Input and elimination of pharmaceuticals from hospital wastewater

The significance of hospitals as point sources for the input of pharmaceuticals into the environment is evaluated. Selected pharmaceuticals as well as disinfectants will be measured in all environmental compartments like hospital wastewater, sewage and surface water to quantify their mass fluxes. By comparing measurements with the quantities of medicines dispensed in hospitals the fraction which is excreted in the hospital and not at home by outpatients will be elucidated. A GIS-based model is developed to predict the concentrations in receiving waters based on average excretion of pharmaceuticals by humans into municipal wastewater and the input from hospitals. Moreover, possible technologies to treat hospital wastewater are evaluated to reduce the input of pharmaceuticals into ambient water. Therefore, a pilot plant is installed in a Swiss hospital and is studied in terms of feasibility, efficiency, technical and economical factors. In a complementary project, a stakeholder analysis combined with multi-criteria decision analysis will be done to structure the decision problem on how to handle hospital wastewater and elicit the stakeholders’ roles and preferences.

Building on this knowledge, a decision basis will be developed to formulate a strategy concerning the emission of pharmaceuticals from hospitals and to optimize the setup for full-scale treatment of hospital wastewater. For decision support, a working group on “Hospital wastewater” has been established in Switzerland, comprising experts from research, government and engineering consultancies.

Finances

State Secretariat for Education and Research SER/COST within the COST Action 636 (Project No. C05.0135), the EU project NEPTUNE (No. 036845, SUSTDEV-2005-3.II.3.2, www.eu-neptune.org), the Swiss Federal Office for the Environment FOEN, the Cantons Aargau, Bern, Basel District, Geneva, St. Gallen, Schaffhausen, Solothurn, Schwyz, Thurgau, Vaud and Zurich, the InterReg IVB Project PILLS (www.pills-project.eu), and the Eawag Action Field Project “A Stakeholder Perspective on how to handle hospital wastewater”.

Publications

Kovalova L., Siegrist H., Singer H., Wittmer A., and McArdell C.S. (2012) Hospital Wastewater Treatment by Membrane Bioreactor: Performance and Efficiency for Organic Micropollutant Elimination. Environ. Sci. Technol. 46, 1536−1545, http://dx.doi.org/10.1021/es203495d

McArdell C.S., Kovalova L., Siegrist H., Kienle C., Moser R., Schwartz T. (2011) Input and Elimination of Pharmaceuticals and Disinfectants from Hospital Wastewater. Final Report, 95 pages. Can be received free of charge from christa.mcardell@eawag.ch

Lienert, J., M. Koller, J. Konrad, C.S. McArdell, N. Schuwirth (2011) Multiple-criteria decision analysis reveals high stakeholder preference to remove pharmaceuticals from hospital wastewater. Environ. Sci. Technol. 45(9): 3848–3857.

McArdell C.S., Lienert J. How to deal with hospital wastewater? Eawag Annual Report 2010, 10-11

Escher, B.I., Baumgartner R., Koller M., Treyer K., Lienert J., McArdell C.S. (2011) Environmental toxicology and risk assessment of pharmaceuticals from hospital wastewater, Water Research 45, 75-92.

McArdell C.S., Kovalova L., Eugster J., Hagenbuch M., Wittmer A., Siegrist H. (2010) Elimination of pharmaceuticals from hospital wastewater in a pilot membrane bioreactor with PAC or ozone post-treatment. Conference Proceeding: SETAC Europe, 20th Annual Meeting, 23-27 May 2010, Seville, Spain.

McArdell C.S. Local treatment of hospital wastewater? Eawag Annual Report 2009, 40-41.  

Weissbrodt D., Kovalova L., Ort C., Pazhepurackel V., Moser R., Hollender J., Siegrist H., McArdell C.S. (2009). Mass flows of X-rax contrast media and cytostatics in hospital wastewater. Environ. Sci. Technol. 43, 4810-4817.

Kovalova L., McArdell C.S., Hollender J. (2009) Challenge of high polarity and low concentrations in analysis of cytostatics and metabolites in wastewater by hydrophilic interaction chromatography/tandem mass spectrometry. J. Chromatography A, 1216, 1100-1108.

Moser R., McArdell C.S., Weissbrodt D. (2007) Micropollutants from Urban Drainage: Pretreatment of Hospital Wastewater. GWA 11, 869-875.

McArdell C.S., Weissbrodt D., Kovalova L., Hollender J., Siegrist H. (2007) Where should hospital wastewater be treated. Eawag Annual Report 2007.