Conflict of interest: none declared. Financial support: none declared.
Medications and radiographic contrast dyes are sometimes detected in surface waters, ground water and drinking water; these have proven detrimental effects on organisms living in such waters.
The concentration of medications found in drinking water is at least a thousand times below their minimum therapeutic dosages.
In humans, the long-term effects of daily exposure to low dosages of medications and 'mixture toxicity' is not known; based on the concentrations and substance toxicity, it is presumed that the risk is nil..
Physicians can play their part in controlling the problem of medications becoming part of the water cycle by taking this into account when prescribing medications.
Users can make a difference by handling their medications with care and by returning all unused portions to the pharmacy.
The pharmaceutical industry can also do its part by taking degradability, options for removal and the environmental effects of medications into account during their stages of development.