17 hours ago
Drugs are intended to cure, instead they're becoming water contaminants
In the 1950s, the Chisso Corporation operated in the small Japanese town of Minamata.
During that time, the company began producing acetaldehyde, a chemical used in the manufacturing of plastics.
The production process generated mercury as a byproduct, which is a highly toxic substance.
For 34 years, the Chisso Corporation discharged its industrial waste, including mercury, directly into Minamata Bay, a primary food source for the local community.
As a result, the people of Minamata began to suffer from mercury poisoning.
Over 2,000 people died, and thousands more experienced debilitating symptoms.
The disease was also passed on to future generations, with many children born with severe deformities and neurological disorders.
How does this relate to the disposal of medicines in Malaysia?
The Minamata disaster serves as a grim reminder of how unchecked pollution can lead to catastrophic human suffering.
Similarly, improper disposal of medicines can introduce harmful chemicals into the environment, posing significant risk to human health and the ecosystem.
Several studies have examined the presence of pharmaceutical residues in Malaysia's water supply.
One notable study conducted in 2010 involved sampling tap water from 80 households in Putrajaya.
The analysis detected multiple active pharmaceutical ingredients (APIs) in the tap water; including antibiotics (e.g. amoxicillin, chloramphenicol, ciprofloxacin, nitrofurazone and sulfamethoxazole), steroids (such as dexamethasone) and nonsteroidal anti-inflammatory drugs (such as diclofenac which is commonly used as a painkiller).
These pharmaceutical residues in tap water was linked to improper handling and disposal of pharmaceutical waste by the surrounding households.
The study also highlighted low public awareness regarding pharmaceutical waste management, revealing that only 44.5% of the participants had good knowledge about proper pharmaceutical handling, while a mere 1.6% demonstrated good practices related to medicine disposal.
In line with these findings, a more recent global study conducted in 2021 further highlighted the severity of pharmaceutical contamination in water sources.
The study, which analysed samples from 1,052 locations across 104 countries, found that 25.7% of the sites had at least one API present at concentrations exceeding safe environmental thresholds.
Malaysia was among the countries included, with alarming results reported in the Kajang River in Selangor, where 14 different APIs were found.
These included various types of antibiotics, antidepressants, antidiabetics, heart medicines and other pharmaceutical substances.
Notably, the Kajang River was ranked 19th as the most polluted river catchments in the study. Globally, Malaysia is among the countries with alarming levels of pharmaceutical contamination in water sources.
Why is this happening?
The presence of pharmaceutical chemicals in Malaysian water supplies can be attributed to the limited capacity of existing sewage treatment plants to effectively remove complex pollutants.
The current infrastructure of these facilities lacks the advanced filtration systems required for the complete removal of pharmaceutical residues.
As a result, many of these substances remain in the water and persist in the environment.
If the question arises as to who is responsible for polluting the water supplies, the unfortunate answer is that the pollution largely originates from human activities, including those related to the way these pharmaceutical wastes are disposed of.
In Malaysia, the most common methods to dispose of expired or unused medicines are by discarding them in household garbage bins or by flushing them down the toilet.
Both practices contribute to the contamination of water supplies.
Disposing of medicines in domestic thrash leads to the leaching of pharmaceutical waste from landfills into groundwater or nearby rivers.
On the other hand, flushing medicines into the toilet bowl or pouring them into the sink introduces these substances directly into aquatic environments such as rivers, lakes and seas.
Besides improper disposal methods, the accumulation of unused medicines at home also contributes significantly to this issue.
Stockpiling of medicines often leads to the need for disposal, but due to a lack of awareness about proper disposal methods, many individuals discard medicines in ways they believe are harmless, without realising the potential impact on human health and the environment.
There are several reasons for stockpiling of medicines at home.
One of those reasons is when patients obtain medicines supplies from multiple healthcare facilities despite already having sufficient stock.
There are also changes in treatment regimen based on the patient's current health status, which can contribute to the issue.
Additionally, some people purchase medicines without genuine need, storing them temporarily for emergencies.
Furthermore, non-adherence to prescribed medicine regimens is common, particularly among patients with chronic diseases.
This non-adherence can occur for various reasons e.g. patients who experience serious side effects may stop taking their medicines.
Others may discontinue treatment once they feel better or decide to switch to alternative remedies.
What can we do?
Fortunately, it is not too late to address the issue.
Various strategies can be implemented to reduce pharmaceutical pollution in water sources, and one such initiative is the MyMediSAFE.
This initiative is a structured initiative aimed at promoting the proper disposal of medicines.
It enables members of the public to return expired or unused medicines to designated collection points.
MyMediSAFE is a collaborative effort between the Health Ministry and various strategic partners from both the public and private sectors, including community pharmacies and pharmaceutical companies.
To help prevent pollution of water sources and the environment caused by pharmaceutical waste, members of the public are encouraged to dispose of their medicines properly and safely through the MyMediSAFE. Expired or unused medicines can be returned to designated collection points at healthcare facilities. — Photos: Filepic
The first step involves checking and sorting all expired or unused medicines from those in good condition.
These may include tablets, capsules, liquids, powders and other forms of medicines.
It is important to remove any personal information and hologram security labels from the medicines packaging to ensure privacy protection.
The medicines need to be packed in a suitable container such as a used paper bag.
Next, individuals can visit the official MyMediSAFE website at to locate the nearest medicine collection centre.
Once at the collection centre, they can place their medicines into the designated disposal bin.
They are also encouraged to complete a simple survey by scanning the QR code displayed at the medicines disposal bin.
In conclusion, the presence of pharmaceutical residues in Malaysia's water sources highlights the need for greater public awareness and proper disposal practices.
Through efforts like the MyMediSAFE, individuals can help prevent further pollution and protect both the environment and public health.
Collaborative efforts from all sectors are required to safeguard future generations from the impact of pharmaceutical waste.
For any inquiries regarding medicines, please call the National Pharmacy Call Centre (NPCC) at the toll-free number 1-800-88-6722 during weekdays from 8am to 5pm, except on public holidays.
Kernas is a pharmacist at the Pharmaceutical Services Division, Negeri Sembilan State Health Department. This article is courtesy of the Health Ministry's Pharmacy Practice and Development Division. For more information, email starhealth@ The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
