Pharmaceuticals are being found at an increasing rate in fresh water, including the drinking water of many major cities. The following is an excerpt from the report: Urine Diversion: One Step Towards Sustainable Sanitation by EcoSanRes.
There are research projects going on to investigate the environmental effect of pharmaceuticals in urine. By far the majority of all pharmaceutical substances are derived from nature, even if many are synthetically produced, and they are thus found and degraded in natural environments with a diverse microbial activity. This has been verified in ordinary wastewater treatment plants, where the degradation of pharmaceutical substances improved when the retention time was prolonged from a number of hours to a number of days. Urine and faecal fertilizers are mixed into the active topsoil, which has a microbial community just as diverse and active as that in wastewater treatment plants, and the substances are retained for months in the topsoil. This means that there is plenty of time for the microbes to degrade any pharmaceutical substances and that risks associated with them are small.
Concerning both hormones and pharmaceutical substances, it thus seems far better to recycle urine and faeces to arable land than to flush them into recipient waters. Since the aquatic systems have never before been exposed to mammal hormones in large quantities, it is not surprising that the sex development of fish and reptiles is disturbed when they are exposed to wastewater effluent. Furthermore, the retention time of the wastewater in the treatment plants is far too short for many pharmaceutical substances to degrade and recipient waters are also usually connected to water sources.
There are many indications that the possible risk from pharmaceutical substances in the agricultural system is small and far smaller than the risks associated with the present system. One such indication is that in many countries the human consumption of pharmaceuticals is small compared to that by domestic animals, as in most countries most commercial feeds contain antibiotic substances, added as growth promoters. Furthermore, the human use of pharmaceutical substances is small compared to the amount of pesticides (insecticides, fungicides, bactericides and herbicides) used in agriculture, which are just as biologically active as pharmaceutical substances.