Abstract
Background Improper disposal of medications potentially poses a significant environmental risk and storage of expired and unused medications in households provides an increased risk of accidental childhood poisonings. Objective The objective of this study was to investigate the storage and disposal habits of medications amongst the population in the South Bačka District of Serbia, and to gain insight into the attitudes and knowledge of the population about the proper disposal of medications. Setting Households in South Bačka District. Method The study was conducted during the 6-month period from February 2010 to July 2010 and involved a random sample of households. The questionnaire-based study was performed by a trained interviewer. Main outcome measure number of expired and unused medications in families, behavior and knowledge about the disposal of medications. Results Of 230 families, 208 (108 urban and 100 rural) agreed to participate and complete the questionnaire(90 % response rate). The drugs were mostly kept in a specific place-home pharmacy (89.8 % [urban] and 89.0 % [rural]). Exposure of children to medications in the home environment was similar in urban and rural families (19.6 % [urban] and 23.1 % [rural]). The frequency of expired medications was not observed to be different between the urban and rural households (10.3 % [urban] and 11.8 % [rural]). The most common method for disposal of household medications is disposal in the garbage (85.6 % [urban] and 74.5 % [rural]) or in the toilet (8.7 % [urban] and 6.4 % [rural]). However, inconsistent with disposal practices, half of the urban and rural participants thought that throwing medications in the garbage, toilet, or sink has a detrimental effect on the environment. Conclusion Public services in Serbia, including government and health sectors, need to be more proactive about educating people on how to store and dispose medications, as well as finding a way for implementation of the law on medications wastage destruction.
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References
Bound JP, Voulvoulis N. Household disposal of pharmaceuticals as a pathway for aquatic contamination in the United Kingdom. Environ Health Perspect. 2005;113(12):1705–11.
Abahussain EA, Ball DE. Disposal of unwanted medicines from households in Kuwait. Pharm World Sci. 2007;29(4):368–73.
Kyingi KS, Lauvo JAK. Drugs in the home: danger and waste. World Health Forum. 1993;14:381–4.
Beirens TM, van Beeck EF, Dekker R, Brug J, Raat H. Unsafe storage of poisons in homes with toddlers. Accid Anal Prev. 2006;38:772–6.
Franklin RL, Rodgers GB. Unintentional child poisoning treaated in United States hospital emergency departments: national estimates of incident cases, population-based poisoninig rates, and product involvement. Pediatrics. 2008;122:1244–51.
Tong AY, Peake BM, Braund R. Disposal practices for unused medications around the world. Environ Int. 2011;37(1):292–8.
Zargarzadeh AH, Tavakoli N, Hassanzadeh A. A survey on the extent of medication storage and wastage in urban Iranian households. Clin Ther. 2005;27:970–8.
Serbian Rule on Medical Waste Management (2010). State Gazzete No 78/Nov 2010.
Republic of Serbia. Republic Fund for Health Insurance, Serbia http://www.rzzo.rs/download/lista_A.pdf (2010). Accessed 12 Jan 2012.
Republic of Serbia. Republic Fund for Health Insurance Serbia http://www.rzzo.rs/download/lista_A1.pdf (2010). Accessed 12 Jan 2012.
Persson M, Sabelström E, Gunnarsson B. Handling of unused prescription drugs-knowledge, behavior and attitude among Swedish people. Environ Int. 2009;35(5):771–4.
Lwanga SK, Lemeshow S. Sample size determination in health studies. Geneva: World Health Organization; 1991.
Aljinovic-Vučić V, Trkulja V, Lackovic Z. Content of home pharmacy and self-medication practices in households of pharmacy and medical students in Zagreb, Croatia: findings in 2001 with a reference to 1977. Croat Med J. 2005;46(1):74–80.
Stilinović N, Vukmirović S, Milijašević B, Horvat O, Sahman M, Tomić Z, Šramka M, Sabova A. Lieky v domacich lekarničkach v Srbsku a na Slovensku: ich nebezpečie na zdravie uživatelov [Drugs in home in Serbia and Slovakia: danger to health] Zdravotnictvo a socialna praca 2008; 3(3–4): 15–21.
De Bolle L, Verrue C, Mehuys E, Adriaens E, Remon JP, Van Bortel L, Christiaens T. Home medication cabinets and self-medication: a source of potential health threats? J Pharm Belg. 2009;1:1–4.
Horvat O, Mijatović V, Paut M, Tomić Z, Mijatović V. Antibiotici kupljeni bez recepta na teritoriji Južnobačkog okruga [Antibiotics purchased without prescription in South Bačka District]. 3. Nedelja bolničke i kliničke farmakologije, Beograd, Srbija; 2011. p. 42–43.
Tourinho FS, Bucaretchi F, Stephan C, Cordeiro R. Home medicine chests and their relationship with self-medication in children and adolescents. J Pediatr. 2008;84(5):416–22.
Abou-Auda HS. An economic assessement of the extent of medication use and wastage among families in Saudi Arabia and Arabian Gulf countries. Clin Ther. 2003;25(4):1276–92.
Ćalasan J, Mijatović V, Horvat O, Varga J, Sabo A, Stilinović N. The outpatient utilization of non-steroidal anti-inflammatory drugs in South Backa District. Serbia Int J Clin Pharm. 2011;33:246–51.
Mijatović V, Ćalasan J, Horvat O, Sabo A, Tomić Z, Radulović V. Consumption of non-steroidal anti-inflammatory drugs in Serbia compared with Croatia and Denmark during 2005–2008 period. Eur J Clin Pharmacol. 2011;67(2):203–7.
Boehringer SK. What’s the best way to dispose of medications? Pharmacist’s letter/Prescriber’s letter. Stockton: Environmental Protection Authority; 2004; 20: Number 200415.
Smith CA. Managing pharmaceutical waste—what pharmacists should know. J Pharm Soc. Wisconsin, Nov/Dec 2002;17–22.
Krupiene J, Dvarioniene J. Pharmaceutical pathways to the environment in Lithuania. Environ Res Eng Manag. 2007;41:33–9.
Sharif SI, Abduelkarem AR, Bustami HA, Haddad LI, Khalil DS. Trends of home drug storage and use in different regions across the Northern Arab Emirates. Med Princ Pract. 2010;19(5):355–8.
Daughton CG. Cradle to cradle stewardship of drugs for minimizing their environmental disposition while promoting human health. II Drug disposal, waste reduction, and future directions. Environ Health Perspect. 2003;111:775–85.
Jones OA, Voulvoulis N, Lester JN. Potential impact of pharmaceuticals on environmental disposition while promoting human health. Bull World Health Organ. 2003;81:768–9.
Daughton CG, Ternes TA. Pharmaceuticals and personal care products in the environment: agents of subtle change? Environ Health Perspect. 1999;107(Suppl 6):907–38.
Schwab BW, Hayes EP, Fiori JM, et al. Human pharmaceuticals in US surface waters: a human health risk assessment. Regul Toxicol Pharmacol. 2005;42:296–312.
Webb S, Ternes T, Gibert M, Olejniczak K. Indirect human exposure to pharmaceuticals via drinking water. Toxicol Lett. 2003;142:157–67.
Seehusen DA, Edwards J. Patient practices and beliefs concerning disposal of medications. J Am Board Fam Med. 2006;19(6):542–7.
Braund R, Peake BM, Shieffelbien L. Disposal practices for unused medications in New Zealand. Environ Int. 2009;35:953–5.
Kotchen M, Kallaos J, Wheeler K, Wong C, Zahller M. Pharmaceuticals in wastewater: behaviour, preferences, and willingness to pay for a disposal program. J Environ Manag. 2009;90:1476–82.
http://www.farmakon.rs/rubrike/aktuelno/958-svi-peru-ruke-od-neupotrebljivih-lekova.html. Accessed 12 Feb 2012.
Funding
This work was supported by the Ministry of Science and Technological development, Republic of Serbia, project No. 41012 and is part of the project No. 114-451-2458/2011 (Provincial Secretariat for Science and Technological Development, Autonomous Province of Vojvodina).
Conflicts of interest
The authors of this manuscript have no conflicts of interest to declare.
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Appendix
Appendix
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1.
Houseshold members
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2.
Age
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3.
Gender
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4.
Education
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5.
Occupation
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6.
Number of all medications in the household
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7.
Storage of medications
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At a several places around the house
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At a specific place/home pharmacy
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8.
Availability of medications to children.
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Yes
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No
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No children
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9.
Number of expired medications.
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10.
Number of medications no longer being used.
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11.
How do you dispose of unused drugs?
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Throw in the garbage
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Throw in the toilet or sink
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Burn
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Return to a pharmacy
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Give to a friend
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12.
Throwing medications in the garbage of toilet or sink has a detrimental effect on the environment?
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Yes
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No
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Not sure
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13.
In your opinion what is the most appropriate method to dispose of unused drugs?
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Return them to a public health care center
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Put them in a special containers in the pharmacy
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Burn
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Other
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Kusturica, M.P., Sabo, A., Tomic, Z. et al. Storage and disposal of unused medications: knowledge, behavior, and attitudes among Serbian people. Int J Clin Pharm 34, 604–610 (2012). https://doi.org/10.1007/s11096-012-9652-0
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DOI: https://doi.org/10.1007/s11096-012-9652-0