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2010 | Buch

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Green and Sustainable Pharmacy

herausgegeben von: Klaus Kümmerer, Maximilian Hempel

Verlag: Springer Berlin Heidelberg

Enthalten in: Springer Professional "Wirtschaft+Technik" , Springer Professional "Technik"

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Über dieses Buch

Within recent years pharmaceuticals have come into focus as contaminants of the environment (see for example Kümmerer, K. editor: Pharmaceuticals in the Environment). At the same time the issue of sustainable chemistry gained momentum. Bringing both together would result in sustainable pharmacy. Sustainable pharmacy is a totally new issue and approach. It addresses environmental, economical and social aspects of pharmacy. In the present stage the focus will be on environmental issues along the whole lifecycle of a pharmaceutical entity. That is dealing with resources and energy input but also with waste issues for example during the synthesis and production of an active pharmaceutical ingredient. Furthermore, it would also look on the compounds themselves and will aim to improve the degradability of the compounds after their use in the environment to reduce the environmental risk caused by pharmaceuticals in the environment. Another issue is the people using pharmaceuticals such as pharmacists, medical doctors and patients. How can they contribute to more efficient use of pharmaceuticals with less environmental burden and less risk for drinking water. The book "Sustainable Pharmacy" will address all these issues and will be the first one dealing with this important topic.

Inhaltsverzeichnis

Frontmatter

General aspects

Chapter 1. Why Green and Sustainable Pharmacy?

Abstract

First reports on the presence of pharmaceuticals in the environment were published in the early 1970s, but it was not until better analytical instruments became available that scientists began to develop a real interest in the topic. When in the 1990s concerns began to grow about the presence of pharmaceuticals in drinking water, the subject also aroused increased interest among the general public. Since then, pharmaceuticals in the environment have continued to be a “hot bed” of interest, as demonstrated by the huge number of publications (for an overview see the book “Pharmaceuticals in the Environment. Sources, fate effects and Risk”, Springer Publisher).

Klaus Kümmerer

Chapter 2. Pharmaceuticals in the Environment: Moving from a Problem to a Solution

Abstract

Despite the fact that concern was raised a few decades ago about the (probable) presence of human pharmaceuticals in the aquatic environment (e.g. Aherne et al.) , the issue received little attention until two discoveries coincided. One was the finding by several analytical chemists, Thomas Ternes in particular, that many different human pharmaceuticals were present in effluents of sewage treatment works (STWs) (Ternes ).

John P. Sumpter

Chapter 3. Pharmaceuticals in Society

Abstract

The great discoveries in biology of the twentieth century have enormous potential to improve global health. There are, however, many challenges. How do we handle the fact that one billion people are overweight and obese while one billion are undernourished? That drugs for poor people are often considered to be a bad investment? Sick care or health care? Can health care be delivered effectively through a profit-driven “free market” system? What will be the role of pharmaceuticals in the twenty-first century? This role must be considered not only from a scientific perspective, but also from global social and economic perspectives.

David J. Triggle

Chapter 4. Green(er) Pharmacy

Abstract

Although the issue of pharmaceuticals in the environment has been known for many years in some quarters, it has recently come to the attention of the general public in a much more substantive way. This has led to a growing body of research on environmental risk assessment and the environmental classification of drugs, as well as on the stewardship of drugs post-manufacturing (Kümmerer 2007). As with any chemical-containing article it is important that we understand, control, avoid or minimise the impact of the drugs entering the environment, and the deliberately high biological activity of active pharmaceutical ingredients (APIs) makes this especially important. There are many authoritative publications on the impact of pharmaceuticals on the environment post consumer use, and so these issues will not be addressed in any significant way in this chapter, but very little work has been carried out on determining the environmental impact of pharmaceuticals prior to administration to the patient.

James H. Clark, Simon W. Breeden, Louise Summerton

Chapter 5. Creating a Sustainability Culture – A (Human Resources) Management Perspective for Sustainable Pharmacy

Abstract

Given today’s worldwide financial crisis, there was never a more appropriate moment to reflect on the relevance of Sustainability in businesses! Since future generations will mainly have to bear the costly results of the far too short-term, non-sustainable focus of many business leaders, now is the time to push the envelope towards a much more sustainable approach across the entire value creation chain; now is the time to onboard for a significant change in the way we do business.

Michael Läufer

Chapter 6. Reducing the Ecological Footprint of Pharmaceutical Usage: Linkages Between Healthcare Practices and the Environment

Abstract

The design of pharmaceuticals and the practices surrounding the lifecycle of their manufacture and usage are central to minimize their impacts on the environment and increase the sustainability (see Kümmerer, Chaps. 1 and Chaps. 9, this book) of healthcare. Cradle-to-cradle design, as conceptualized by McDonough and Braungart, could play a key role in redesigning healthcare and reducing its environmental footprint (Daughton 2003). This chapter examines the following thesis involving the environmental sustainability of medication usage: “When actions designed to reduce the potential for environmental impact are integrated within the existing systems of pharmacopeia, pharmacy, and healthcare, significant natural collateral outcomes include improvements in the quality and efficiency of healthcare and in human well-being.” The major factors that could shape the future for sustainability of healthcare are discussed.

Christian G. Daughton, Ilene S. Ruhoy

Development, Synthesis and Production and Disribution of Pharmaceuticals

Chapter 7. Ecopharmacostewardship – A Pharmaceutical Industry Perspective

Abstract

Until the late 1990s, the environmental impact of the pharmaceutical industry was universally considered to be very minor. Any environmental impact was considered to arise from manufacturing facilities and these were relatively small in size with well controlled emissions. It was appreciated that the pharmaceuticals themselves were biologically active, but in view of the small quantities being manufactured and the high cost of production, releases to the environment from manufacturing were expected to be very small.

David Taylor

Chapter 8. Protein and Peptide Therapeuticals: An Example of “Benign by Nature” Active Pharmaceutical Ingredients

Abstract

Protein and peptide therapeuticals (PPTs) form a relatively recent class of active pharmaceutical ingredients (APIs) (Leader et al. 2008). Mostly, they consist of biotechnologically produced monoclonal antibodies and peptide hormones, but there are also examples isolated from natural tissues, as well as some chemically synthesised peptides. The monoclonal antibodies in particular are highly specific and therefore constitute precisely targeted APIs. In certain cases these PPTs may be covalently bound to long-chained polyethylene glycol (PEG) as so-called PEGylated PPTs, which show significantly prolonged elimination half-lives (Webster et al. 2007).

Jürg Oliver Straub

Chapter 9. Rational Design of Molecules by Life Cycle Engineering

Abstract

The history of pharmaceutical sciences is an impressive success story. The products of the pharmaceutical industry help to maintain the modern way of living, and contribute to our high living standard and health. Today, proper and effective treatment of emissions and prevention of emissions into air, water and soil is in practice in developed countries and will hopefully day become commonplace around the world. It has been known since the turn of the twentieth century that pharmaceutical products themselves cause environmental pollution and that they may, due to their very nature, present a health risk for the consumer. These molecules end up in the environment, not because of improper use, but, paradoxically, because of proper use.

Klaus Kümmerer

Use and Disposal of Pharmaceuticals

Frontmatter

Chapter 10. Options for a More Environmentally Friendly Handling of Pharmaceuticals

Abstract

Findings from a large number of studies on pharmaceutical residues in the water cycle, particularly drinking water, are now available (for an overview see Schulte-Oehlmann et al. 2007, Sumpter, Chap. 2, this book). The paths by which they enter the environment are also known. In the course of normal use, medications are taken by patients, metabolised within the body and subsequently excreted, largely in urine. Human pharmaceuticals can also end up in the water cycle as a result of inappropriate household disposal via the washbasin or toilet.

Konrad Götz, Jutta Deffner

Chapter 11. Disposal of Pharmaceutical Waste in Households – A European Survey

Abstract

Pharmaceutically active compounds are created to have specific physicochemical and biological properties. While such characteristics are necessary to deliver the desired therapeutic effect, many pharmaceutical products have an impact on the aquatic environment (comprehensive information on sources, fates and effects in K Kümmerer Pharmaceuticals in the Environment 2008). In an EEA report (European Environment Agency 2010) on “Pharmaceuticals in the Environment” the results on a workshop including proposals for action are summarised.

Gerald Vollmer

Chapter 12. Pharmaceutical Waste: The Patient Role

Abstract

The manufacture and use of pharmaceuticals will always be connected with the generation of various categories of waste containing active pharmaceutical ingredients (APIs) and excipients, their transformation products and unwanted by-products. The release of these often highly biologically active chemicals into the environment must be controlled to prevent unacceptable consequences to the environment or to people’s health.

Staffan Castensson, Anders Ekedahl

Chapter 13. Forecast of Pharmaceutical Consumption in the Netherlands Using Demographic Projections

Abstract

One of the main factors likely to shape future developments in public health and health care services are demographic changes in the population. Demographic (population) projections are “what-if” scenarios that provide an estimate of future size and structure of the population. Such projections take into account both increases driven by growth of the population and structural changes in the population, such as an ageing population. All other things being equal, the consequence of a larger population is an increase in the number of people requiring health care, while that of population ageing is an increased incidence of illnesses associated with older patients.

Monique van der Aa, Geertjan Kommer

Emission Management

Frontmatter

Chapter 14. Point Sources of Human Pharmaceuticals into the Aquatic Environment

Abstract

It is generally accepted that treated sewage effluent discharges are the principal source of pharmaceutically active compounds and their metabolites from humans into the aquatic environment (Daughton and Ternes 2000, Heberer 2002). As has been discussed in other chapters of this book in order for the sustainable use of pharmaceuticals to become a reality there is a need to understand the complete life cycle of a pharmaceutical compound including the various pathways by which it can enter the aquatic environment.

Kevin V. Thomas, Katherine H. Langford

Chapter 15. Pharmaceuticals for Human Use: An Integrated Strategy for Reducing the Contamination of Water Bodies

Abstract

Pharmaceuticals are in many cases an indispensable element of a comfortable and healthy life. Nevertheless, there is also a downside to the extensive use of medicinal products: their impact on the environment. Since the early 1990s, research findings have confirmed the occurrence of a wide range of human and veterinary active pharmaceutical ingredients (API) in surface waters, in groundwater and occasionally even in drinking water. Moreover, an increasing volume of data shows that specific substances can also trigger negative effects in animals and plants (for an up-to-date overview cf. Kümmerer 2008, SRU 2007). It still remains scientifically uncertain which risks to humans and the environment actually exist. It must be expected, however, that the problem will be aggravated in coming years, since the demographic development in Europe towards increasingly aging societies will bring with it an increase in consumption of medicinal products (see van der Aa and Kommer, Chap. 13, this book). The need for precautionary action is therefore more and more indicated.

Florian Keil

Chapter 16. Experiences with the Swedish Environmental Classification Scheme

Abstract

The European Commission launched, in November 2001, a proposal for a new directive on medicinal products for human use within the community. In accordance with the EU process for co-decision, the proposal was submitted to Parliament for reading. In that process a suggestion was raised in Parliament that the Commission should develop an environmental classification system for human medicinal products. The rationale behind the suggestion was the emerging evidence that used human medicinal products often reach the aquatic environment, after normal use or after disposal of unused or expired medicines. The suggestion from Parliament on environmental classification of human medicines was not accepted by the Commission at that time, but the rejection was considered “soft”, i.e. a door was kept open that such a system might be considered later.

Åke Wennmalm, Bo Gunnarsson

Incentives, Regulation and the Market

Frontmatter

Chapter 17. European Regulations

Abstract

This chapter reviews key existing policy instruments and approaches at EU level that are relevant to limiting the discharge of pharmaceutical products (PPs) into the aquatic environment. EU policies treated in this review address issues of authorisation of PPs, pollution prevention, wastewater treatment as well as monitoring of environmental quality. The analysis serves as a basis for the identification of potential gaps in current approaches. Future policy action might build on this assessment in order to reduce the risk of harmful impacts to the environment.

Eleftheria Kampa, Thomas Dworak, Cornelius Laaser, Rodrigo Vidaurre

Chapter 18. Regulation and the Market-Incentives

Abstract

Pharmaceutical products (PPs) have been detected in surface, ground and drinking waters in Europe and worldwide. This has raised concerns about potential impacts on humans and organisms in the environment. Regulators are now acting on these concerns. For example, Sweden’s Stockholm County Council has been working toward the assessment and classification of pharmaceuticals according to their environmental impact (see Wennmalm and Gunnarsson, Chap. 16, this book). An environmental label is being introduced in Sweden with the assistance of the pharmaceutical industry, which would enable the physician and the patient, where medications of similar action and efficiency are available, to select the treatment that is more environment friendly. The European Union is proposing more extensive environmental testing for product registrations while others are investigating mitigation measures such as take-back schemes, water treatment upgrades and labelling revisions (Wennmalm and Gunnarsson 2009). Other ideas involve incentives for development and market introduction of “green” pharmaceuticals and raising public awareness of the issues surrounding the environmental impacts of pharmaceutical products need strong support (Knappe 2008).

Benoît Roig, Evelyne Touraud

Chapter 19. Do Pharmaceuticals in the Environment Present an Investment Risk?

Abstract

The Sarasin Group is represented in 19 locations worldwide across Europe, the Middle East and Asia. By June 2009 it managed total client assets of CHF 80 billion and employed over 1,500 staff. Its majority shareholder is the Dutch Rabobank. Sustainable asset management is one of the three core investment styles offered by the bank. Here, stock selection is based not just on financial analysis, but also on environmental and social criteria. The sustainability of companies and industries is assessed by a team of nine experts on the basis of more than 70 criteria (Plinke 2007). In the bond segment, Sarasin’s analysts not only award sustainability ratings to companies, but also to countries and supranational organisations. Over the past 10 years the volume of assets that Sarasin manages according to sustainable principles has soared from CHF 626 million to CHF 10 billion.

Andreas Holzer

Outlook

Frontmatter

Chapter 20. Sustainable Health Products and Service Solutions in the Year 2050

Abstract

In this chapter we provide a vision of sustainable health products and service solutions in the future. Probably some will turn out to be wrong. However, forecasts can prevent certain unwanted developments. Another purpose is to trigger changes or initiate developments by playing the role of a self-fulfilling prophecy. In all cases, sustainability has proven to be a paramount paradigm not only of importance for the present but even more for the future.

Ludwig Metz, Klaus Kümmerer

Chapter 21. Summary and Outlook

Abstract

The fact that pharmaceuticals are present in the environment where they impact on wildlife is widely accepted nowadays. Although there is general agreement that the presence of pharmaceuticals in drinking water does not constitute an acute risk to human health, there is uncertainty about possible long-term health and environmental risks caused by pharmaceuticals in the environment and a need for action has been identified. The public perception is often driven by concerns about the quality of drinking water and possible adverse or at least undesirable effects on humans and organisms in the environment. The presence of pharmaceuticals in the environment has therefore stimulated public discussion on drinking water safety and research into fate and effects of active pharmaceutical ingredients (APIs) and adjutants in water and soil, and the related risks is under way. However, learning about this problem can only be the starting point. For pharmacy in general a broader view is needed and it is about time to learn how pharmacy can be more sustainable in general.

Klaus Kümmerer, Maximilian Hempel, Hans-Christian Schaefer, Florian Keil

Backmatter

Titel: Green and Sustainable Pharmacy
herausgegeben von: Klaus Kümmerer
Maximilian Hempel
Verlag: Springer Berlin Heidelberg
Electronic ISBN: 978-3-642-05199-9
Print ISBN: 978-3-642-05198-2
DOI: https://doi.org/10.1007/978-3-642-05199-9