MEDICATION DISPOSAL: A REFLECTION ABOUT POSSIBLE SANITARY AND ENVIRONMENTAL RISKS

This article has analyzed the drug disposal form by the population of Distrito Federal (DF), reflecting about its possible health and environmental risks. For that, an exploratory cross-sectional study was conducted based on interviews with residents of all Territorial Planning Units in DF. Among the 393 interviewees, 73.8% had a stock of medicines at home, 78.9% had already discarded drugs, which were mostly done in the common waste (73,6%). Adequate discharge was strongly associated with greater schooling (p = 0,027), higher economic classification (p = 0,005), male sex (p = 0,006) and with receiving information about the subject (p <0,001). It is noted that the inappropriate disposal of drugs is common. It presents the need to incorporate the theme into specific policies and media.

Keywords:
Drug Residues; Public Health; Environmental Health; Medical Waste

Authorship

HAYSSA MORAES PINTEL RAMOS

. Sanitation Specialist, Master in Health Sciences and Technologies, Brasília University (UnB). Email: hayssaramos@hotmail.comBrasília UniversityBrazilBrazil. Sanitation Specialist, Master in Health Sciences and Technologies, Brasília University (UnB). Email: hayssaramos@hotmail.com

VANESSA RESENDE NOGUEIRA CRUVINEL

. Professor of the Collective Health Department at Ceilândia Faculty, Brasília University (UnB). Email:vanessarcruvinel@gmail.comBrasília UniversityBrazilBrazil. Professor of the Collective Health Department at Ceilândia Faculty, Brasília University (UnB). Email:vanessarcruvinel@gmail.com

MICHELINE MARIE MILWARD DE AZEVEDO MEINERS

. Professor of the Pharmacy Department at Ceilândia Faculty, Brasília University (UnB). Email: michelinemeiners@gmail.comBrasília UniversityBrazilBrazil. Professor of the Pharmacy Department at Ceilândia Faculty, Brasília University (UnB). Email: michelinemeiners@gmail.com

CAMILA ARAÚJO QUEIROZ

. Pharmacy Department of Ceilândia Faculty, Brasília University (UnB). Email: camilaqueiroz01@gmail.comBrasília UniversityBrazilBrazil. Pharmacy Department of Ceilândia Faculty, Brasília University (UnB). Email: camilaqueiroz01@gmail.com

DAYANI GALATO

. Professor of the Post-Graduation Program in Health Sciences and Technologies at Brasília University (UnB). Email: dayanigalato@gmail.com Brasília UniversityBrazilBrazil. Professor of the Post-Graduation Program in Health Sciences and Technologies at Brasília University (UnB). Email: dayanigalato@gmail.com

SCIMAGO INSTITUTIONS RANKINGS

Figures | Tables

Figures (1)
Tables (4)

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Figure 1:
Federal District Territorial Planning Units (Unidades de Planejamento Territorial do Distrito Federal). Source: adapted from the Territorial Ordering Direction Plan (Plano Diretor de Ordenamento Territorial/ DF, 2009).

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Table 1:
Socio-demographic characteristics and residence locations according to the seven Territorial Planning Units of the Federal District’s interviewees, 2016.

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Table 2:
Medication use by the interviewee or a family member, frequency of use, home pharmacy, checking on the expiring date, storage and children living in the house (data collected from the Federal District population in 2016).

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Table 3:
Medication disposal according to the interviewees’ practices, as well as motives, anatomic group, information and disposal places used by residents in the seven Federal District Territorial Planning Units, 2016.

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Table 4:
Association between the interviewees’ profile and the proper discard done by residents in the seven federal District Territorial Planning Units, 2016.

Figure 1: Federal District Territorial Planning Units (Unidades de Planejamento Territorial do Distrito Federal). Source: adapted from the Territorial Ordering Direction Plan (Plano Diretor de Ordenamento Territorial/ DF, 2009).

Table 1: Socio-demographic characteristics and residence locations according to the seven Territorial Planning Units of the Federal District’s interviewees, 2016.

Variables	N	%
Sex
Female	254	64.6
Male	139	35.4
Age (in years)
18-29	142	36.1
30-39	83	21.1
40-49	61	15.6
50-59	27	6.9
60 or older	28	7.1
Non-informed	52	13.2
Schooling
Complete elementary school	12	3.0
Incomplete elementary school	32	8.1
High School degree	159	40.4
Incomplete High school	34	8.7
College Degree	93	23.7
Incomplete higher education	62	15.8
Non-declared	1	0.3
Marital status
Single	195	49.6
Married	146	37.2
Widow/widower	9	2.3
Divorced	22	5.6
Common law marriage	16	4.0
Non-declared	5	1.3
Occupation
Assistant/sales person	143	36.4
Student	64	16.3
Education professional	27	6.9
Public server	20	5.0
housewife / retired	45	11.5
Healthcare professional	16	4.0
Other professions	18	4.6
Unemployed Non-informed	39 21	10.0 5.3
Residence location
Downtown	15	3.8
Central neighborhoods 1	16	4.0
Central neighborhoods 2	64	16.3
West side	180	45.8
South	52	13.3
East side	24	6.1
North	42	10.7
Economic classification *
A	32	8.1
B1	42	10.7
B2	92	23.4
C1	84	21.3
C2	63	16.0
D-E	26	6.7
Non-declared	54	13.8
Color/race
White	130	33.1
Black	63	16.0
Yellow	34	8.7
Brown	149	38.0
Indigenous	9	2.2
Non-declared	8	2.0

* The Brazilian Classification Criterion was used in this variable.

Table 2: Medication use by the interviewee or a family member, frequency of use, home pharmacy, checking on the expiring date, storage and children living in the house (data collected from the Federal District population in 2016).

Variables	N	%
Medication use (Family members)
Yes	299	76.1
No	89	22.6
Does not know	5	1.3
Medication use (interviewee)
Yes	243	61.8
No	150	38.2
Frequency of use (interviewee / n= 243)
Sometimes	70	28.8
Regularly	19	7.8
Everyday	115	47.3
Every once in a while Did not answer	36 03	14.8 1.3
Home pharmacy (n= 393)
Yes	290	73.8
No	103	26.2
Checking on the expiring data (n=290)
Yes	218	75.2
No	72	24.8
Time checking on the expiring date * (n= 218)
At purchase	92	42.2
At the time to take it	145	66.5
When the home pharmacy is checked	36	16.5
Others	1	0.4
Storage * (n=290)
Kitchen	125	43.1
Bedroom	116	40
Bathroom	35	12.0
Living room	13	4.5
Laundry area	9	3.1
Other	3	1.0
Children living in the house
Yes	223	56.7
No	170	43.3
Medications on children’s reach (**) (n=223)
Yes	32	14.3
No	191	85.7
Storage height (n=223)
Shorter than 1 meter	17	7.6
Between 1 and 1.5 meters	86	38.6
between 1.6 and 2 meters	20	8.9
Higher than 2 meters	46	20.7
Did not answer	54	24.2
Report on intoxication with medication (n=393)
Yes	23	5.9
No	365	92.9
Does not know	5	1.2

* The answer for this variable was of multiple choice nature and it led to a percentage higher than 100%; **estimated through the height from the floor chosen to store the medications.

Table 3: Medication disposal according to the interviewees’ practices, as well as motives, anatomic group, information and disposal places used by residents in the seven Federal District Territorial Planning Units, 2016.

Variables	N	%
Medication disposal (n=393)
Yes	310	78.9
No	83	21.1
Motive to discard* (n=310)
Was not using them	67	21.6
Expired date	195	62.9
Leftovers	57	18.3
Abandoned the treatment	13	4.1
All options above	9	2.9
Anatomic groups of the discarded medications * (n=310)
Eating tract and metabolism	27	8.7
Blood and blood production organs	19	6.1
Cardiovascular system	51	16.5
H- Hormonal system and preparations	51	16.5
J- Anti-inflammatory and antibiotics for systemic use	81	26.3
N- Nervous system,	29	9.4
R- respiratory tract	75	24.2
Others	9	2.9
Report to have received information about discard (n= 393)
Yes	76	19.3
No	317	80.7
Where did the information come from* (n=76)
Healthcare unit	4	5.3
Media	9	11.8
College/university	9	11.8
Lecture	6	7.8
Supermarket	1	1.3
Does not remember	49	64.4
How the discard was done* (n=310)
Garbage can for common residues	221	71.3
Sink	38	12.3
Toilet	25	8.0
Healthcare unit	13	4.2
Drug stores	8	2.6
University	4	1.3
Supermarket	1	0.3
Last form of discard* (n=310)
Garbage can for common residues	228	73.6
Sink	27	8.7
Toilet	22	7.0
Healthcare unit	11	3.6
Drug stores	9	2.9
University	4	1.3
Supermarket	1	0.3
Did not answer	8	2.6

* the answer for this variable was of multiple choice nature and it led to a percentage higher than 100% on the answers.

Table 4: Association between the interviewees’ profile and the proper discard done by residents in the seven federal District Territorial Planning Units, 2016.

Exposure variable	Proper disposal - n (%)	Inappropriate disposal - n (%)	p ()* value
Sex (n=302) Female Male	8 (3.9) 12 (12.4)	197 (96.1) 85 (87.5)	0.006
Age (n=273) Up to 32 years Older than 32 years	8 (5.9) 7 (5.1)	127 (94.1) 131 (94.9)	0.757
Schooling (n=301) High school Higher education	7 (4.0) 13 (10.4)	169 (96.0) 112 (89.6)	0.027
Marital Status (n=289) Single Others	8 (5.6) 12 (7.7)	134 (94.4) 144 (92.3)	0.478
Residence location (n=302) Downtown areas Others	5 (8.6) 15 (6.1)	53 (91.4) 229 (93.9)	0.496
Economic classification (n=302) A and B C, D and E	15 (11.0) 5 (3.0)	121 (89.0) 161 (97.0)	0.005
Skin color (n=302) White Non-white	8 (7.3) 12 (6.2)	102 (92.7) 180 (93.8)	0.731
Performs selective collection (n=266) Yes No	13 (7.2) 6 (7.1)	168 (92.8) 79 (92.9)	0.971
Information about disposal (n=302) Yes No	17 (29.3) 3 (1.2)	41 (70.7) 241 (98.8)	<0.001(**)

*values were significant when p≤ 0.05; **the p value was found through Fisher’s exact test.

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MEDICATION DISPOSAL: A REFLECTION ABOUT POSSIBLE SANITARY AND ENVIRONMENTAL RISKS

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[TFN1] * The Brazilian Classification Criterion was used in this variable.