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Reducing the environmental impact of medicines is an important part of Region Stockholm's environmental work. Preventive environmental work contributes to healthy residents in an environment of fresh air and clean water. Efforts to reduce the content of the most environmentally harmful drug substances in nature are therefore an important part of Region Stockholm's environmental work. This work involves assessing and classifying pharmaceuticals following their environmental impact.

The pharmaceuticals are classified both in terms of their inherent capacity to affect the environment (environmental hazard), and to the environmental risk posed by the pharmaceutical substances when used to their current extent. The environmental hazard assessment was initiated in 2003 by Environmental Department of the former Stockholm County Council. During 2005, the classification was extended to also cover an environmental risk assessment.

The classification system is used in considering the environmental impact of the pharmaceuticals on the so called Wise list, a list of recommended pharmaceuticals for common diseases in Region Stockholm, issued by the Drug and Therapeutics Committee.

The information on environmentally classified pharmaceuticals has been transferred to a database in 2016. From the beginning, the classification has been based mainly on environmental data from fass.se. For newly approved pharmaceutical products environmental information may be obtained from the European Public Assessment Report (EPAR) by the European Medicines Agency (EMA). Nowadays, additional environmental information is also available, where risk assessment is made based on concentrations measured in the environment in Sweden and efficacy studies that are judged to be of good quality. The database is continuously updated with such information.

Author: Health and Medical Care Administration, Region Stockholm.

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