Judging pharmaceutical environmental risk by its cover? The effects of prescription medication and disease severity on environmental risk perception

Recent water analysis performed in senior residences showed high levels of water pollution due to pharmaceutical waste. The way people perceive pharmaceuticals’ environmental risk can contribute to reverse this problem, but it is still relatively unknown which factors influence their perception. The present study is two-fold. We first focused on exploring the levels of knowledge regarding environment/water pollution due to pharmaceutical residue of the groups responsible for prescribing (health professionals), handling (staff), and consuming pharmaceuticals on a daily basis (seniors) in senior residences. Secondly, we assessed their environmental risk perception of four pharmaceutical based on two main factors: prescription medication (non-prescribed versus prescribed) and disease severity (milder versus severe disease), accounting for their level of knowledge (deficit vs. sufficiency of knowledge). Data was collected in multiple senior homes located in three Southwestern European countries – Portugal, Spain, and France (N=300), using self-report surveys. Results show that across all groups, current knowledge was perceived to be low and the need to know more was perceived to be high. Results further indicate that participants made use of irrelevant information to assess the environmental risk of the pharmaceuticals. Prescribed pharmaceuticals and/or medication used to treat severe diseases were perceived as being more hazardous for the environment. Moreover, only for disease severity did this effect occur mostly in the deficit of knowledge group. These misconceptions might discourage stakeholders to take a more active role in reducing the impact of pharmaceutical residues in the environment/water sources, causing them to overlook this crisis.