Sweden considers the case for action on pharmaceuticals in sewage

Cover story


Sweden has been investigating the issue of pharmaceuticals in the environment, and of micropollutants more generally, and recently saw commissioning of its first large-scale sewage treatment plant application of treatment to remove these contaminants. Earlier this year, the Swedish Environmental Protection Agency recommended to the country’s government that action is taken to treat pharmaceuticals at sewage treatment plants, a step that would also help tackle micropollutants. Keith Hayward heard from Linda Linderholm about the agency’s recommendations, while the accompanying articles look in more detail at the key reports that informed the call for action.

Bronze sculpture of The Thinker by Auguste Rodin at the Prince Eugens Museum, Stockholm. © Stefan Holm / Shutterstock
Bronze sculpture of The Thinker by Auguste Rodin at the Prince Eugens Museum, Stockholm. © Stefan Holm / Shutterstock

Pharmaceuticals in the environment represent a complex issue, not least because of the sheer number of different substances that are in use – several thousand in somewhere around 20,000 products in the case of Sweden. One point of certainty though is that sewage treatment plants feature prominently in this issue. Excreted pharmaceuticals are carried to them in sewage, as are unwanted medicines that are flushed down toilets or poured down sinks.

‘Their path to get to the environment is through the wastewater treatment plant,’ comments Linda Linderholm, environmental scientist with the Swedish Environmental Protection Agency. Sewage treatment plants therefore represent part of the problem, but at the same time they are potentially part of the solution. ‘That is one place where you could do something,’ adds Linderholm.

Switzerland and parts of Germany are already taking action on pharmaceuticals and installing more advanced processes at sewage treatment plants. Now Sweden is moving in that direction also. Earlier this year, the Swedish EPA responded to a government commission to assess the need for advanced treatment in wastewater treatment plants to reduce the emission of pharmaceuticals. The top-line message of the report is that the EPA sees a need for the introduction of advanced treatment of pharmaceutical substances in wastewater. The EPA adds that this move can be further justified by the fact that the additional treatment would help tackle other hazardous substances and low-level pollutants – micropollutants. ‘It was not only due to the pharmaceuticals but due to other pollutants as well,’ says Linderholm.

The recommendations of the report are based in particular to two recent assessments the agency commissioned. The overall message is that there is a clear need for action. ‘That is the way we see it,’ comments Linderholm.


Clarity and complexity

The EPA’s clarity over the need for action is based on a broad view of the concerns around pharmaceuticals as well as some specific evidence.

In its report to government, the EPA says that the need for action can be justified broadly on the possibility of adverse effects on aquatic organisms due to the long-term effects of a constant exposure to low levels of pharmaceuticals.

On top of this, it sees that some pharmaceutical substances accumulate in the environment, and that treatment can be justified on the basis of the precautionary principles it says are enshrined in the Swedish Environmental Code.

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  • Sweden, pharmaceuticals, micropollutants