A framework for the assessment of the environmental risk posed by pharmaceuticals originating from hospital effluents

Title: A framework for the assessment of the environmental risk posed by pharmaceuticals originating from hospital effluents
Authors: Al Aukidy, M
Verlicchi, P
Voulvoulis, N
Item Type: Journal Article
Abstract: The consumption of pharmaceuticals is increasing in both hospitals and households. After administration, many compounds enter the water cycle as parent compounds or their metabolites via excretion. Conventional municipal wastewater treatment plants are unable to efficiently remove all the different compounds found in sewage and, consequently, treated effluents are one of the main sources of persistent micropollutants in the environment. Hospital patients are administered relatively high quantities of drugs and therefore hospital wastewaters can consistently contribute to treatment plant influent loads, with the magnitude of environmental risk posed by pharmaceuticals originating from hospital effluents largely unknown. This study has therefore developed a framework to enable authorities responsible for hospital management and environmental health to evaluate such risk, considering site-specific information such as the contribution of human population and hospital sizes, wastewater treatment removal efficiency, and potential dilution in the receiving water body. The framework was applied to three case studies, that are representative of frequent situations in many countries, and findings demonstrated that the degree of risk posed by any compound was site-specific and depended on a combination of several factors: compound concentration and toxicity, compound removal efficiency in the wastewater treatment plant and dilution factor. Ofloxacin, 17α-ethinylestradiol, erythromycin and sulfamethoxazole were identified as compounds of concern and might require management in order to reduce risk.
Issue Date: 15-Sep-2014
Date of Acceptance: 27-May-2014
URI: http://hdl.handle.net/10044/1/67876
DOI: https://doi.org/10.1016/j.scitotenv.2014.05.128
ISSN: 0048-9697
Publisher: Elsevier
Start Page: 54
End Page: 64
Journal / Book Title: Science of the Total Environment
Volume: 493
Copyright Statement: © 2014 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Science & Technology
Life Sciences & Biomedicine
Environmental Sciences
Environmental Sciences & Ecology
Environmental risk
Framework
Hospital effluent
Management
Pharmaceuticals
Treatment
PERSONAL CARE PRODUCTS
MUNICIPAL WASTE-WATER
EMERGING CONTAMINANTS
AQUATIC ENVIRONMENT
TREATMENT WORKS
SURFACE WATERS
PRIORITY LIST
PO VALLEY
MICROPOLLUTANTS
REMOVAL
Environmental Monitoring
Hospitals
Pharmaceutical Preparations
Risk Assessment
Sewage
Waste Disposal, Fluid
Waste Water
Water Pollutants, Chemical
Water Pollution, Chemical
MD Multidisciplinary
Publication Status: Published
Online Publication Date: 2014-06-14
Appears in Collections:Centre for Environmental Policy
Faculty of Natural Sciences



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