopt one of the afore - mentioned treatment techniques deemed most effective. At the very least, they should advise consumers to never flush unused pharmaceuticals down the toilet, which was once the recommended dis - posal technique before the EPA and FDA got wise. While a complete understanding of the effects of PPCPs and EDCs still escapes us, common sense suggests that the continuous, increasing, and haphaz - ard introduction of manmade chemicals into the environment, especially prov - en endocrine disruptors, is not without consequence. Just this year, the World Health Organization (WHO) and the United Nations Environment Programme (UNEP) acknowledged in a joint study that “Known EDCs are only the ‘tip of the iceberg’ and more comprehensive testing methods are required to identify other possible endocrine disruptors.” 11 In other words, the impacts are likely worse than we realize. The study concluded that, “As science continues to advance, it is time for both management of endocrine disrupting chemicals and further research on exposure and effects of these chemicals in wildlife and humans.” It may be too late for the boys that never were, but it’s a step in the right direction for the sons and daughters — especially the sons — of the future.
n References 1. http://www.anh-usa.org/chemicals-in-your-home-are-toxic/ 2. http://thetyee.ca/News/2013/06/17/Gender-Bending-Chemicals/ 3. Environ Health Perspect. 2007 Jun;115(6):941-6. Epub 2007 Apr 9. 4. http://www.cbc.ca/documentaries/doczone/2008/disappearingmale/ infertility.html 5. http://medical-dictionary.thefreedictionary.com/Endocrine+Disruptor 6. Environ Sci Technol. 2011 Jan 1;45(1):51-60. doi: 10.1021/es1014482. Epub 2010 Oct 26. 7. http://hosted.ap.org/specials/interactives/pharmawater_site/ 8. Environ Health Perspect. 2005 Oct;113(10):1295-8. 9. Endocrine Reviews March 14, 2012 er.2011-1050 10. “State of Knowledge of Pharmaceutical, Personal Care Product, and Endocrine Disrupting Compound Removal during Municipal Wastewater Treatment,” April 17, 2009. Carson O. Lee, Dr. Kerry J. Howe, P.E., BCEE, Dr. Bruce M. Thomson, P.E. 11. WHO/PCS/EDC/02.2
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