Pharmaceuticals in wastewater: Behavior, preferences, and willingness to pay for a disposal program

Kotchen, Matthew J.; Kallaos, James; Wheeler, Kaleena; Wong, Crispin; Zahller, Margaret

doi:10.1016/j.jenvman.2008.10.002

Cited by 125 publications

(121 citation statements)

References 23 publications

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“…Several international studies have shown that 48-75% of their population are aware that improper disposal of unwanted medication will lead to contamination of the environment. [9][10][11][12] The most common way to discard unwanted medication in majority of the countries is to throw it into the trash, [13][14][15][16] except for the Swedish where returning to the pharmacy is the predominant method to "dispose" unused medication. [17] A systematic review reported that due to the paucity of evidence, connection between knowledge on environment impact of inappropriate disposal and the preference toward disposal method cannot be established.…”

Section: Introductionmentioning

confidence: 99%

Utilization of Ministry of Health Medication Return Programme, Knowledge and Disposal Practice of Unused Medication in Malaysia

Yang¹,

Tan²,

Goh³

et al. 2018

JPPCM

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Objective: (1) To report the awareness on MRP and its utilization rate. (2) To assess environment awareness with regards to improper disposal. (3) To explore practices toward unused medication. Methods: A cross-sectional study was conducted in 33 out-patient pharmacies in Sabah healthcare facilities. Quota sampling was used to recruit 244 subjects. Data collector from each facility was identified and trained prior to data collection. Self-reporting questionnaire captured data of socio-demographic, awareness on MRP and patient's knowledge and practice towards unused medication. Independent t-test and chi square test were performed to detect differences and association. Result: Subject mean (SD) age was 45.1(15.5) years and almost two-third (60%) of the subjects were female. Majority (73%, 95%CI 67-78%) knew that inappropriate disposal of medication will cause environmental hazard. Only 54% (95% CI 47-60%) had heard of MRP, 26% (95%CI 21-32%) had utilized MRP to return unused medication.Subject's awareness on environmental hazard and MRP were associated with their practice to return unused medication (p=0.001 and p<0.001 respectively). Mean years of education and median family income were significantly different between the aware and unaware group respectively [11.3(6.0) vs 8.9(4.5) yrs, p=0.003; RM2000 vs RM1260, p<0.001]. The most common unused medication were analgesics (27.1%), antihypertensive (24.4%), antiglycemic (14.7%) and supplements (12%). The two predominant methods to "dispose" unused medication at home were through garbage (47.8%) and return to healthcare facilities (30.0%). Conclusion: This study has established the evidence for public awareness on MRP, environment awareness and disposal practice of Malaysian citizen. Creative and innovative recommendations have been made for MRP promotion and to improve public knowledge on safety disposal of unused medication.

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Section: Introductionmentioning

confidence: 99%

Utilization of Ministry of Health Medication Return Programme, Knowledge and Disposal Practice of Unused Medication in Malaysia

Yang¹,

Tan²,

Goh³

et al. 2018

JPPCM

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“…Additional studies investigated various strategies for efficient removal and transformation of pharmaceuticals using advanced treatment employing processes of chemical [32,[40][41][42][43], biological [44][45][46][47] and physical nature [48,49]. Since not all pharmaceuticals present in sewage are the result of intentional intake, metabolism and excretion, some researchers have investigated the composition of wastewaters from the pharmaceutical industry [50], and healthcare facilities [51], as well as the importance of disposal of unwanted or leftover pharmaceuticals into sanitary sewers [1,2,[52][53][54][55][56].…”

Section: Introductionmentioning

confidence: 99%

Pharmaceuticals in the Built and Natural Water Environment of the United States

Deo

Halden

2013

Water

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Abstract:The known occurrence of pharmaceuticals in the built and natural water environment, including in drinking water supplies, continues to raise concerns over inadvertent exposures and associated potential health risks in humans and aquatic organisms. At the same time, the number and concentrations of new and existing pharmaceuticals in the water environment are destined to increase further in the future as a result of increased consumption of pharmaceuticals by a growing and aging population and ongoing measures to decrease per-capita water consumption. This review examines the occurrence and movement of pharmaceuticals in the built and natural water environment, with special emphasis on contamination of the drinking water supply, and opportunities for sustainable pollution control. We surveyed peer-reviewed publications dealing with quantitative measurements of pharmaceuticals in U.S. drinking water, surface water, groundwater, raw and treated wastewater as well as municipal biosolids. Pharmaceuticals have been observed to reenter the built water environment contained in raw drinking water, and they remain detectable in finished drinking water at concentrations in the ng/L to μg/L range.

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“…This situation calls for regulations and subsidies from the government who could levy a disposing tax on the pharmaceutical industry or medication users, and then assist the RSC for UMs. Kotchen et al [40] made a survey to study the residents' willingness to pay for a disposal program, and the results show that the conservative estimate of mean willingness to pay is $1.53 per prescription and this assumption implies $320 million for the United States as a whole, which easily outweighs the costs of establishing disposal programs.…”

Section: Discussionmentioning

confidence: 99%

Game Theoretic Analysis of Pricing and Cooperative Advertising in a Reverse Supply Chain for Unwanted Medications in Households

2017

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Improper disposal of household unwanted medications (UMs) is an emergency problem around the world that adversely affects the sustainability of the environment and human's health. However, the current disposal practices, mainly based on advertising and collecting status, are unsatisfactory in most countries and regions. Thus, some scholars proposed an alternative disposal practice that is to provide incentives to customers. This study aims to compare a Single Model (advertising only) with a Joint Model (advertising with take-back pricing) in a two-echelon reverse supply chain (RSC) that is composed of one disposer and one collector. In each model, four games (non-cooperative, collector as the Stackelberg leader, disposer as the Stackelberg leader, and cooperative) were established in order to identify the optimal pricing and advertising strategies for both members. The results of the study indicate that there is a Pareto dominant range for Joint Model compared to Single Model, whereas Single Model has no Pareto improvement in any games. Furthermore, in non-cooperative games of Joint Model, it is better to implement the leader-follower structure rather than simultaneous movement structure. Additionally, it is verified that the cooperative game is feasible, which leads to the cooperation between the disposer and the collector, and the extra profit from the cooperation can be shared based on the Nash bargaining game. However, in Single Model, it is better for the disposer to act as a channel leader and the collector figures the follower.

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Pharmaceuticals in wastewater: Behavior, preferences, and willingness to pay for a disposal program

Cited by 125 publications

References 23 publications

Utilization of Ministry of Health Medication Return Programme, Knowledge and Disposal Practice of Unused Medication in Malaysia

Utilization of Ministry of Health Medication Return Programme, Knowledge and Disposal Practice of Unused Medication in Malaysia

Pharmaceuticals in the Built and Natural Water Environment of the United States

Game Theoretic Analysis of Pricing and Cooperative Advertising in a Reverse Supply Chain for Unwanted Medications in Households

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