Pharmaceutical pollution

is a worldwide threat to

humans and the environment

More than 770 pharmaceuticals and their metabolites have been found in the environment worldwide. Pharmaceutical residues can enter the environment at all stages of their life cycle. They can accumulate in fish, vegetables, livestock, and end up in drinking water.

This website brings together key information and materials about pharmaceutical pollution, recommendations for stakeholders, and an overview of flagship EU regulatory developments. It also features a free-to-access database of initiatives to tackle pharmaceuticals in the environment and pharmaceutical waste.

It is hosted by Health Care Without Harm (HCWH) Europe, a non-profit network of European hospitals and healthcare providers, healthcare systems, local authorities, research/academic institutions and environmental and health organisations.

HCWH Europe’s mission is to transform the European healthcare sector so that it reduces its environmental footprint, becomes a community anchor for sustainability, and a leader in the global movement for environmental health and justice.

This website follows on from the Safer Pharma campaign that ended in 2020. You can find more information about the campaign here.

Find out more about HCWH Europe here.


How do pharmaceuticals get into the environment?

Pharmaceutical residues can enter the environment during production, consumption, and disposal. We need to achieve zero discharge from the manufacturing plants.

Medicines also enter into the environment through human excretion via wastewater and animal excretion via runoff from agricultural areas and discharges from aquaculture.

Another route is through improper disposal (unused medicine should never be disposed of in a toilet or sink). Current wastewater treatment plants are unable to completely destroy or remove pharmaceuticals.

Consequently, pharmaceutical residues can re-enter terrestrial systems, spread to surface waters and agricultural lands, and can ultimately end up in drinking water, and build up in vegetables and fish.

How are humans exposed to pharmaceuticals in the environment?

  • Pharmaceuticals and their residues that enter the water supply and spread to surface waters and agricultural lands can ultimately end up in drinking water and build up in vegetables and fish.
  • Humans can be unintentionally exposed by consuming contaminated water and food.
  • Low concentrations of pharmaceuticals in the environment can have adverse effects on animals and other organisms, which raises questions about how humans can be affected by continuous, long-term exposure to low concentrations of pharmaceuticals.

How can pharmaceuticals in the environment affect wildlife?

  • Though the traces of pharmaceuticals in the environment are well below therapeutic doses, they can still have effects on unintended targets.
  • Animals and other organisms that are exposed to pharmaceuticals in water, soil, or even by feeding on medicated animals can experience behavioural, physiological, and histological effects.
  • Antibiotics in the environment can promote the development of antibiotic-resistant pathogens.

Patients consume and excrete medicine:


Pharmaceuticals in the environment

Pharmaceuticals can enter the environment at all stages in their life cycle. When present in the environment, their active substances can have unintended effects on ecosystems. In the case of antimicrobials, they can also be a driver for the development of antimicrobial resistance in the environment.

2017. Subtitles available: EN/DE/FR/ES

[RU] Безопасное обращение с отходами лекарствn

The impact of pharmaceutical manufacturing pollution

Pharmaceutical pollution can occur during the manufacturing process. European companies that market medicines often produce their active substances outside Europe, therefore outsourcing the problem. They should implement higher manufacturing standards to ensure zero discharge from production.

2019. Subtitles available: EN/DE/FR/ES

How doctors can help reduce pharmaceutical pollution

Tackling pharmaceutical pollution requires a multidisciplinary approach, in which medical doctors have a key role to play.

Medical doctors can reduce unnecessary pharmaceutical emissions and waste by adopting simple prescription practices, educating patients, and ​​leveraging their trusted voice to change procurement and prescription practices.

2021. Subtitles available: EN/DE/FR

What can I do?

How can you help reduce pharmaceutical pollution?

  • Don’t dispose your unused or expired drugs in the toilet or sink
  • Buy over-the-counter medicine only as needed
  • Avoid stockpiling medicines that cannot be used before expiry
  • Learn about your local recommended method for disposing of pharmaceuticals and packaging
  • Never take antibiotics without medical advice
  • Never stop your antibiotic therapy without medical recommendation

Doctors control the duration and dosage of individual prescriptions, and are well positioned to help reduce the risk for accumulation of unused pharmaceuticals that become waste and can end up in the environment.

Simple practices can help reduce unnecessary pharmaceutical emissions in the environment:

  • Prescribing starter packs for new medicines
  • Prescribing the smallest package possible, and giving refills as needed
  • Prescribing preventative measures and non-medicinal therapy where possible
  • Prescribing antibiotics prudently

Reducing unused medicine can also:

  • Reduce healthcare costs
  • Reduce loss of patient benefits
  • Optimise use of healthcare resources
  • Be part of your hospital’s or clinic’s sustainability strategy


Doctors can also help educate patients about pharmaceutical pollution and on ways to reduce waste and unnecessary emissions.

  • Hundreds of different active pharmaceutical compounds are being discovered in waterways around the world.
  • Concern is increasing about the harm these might be doing to human health and the environment.
  • Whilst pharmaceutical residues can enter the environment during the production, consumption and disposal, incorrect disposal of household pharmaceutical waste is considered the second major pathway into the environment.
  • Proper collection and disposal of household pharmaceutical waste can contribute to reducing the impact of pharmaceuticals in the environment.
  • Effective collection schemes would divert unused medicines from mixed waste streams that are not designed to deal specifically with pharmaceutical products.
  • European citizens do not know how to dispose of unwanted medicines safely, their common disposal practices being toilet, sink and household rubbish.

Pharmaceutical Industry Groups can:

  • Sponsor and promote awareness-raising and educational campaigns targeting different age groups, using various communication channels
  • Make available medicine pack sizes that are adapted to different therapies
  • Cover the costs associated with the collection schemes
  • Design and develop benign pharmaceuticals that rapidly biodegrade in the environment into harmless compounds


This timeline gives an overview of key regulatory developments on pharmaceuticals in the environment in the EU.

Pharmaceuticals in the Environment database

This database brings together initiatives by local, regional, and national NGOs, European projects, and national/regional authorities of EU Member States to tackle pharmaceuticals in the environment and pharmaceutical waste, including in wastewater.

Test your knowledge!

What do you know about pharmaceuticals in the environment?

What do you know about pharmaceuticals in the environment?


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    Funded by the European Union, the German Federal Ministry for the Environment, Nature Conservation, and Nuclear Safety (BMU), and the German Environment Agency (UBA). Views and opinions expressed are however those of Health Care Without Harm (HCWH) Europe only and do not necessarily reflect those of the European Union, CINEA, BMU or UBA. The European Union, CINEA, BMU, and UBA cannot be held responsible for them.