Safe lists for medications in pregnancy: inadequate evidence base and inconsistent guidance from Web-based information, 2011.

PURPOSE: Medication use during pregnancy is common and increasing. Women are also increasingly getting healthcare information from sources other than their physicians. METHODS: This report summarizes an environmental scan that identified 25 active Internet sites that list medications reported to be safe for use in pregnancy and highlights the inadequate evidence base and inconsistent guidance provided by these sites. RESULTS: These lists included 245 different products, of which 103 unique components had been previously evaluated in terms of fetal risk by the Teratogen Information System (TERIS), a resource that assesses risk of birth defects after exposure under usual conditions by consensus of clinical teratology experts. For 43 (42%) of the 103 components that were listed as 'safe' on one or more of the Internet sites surveyed, the TERIS experts were unable to determine the fetal risk based on published scientific literature. For 40 (93%) of these 43, either no data were available to assess human fetal risk or the available data were limited. CONCLUSIONS: Women who see a medication on one of these 'safe' lists would be led to believe that there is no increased risk of birth defects resulting from exposure. Thus, women are being reassured that fetal exposure to these medications is safe even though a sufficient evidence base to determine the relative safety or risk does not exist.

Are sustainable drainage systems (SuDS) effective at retaining dissolved trace elements?

Sustainable drainage systems (SuDS) are increasingly deployed to mitigate against increased trace element contaminant loads associated with urban and road runoff. However, there is a lack of research on their capabilities in removing these trace elements, particularly from the dissolved phase. Water samples were taken, following various rainfall events, from three different SuDS in Devon; one wetland pond adjacent to a busy dual carriageway, a new SuDS serving a housing estate and an established SuDS draining a mixed housing/light industrial area. A total of 15 elements were studied over the course of six rain events including the first flush of runoff. Removal rates varied within and between rain events as well as between types of SuDS. Although there was a general (modest) removal of dissolved elements within any given SuDS, this was not the case for all of the elements studied. Highest observed element concentrations entering the SuDS occurred at the onset of a rain event (first flush), the intensity of which, was related to the antecedent dry period. During high flows associated with intense rainfall, the SuDS could also act as a source of trace elements associated with fine particulates (e.g. lead) owing to resuspension of fine particulate material. Mature ponds with an abundance of macrophytes help retain solids and particulate metals, however poor maintenance leading to successional growth of shrubs and trees, reduces the efficiency of metal removal. This study highlighted the importance of long-term management planning to be included within any SuDs scheme.