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Review
. 2015 May 1:514:467-91.
doi: 10.1016/j.scitotenv.2015.02.020. Epub 2015 Feb 16.

What have we learned from worldwide experiences on the management and treatment of hospital effluent? - an overview and a discussion on perspectives

P Verlicchi  1 , M Al Aukidy  2 , E Zambello  3
Affiliations
Review

What have we learned from worldwide experiences on the management and treatment of hospital effluent? - an overview and a discussion on perspectives

P Verlicchi et al. Sci Total Environ. .

Abstract

This study overviews lessons learned from experimental investigations on dedicated treatment systems of hospital effluent carried out worldwide in the last twenty years. It includes 48 peer reviewed papers from 1995 to 2015 assessing the efficacy of different treatment levels (preliminary, primary, secondary and polishing) of hospital wastewater in removing a wide spectrum of pharmaceutical compounds as well as conventional contaminants. Moreover, it highlights the rationale and the reasons for each study: reducing the discharge of micropollutants in surface water, improving existing wastewater treatment technologies and reducing the risk of spread of pathogens causing endemic diseases and finally, it offers a critical analysis of the conclusions and suggestions of each study. The most investigated technologies are membrane bioreactors equipped with ultrafiltration membranes in the secondary step, ozonation followed by activated carbon filtration (in powder and in granules) in the polishing step. Interesting research projects deal with photo-Fenton processes acting as primary treatments to enhance biodegradation before biological treatment, and as a polishing step, thus further reducing micro-contaminant occurrence. Investment and operational costs are also presented and discussed for the different treatment technologies tested worldwide, in particular membrane bioreactors and various advanced oxidation processes. This study also discusses the need for further research to evaluate toxicity resulting from advanced oxidation processes as well as the need to develop an accurate feasibility study that encompasses technical, ecotoxicological and economic aspects to identify the best available treatment in the different situations from a global view point.

Keywords: Advanced oxidation processes; Environmental risk assessment; Hospital effluent; Pharmaceutical removal; Toxicity; Treatment costs.

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Figures

None
Graphical abstract
Fig. 1
Fig. 1
Observed removal efficiencies from HWW for selected PhCs in different primary treatments.
Fig. 2
Fig. 2
Observed removal efficiencies for a group of selected compounds in MBRs and CAS operating at different SRTs.
Fig. 3
Fig. 3
Observed removal efficiencies for a group of selected compounds in MBRs and CAS operating at different SRTs.
Fig. 4
Fig. 4
Observed removal efficiencies for a group of selected PhCs in HWW by PAC and GAS systems.
Fig. 5
Fig. 5
Observed removal efficiencies for a group of selected PhCs in HWW by PAC and GAC systems.
Fig. 6
Fig. 6
Observed removal efficiencies for a group of selected PhCs in HWW by ozonation.
Fig. 7
Fig. 7
Observed removal efficiencies for a group of selected PhCs in HWW by ozonation.
Fig. 8
Fig. 8
Observed removal efficiency for a group of selected PhCs in HWW by UV treatment.
Fig. 9
Fig. 9
Observed removal efficiency for a group of selected PhCs in HWW by UV treatment.
Fig. 10
Fig. 10
Observed removal efficiencies for a group of selected PhCs in HWW by AOPs.
Fig. 11
Fig. 11
Removal of PhCs by final chlorination. Data from: Nielsen et al., 2013.
Fig. 12
Fig. 12
Comparison among secondary and tertiary treatments of HWW with a view of the number of investigated compounds and of compounds exhibiting a removal efficiency greater than 80%.
See this image and copyright information in PMC

References

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