EQUILIN

Prescription hormone therapy products containing conjugated equine estrogens; excretion after use to wastewater; releases from drug manufacturing and healthcare waste [3][4][5].

Taking these medicines; skin contact with hormone pills/creams; occupational handling in pharmacies, hospitals, or long‑term care; trace amounts may occur in water downstream of wastewater plants (typically very low) [3][4].

Steroidal estrogens are known human carcinogens; menopausal hormone therapy with estrogens increases risks for breast and endometrial cancers [1][2]. Estrogenic hormones can also disrupt fish reproduction [3].

People using estrogen therapy; healthcare and pharmacy workers who handle or clean up these drugs [2][4].

Use only as prescribed; avoid touching others’ hormone meds; do not flush—use drug take‑back or local disposal guidance; workers should follow NIOSH hazardous‑drug precautions (PPE, engineering controls) [3][4].