探討聯合國及美國對放流水中環境持久性藥物汙染物 之管理現狀及執行策略

Abstract

近年來，全球人口增長與醫療需求提升，環境持久性藥物污染物（Environmental Persistent Pharmaceutical Pollutants, EPPPs）已成為全球環境治理的重要議題。EPPPs主要來源包括家庭污水、醫療機構及製藥業廢水，這些污染物因其化學穩定性與生物降解性低，容易在水體中長期累積，對生態系統與人類健康構成潛在風險。研究顯示，EPPPs可能影響水生生物的繁殖能力、干擾內分泌系統，並加劇抗生素抗性菌株的擴散，使公共衛生面臨更大挑戰。由於EPPPs在環境中的普遍性與危害性，國際社會對其治理的關注度日益提升。 本研究分析聯合國（UN）與美國（U.S.）在放流水EPPPs管理方面的政策與執行策略，探討其異同點與挑戰。聯合國透過《國際化學品策略方針》（SAICM）與《可持續發展目標》（SDGs）等國際框架，鼓勵各國加強監測與污水處理技術發展。而聯合國的政策多為指導性建議，欠缺強制性，使各國落實情況存在顯著差異，特別是在技術與經濟資源有限的發展中國家，EPPPs的治理成效仍然不足。相較於美國環保署（EPA）則透過《清潔水法》（CWA）與《安全飲用水法》（SDWA）建立嚴格的污染物監管標準，要求污水處理廠強化EPPPs去除技術，並實施藥品回收計畫，以降低藥物污染風險。另外，美國近年來積極研發並應用先進污水處理技術，如活性碳吸附、薄膜過濾技術與先進氧化技術（AOPs），以提升藥物污染物的去除率。而現行技術仍然無法完全消除所有類型的EPPPs，顯示政策與技術發展之間的落差。 本研究發現，聯合國強調國際合作與政策指導，有助於全球性污染治理的長遠規劃，但因缺乏強制性約束，使執行成效受各國資源與政策優先順序影響；美國則透過嚴格法規與技術發展，提高EPPPs管控成效，但高昂的治理成本與監測範圍的限制仍是一大挑戰。經過綜合比較後，建議未來聯合國與美國於EPPPs治理上應加強國際間法規協調、促進污水處理技術創新、優化藥品回收制度，並提高公眾參與度，以確保全球水資源的永續發展。而台灣目前在EPPPs的管理上仍處於初步階段，雖然《水污染防治法》與《廢棄物清理法》已規範部分醫療廢水與藥品廢棄物的處理，但針對EPPPs的專門法規與監測標準仍需進一步強化，可透過參考歐盟與美國標準，制定台灣水體中EPPPs的允許濃度，並強制污水處理廠進行定期監測與報告，以及提供政府補助，幫助污水處理廠導入先進處理技術，如活性碳吸附或薄膜過濾技術，以提高EPPPs去除效率。未來，在法規制定、技術創新、藥品回收與公眾教育等方面同步推動，確保EPPPs的污染問題能獲得更全面的治理，並與國際標準接軌，以維護水資源的永續發展。

With the rapid growth of the global population and the increased demand for healthcare, Environmental Persistent Pharmaceutical Pollutants (EPPPs) have emerged as a critical issue in global environmental governance. EPPPs mainly originate from domestic sewage, healthcare facilities, and pharmaceutical manufacturing wastewater. Due to their high chemical stability and low biodegradability, these pollutants tend to accumulate in water bodies over time, posing significant risks to both ecosystems and human health. Studies indicate that EPPPs can impair the reproductive capabilities of aquatic organisms, disrupt endocrine systems, and facilitate the spread of antibiotic-resistant bacteria, thereby intensifying public health challenges. As a result of their widespread presence and potential hazards, international attention towards the management of EPPPs has steadily increased. This study examines the policies and implementation strategies adopted by the United Nations (UN) and the United States (U.S.) for managing EPPPs in effluent discharges, highlighting their similarities, differences, and associated challenges. The UN, through international frameworks such as the Strategic Approach to International Chemicals Management (SAICM) and the Sustainable Development Goals (SDGs), advocates for enhanced monitoring and the development of advanced wastewater treatment technologies. However, the UN’s recommendations are largely advisory and lack enforceability, leading to significant variations in implementation—especially in developing nations with limited technical and economic resources. In contrast, the U.S. Environmental Protection Agency (EPA) enforces stringent regulatory standards through the Clean Water Act (CWA) and the Safe Drinking Water Act (SDWA), requiring wastewater treatment plants to upgrade their EPPP removal technologies and implement pharmaceutical take-back programs to mitigate pollution risks. Moreover, the U.S. has actively developed and applied advanced treatment technologies, including activated carbon adsorption, membrane filtration, and advanced oxidation processes (AOPs), to enhance the removal efficiency of pharmaceutical pollutants. Nonetheless, existing technologies remain insufficient to completely eliminate all types of EPPPs, revealing a gap between policy ambitions and technological capabilities. The findings of this study suggest that while the UN’s emphasis on international cooperation and policy guidance is beneficial for long-term global pollution management, the absence of binding regulations leads to varied outcomes based on national resources and policy priorities. Conversely, the U.S. model, characterized by strict regulations and technological advancements, achieves higher efficacy in controlling EPPPs but faces challenges related to high implementation costs and limited monitoring scopes. Based on a comprehensive comparative analysis, this study recommends that future management of EPPPs should involve enhanced international regulatory coordination, continuous innovation in wastewater treatment technologies, optimization of pharmaceutical recycling programs, and increased public engagement to ensure the sustainable development of global water resources. In the context of Taiwan, current EPPP management remains at an early stage. Although the Water Pollution Control Act and the Waste Disposal Act regulate certain aspects of medical wastewater and pharmaceutical waste, there is a pressing need for specialized regulations and monitoring standards for EPPPs. By adopting standards from the European Union and the United States, Taiwan should establish permissible concentration limits for EPPPs in water bodies, mandate regular monitoring and reporting by wastewater treatment facilities, and provide government subsidies to support the integration of advanced treatment technologies such as activated carbon adsorption or membrane filtration. A synchronized effort in legislative formulation, technological innovation, pharmaceutical recycling, and public education is essential to comprehensively address EPPP challenges and align with international standards to safeguard sustainable water resource management.