Drugs, Drinking Water, and The Public Health
Time Maybe, to Reconsider

Back in mid-January, Attorney General Andrew Cuomo made a news splash by nailing five hospitals and nursing facilities, four in Delaware County, for unlawfully disposing of pharmaceuticals by flushing them away. Yeah, it's a bad practice of questionable legality and we'd be hard pressed to find anyone who thinks otherwise. Rather than face charges in court, the facilities quickly settled for modest fines and a good-sized stack of policy changes and consent orders. Now we're normally solid fans of the state AG's office, which we think on balance has an excellent record of trying to protect the public interest. But in this case it seems something's gone terribly wrong though we're not quite sure what.

The AG's office said the actions in question were illegal anywhere in the state, but they only chose to target health care facilities within the City's watershed. It's not as if those facilities didn't try to cooperate with the AG's investigation, the AG said they all did. And it's not as if they were doing something different from every other hospital in the state or the rest of the country...they weren't. In fact, the state Department of Health says what they did is perfectly allowable. In some cases all the facilities did was to simply return unused drugs to their suppliers for disposal, but were prosecuted because the suppliers didn't have the appropriate disposal permits. Now we don't pretend to understand every nuance of the various charges initially leveled or how they've been resolved, but the issue is clearly more complicated than the sound bites it's generated.

The issue of pharmaceuticals turning up in public water supplies has been in the news since at least 2001. We think (and we think most people think) it's a potentially serious issue that needs to be addressed efficiently and effectively. But the fact is that in New York State we don't have any statutory guidelines, any effluent standards for the discharge of pharmaceuticals from hospitals, kitchen sinks, wastewater treatment plants or anywhere else. Discharge is unregulated under state law, except for the 5 percent or so of pharmaceuticals classified as hazardous and subject to federal control. And the federal government, the US EPA, has just barely finished taking public comments on how to deal with the problem. They're stewing over the substantial public input right now, trying to figure it out. And a similar process is happening at the state level where the regulatory agencies - DEC and DOH - are also busy working on guidance for new regs on the issue.

As a result, we find the AG's choice of subjects for prosecution difficult to understand, except from a public relations point of view. Yes, we appreciate the critical importance of protecting the drinking water for nine million people downstate. In fact, like most people in the watershed, we think we appreciate it better than most people downstate do. But the fact is that the AG's settlements signed here in the watershed impose far stricter conditions than current state or federal laws require. And it certainly looks like those conditions are de facto new regulations which apply only here in the watershed. The City had nothing to do with this at all; it's a state issue only, but at its core it's also an ethical issue. Going after only small rural hospitals for something big city and suburban hospitals do on a far grander scale every day isn't just disingenuous, it isn't right. If it's being done for political advantage, it's wrong. And if backlash against it is being milked for political advantage that's wrong too.

But let's be clear. If new regulations are needed to protect the public health - and they certainly appear to be - let's try and make sure they get put in place. But they have to apply statewide, they have to be enforced uniformly, and they have to emerge through the regulatory process, whatever time that takes or hassle is involved. There aren't any shortcuts here where the public health is concerned.

And speaking of effluent and drugs and the public health, maybe it's time to really reconsider some of our wastewater treatment issues. We've got new and even newer plants going operational all over the watershed, and they work good on bacteria and even a few viruses. But not a single one of them does anything at all to remove pharmaceuticals, hormones, heavy metals, or a range of toxic elements that course through the city's drinking water system entirely unmonitored and unregulated. These are the state-of-the-art systems that are coming on line, and they do absolutely nothing to address this now obviously serious problem.

Could we in the watershed, together with the City's DEP, really protect those nine million people as well as they expect they're being protected? Yes, the technology exists that'll do that. And it costs the same or less as the ones we currently use. Only it isn't the technology that DEP likes, it's the one they've decided, without testing, doesn't work as well, even though it works great all over Europe. Because it's the living wastewater treatment systems, the vegetative reedbeds, the ones that are actually green, that remove these things once and for all, and actually make the water safe enough not to worry about.

So far, our observation is that DEP doesn't seem to care, and isn't interested in doing anything to protect its water supply that the state or the federal government doesn't compel it to. That's only based on 20 or so years of tracking it carefully, and it does reflect a near-complete lack of leadership and vision at the level of New York's mayoral politics. But with both the state and federal regulatory communities looking hard at the issues of unregulated and eternal chemical pollution, maybe there's a chance that can change. Could be, Phoenicia - and Boiceville, that it's worth waiting for.

BP