Pharmaceutical Disposal Research Articles

Household Pharmaceutical Disposal Practices, Community Understanding, and Readiness for Medicines Take-Back in Asmara, Eritrea: A Cross-Sectional Analysis

Household Pharmaceutical Disposal Practices, Community Understanding, and Readiness for Medicines Take-Back in Asmara, Eritrea: A Cross-Sectional Analysis

Environmental impact of pharmaceutical contaminants in dumpsites: a study from Ejisu-Juaben municipality, Ghana

This study assessed the occurrence of nine pharmaceuticals (caffeine, ibuprofen, metronidazole, ciprofloxacin, amoxicillin, chloramphenicol, diclofenac, doxycycline, and paracetamol) in leachate and soil samples from eight dumpsites within the Ejisu-Juaben Municipality in the Ashanti Region of Ghana. It evaluated the ecotoxicological risk posed by these pharmaceuticals to organisms. The study also investigated the disposal patterns of pharmaceuticals by inhabitants of the municipality. After solid-phase extraction, the residues of selected antibiotics and analgesics in soil and leachate samples were analyzed using an HPLC–PDA method. Five of the pharmaceuticals were detected in the leachate and soil samples. Chloramphenicol, diclofenac, and paracetamol were detected in all leachate and soil samples, with concentrations ranging from 0.01 to 74.53 µg/L in leachate and 0.06–305.06 µg/kg in soil samples. Chloramphenicol had the highest concentration in leachate samples, while amoxicillin had the highest concentration in soil samples. Ecological risk assessment indicated that even the least detected pharmaceuticals posed a significant risk to fish, daphnia, and algae, with hazard quotients ranging from 0.56 to 1742.75. Survey results indicated that 71.0% of respondents disposed of unwanted or expired medicines. Within this group, 83.5% inappropriately disposed of expired drugs by placing them in household garbage, which is destined for dumpsites. Additionally, 52% of respondents wanted to protect the environment and would willingly contribute financially to enhance remediation efforts. The findings emphasize the urgent need for environmental policies and public education on proper pharmaceutical disposal to mitigate the ecological risks posed by pharmaceutical contaminants in developing regions. Altogether, the study highlights the presence of pharmaceutical residues in dumpsites at levels that could harm the ecosystem's health. Continuous monitoring and strategies to reduce pharmaceutical release into the environment are essential to protect the environment.

Medication Disposal Patterns and Practices with Awareness of Environmental Contamination Caused by Pharmaceuticals among the General Public in Malaysia.

The proper disposal of pharmaceuticals has become a prime concern in contemporary healthcare and environmental management. The evolving awareness highlights the ecological and public health risks associated with pharmaceutical waste. Therefore, evaluating medication disposal patterns and public awareness regarding pharmaceutical-related environmental issues is crucial for promoting responsible practices. The primary aim of this study is to identify the determinants of participation in the Medicine Return Program (MRP) among Malaysians. This cross-sectional study employed snowball sampling and an online questionnaire, disseminated via multiple social media platforms. Results: Out of 389 respondents, 46% were 18 to 29 years old, 61% were female, and 69.7% attained a tertiary educational level. Most of them (71.5%) reported disposing of their unused medicines into the rubbish bin, indicating that this disposal method is prevalent among Malaysians. Only 26.2% participated in the MRP program. The study revealed that 73.0% of respondents were aware of pharmaceutical-related environmental contamination. Furthermore, significant associations were demonstrated between a factor of receiving advice from healthcare professionals (p < 0.001), awareness level on environmental pharmaceutical contamination (p < 0.001) and MRP (p < 0.001) and willingness to participate in MRP (p < 0.001) with MRP support. This study provides valuable insights on Malaysian pharmaceutical disposal practices and the factors influencing MRP participation. These findings can inform targeted interventions and public health campaigns to improve medication disposal behaviors and reduce pharmaceutical waste's environmental impact.

Prevalent Parental Practice Toward Drug Storage and Disposal.

Introduction The environment, healthcare services, and public safety can all be directly impacted by improper drug storage and disposal practices. It is unknown whether parents store drugs at home in accordance with recommended storage guidelines, despite the fact that storage conditions are strictly regulated and monitored at every stage of the drug supply chain prior to drug dispensing. Therefore, it is crucial to dispose of medications properly and store them at home to avoid the consequences. Aim The purpose of this study was to evaluate the drug storage safety measures used by parents to prevent unintentional drug poisoning in children. Methodology A structured questionnaire was used to conduct a cross-sectional, interview-based study on home medication storage, attitudes, and disposal practices between October 2023 and January 2024. We recruited parents who visited primary healthcare centers or pediatric clinics using a convenience sampling technique. Results All of the 353 returned questionnaires were valid for data entry and analysis. The mean age of the parents was 35.1 ± 11.9 years old and more than half of them 229 (64.9%) have bachelor's degrees. The majority of drugs (271, 88.6%) were stored in the fridge, followed by bedrooms (26.8%). The medication classes that were stored the most frequently were analgesics (92.2%) and antihistamines (62.1%). The majority of parents (214, 69.9%) kept medications above adult eye level, even though only 28% did not keep them in safe and secure locations like locked drawers or boxes. Eighty percent (80%) disposed of unwanted medicines by throwing them in the trash, and only 10 (2.8%) returned them to the pharmacy. Conclusions Drug storage at home encourages self-medication, which has a number of negative effects. Over time, there has been an increase in the use of medications due to a rise in people's health-seeking awareness and behavior on a global scale. Therefore, this study may be used as a guide by national policy-makers for pharmaceutical disposal and storage management. Moreover, it might help in raising public awareness of the importance of pharmacists in the society and the safe handling and storage of medications at home.

Impact of Educational Intervention on Pharmaceutical Waste Management in a Tertiary Care Teaching Hospital-Healthcare Staff Centered Study

Expired and unused medicines are potentially toxic substances that should be managed effectively to avoid accumulation of potentially toxic pharmaceuticals in the hospital and environment. This study aimed to identify and assess the disposal practices of pharmaceutical waste at tertiary care teaching hospital. A cross-sectional prospective questionnaire study was conducted for a period of six months at tertiary care teaching hospital with a sample size of 120. Healthcare professionals above the age of 18 years were included in the study. Data from the questionnaire was analyzed using appropriate statistical tools and Chi-square test. A pre and post educational intervention study was conducted among 120 participants. The study found that 90.83% (109) participants were under the age group of 18-25 years. Among them 77.5% (93) were female and 22.5% (27) were male. Before intervention only 80.8% (97) participants were aware of different types of bags used to dispose pharmaceutical waste, whereas after educational intervention 97.5% (117) are aware of bags used to dispose pharmaceutical waste (x2=0.000&lt;0.001). Before intervention 55.83% (67) of participants were known of drug takeback system, after intervention 99.16% (119) known of drug takeback system (x2=0.000&lt;0.001). Majority of the study participants agreed that safe pharmaceutical disposal practice is an important concern in both pre and post study. Hence awareness and concern regarding the problem is high. It was observed that the knowledge of healthcare staff about pharmaceutical waste management was good. We found that educational programs can improve staff awareness level on pharmaceutical waste management.

Public awareness on the rationale consumption and appropriate disposal methods of unused and expired medications in Kanchipuram district, Tamilnadu, India

Background/Aim: Improper drug disposal methods are a threat to the nature and its ecosystem by accumulation of active compounds included in these pharmaceuticals. Aim of this study was to assess the knowledge, attitude and practice (KAP) on the rationale consumption and appropriate disposal methods of unused and expired medications among common public in Kanchipuram district, Tamilnadu, India. Method: KAP questionnaire was prepared to get responses from all participants who had volunteered for the study. Questionnaire had queries pertaining to the personal information about the respondent and respondent's knowledge, practice and attitude concerning drug usage, the disposal methods of unused and expired medicines and their awareness and knowledge towards drug take back programme. Results: In this study 37.91 % out of the 807 participants had excellent knowledge on the rationale consumption and appropriate disposal of unused/expired medications, 48.94 % had average knowledge, but only 6.56 % of the total participants had more positive attitude and 66.66 % had positive attitude. Only around 45.84 % of the participants were following the good practices. Conclusion: Guidelines, policies and strict vigilant actions need to be initiated by government of India for safe utilisation of pharmaceutical products and disposal of unused/expired medications to safeguard our ecosystem from some of the major treats like antimicrobial resistance.

The veterinarian's role in and attitude to the disposal of unwanted pharmaceuticals

A wide range of pharmaceutical chemicals have been documented in rivers, streams, lakes, coastal waters, groundwater, sewage sludge, landfill leachate, soils, air, and plant and animal tissues nationwide and around the world. Veterinarians’ unique relationship with pharmaceuticals compared to other health professionals provide a wide breath of potential pathways. Given the role that veterinarians can play as both a source of new pharmaceuticals to the environment and a method of drug disposal, as well as their role as trusted professionals, the veterinarian is key to keeping unused and unwanted medicine out of the environment. However, little is known about their behaviors. The objectives were to: learn about the drug disposal practices of the veterinarian and their clients from the veterinarian's perspective; learn about the importance of the topic of drug disposal to veterinarians; and determine the outreach needs and preferences of veterinarians and how best to educate about this issue. This research was conducted through a cross-sectional online survey of licensed veterinarians in states within the Great Lakes region working with those states’ veterinary medical associations or licensing boards. The 587 respondents were 72% female, 81% small animal practice, and 52% practicing in suburban geographic areas. Legal disposal requirements were the biggest factor influencing veterinarians to change pharmaceutical disposal behaviors followed by avoiding misuse and abuse. Veterinarians discussed disposal with clients in only 11% of appointments with clients. The most notable barriers include not remembering to mention, not enough time, not high enough priority, or not enough information known by the veterinarian. Continuing education opportunities need to be provided across the spectrum of practicing veterinarians so they can have a greater understanding of the problem of pharmaceutical waste and potential avenues they can implement to mitigate.

Self-Reported Pharmaceutical Storage, Use, and Improper Disposal to The Environment Among Urban Parents in Indonesia

Pharmaceuticals are increasingly used to treat and prevent disease globally. However, this trend has the potential to increase pharmaceutical discharge into the environment, especially from households. Pharmaceuticals released into the environment can harm human health, e.g., antimicrobial resistance. Thus, it is important to understand the drivers of pharmaceutical use, storage, and disposal among the community. The main objectives of this study are twofold: (1) to identify the commonly stored and used pharmaceuticals based on its classification; and (2) to identify the disposal method of unused pharmaceuticals at home. In October 2018, an exploratory online survey was conducted on 262 urban parents in the Jabodetabek area and Bandung with children ≤5 years old. This online survey revealed that the most stored medicine at home was acetaminophen. Irrational use of medicines was more common in the treatment-seeking behavior of parents rather than children. Doctor’s prescription is the most factor affecting buying decisions of pharmaceuticals at home, whether for themselves or their children. In most cases, pharmaceutical waste was treated as domestic waste, which was improper disposal. To reduce improper use and disposal, we suggest a targeted campaign to raise awareness of pharmaceutical waste’s unintended health and environmental impacts.

Assessment on disposal practices of unused and expired medications

Pharmaceutical disposal practices have become a global issue that has caught the concern of health authorities, pharmaceutical firms, healthcare practitioners, and the general public. The current study aimed to assess the disposal practices of unused and expired medications among the households Namakkal district, Tamil Nadu, India. The qualitative, cross-sectional study was conducted using a well-structured questionnaire form. A total of 400 responses were obtained from each member of the family. Participants under the age of 18 were excluded from the study. Respondents who refused to participate were not included in the study. More than 50% of the study population reported that they stored unused and expired medications at home. Most of the participants revealed that the unused medications they stored costs approximately ≤₹300. Majority of participants dispose unused/expired medications by means of trash can (53.1%). A significant population (71.2%) was unaware of novel disposal practices like drug take-back system. The study concluded that there is an inappropriate disposal practice among households which has to be rectified by providing awareness among the public. Further studies should be conducted for the development of well formalized protocol regarding proper disposal practices.

Recycling of Expired Ceftamil Drug as Additive in the Copper and Nickel Electrodeposition from Acid Baths.

Due to the large quantity of expired and unused drugs worldwide, pharmaceutical disposal has become a serious problem that requires increased attention. In the present paper, the study on recycling ceftazidime (CZ) as an additive in copper and nickel electrodeposition from acid baths is highlighted. CZ is the active substance from expired commercial drug Ceftamil®. Its electrochemical behavior was studied by cyclic voltammetry. As well, kinetic parameters for copper and nickel electrodeposition were determined using Tafel plots method at different temperatures and CZ concentrations in these acid baths. The activation energy was calculated from Arrhenius plots. Electrochemical impedance spectroscopy was used to investigate the charge transfer resistance and coverage degree in the electrolyte solutions at several potential values. Gibbs free energy values, calculated from Langmuir adsorption isotherms, revealed the chemical nature of CZ–electrode surface interactions. The favorable effect of the organic molecules added in copper and nickel electroplating baths was emphasized by optical microscope images. The morphology of the obtained deposits without and with 10−4 mol L−1 CZ was compared. The experimental results revealed that expired Ceftamil® is suitable as additive in copper and nickel electroplating processes from acid baths.

Pharmaceutical Pollution and Disposal of Expired, Unused, and Unwanted Medicines in the Brazilian Context.

The occurrence of pharmaceuticals in the environment is an everyday recognized concern worldwide, and drugs as environmental contaminants have been detected in water and soil systems, posing risks to humans and wildlife. The presence of drugs in wastewater, groundwater, and even drinking water occurs in several countries, including Brazil, where the pharmaceutical market is expanding over the years. The adverse, harmful effects of pharmaceuticals in the environment range from the spreading of antimicrobial resistance and species survival to the interference with reproduction and increased cancer incidence in humans. Therefore, it is demanding to count on proper legislation to prevent these pollutants from entering the distinct environment compartments. In some developed countries, laws, directives, programs, and initiatives regarding drug disposal reach a mature status. In Brazil, federal laws dealing with drug residues’ management are recent, with flaws that might facilitate non-compliance with drug pollution issues. Besides, pharmacies and drugstores are not obligated to collect unneeded household medicines, while particular State laws aim to ordinate the disposal of drug residues regionally. In this review, we consider the current knowledge about pharmaceutical (drug) pollution, the recommendation and regulations on the disposal of useless medicines in some countries, and in the context of the expanding pharmaceutical market in Brazil. The awareness of emerging contaminants in the environment, besides the joint effort of authorities, consumers, and the general public nationwide, will be required to avoid pharmaceutical/drug pollution and achieve an eco-friendly environment and a sustainable society.

A novel and safe pharmaceutical effluent disposal protocol by glass-based Ag0 nanocomposite/oxidant degradation process and Ascorbic acid cooperation

In this study, the glass based Ag0 nanocomposite was synthesized for the activation of persulfate ions as an oxidant. Field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD) method and high-resolution transmission electron microscopy (HR-TEM) were applied to characterize the nanocomposite. Moreover, the effects of operational parameters on the removal of Cefixime (CFE) were investigated via S2O82−/Ag-NC/heat. Artificial Neural Network (ANN) and Decision Tree (DT) algorithms were expanded to optimize the results of the CFE removal process. The results revealed that in the optimal conditions (i.e., time of reaction = 90 min, temperature= 70 °C, [CFE]0 = 25 mg L−1, pH0 = 3.57, [K2S2O8]0 = 70 mM and Ag-NC dosage = 0.2 g), the CFE removal efficiency and the total organic carbon (TOC) removal were 100% and 94.9%, respectively. The kinetic study and LC-MS/MS analysis were then carried out to better understand the CFE decomposition process. Besides, the reusability test of Ag-NC displayed only 2.5% reduction of the CFE removal after five consecutive runs, thus showing that Ag-NC has ultra-high catalytic stability. Consequently, the use was made of Ascorbic Acid as a post-treatment process to reduce the eco-toxicity level of the effluent. Lemna minor (L. minor) survival confirmed the environmentally friendly oxidation process. Thus, all of the obtained results demonstrated that Ag-NC and the used procedures could contribute to increasing our understanding of their potential in engineering and environment sciences, as well as decreasing the operational costs.

Institutional Collective Action on Drugs: Functional and Vertical Dilemmas of Unused Pharmaceuticals

The authors use the Institutional Collective Action Framework to analyze the barriers, opposition, and opportunities for residential pharmaceutical disposal programs in the United States via a case study on a series of take‐back programs pioneered in the state of Washington by local and state governments, as well as the corresponding backlash from federal agencies. While successful in some ways, these innovative solutions directly challenged the competing federal policy regimes controlled by the Drug Enforcement Agency (DEA), and, to a lesser extent, the Environmental Protection Agency (EPA). Findings from case studies suggest that functional dilemmas created by existing institutions with entrenched regulatory regimes are a key challenge to finding efficient solutions to vertical ICA dilemmas. Conclusions, then, connect to the broader ICA research agenda, and implications for multi‐level governance issues.

Characterization and Optimization of process parameter for Pharmaceutical waste management and disposal by using Nano Zero Valent Iron impregnated agricultural waste from aqueous solution

Characterization and Optimization of process parameter for Pharmaceutical waste management and disposal by using Nano Zero Valent Iron impregnated agricultural waste from aqueous solution

Pharmaceutical disposal facilitates the mobilization of resistance determinants among microbiota of polluted environment

The emergence of resistance on exposure to pharmaceuticals among microorganisms has raised serious concern in the therapeutic approach against infectious diseases. Effluents discharge from hospitals, industries, and urban settlements containing pharmaceuticals and other toxic compounds into the aquatic ecosystem selects bacterial population against them; thereby promotes acquisition and dissemination of resistant traits among the inhabitant microbiota. The present study was aimed to determine the prevalence and multidrug resistance pattern of Extended Spectrum β-lactamase (ESBL) producing and non-producing bacterial isolates from the heavily polluted Delhi stretch of river Yamuna, India. Additionally, the role of abiotic factors in the dissemination of conjugative plasmids harbouring resistance genes was also studied using E. coli J53 as recipient and resistant E. coli isolates as donor strains. Of the 227 non-duplicate bacterial isolates, 60% (136) were identified as ESBL+ and 40% (91) as ESBL. ESBL+ isolates were found highly resistant to β-lactam and non-β-lactam classes of antibiotics compared with the ESBL− isolates. 68% of ESBL+ and 24% of ESBL− isolates showed an MAR index of ≥0.5. Surprisingly, multidrug resistance (MDR), extensively drug resistance (XDR), and pandrug resistance (PDR) phenotype were observed for 78.6%, 16.9%, and 0.7% of ESBL+ and 90%, 3%, and none for PDR among ESBL− isolates. Conjugation under different conditions showed a higher mobilization rate at neutral pH (7–7.5) for ESBL+ isolates. Conjugation frequency was maximum at 40 °C for the isolate E. coli MRB6 (4.1 × 10−5) and E. coli MRE32 (4.89 × 10−4) and at 35 °C for E. coli MRA11 (4.89 × 10−5). The transconjugants obtained were found tolerating different concentrations of mercuric chloride (0.0002–0.2 mg/L). Increased biofilm formation for ESBL+ isolates was observed on supplementing media with HgCl2 (2 μg/mL) either singly or in combination with CTX (10 μg/mL). The present study demonstrates that anthropogenically influenced aquatic environments act as a reservoir of MDR, XDR, and even PDR strains; thereby posing a potent public health risk.

Overview of Pharmaceutical Disposal Methods: Addressed to the General Assembly of Illinois

Drug donation programs increase medication availability and encourage proper pharmaceutical disposal. Proper disposal decreases the potential human and environmental risk posed by the presence of pharmaceutical compounds in water bodies. Furthermore, the public health hazard of drug abuse is mitigated due to the decreased availability of drugs. The preferred pharmaceutical disposal method is through drug take-back programs, in which medications are returned to local pharmacies, law enforcement, or other responsible agencies. Take-back programs can also involve medication donation, and states such as Oklahoma and Iowa have programs to fill prescriptions for people who would otherwise have financial difficulty. Because the state of Illinois currently does not have an enacted law for the donation and reuse of medication, we propose that Illinois enact clearer laws regarding pharmaceutical disposal and take-back programs.

Leftover drug disposal: Customer behavior, pharmacist recommendations, and obstacles to drug take-back box implementation

Production and use of pharmaceuticals in the United States is high and continues to grow. This, combined with poor wastewater removal rates for drugs in excreted waste, and improper pharmaceutical disposal leads to the presence of pharmaceuticals in fresh- and marine waters and wildlife. In the United States, safe drug take-back boxes, or dropboxes, were established in pharmacies after federal legislation passed in 2014, allowing for year-round safe collection of leftover pharmaceuticals. The overarching objective of this work was to identify opportunities for improving access to proper pharmaceutical disposal. We assessed consumer behavior regarding drug disposal choices and knowledge of dropboxes at pharmacies, investigated pharmacist attitudes toward and recommendations about leftover drug disposal, and compared responses at locations with and without dropboxes. We also explored obstacles to dropbox adoption and usage. We found that customer awareness of dropboxes as well as knowledge about risks of improper disposal are low, however awareness was greater at pharmacies with dropboxes. Additionally, pharmacists at dropbox locations were more consistent in their messaging to customers, more likely to recommend proper disposal methods, and more supportive of drug take-back programs. Through a focus group, we learned that further consumer education would overwhelm the capacity of the existing dropboxes. Based on our findings, we recommend solutions to improper disposal focus on legislation mandating dropboxes at pharmacies and pressure on the pharmaceutical industry to fund proper disposal of unused pharmaceuticals.

What's in Your Body of Water? A Pilot Study Using Metaphoric Framing to Reduce the Psychological Distance in Pharmaceutical Pollution Risk Communication.

Aquatic pharmaceutical pollution poses ecotoxicological risks to the environment and human health. Consumer pharmaceutical use and disposal behaviors represent a significant source of pharmaceutical compounds in surface waters, and communication strategies are needed to promote pro-environmental behaviors to reduce pharmaceutical pollution. Designing effective risk communication campaigns requires an understanding of public perceptions of aquatic pharmaceutical pollution. The purpose of this mixed-methods pilot study was to test the efficacy of using theories from cognitive linguistics and psychology (conceptual metaphor theory and construal level theory of psychological distance, respectively) in using metaphors in pharmaceutical pollution risk communication. Our methods included a randomized cross-over design in which a convenience sample of university students (n = 20) viewed visual representations of pharmaceutical pollution risks (metaphor based and non-metaphor). We used cognitive interviewing methods to assess metaphor use on participants understanding of pharmaceutical pollution risk, concern about this risk, and willingness to act. Results indicate that participants preferred the metaphorically-framed visual, and that the use of metaphor significantly reduced participants' perceived social and geographic distance of pharmaceutical pollution risk, suggesting a relationship between metaphoric framing and psychological distance warranting additional research. Theoretical and practical implications of metaphor use in risk communications are discussed.

Consumer willingness to pay for a pharmaceutical disposal program in Serbia: A double hurdle modeling approach

Proper collection and disposal of pharmaceutical waste from households can reduce the negative influence of medicines on the environment. The aim of this paper is to examine the current methods of disposal of unused medicines from households, as well as the willingness of Serbian residents to participate and bear the costs of an organized collection program. Moreover, this research aims to define factors contributing to an individual's willingness to participate and pay for a medicine collection program. The survey included randomly selected patients older than 18 years visiting private pharmacies in the four largest Serbian cities. The questionnaire included information regarding the presence of unwanted medicines within the household, general medicine disposal practices, the likelihood to participate in a medicine take-back program, willingness to pay for a medicine disposal program (per prescription and per visit), importance to the environment, and demographic variables from participants. Approximately 80% of surveyed respondents are very or somewhat likely to participate, however less than half of the respondents are willing to pay for the collection of their unused medicines. The factors that influenced willingness to participate are environmental awareness and income, while the factors affecting willingness to pay, are previously received advice about proper disposal, education level, number of unwanted medicines in the household and gender. The majority of Serbian people dispose unused medicines improperly, mostly into household garbage. Well-organized and easily accessible collection programs are essential in order to enable the general public to return unused medicines for proper disposal.

The importance of household pharmaceutical products disposal and its risk management: Example from Southwestern Europe

The presence of pharmaceuticals in the environment is an emergent unknown environmental problem, linked to increased production and consumption of pharmaceuticals and, as such, understanding risk perception is fundamental. This study focuses on exploring causes (trust and knowledge) and effects (intention and proper individual disposal of pharmaceutical leftovers) of environmental and health risk perception. Survey data was collected in Portugal, Spain, and France (sample of 509 individuals). Data illustrated that in France, where the quantity of recycled pharmaceuticals is much higher, respondents reported a higher need for knowledge, but not a higher risk perception nor self-reported behaviour. Although previous research illustrates that higher trust correlates with lower risk perception, we found a positive correlation, which highlights the need to comprehend these variables in emergent risks. Results further confirmed a hypothesized moderated mediation model to explain proper disposal behaviour. We found an indirect effect of risk perception on behaviour through intention, which was stronger for participants with higher environmental identity. Understanding the causes and effects of risk perception of pharmaceuticals in the environment thereby contributes to improve pharmaceutical waste management processes and to promote the proper disposal of pharmaceuticals.