Managing pharmaceutical waste from households in Hong Kong

Environmental contamination by pharmaceutical residues (PRs) represents an emerging concern for sustainability of public health and the environment, particularly in rapidly urbanizing areas. Recent studies have confirmed that risks to ecosystems and human populations must be examined more thoroughly and high priority research needs are identified. Documented ecological impacts from PRs include but do not limit to extensive mortality of vultures on Indian subcontinent and feminization of gudgeon. This problem has not been contained despite initial actions from Europe and the USA. One reason is that world’s drug demand has been increasing due to ageing and increasing population.

Important information, e.g. how much and what type of PRs are being added to the environment every year, where in the built environment is the best place to remove them from entering the environment and what schemes are most effective in collecting unused pharmaceuticals, are largely unknown for Asian countries including China. Although environmental information in general are more complete and readily available in Hong Kong, a Special Administrative Region of China, than other Chinese cities, the sources and the environmental effect of PRs in Hong Kong are similarly unknown. Further, available information collected using robust analytical methods and QAQC programs are largely lacking from this region. Thus, it is imminent to initiate a surveillance program and develop an effective reverse logistics scheme to arrest the growing problem in such a fragile and stressed environment before irreversible damages are inflicted.

There are two main sources of environmental PRs. One is discharges from drug manufacturing plants and another, which is also believed to be the main source, is through routine domestic application and consumption. This study focuses on the management of the latter. A comprehensive survey on the general public will be conducted to find out the estimated amount of unwanted pharmaceuticals generated from Hong Kong. A series of interviews with primary stakeholders such as pharmacy operators and (outpatient) clinics will be conducted to examine the possibility of setting up a return programme within this network. A parallel workstream is to measure the environmental concentrations of targeted pharmaceuticals, including antibiotics, and other effluent tracer in the wastewater system and aquatic ecosystems in Southern China. This information will then be translated using a novel modeling approach to estimate surface water quality hazards. The feasibility of a setting up the take-back logistics of unwanted pharmaceutical will be examined to conclude this study.