The environmental impact of Pharmaceuticals and Personal Care Products (PPCPs) has been a growing concern since the 1990s, with initial reports of waterway contamination dating back to the 1970s. These widely produced substances, used for personal health, cosmetics, and agribusiness, are inadequately removed by conventional sewage treatment plants and are detected globally in water bodies; the European Union has declared pharmaceutical residues "priority substances." Research confirms PPCPs pose risks of toxicity, persistence, and bioaccumulation, impacting diverse ecosystems and species like coral reefs and fish.
A significant 2022 study, the most comprehensive to date, investigated 258 rivers across 104 countries and found that pharmaceutical pollution threatens environmental and human health in over a quarter of the studied locations. This pollution is particularly severe in low- to middle-income countries due to poor wastewater management and pharmaceutical manufacturing. Despite the vast production of these chemicals and the clear risks they pose through human excretion, improper disposal, and industrial waste, few of the thousands of manufactured pharmaceutical chemicals are routinely screened in waterways, and comprehensive federal regulations remain largely absent.