Paper short abstract:

This presentation analyzes, through a chemical and a sociological analysis, the chemical fingerprint of the hospital, the disposition and the social pressures on the greening process of the medical practices faced the environmental issue of the pharmaceutical residues in the hospital of Bordeaux.

Paper long abstract:

The aquatic environment contamination by pharmaceutical residues appears as a new emergent pollutant which interrogates the very heart of the medical practices.

Realized in the RESEAU/REGARD research programs led by IRSTEA of Bordeaux, UMR-EPOC and R&D center of SUEZ, this communication proposes an interdisciplinary analysis of the Bordeaux University Teaching Hospital through a chemical and a sociological analysis.

Based on 42 semi-directive interviews, the sociological analysis will show that the awareness of the contamination of aquatic environment by medications is unsymmetrically spread between the hospital actors. We will explain this asymmetry through several factors: the sanitary social pressures, the occupational health risk induces by the use of cancer drugs, and the development of ambulatory care.

The chemical analyses were performed for 8 different hospital wastewater canalizations, such as those related to pediatric or administration departments. A wide list of 69 pharmaceuticals, including anti-inflammatories, analgesics, antibiotics and cancer drugs was targeted. Some quite typical fingerprints have been evidenced in relation with specific therapeutic activities. Nevertheless globally speaking, paracetamol (analgesic) was found at the highest concentration (µg-mg.L-1) due to its high consumption at the hospital (1.5 ton per year). Cyclophosphamide (cancer drug) was found at low concentration (ng.L-1) but nevertheless was enhanced as compound of concern due to its high cytotoxicity.

Finally, we will present some tools (ex. video scribing) used to initiate a discussion with the hospital actors.