ON PHARMACEUTICAL RESIDUES

ON DRUG RESIDUES IN URINE AND SLUDGE

1. When you fertilize with sludge, you add about the same amount of drugs as when you fertilize with urine. In Sweden, no drugs have been detected in any crop fertilized with sludge, even after about 35 years of sludge fertilization. Four drugs have been detected in the soil, three antidepressants and one blood pressure regulator (Magnér, J., Rosenqvist, L., Rahmberg, M., Graae, L., Eliaeson, K., Örtlund, L., … & Brorström-Lundén, E. (2016). Fate of pharmaceutical residues-in sewage treatment and on farmland fertilized with sludge. IVL report B2264), but between the soil and the crop we have the soil-root barrier that does not readily let large molecules through.

2. 26 different pharmaceutical substances were detected in Stockholm’s drinking water by Fick et al. (Fick, J., Lindberg, R.H., Kaj, L., Brorström-Lunden, E. (2011). Results from the Swedish National Screening Program 2010- Subreport 3 Pharmaceuticals. Report B2014, Swedish Environmental Research Institute IVL). However, this is not a danger and the drinking water in Stockholm is safe, but containing detectable levels of many pharmaceuticals does.

3. because the levels are so low that they cannot be measured, we simulated with a Canadian model how much drug you would ingest if all the wheat or carrots you ate were fertilized with toilet water (urine + faeces) as the only fertilizer. We concluded that it would take between 5000 years (carrot, child, losartan) and 4.2 billion years (carrot, adult, hydrochlorothiazide) to ingest a therapeutic daily dose of the drug and that the supply via the drinking water in Stockholm for the different drugs was 20-150,000 times greater. However, we were not allowed to keep the comparison with the drinking water in Stockholm in the report, which was funded by Swedish Water. They said that the comparison could scare people away from drinking the water in Stockholm, even though it is completely safe and of very high quality.

4. Concerns about ingesting some drugs are hugely exaggerated compared to the real risk. All medicines have gone through Phase 1, 2 and 3 trials in humans. These tests ensure that the drugs do not cause side effects. Moreover, the drugs that are available in larger quantities are those that many people take for a long time, such as blood pressure regulators and diuretics, which many people take for decades without side effects, which means that the risk if you accidentally ingest a hundred-millionth dose of the drug is completely negligible. Especially as medicines are designed to be rapidly excreted from the body. This is necessary so that the dose of the medicine can be easily controlled.

5. on the contrary, a reasonable number of researchers believe that all elderly people in the community should be given a polypill, a four-drug combination pill for high blood fats and high blood pressure. They claim that this would benefit public health and, according to one study, would roughly halve the risk of cardiovascular disease https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31791-X/fulltext.

6. thus: no pharmaceuticals detected in harvested products during sewage fertilization. Extremely low levels according to simulation. Drugs found in large amount in urine are used in therapeutic dose by many for many years without serious side effects.

7. This can be compared to the fact that the Swedish Food Agency detected pesticides in 24% of the Swedish conventionally grown grain samples, however, no sample above the limit value (Livsmedelsverket. Johansson, A and & Ahmed, T M. (2020). Control of pesticide residues in food in 2018. L 2020 no 16, Swedish Food Agency report series. Uppsala).

8. Pesticides are not tested on humans at all, let alone long-term, like drugs. The limit value is set by a safety factor, often 100 times, of the dose that causes organ damage in the test organism, often mice. The tests are not particularly long-lasting. The safety factor is therefore much smaller than the proportion of a therapeutic dose of a drug that can be ingested by eating a crop fertilized with urine. Moreover, the therapeutic dose does not cause any harm to humans even with long-term use.

9. assessing the toxicity of pesticides is difficult. As recently as a year ago, chlorpyrifos was banned by the EU because it was feared to cause nerve damage. It had been approved for many years before this was discovered. https://www.extrakt.se/bekampningsmedel-i-citrusfrukter-paverkar-hjarnans-utveckling/

10. The maximum amount of medicines applied per hectare in the case of urine fertilization is less than one gram per hectare (Figure 5, page 17 of the attached report). These drugs are applied to the soil before the crop has emerged. This can be compared with an average of 1.34 kg of active substance of herbicides and 2.53 kg of fungicides used in potatoes in Skåne in 2009/10 (page 18 of the attached report). The fungicide was sprayed on the blast of the almost finished potato repeatedly.

Overall: It is recognized that pesticides are present in much of the conventionally grown food. Pesticides are not tested on humans and the safety factor (usually 100) is not very high. The drugs that are present in larger quantities are used by many people daily for many years without side effects. This means very extensive testing on humans. Pharmaceuticals have not been detected in harvested crops in Sweden, but have been detected in drinking water in many cities (Stockholm, Gothenburg, etc.). Based on this evidence, it is not rational to be concerned about pharmaceuticals if you fertilize with urine, but still eat conventionally grown food and drink water.

HÅKAN JÖNSSON