Types and quantities of leftover drugs entering the environment via disposal to sewage — Revealed by coroner records ☆ Ilene Sue Ruhoy a , Christian G. Daughton b, ⁎ a Department of Environmental Studies, University of Nevada, Las Vegas, 4505 Maryland Parkway, Box 45030, Las Vegas, NV 89154, United States b Environmental Chemistry Branch, National Exposure Research Laboratory, US Environmental Protection Agency, 944 East Harmon Avenue, Las Vegas, Nevada 89119, United States Received 29 May 2007; received in revised form 30 July 2007; accepted 3 August 2007 Abstract Pharmaceuticals designed for humans and animals often remain unused for a variety of reasons, ranging from expiration to a patient's non-compliance. These leftover, accumulated drugs represent sub-optimal delivery of health care and the potential for environmentally unsound disposal, which can pose exposure risks for humans and wildlife. A major unknown with respect to drugs as pollutants is what fractions of drug residues occurring in the ambient environment result from discarding leftover drugs. To gauge the significance of leftover drugs as potential pollutants, data are needed on the types, quantities, and frequencies with which drugs accumulate. Absence of this data has prevented assessments of the significance of drug accumulation and disposal as a contributing source of drug residues in the environment. One particular source of drug accumulation is those drugs that become “orphaned” by the death of a consumer. A new approach to acquiring the data needed to assess the magnitude and extent of drug disposal as a source of environmental pollution is presented by using the inventories of drugs maintained by coroner offices. The data from one metropolitan coroner's office demonstrates proof of concept. Coroner data on leftover drugs are useful for measuring the types and amounts of drugs accumulated by consumers. This inventory also provides an accurate measure of the individual active ingredients actually disposed into sewage by coroners. The types of questions these data can address are presented, and the possible uses of these data for deriving estimates of source contributions from the population at large are discussed. The approach is proposed for nationwide implementation (and automation) to better understand the significance of consumer disposal of medications. © 2007 Elsevier B.V. All rights reserved. Keywords: Coroner; Disposal; Pharmaceuticals; Patient compliance; Environmental pollution; Sewage 1. Introduction Understanding the scope and magnitude of medica- tion disposal is required for providing: (1) more accurate and comprehensive data for models used for predicting amounts or concentrations of active pharmaceutical ingredients (APIs) introduced to the environment, and (2) a better understanding of the prescribing, dispensing, and consumer consumption practices that lead to the Science of the Total Environment xx (2007) xxx – xxx + MODEL STOTEN-10159; No of Pages 12 www.elsevier.com/locate/scitotenv ☆ US EPA Notice: The United States Environmental Protection Agency through its Office of Research and Development funded and managed the research described here. It has been subjected to Agency's administrative review and approved for publication as an EPA document. ⁎ Corresponding author. Tel.: +1 702 798 2207; fax: +1 702 798 2142. E-mail address: daughton.christian@epa.gov (C.G. Daughton). 0048-9697/$ - see front matter © 2007 Elsevier B.V. All rights reserved. doi:10.1016/j.scitotenv.2007.08.013 ARTICLE IN PRESS Please cite this article as: Ruhoy IS, Daughton CG ., Types and quantities of leftover drugs entering the environment via disposal to sewage — Revealed by coroner records, Sci Total Environ (2007), doi:10.1016/j.scitotenv.2007.08.013