Issues around household pharmaceutical waste disposal through community pharmacies in Croatia

详细信息    查看全文

• 作者：Danijela Jonji? (1)
  Ksenija Vitale (1)
  
• 关键词：Croatia ; Disposal ; Household waste ; Pharmaceutical waste ; Pharmacies ; Unused medicines
• 刊名：International Journal of Clinical Pharmacy
• 出版年：2014
• 出版时间：June 2014
• 年：2014
• 卷：36
• 期：3
• 页码：556-563
• 全文大小：
• 参考文献：1. Kümmerer K. Pharmaceuticals in the environment. Annu Rev Environ Resour. 2010;35:57-5. CrossRef
  2. Heberer T. Occurrence, fate and removal of pharmaceutical residues in the aquatic environment: a review of recent research data. Toxicol Lett. 2002;131:5-7. CrossRef
  3. Hannah R, D’Aco VJ, Anderson PD, Buzby ME, Caldowell DJ, et al. Exposure assessment of 17 α-ethinylestradiol in surface waters of United States and Europe. Environ Toxicol Chem. 2009;28:2725-2. CrossRef
  4. Caldwell DJ, Mastrocco F, Hutchinson TH, Lange R, Heijerick D, et al. Derivation of an aquatic predicted no-effect concentration for the synthetic hormone, 17 α-ethinylestradiol. Environ Sci Technol. 2008;42:7046-4. CrossRef
  5. Carlsen E, Giwercman A, Keiding N, et al. Evidence for decreasing quality of semen during past 50?years. BMJ. 1992;305:13-0. CrossRef
  6. Kümmerer K. Antibiotics in the environment—a review—part II. Chemosphere. 2009;75:435-1. CrossRef
  7. Kümmerer K. The presence of pharmaceuticals in the environment due to human use—present knowledge and future challenges. J Environ Manag. 2009;90:2354-6. CrossRef
  8. Bound JP, Voulvoulis N. Household disposal of pharmaceuticals as a pathway for aquatic contamination in the United Kingdom. Environ Health Perspect. 2005;113:1705-1. CrossRef
  9. Ruhoy IS, Daughton CG. Beyond the medicine cabinet: an analysis of where and why medicines accumulate. Environ Int. 2008;34:1157-9. CrossRef
  10. Ahel M, Jeli?i? I. Phenazone analgesics in soil and groundwater below a municipal solid waste landfill. In: American Chemical Society. Pharmaceuticals and Personal Care Products in the Environment. Washington: ACS Symposium Series 791; 2001. p. 100-15. ISBN: 0-8412-3739-5.
  11. Ahel M, Terzi? S, Tepi? N. Organic contaminants in the Jakusevec landfill and their impact on groundwater quality. Arh Hig Rada Toksikol. 2006;57(3):307-5.
  12. Terzi? S, Senta I, Ahel M, Gros M, Petrovi? M, Barcelo D, Müller J, Knepper T, Martí I, Ventura F, Jovan?i? P, Jabu?ar D. Occurrence and fate of emerging wastewater contaminants in Western Balkan Region. Sci Total Environ. 2008;399:66-7. CrossRef
  13. Terzi? S, Ahel M. Organic contaminants in Croatian wastewaters. Arh Hig Rada Toksikol. 2006;57:297-06.
  14. Croatian Ministry of Environmental and Nature Protection. Pravilnik o gospodarenju medicinskim otpadom [Ordinance on Medicinal Waste Management]. Croatian Official Gazette No. 72/07.
  15. Guirguis K. Medicines collected for disposal by outreach pharmacists in Australia. Pharm World Sci. 2010;32:52-. CrossRef
  16. Tong AYC, Peake BM, Braund R. Disposal practices for unused medicines around the world. Environ Int. 2011;37:292-. CrossRef
  17. Seehusen DA, Edwards J. Patient practices and beliefs concerning disposal of medicines. J Am Board Fam Med. 2006;19:542-. CrossRef
  18. Kümmerer K, Hempel M. Green and sustainable pharmacy. Berlin: Springer; 2010. Part III, Use and Disposal of Pharmaceuticals; p. 179-01. ISBN: 978-3-642-05198-2.
  19. Zakon o otpadu [Waste Act]. Croatian Official Gazette No. 178/04 and 111/06.
  20. ?timac D, ?ulig J, ?ostar Z, Bolan?a M. Lijekovi kojima je istekao rok trajanja i njihovo javnozdravstveno zna?enje [Unused/Expired drugs and their importance for public health]. Pharmaca. 2007;45(0031-857):81-.
  21. ?timac D, ?ulig J, ?ostar Z, Bolan?a M. Opasni otpad: zbrinjavanje starih lijekova [Hazardous waste: unused drugs disposal]. Gospodarstvo i okoli?. 2007;85:160-.
  22. European Environment Agency 2001. Pharmaceuticals in the Environment. Results of EEA Workshop. EEA Technical Report No 1/2010. Denmark: ISBN: 978-92-9213-063-3.
  23. ZAGREB.HR: Official website of the City of Zagreb. Osnovni podaci o gradskim ?etvrtima [Basic information about neighborhoods] 2012 [Internet] Accessed in March of 2014: http://www.zagreb.hr/default.aspx?id=12915.
  24. Croatian Chamber of Pharmacists. Register of Pharmacies. June, 2011.
  25. Zakon o ljekarni?tvu [Pharmacy Act]. Croatian Official Gazette No. 121/03, 142/06, 35/08, 117/08.
  26. Croatian Chamber of Pharmacists. Internal documents: minutes from the meetings of the Commission for technical and professional issues. 2008, 2009. Located at: Croatian Chamber of Pharmacists, Marti?eva 27, Zagreb, Croatia.
  27. ?ogelja ?ajo G, Osre?ki V, Tomi? S. Utjecaj lijekova na okoli? [Pharmaceuticals and their impact on the environment]. Kem Ind 2010; 59(7-):351-54.
  28. Zakon o lijekovima [Medicinal Products Act]. Croatian Official Gazette No. 113/08.
  29. York Health Economics Consortium/The School of Pharmacy University of London. Evaluation of the Scale, Causes and Costs of Waste Medicines. Final Report. ISBN 978 090 293 620 1.
  30. Krupiene J, Dvarioniene J. Pharmaceutical pathways to the environment in Lithuania. Environ Res Eng Manag. 2007;41(3):33-.
  31. Marceli? S. Zagreba?ke ?etvrti i stupanj obrazovanja. [Zagreb’s neighborhoods and the level of education] [Internet] Accessed in March of 2014: http://www.grupa22.hr/zagrebacke-cetvrti-i-stupanj-obrazovanja/.
  32. Vitale K, Palian M, Jonji? D, Mili? M, Sovi? S, D?akula A. Patients-practice and knowledge of pharmaceuticals disposal: example from some rural areas of Croatia. In: Vitale K. (ed.) Environmental and Food Safety and Security for South-East Europe and Ukraine. NATO Science for Peace and Security Series. Springer, 2012. p. 213-17. ISBN: 978-94-007-2955-1.
  33. ADIVA—Health through Advice. [Internet] Accessed in March of 2014: http://www.adiva.hr/#!.
  34. Vitale K, D?akula A, ?ulji? P, Todorovi? G, Vuleti? S, ?ovi? A. Who empowers women towards healthier lifestyles? Example from western Croatia. Coll Antropol. 2009;33(1):165-0.
  35. Pharmaceutical Group of European Union. Fact Sheet: Waste Management. 2006. Ref No. : 06.07.04E 009FS.
  36. Pharmaceutical Group of European Union. Fact Sheet: Services provided in and by community pharmacies. 2008. Ref No: 10.02.10E 004FS.
  37. Malovi? A, Huml D. HLJK o gospodarenju medicinskim otpadom [Croatian Chamber of Pharmacists about medicine waste management] Bilten HLJK 2008; 2008(3/4):191-93. Accessed in March of 2014: http://www.hljk.hr/LinkClick.aspx?fileticket=ghLwzmJ4niM%3d&tabid=69&mid=545.
  38. PGEU Fact Sheet: Community pharmacies services. 2012. Ref No: 12.07.30E 011FS.
  39. Health Canada. Environmental Impact initiative. Pharmaceutical Disposal Programs for the Public: a Canadian Prospective. November 2009. [Internet] Accessed in March of 2014: http://www.enviroadvisory.com/pdf/Takeback.pdf.
  40. Strategija gospodarenja otpadom Republike Hrvatske [Waste management strategy of Republic of Croatia]. Croatian Official Gazette, 130/05.
  41. Kusturica MP, Sabo A, Tomi? Z, Horvat O, Solak Z. Storage and disposal of unused medicines: knowledge, behavior, and attitudes among Serbian people. Int J Clin Pharm. 2012;34:604-0. CrossRef
  42. ?timac D, ?ulig J, John V. Propisivanje statina u Zagrebu (2001-006) i njihova uloga u sekundarnoj prevenciji kardiovaskularnih bolesti. [Statin prescribing in the City of Zagreb (2001-006) and their role in secondary prevention of cardiovascular events]. Acta Med Croatica. 2009;63(2):173-.
  43. ?timac D, ?ulig J, Vuku?i? I, Cattunar A, Stojanovi? D. Quality of the cardiovascular drugs prescribing in Zagreb during the period 2001-004. Medicinski glasnik Ljekarske komore Zeni?ko-dobojskog kantona. 2009;6(1):118-4.
  44. Poli?-Vi?intin M, Tripkovi? I, ?trban-?tok Z, ?timac D, ?ulig J. Analiza indikatora morbiditeta, mortaliteta i potro?nje lijekova u Zagrebu. [Indicators of morbidity, mortality and drug utilization in the city of Zagreb] Med Jadertina. 2006; 36(1-): 31-0. Accessed in March of 2014: file:///C:/Users/owner/Downloads/polic_vizintin_et_all.pdf.
  45. Bo?kovi? J, ?ulig J, Leppee M, Huml D. Pharmacist’s advice could improve the patients-medicine adherence in chronic diseases. ESCP-GSASA 2009 Symposium on Clinical Pharmacy, Abstractbook/Beney, Johnny—Geneva: European Society of Clinical Pharmacy (ESCP). 2009. 31-1.
  
• 作者单位：Danijela Jonji? (1)
  Ksenija Vitale (1)
  
  1. School of Medicine, School of Public Health “Andrija ?tampar- University of Zagreb, Rockfellerova 4, 10 000, Zagreb, Croatia
  
• ISSN：2210-7711

文摘

Background Croatian regulations mandate pharmacies to receive unused medicines from households. Pharmacies are considered as producers and holders of pharmaceutical waste and are obliged to finance this service. Model where pharmacies are responsible for financing disposal of unused medicines without reimbursement is not common in Europe. Present service was not tested before implementation. Objective To investigate the elements of the pharmaceutical waste disposal service provided by pharmacies, and to gain insight into the factors that might influence the effectiveness of the service. Setting All pharmacies in the city of Zagreb. Method Each pharmacy was asked to weigh the collected waste from the public during a period of 30?days, between June 1st and July 10th of 2011, absent from any media advertisement and answer a specifically designed questionnaire that was exploring possible connections between the amount of collected waste, type of pharmacy ownership, discretion while disposing, location of the container, appropriate labeling and to compare the amount of collected waste between neighborhoods. Main outcome measure Quantity of collected unused medicines from the public. Results Of 210 pharmacies, 91 participated completing the questionnaire (43?% response rate). The total amount of collected waste was 505?kg. Pharmacies owned by the city of Zagreb had higher response rate (74?%) than privately owned pharmacies (36?%), and collected significantly higher amount of waste. Anonymity when disposing influenced collected quantity, while labelling and location of the container did not. There were differences in the amount of collected waste between neighborhoods due to the demographic characteristics and number of pharmacies per capita. Conclusion The effectiveness of the pharmacy service of collecting unused medicines in Croatia shows a number of weaknesses. The amount of collected medicines is below the European average. Functioning of the service seems to be negatively influenced by the type of pharmacy ownership, distribution of pharmacies and lack of anonymity when disposing unused medicines. Additionally, type of ownership is connected with financial burden for pharmacies. Governmental bodies should examine current legislation regulating pharmaceutical waste disposal, particularly financial responsibility for providing the service, in order to increase pharmacies-compliance. Advertising of the service may increase awareness of the importance of proper disposal of unused medicines.