Hospital Wastewaters: Characteristics, Management, Treatment and Environmental Risks (The Handbook of Environmental Chemistry (60))

Preface......Page 10 References......Page 13 Contents......Page 14 Hospital Wastewater: Existing Regulations and Current Trends in Management......Page 16 1 Introduction......Page 17 2 Regulations about Hospital Wastewater......Page 18 3.1 WHO Guidelines......Page 21 3.2 EPA Guidelines......Page 23 3.3 Guidelines about Radionuclide Releases to the Environment from Hospitals......Page 25 4 Case Study......Page 27 5 Final Remarks......Page 29 References......Page 30 Occurrence of Common Pollutants and Pharmaceuticals in Hospital Effluents......Page 32 1 Introduction......Page 33 2.2 Bacteriological Characterization......Page 35 2.3 Heavy Metals and Other Toxic Chemical Compounds Characterization......Page 37 2.4 Pharmaceuticals Residues Characterization......Page 38 3 Hospital Effluent Treatment Guidelines and Regulatory Efforts......Page 42 4 Conclusions......Page 43 References......Page 44 Ecotoxicity of Hospital Wastewater......Page 48 1 Introduction......Page 49 2.1 Identification and Ecotoxicity of the Substances......Page 50 2.2 Involvement of PRs from Various Therapeutic Groups in HWW Ecotoxicity......Page 51 3.1 Synthesis of Experimental Measurements Performed......Page 54 3.3.1 Variability During a Normal Day of Activity......Page 55 4 Interaction Between Ecotoxic Substances from HWW......Page 56 5.1 Identification and Prioritization of Bioaccumulative Pharmaceuticals in HWW......Page 57 5.2 Experimental Characterization of the Bioaccumulation of Pharmaceuticals from HWW......Page 58 6.2 Approach Taking Bioaccumulation into Account......Page 59 References......Page 60 Prioritization of Active Pharmaceutical Ingredients in Hospital Wastewater......Page 63 1 Introduction......Page 64 2.1 Method Overview......Page 65 2.2 Prioritization Studies Applied to Hospital Wastewater......Page 68 3.1 Setting and Consumption Data Collection......Page 69 3.2.1 PBT Approach......Page 72 3.2.2 Environmental Risk Assessment......Page 73 3.3 Sensitivity Analysis......Page 76 3.4.2 Comparison with Other Studies......Page 77 4 Conclusions and Perspectives......Page 78 References......Page 80 Occurrence and Risks of Contrast Agents, Cytostatics, and Antibiotics in Hospital Effluents......Page 84 1 Introduction......Page 85 2.1 Iodine-Based Contrasting Agent......Page 86 2.2 Gadolinium-Based Contrasting Agents......Page 87 3 Cytostatics Occurrence......Page 88 4 Antibiotics Occurrence......Page 92 4.2 Macrolides......Page 101 4.6 Lincosamides......Page 102 5 Risk Assessment......Page 103 5.1 Antibiotic Resistance......Page 106 6 Conclusion......Page 107 References......Page 108 Pharmaceutical Concentrations and Loads in Hospital Effluents: Is a Predictive Model or Direct Measurement the Most Accurate A.........Page 114 1 Introduction......Page 115 2 Models Proposed for Predicting the Concentration and Load of PhCs in Hospital Effluents......Page 117 3 Overview of Studies and Investigations on the PEC and PEL of PhCs in HWW......Page 118 4 Model Parameters......Page 121 4.1 Consumption Data......Page 122 4.2 Excretion Factor......Page 125 4.3 Flow Rate Prediction......Page 127 5 Comparison Between Measured and Predicted Concentrations and Loads......Page 129 6.1 Inaccurate Estimation of PhC Consumption Within the Hospital......Page 132 6.4 Inaccuracy in the Excretion Factor Assumed for the Evaluation of PEC......Page 133 6.5 Wastewater Flow Variations......Page 134 6.7 Biodegradation/Biotransformation or Adsorption Processes Occurring in the Sewage System Before the Sampling Point......Page 135 7.1 Sampling Protocols......Page 136 7.2 Analytical Errors......Page 137 7.4 Flow Rate Measurement......Page 138 8.1 Uncertainties in Concentration and Load Predictions......Page 139 8.2 Uncertainties in Concentration and Load Measurements......Page 140 9 Conclusions and Perspectives......Page 142 References......Page 143 Contribution of Hospital Effluents to the Load of Micropollutants in WWTP Influents......Page 147 1 Introduction......Page 149 2 Characteristics of Hospital Contribution (HC)......Page 150 3.2 Healthcare Facility- and Region-Specific HC......Page 152 3.3 Temporal Changes......Page 153 4.1 Direct Measurements......Page 154 4.2 Consumption Data......Page 155 5 Environmental Risk of Hospital Effluents......Page 156 6.1 The SIPIBEL Observatory: Study Site and Monitoring......Page 157 6.2 Pollutant Concentrations in Urban and Hospital Wastewaters......Page 158 6.3 Pollutant Loads and Contributions in Urban and Hospital Waters......Page 159 7 Conclusion......Page 160 References......Page 161 Lessons Learned from European Experiences and Presentation of Case Studies......Page 165 1 Introduction......Page 166 2 Conventional Management of Hospital Wastewater: Centralized Treatment......Page 167 3 Is a Decentralized Treatment an Option?......Page 170 3.1 Other Relevant European Cases......Page 175 4 Alternative Actions to the Technical Solutions......Page 177 5 Conclusions......Page 178 References......Page 179 Hospital Wastewater Treatments Adopted in Asia, Africa, and Australia......Page 182 1 Introduction......Page 183 2 Treatment Scenarios of HWWs......Page 184 3 Overview of the Included Studies......Page 185 4 Antibiotic Resistant Bacteria in HWWs......Page 188 5 Treatment Sequences for HWWs Under Review......Page 189 6.1 Removal Efficiency of Conventional Pollutants......Page 191 6.2 Removal Efficiency of PhCs......Page 193 8 Conclusions......Page 195 References......Page 196 Full-Scale Plants for Dedicated Treatment of Hospital Effluents......Page 200 1 Introduction......Page 201 2 Discussion......Page 202 2.1.1 Primary Treatment......Page 208 2.1.2 Secondary Treatment......Page 209 Other Biological Systems......Page 210 2.1.3 Tertiary Treatment......Page 211 2.2.1 Antibiotics......Page 212 2.2.2 Antibiotic Resistance......Page 213 2.2.3 Toxic Effect......Page 214 3 Conclusions and Future Prospects......Page 215 References......Page 217 Overview on Pilot-Scale Treatments and New and Innovative Technologies for Hospital Effluent......Page 220 1 Introduction......Page 222 2.1.2 Membrane Bioreactors......Page 223 2.1.3 Other Configurations......Page 225 2.2.1 Fungal Treatments......Page 226 2.2.2 Innovative MBR Treatments......Page 227 2.2.4 Other Treatments and Studies......Page 228 3.1.1 Adsorption......Page 229 3.1.2 Membrane Filtration......Page 230 3.2 Oxidation......Page 231 3.2.1 Ozonation......Page 232 3.2.3 Photocatalysis......Page 233 4 Concluding Remarks......Page 235 References......Page 236 Final Remarks and Perspectives on the Management and Treatment of Hospital Effluents......Page 242 1 Lessons Learned......Page 243 2 Hospital Effluents: Regulated or Unregulated Wastewater?......Page 244 3 Compositions of Hospital Wastewater: What We Know and What Remains Unknown......Page 245 4 Management and Treatment: What Is Sustainable and Correct?......Page 247 References......Page 248 Index......Page 250 "This volume addresses hospital effluents in terms of their composition and the management and treatment strategies currently (being) adopted around the globe. In this context, one major focus is on pharmaceutical compounds: their observed concentration range, ecotoxicological effects, and the removal efficiency achieved by the different technologies. Another focus is on management strategies (dedicated hospital wastewater treatment, or a combined approach also involving urban wastewater) and currently adopted treatments to reduce the released pollutant load. Innovative and promising technologies under investigation at the lab and pilot scale are presented. A discussion of remaining knowledge gaps and future research requirements rounds out the coverage. The respective chapters, written by experts in the different fields, provide useful information for a broad audience: scientists involved in the management and treatment of hospital effluents and wastewater containing micropollutants, administrators and decision-makers, legislators involved in the authorization and management of healthcare structure effluents, and environmental engineers involved in the design of wastewater treatment plants, as well as newcomers and students interested in these issues."--Page 4 de la couverture