Researchers from the University of Nottingham are part of a major new project that has been awarded £1.19m to tackle pharmaceutical pollution in the water environment.
Researchers from the School of Pharmacy at the University of Nottingham are working with the University of the Highlands and Islands (UHI), The James Hutton Institute, NHS Highland and, Heriot-Watt University to co-develop a novel, systems-based approach to reducing the environmental impacts of medicine.
Pharmaceutical pollution in rivers, lochs and coastal waters is an internationally recognised public health and environmental challenge. Pollution can arise across the entire pharmaceutical lifecycle – from production, prescribing, and patient use to disposal and wastewater treatment. Following administration, up to 90% of some medicines may be excreted unchanged, entering wastewater systems that were not designed to remove these compounds. Additional pollution occurs when unused or expired medicines are incorrectly flushed down toilets or sinks rather than returned to pharmacies for safe disposal.
As a result, medicines such as antibiotics, anti-inflammatories, and antidepressants have been detected in Scottish waters. These substances are designed to have biological effects in humans and may similarly affect aquatic life, while also contributing to the environmental spread of antimicrobial resistance (AMR).
Considering the complicated issues around eco-toxicity and pharmaceutical pollution, it is great to build on our previous project, and strengthen our multidisciplinary collaboration.
Against a backdrop of evolving regulation, the healthcare and water sectors face increasing pressure to improve environmental performance, control costs, and meet sustainability targets – including addressing the environmental impact of pharmaceuticals.
Using Scotland as a national pilot the project brings together an interdisciplinary team spanning environmental, biomedical, materials, biological, and social sciences, alongside key partners including Scottish Water, Scottish Environment Protection Agency (SEPA), and Uppsala University in Sweden.
The new project, PhRESHWater (Pharmaceuticals Reduction in the Environment through Sustainable Healthcare), will apply a systems-based 'One Health' approach that recognises the interconnectedness of human, animal, and environmental health. By working collaboratively across the healthcare, water, and environmental sectors, the project will co-develop practical solutions at multiple points in the pharmaceutical lifecycle.
These include:
+ Pollution risk modelling to identify priority medicines and hotspots
+ Behaviour-change interventions to support sustainable prescribing and disposal
+ Innovative pollution-reduction technologies
+ Shared decision-making tools to enable coordinated cross-sector action
PhRESHWater builds on a strong foundation of collaboration established through the Scottish One Health Breakthrough Partnership, which brings together researchers, public agencies, and policymakers to address pharmaceutical pollution. UHI, NHS Highland, Scottish Water, SEPA, and Scotland's Centre of Expertise for Waters are co-founders and steering group members of the partnership.
The research will also make use of a novel visualisation tool developed by the Scottish One Health Breakthrough Partnership, which integrates data on pharmaceuticals detected in Scottish waters with NHS Scotland prescribing data. This tool supports a clearer understanding of how prescribing practices relate to environmental pollution and helps identify targeted opportunities for intervention.
Through this investment, the project will generate new evidence, tools, and resources to support coordinated action on pharmaceutical pollution, helping to safeguard environmental and human health while enabling the healthcare and water sectors to meet sustainability goals. The work will position Scotland as an international leader in developing integrated, systems-based solutions to reduce the environmental impact of medicines.
