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.