Contraceptive-Patch Worry: Disposal concern focuses on wildlife

Lately, television commercials in Europe and the United States have shown scantily clad women sporting the latest accessory–a contraceptive patch. Impregnated with the same synthetic estrogen that’s in birth-control pills, these plastic bandages are worn for a week and then tossed. Some scientists now worry that because the discards still contain plenty of the hormone, sending them down toilets or into landfills risks harming wildlife.

The patches’ primary hormone, ethinylestradiol, can pass through water-treatment plants and into rivers (SN: 6/17/00, p. 388: Excreted Drugs: Something Looks Fishy), where trace quantities can induce male fish and juveniles of either gender to inappropriately produce an egg-yolk protein (SN: 1/8/94, p. 24: https://www.sciencenews.org/sn_edpik/ls_7.htm). “We have tracked the feminizing effects [of pills’ ethinylestradiol on fish] 2 kilometers downstream from sewage-treatment works,” Joakim Larsson of Göteborg University in Sweden noted in a letter to his nation’s Medical Products Agency (MPA) in Uppsala.

The patches’ manufacturer–a European division of the U.S. company Johnson & Johnson–states that each discarded patch still contains 600 micrograms of ethinylestradiol. From that, Larsson calculates that just a single patch flushed every 3 days into the catchments of a Swedish sewage plant serving 3,500 people would release enough hormone to impair fish downstream.

MPA reviewed this claim and asked the manufacturer for comment. Both the company and MPA “confirmed Larsson’s initial estimation–that relatively few patches flushed down the toilet could have a negative impact on the environment,” MPA’s Tomas Salmonson told Science News. Even patches sent to landfills might leach ethinylestradiol into water seeping through buried wastes, Larsson says.

The patches’ manufacturer has agreed to warn Europeans not to flush the product and not to include it in waste that won’t be incinerated, Larsson notes. European packages will also include a bag for encasing discards, says Kelly McLaughlin of Johnson & Johnson in Raritan, N.J.

On the market since May, the U.S. version of the company’s patch, Ortho-Evra, comes with no disposal bags. Labeling recommends that it “be carefully folded in half so that it sticks to itself before throwing it away.” That’s not good enough, Larsson argues in a letter he sent to the U.S. Food and Drug Administration this week.

The FDA doesn’t require an environmental-risk assessment of products that will contribute to drug concentrations in the environment that are less than 1 part per billion, Larsson says. However, he notes, ethinylestradiol is biologically active in fish at a ten-thousandth of that concentration. So, U.S. labels should warn against flushing patches or disposing of them carelessly, he says. He also asks the FDA to consider whether the patch is warranted, since birth control pills provide “more environmentally friendly alternatives.”

Ethinylestradiol “persists in the environment far longer than natural hormones do,” says wildlife endocrinologist Louis J. Guillette Jr. of the University of Florida in Gainesville. With the potential for large quantities of patches releasing hormone into the environment, he says, “you have to, in fact, be concerned.”

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Janet Raloff is the Editor, Digital of Science News Explores, a daily online magazine for middle school students. She started at Science News in 1977 as the environment and policy writer, specializing in toxicology. To her never-ending surprise, her daughter became a toxicologist.