Critical review of technologies for the on-site treatment of hospital wastewater: From conventional to combined advanced processes. (15th October 2022)

• Record Type: Journal Article
• Authors: Pariente, M.I.; Segura, Y.; Álvarez-Torrellas, S.; Casas, J.A.; de Pedro, Z.M.; Diaz, E.; García, J.; López-Muñoz, M.J.; Marugán, J.; Mohedano, A.F.; Molina, R.; Munoz, M.; Pablos, C.; Perdigón-Melón, J.A.; Petre, A.L.; Rodríguez, J.J.; Tobajas, M.; Martínez, F.
• Is Part Of: Journal of environmental management. Volume 320(2022)
• Publication Date: 2022-10-15
• Subjects: Advanced oxidation processes -- Biological wastewater treatment methods -- Combined technologies -- Hospital wastewater -- Pharmaceutical compounds; Environmental policy -- Periodicals; Environmental management -- Periodicals; Environment -- Periodicals; Ecology -- Periodicals; 363.705
• DOI: 10.1016/j.jenvman.2022.115769
• Languages: English
• ISSNs: 0301-4797

Abstract

Abstract: This review aims to assess different technologies for the on-site treatment of hospital wastewater (HWW) to remove pharmaceutical compounds (PhCs) as sustances of emerging concern at a bench, pilot, and full scales from 2014 to 2020. Moreover, a rough characterisation of hospital effluents is presented. The main detected PhCs are antibiotics and psychiatric drugs, with concentrations up to 1.1 mg/L. On the one hand, regarding the presented technologies, membrane bioreactors (MBRs) are a good alternative for treating HWW with PhCs removal values higher than 80% in removing analgesics, anti-inflammatories, cardiovascular drugs, and some antibiotics. Moreover, this system has been scaled up to the pilot plant scale. However, some target compounds are still present in the treated effluent, such as psychiatric and contrast media drugs and recalcitrant antibiotics (erythromycin and sulfamethoxazole). On the other hand, ozonation effectively removes antibiotics found in the HWW (>93%), and some studies are carried out at the pilot plant scale. Even though, some families, such as the X-ray contrast media, are recalcitrant to ozone. Other advanced oxidation processes (AOPs), such as Fenton-like or UV treatments, seem very effective for removing pharmaceuticals, Antibiotic Resistance Bacteria (ARBs) and Antibiotic Resistance Genes (ARGs). However, they are not implanted at pilot plant or full scale as they usually consider extra reactants such as ozone, iron, or UV-light, making the scale-up of the processes a challenging task to treat high-loading wastewater. Thus, several examples of biological wastewater treatment methods combined with AOPs have been proposed as the better strategy to treat HWW with high removal of PhCs (generally over 98%) and ARGs/ARBs (below the detection limit) and lower spending on reactants. However, it still requires further development and optimisation of the integrated processes. Graphical abstract: Image 1 Highlights: This review focuses on 2014 to 2020 papers related to hospital effluents treatments. Membrane bioreactors remove pharmaceuticals (>80%) at pilot plant scale. Advanced Oxidation processes require further development at high scales. Combined technologies also remove antibiotic resistance bacteria and genes. Advanced oxidation processes are promising alternatives to treat hospital effluents.