Pharmaceuticals are in many cases an indispensable element of a comfortable and healthy life. Nevertheless, there is also a downside to the widespread and increasing use of drugs: the occurrence of their residues in the aquatic environment and in drinking water. Although there is evidence
for negative effects of active pharmaceutical ingredients (APIs) in some animal and plant species, it has not yet been shown which risks in fact exist for humans and the environment. At the same time there is evidence that people will reject drinking water which contains only the smallest
traces of APIs, despite claims that such traces are harmless. In this mélange of high uncertainties, subjective risk perception, and the undisputed societal benefit of pharmaceuticals, established risk management procedures are likely to fail. Addressing this issue, the article will
suggest applying the concept of systemic risk to the case of APIs in drinking water. With this concept as basis a practical approach to risk management will be presented. It draws upon the recently developed concept of risk governance, as well as the precautionary principle. Finally, concrete
measures for risk precaution in the spheres of drug development, handling of drugs, and technical emissions control in urban water management will be presented.
Risks have been classically understood as a probability of damage or a potential hazard resulting in appropriate management strategies. However, research on environmental issues such as pollutants in the aquatic environment or the impacts of climate change have shown that classical management approaches do not sufficiently cover these interactions between society and nature. There have been several attempts to develop interdisciplinary approaches to risk that include natural as well as social science contributions. In this paper, the authors aim at developing a social-ecological perspective on risk by drawing on the concept of societal relations to nature and the model of provisioning systems. This perspective is used to analyze four cases, pharmaceuticals, microplastics, semicentralized water infrastructures and forest management, with regard to risk identification, assessment and management. Finally, the paper aims at developing a perspective on risks which takes into account non-intended side-effects, system interdependencies and uncertainty.
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