The pharmacy sector produces a range of environmental effects, encompassing greenhouse gas emissions, ecological ramifications of pharmaceuticals in the environment, and plastic waste from pharmaceutical packaging. Let’s delve into their impact on our climate, our health, and discuss actions we can take to mitigate the harm.

Greenhouse gas emissions. Healthcare contributes just under five per cent of Canada’s total greenhouse gas emissions. A quarter of these emissions stem from the production of pharmaceuticals with 90 per cent of those emissions originating from supply chains and the remaining ten per cent from healthcare facilities. This major contributor to climate change and its adverse impacts on health include an increased frequency of heat-related illness, exacerbations of asthma and chronic obstructive pulmonary disease due to exposure of wildfire smoke made more due to climate change and worsening of mental disorders. 

Ecological effects of pharmaceuticals on the environment. Pharmaceuticals enter the environment through various pathways, including human excretion and improper disposal, leading to contamination of waterways and landfills. This contamination poses ecological risks as pharmaceuticals bioaccumulate in the food chain, potentially affecting humans who consume these organisms. Research has identified pharmaceutical levels in the environment that induce toxicity and provoke worries regarding antimicrobial resistance. This renders infections more challenging to manage and heightens the likelihood of disease spread, severe illness and death.

Plastic waste from pharmaceutical packaging. Plastic waste poses a major concern, constituting 30 per cent of hospital waste. In Canada, 87 per cent of plastics, including healthcare-related ones, find their way into landfills or the environment. Packaging makes up almost half of this waste. Exposure to plastic harms wildlife and releases harmful chemicals such as phthalates and bisphenol A, disrupting hormone levels and reproduction. These chemicals are linked to health issues like metabolic abnormalities, reproductive dysfunction, and cancer in humans.

Despite these issues, however, there is still plenty of ways that healthcare professionals can help to make Canada’s drug supply more sustainable.

There are many things individual pharmacy professionals, for instance, could be doing to help. One such way could be adding environmental impact to the list of considerations one must make when choosing a medication for a patient, alongside efficacy and cost-effectiveness. By considering environmental impact in clinical decision-making, such as promoting eco-friendly inhalers and identifying unnecessary medications to deprescribe, pharmacy professionals can reduce environmental harm while bettering care.

Beyond individual efforts, hospitals can make the active choice to work with suppliers who are committed to green practices and can establish their own sustainability committees to advocate for more eco-friendly procurement. By implementing green inventory procurement and management practices, hospital pharmacies can further reduce waste and emissions. Collaboration can also extend further with drug manufacturers and Health Canada to integrate these considerations in their drug approval processes. 

The environmental footprint of healthcare is undeniably significant, yet it holds the potential for change. Through a green-minded approach across the entire supply chain, we can diminish its adverse effects on both the planet’s health and the well-being of our patients

For a more in-depth clinical perspective on this topic, I encourage readers to explore my Clinical Pearl and Resource Spotlight on CSHP.ca.

By Huy Pham

Huy Pham is a former CSHP student and Doctor of Pharmacy candidate at the Leslie Dan Faculty of Pharmacy at the University of Toronto.