John Libbey Eurotext

Environnement, Risques & Santé

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Can doctors and pharmacists in private practice help to reduce drug residues at the source? A sociological study of these health professionals around the Arcachon basin (France) Volume 21, issue 2, March-April 2022

Authors
1 Géographe
Université de Fribourg
4, chemin du Musée
1700 Fribourg
Suisse
2 Chargé de mission « Économie et sciences sociales »
Direction de la recherche et de l’appui scientifique (DRAS)
Office français de la biodiversité (OFB)
5, square Félix Nadar
94300 Vincennes
France
3 Sociologue et consultante, chercheuse associée au laboratoire Eau environnement et systèmes urbains (Leesu)
École nationale des Ponts Paris-Tech (ENPC)
6-8, avenue Blaise Pascal
77420 Champs-sur-Marne
France
4 Ingénieure d’études en statistique, UR ETTIS
Institut national de recherche pour l’agriculture, l’alimentation
et l’environnement (INRAE)
50, avenue de Verdun Gazinet
33612 Cestas Cedex
France
5 Chargée de recherche (HDR) en économie de l’environnement et Directrice de l’UR ETTIS
Institut national de recherche pour l’agriculture, l’alimentation
et l’environnement (INRAE)
50, avenue de Verdun Gazinet
33612 Cestas Cedex
France
* Tirés à part

It is now recognized that residues of medication and more generally of care products (such as sunscreens) contaminate and disturb aquatic and marine environments. The reduction of the source of micropollutants related to drug consumption, including improved management of unused drugs, is needed. In view of their role in the consumption of these drugs in France, we conducted a qualitative sociological study of physicians and pharmacists in private practice around the Arcachon basin (Gironde, France) to examine their understanding of this issue of micropollutants from drug consumption and how they integrate this issue into their drug prescription and dispensing practices. Our study shows their lack of consideration of this issue in general, including in terms of representations, and their failure to integrate this issue into their logic of prescribing, advising, and dispensing drugs to patients and consumers. The constraints and determinants (economic, sociological, organizational, symbolic and cultural, etc.) that structure physician-patient and pharmacist-patient-consumer relationships in France do not help to reduce drug consumption, be it by professionals’ prescriptions or by self-medication. Despite their different professional representations and practices, the physicians and pharmacists surveyed always prioritized health issues (benefit-risk for the patient or the consumer) over the objective of preserving biodiversity. Nonetheless, they underline the existence of leeway for “optimizing” drug consumption in relation to micropollutants. A physician-patient relationship less constrained by time and less organized around drug prescription and a pharmacist-doctor-consumer relationship where pharmacists have a more recognized and active role in the management of individual drug treatments seem to be interesting avenues toward reducing these micropollutants at the source without jeopardizing health goals. Action by public authorities should support the greening of health professionals’ practices, at least by offering them more information and training about the environmental risks associated with the current abundant consumption of medications. Other levers and tools should help health professionals to further integrate the issues of preservation of living things into their professional logic.