Disposal practices, risk perceptions, and quantification of potential active pharmaceutical ingredients (APIs) from used human medicine in Upper Citarum River Basin

This paper highlights potential active pharmaceutical ingredients (APIs) generations from improper disposal of medicines and captures the perceptions of key stakeholders – households and pharmaceutical actors in Upper Citarum River Basin (UCRB). Most pharmaceutical waste is disposed of with household waste, suggesting landfills are the most significant APIs contamination sources. We highlight the complex relationship between knowledge, risk perception, and behavioural intentions, stressing the relevance of risk perception as a mediator when studying how knowledge affects behaviour. Age and income are suggested to moderate risk perception and behavioural intention. There is a heavy use of over-the-counter and prescription drugs in UCRB, especially Paracetamol (426.1 tons/year) and Amoxicillin (343.7 tons/year). Measured herbal APIs highlight the cultural significance and dependence on traditional medicine. We suggest examining the influence of affect on perception and behaviour in safe medicine disposal and the environmental and health risk impact of APIs in the water systems.