Site Mitigation & Restoration Program

We protect and maintain California’s land and places
by setting strict standards for land restoration and cleanup

Human and Ecological Risk Office

Pharmaceutical Waste

What are Pharmaceuticals and Personal Care Products (PPCPs)?

Image showing pharmaceuticals spilt on a counter. The impropper disposal of pharmaceuticals can harm humans and the environment.

Pharmaceuticals and personal care products (PPCPs) comprise a diverse group of chemicals including, but not limited to, prescription and over-the-counter human drugs, veterinary drugs, diagnostic agents, nutritional supplements, and other consumer products such as fragrances, cosmetics, and sun-screen agents.1,2,3,4 The term PPCPs refers to the products we use for personal health or cosmetic reasons.2 We swallow them, rub them on to our skin, have them injected or administer them to our pets. We get them with a prescription or purchase them over the counter.

Why is DTSC Interested in PPCPs?

PPCPs are an emerging issue. PPCPs can be introduced into the environment through many routes.1,3,4 Treated and untreated domestic sewage containing excreted PPCPs and their metabolites following human use represents an important source of these compounds in the environment. Other sources which can potentially introduce PPCPs into the environment include: leaching from landfills following disposal of expired and unused products; disposal of expired and unused PPCPs in the toilet; release of unabsorbed externally applied PPCPs (e.g. lotions) to surface waters from activities such as swimming; excreta from animals including pets and other domestic animals; use of sewage solids and manure for soil amendment and fertilization; and industrial manufacturing waste streams. 

For example, several oral pharmaceuticals are metabolized in the body into less active forms which are then excreted largely into the urine.  In contrast, disposing of a pharmaceutical by flushing the pills or tablets down the toilet can release considerably greater quantities of the biologically active drug into sewer waste water.       

How are These Chemicals Affecting the Environment?

Waste drugs in waste water makes for bad news at the tap. Use up your lotions and potions. The U.S. Geologic Services has reported that PPCPs such as steroids, prescription and nonprescription drugs, antibiotics, hormones, and fragrances have been detected in water samples collected from streams considered susceptible to contamination from various wastewater sources such as those downstream from intense urbanization or livestock.5 Potential risk to aquatic organisms due to exposure to PPCPs in the environment has been identified as a primary concern given that aquatic organisms may be continually exposed to chemicals, including multi-generational exposures.2,3   Certain chemicals in sunscreens, including oxybenzone, have been linked to harming coral reefs. Hawaii has passed a bill that will ban the sale of sunscreens containing oxybenzone and octinoxate, and Safer alternatives, including mineral sunscreens have been proposed.  

Antibiotics are a type of PPCP that have been very important for helping to prevent unwanted bacterial infections, and were initially considered wonder drugs.  However, the use of antibiotics has been linked to the selection and development of antibiotic resistant bacteria.  Bacteria have several genetic mechanisms, including independently replicating DNA plasmids, that have enabled the rapid evolution of antibiotic resistance genes as well as the transmission of antibiotic resistance genes to their bacterial offspring and to certain other bacterial species.  When antibiotics are present in the body or in the environment, antibiotic-resistant bacteria, if present, have a selective advantage and can then grow, replacing susceptible bacteria.  Then the antibiotic no longer works, since resistant bacteria continue to grow.  Selection for antibiotic resistant bacteria can occur both in antibiotic-treated humans and animals, as well as in the environment when antibiotics and/or antibiotic resistant bacteria are released to the environment. 

Soon after the introduction of successive generations of antibiotics antibiotic-resistant bacteria have evolved, and an increasing percentage of the population have bacterial populations that are resistant to multiple antibiotics.  As the incidence of antibiotic-resistant infections increases, there is concern that antibiotics will no longer be effective.  Thus it its also important to properly dispose of antibiotics to help reduce the development of bacteria that are even more antibiotic resistant.    PPCPs including Triclosan in Tooth Paste and Hand Wash have also been linked to selection for increased antibiotic resistance. 

There is also concern for subtle effects on ecological receptors when exposed to low concentrations of PPCPs. For humans, consumption of potable water which may contain trace concentrations (in the part per trillion to part per billion range) of various PPCPs has been identified as one of the primary potential routes of exposure.5 To date, much research has focused on the potential for pathogen resistance to antibiotics and endocrine distribution by natural and synthetic sex steroids.2,3 At this time, many unknowns remain regarding the potential for adverse effects on ecological receptors and humans from exposure to PPCPs in the environment. As new information becomes available, this will facilitate more detailed evaluations of the potential toxicological significance of the detection of PPCPs in the environment.

What are the Regulatory Issues Associated with Pharmaceutical Management?

For a long time, the regulatory distinction between hazardous waste (as defined in the law and by U.S. EPA and DTSC in regulation) and medical waste (with its own definitions) has hampered a truly environmentally-protective approach to the very complex issues surrounding pharmaceutical management. Only recently have environmental agencies begun to grapple with these issues. As described below, there are many levels of this very complex problem.

How Can I Reduce or Prevent Releases of This Waste to the Environment?

As a Household

Waste drugs in waste water makes for bad news at the tap.We can educate ourselves, family members, friends and coworkers about this emerging environmental issue. You can find and use safer alternatives that are healthier for you and the environment.  DTSC created this web page as an information portal on this topic and related subjects. 

For most of us, we have been trained to get rid of old or unwanted drugs by flushing them down the toilet. This practice evolved from our desire to keep potentially dangerous drugs out of the hands of others, especially children. However, recent research is showing that this may be the least environmentally friendly method of disposing of old or unwanted drugs.  We now know that putting unused medications down the drain or flushing them down the toilet may impact downstream drinking water with these chemicals. Many medications cause ecological harm, and our current sewage treatment systems are not completely effective in removing all drugs from waterways. The proper disposal practice may vary depending on county you live in or the wastewater agency that serves your region. Before disposing of old or unwanted drugs, consult your local wastewater agency or How to Recycle Unwanted and Expired Medications page on the proper disposal practice for your area.

Other actions you might consider to reduce the amount of PPCPs entering the environment are to store your medications properly so they will be useful until their established shelf life. Pay attention to the storage instructions just as you do the dosage instructions.

As a Hospital or Business:

EPA Regulations on the Management of Pharmaceutical Hazardous Waste are described at:
EPA’s page on the management of pharmaceutical waste.

In California, Pharmaceutical Waste is also regulated by the Medical Waste Management Act 2017, California Health and Safety Code, Sections 117600-118360. See the California Department of Public Health: Medical Waste Management Program.

For information on Medical Waste, see the California Department of Public Health: Medical Waste Management Program.

Page last updated April 2, 2019

Citations and Links to Other Resources/Websites