From the neighbor's toilet to your lips

As if Atlanta didn't have enough water problems to worry about — drought, water wars with neighboring states, stormwater runoff, sewer overflows and industrial discharges — here comes another one, straight to metro faucets.

Turns out Atlanta's tap water can contain a medicine cabinet cocktail that only a smoker with a hangover would love. Caffeine, acetaminophen (the key ingredient in Tylenol), and cotinine (a remnant of nicotine) were found in metro Atlanta tap water during a water sampling study conducted by the U.S. Geological Survey and the Centers for Disease Control and Prevention.

Scientists also found 16 pharmaceuticals in treated wastewater. Eight antibiotics were found in raw Atlanta drinking water, which, the study says, could lead to bacteria that develop a resistance to penicillin and other drugs that fight off diseases.

Those water samples were taken in the summer and fall of 1999. There's good reason to think those drugs are still present in Atlanta's drinking water today.

The U.S. Environmental Protection Agency enforces laws that require companies and municipalities to properly dispose of and treat hundreds of chemicals. But pharmaceuticals don't fall under those regulations.

Alden Henderson, one of the study's authors and an environmental scientist at the CDC, wouldn't talk about the details of the study until other scientists confirm his team's results. But he did say the drinking water samples contained only a very small amount of the drugs.

That's hardly reassuring. Right now scientists know how the drugs got into the water supply, but they have no idea of the long-term effects those drugs might have.

Pharmaceuticals are making their way through humans and sewer systems, and are turning up in streams, groundwater supplies and drinking water across the globe.

Caffeine, aspirin, chemical contraceptives, diet pill traces and cocaine were found in water samples from the Detroit area. In Ontario, anticancer drugs, psychiatric drugs and anti-inflammatories were found in groundwater. Similar drugs have been found in water supplies in Boston, New Orleans, Croatia and Germany.

These test results raise serious questions that scientists like Henderson are just beginning to ask: How much of these drugs are in the environment and what are the effects of chronic exposure to the witch's brew that is our tap water?

"It's an unknown," says Dana Kolpin, a USGS researcher. He freely admits that no one has studied the problem long enough to know if the drug pollution can lead to health problems.

European countries have been wrestling with pharmaceutical water pollution for a decade, but the issue wasn't publicly broached in North America until an American Chemical Society meeting in March 2000.

Since then, researchers have been catching up with their European counterparts, quietly and cautiously analyzing water supplies.

Kolpin is coordinating the first nationwide program measuring pharmaceutical pollution. USGS scientists took water samples from 200 different sites from 36 states during 1999 and 2000. Seven of those sites were in metro Atlanta.

"Our greatest concern is that someone out there will say we are trying to scare the hell out of the public, or people will criticize us for trying to generate mass hysteria. But we are just trying to take a look at some of these emerging issues," says David Wangsness, the USGS liaison to the EPA in Atlanta.

"The overall hypothesis is, are there things entering water resources that get into drinking water supplies and are consumed by humans? The next question would be, are they at any level that can generate health hazards?"

Some answers may come as early as this summer when Kolpin releases the results from the water sampling study.

"Once we release the data, then other agencies can determine if there is a potential health effect, not just for humans but to aquatic life as well. Certainly there are some compounds that pose a risk and more people are becoming aware of the potential problems," Kolpin says.

For instance, studies suggest that seizure-control drugs for epileptics affect developing brains, but scientists don't know how much it takes to impact humans or other animals.

An EPA report says some anti-depressants can alter the spawning habits of shellfish. Another study says drugs that control cholesterol levels in humans can lower growth hormones in fish.

Terry Snell, a biology professor at Georgia Tech, conducted a study last year that shows birth control chemicals can make small animals infertile.

"My basic concern is that pharmaceuticals are designed to be active in very low concentrations, so when these things are taken and excreted in forms that are still active, they will have an impact on aquatic organisms," Snell says.??