Department Environmental Chemistry

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.


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


Kuroda, K.; Itten, R.; Kovalova, L.; Ort, C.; Weissbrodt, D. G.; McArdell, C. S. (2016) Hospital-use pharmaceuticals in Swiss waters modeled at high spatial resolution, Environmental Science and Technology, 50(9), 4742-4751, doi:10.1021/acs.est.6b00653, Institutional Repository
Lee, Y.; Kovalova, L.; McArdell, C. S.; von Gunten, U. (2014) Prediction of micropollutant elimination during ozonation of a hospital wastewater effluent, Water Research, 64, 134-148, doi:10.1016/j.watres.2014.06.027, Institutional Repository
Kovalova, L.; Siegrist, H.; von Gunten, U.; Eugster, J.; Hagenbuch, M.; Wittmer, A.; Moser, R.; McArdell, C. S. (2013) Elimination of micropollutants during post-treatment of hospital wastewater with powdered activated carbon, ozone, and UV, Environmental Science and Technology, 47(14), 7899-7908, doi:10.1021/es400708w, Institutional Repository
Kovalova, L.; Siegrist, H.; Singer, H.; Wittmer, A.; McArdell, C. S. (2012) Hospital wastewater treatment by membrane bioreactor: performance and efficiency for organic micropollutant elimination, Environmental Science and Technology, 46(3), 1536-1545, doi:10.1021/es203495d, Institutional Repository
Lienert, J.; Koller, M.; Konrad, J.; McArdell, C. S.; Schuwirth, N. (2011) Multiple-criteria decision analysis reveals high stakeholder preference to remove pharmaceuticals from hospital wastewater, Environmental Science and Technology, 45(9), 3848-3857, doi:10.1021/es1031294, Institutional Repository
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(1), 75-92, doi:10.1016/j.watres.2010.08.019, Institutional Repository
Weissbrodt, D.; Kovalova, L.; Ort, C.; Pazhepurackel, V.; Moser, R.; Hollender, J.; Siegrist, H.; McArdell, C. S. (2009) Mass flows of X-ray contrast media and cytostatics in hospital wastewater, Environmental Science and Technology, 43(13), 4810-4817, doi:10.1021/es8036725, Institutional Repository
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, Journal of Chromatography A, 1216(7), 1100-1108, doi:10.1016/j.chroma.2008.12.028, Institutional Repository
Moser, R.; McArdell, C. S.; Weissbrodt, D. (2007) Mikroverunreinigungen. Vorbehandlung von Spitalabwasser, GWA Gas, Wasser, Abwasser, 87(11), 869-875, Institutional Repository

Other reports

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
. Available from

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

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

McArdell C.S., Weissbrodt D., Kovalova L., Hollender J., Siegrist H. (2007)
Where should Hospital wastewater be treated? Eawag Annual Report 2007, 14