• Pharmaceuticals and detergents in hospital and urban wastewater: characterisation and impacts
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Two-year survey of specific hospital wastewater treatment and its impact on pharmaceutical discharges

Abstract

It is well known that pharmaceuticals are not completely removed by conventional activated sludge wastewater treatment plants. Hospital effluents are of major concern, as they present high concentrations of pharmaceutically active compounds. Despite this, these specific effluents are usually co-treated with domestic wastewaters. Separate treatment has been recommended. However, there is a lack of information concerning the efficiency of separate hospital wastewater treatment by activated sludge, especially on the removal of pharmaceuticals. In this context, this article presents the results of a 2-year monitoring of conventional parameters, surfactants, gadolinium, and 13 pharmaceuticals on the specific study site SIPIBEL. This site allows the characterization of urban and hospital wastewaters and their separate treatment using the same process. Flow proportional sampling, solid-phase extraction, and liquid chromatography coupled with tandem mass spectrometry were used in order to obtain accurate data and limits of quantification consistent with ultra-trace detection. Thanks to these consolidated data, an in-depth characterization of urban and hospital wastewaters was realized, as well as a comparison of treatment efficiency between both effluents. Higher concentrations of organic carbon, AOX, phosphates, gadolinium, paracetamol, ketoprofen, and antibiotics were observed in hospital wastewaters compared to urban wastewaters. Globally higher removals were observed in the hospital wastewater treatment plant, and some parameters were shown to be of high importance regarding removal efficiencies: hydraulic retention time, redox conditions, and ambient temperature. Eleven pharmaceuticals were still quantified at relevant concentrations in hospital and urban wastewaters after treatment (e.g., up to 1 μg/L for sulfamethoxazole). However, as the urban flow was about 37 times higher than the hospital flow, the hospital contribution appeared relatively low compared to domestic discharges. Thanks to the SIPIBEL site, data obtained from this 2-year program are useful to evaluate the relevance of separate hospital wastewater treatment.

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References

  1. Al Aukidy M, Verlicchi P, Voulvoulis N (2014) A framework for the assessment of the environmental risk posed by pharmaceuticals originating from hospital effluents. Sci Total Environ 493:54–64

    Article  Google Scholar 

  2. Al Qarni H, Collier P, O’Keeffe J, Akunna J (2016) Investigating the removal of some pharmaceutical compounds in hospital wastewater treatment plants operating in Saudi Arabia. Environ Sci Pollut Res 23:13003–13014

    Article  Google Scholar 

  3. Azuma T, Arima N, Tsukada A, Hirami S, Matsuoka R, Moriwake R, Ishiuchi H, Inoyama T, Teranishi Y, Yamaoka M, Mino Y, Hayashi T, Fujita Y, Masada M (2016) Detection of pharmaceuticals and phytochemicals together with their metabolites in hospital effluents in Japan, and their contribution to sewage treatment plant influents. Sci Total Environ 548:189–197

    Article  Google Scholar 

  4. Backe WJ (2015) An ultrasensitive (parts-per-quadrillion) and SPE-free method for the quantitative analysis of estrogens in surface water. Environ Sci Technol 49:14311–14318

    CAS  Article  Google Scholar 

  5. Barbieri M, Carrera J, Ayora C, Sanchez-Vila X, Licha T, Nodler K, Osorio V, Perez S, Kock-Schulmeyer M, de Alda ML, Barcelo D (2012) Formation of diclofenac and sulfamethoxazole reversible transformation products in aquifer material under denitrifying conditions: batch experiments. Sci Total Environ 426:256–263

    CAS  Article  Google Scholar 

  6. Bergé A, Wiest L, Giroud B, Baudot R, Vulliet E (2017) Occurrence of multi-class surfactants in urban wastewater: contribution of a healthcare facility to the pollution transported into the sewerage system (in this issue)

  7. Bouju H, Nastold P, Beck B, Hollender J, Corvini PFX, Wintgens T (2016) Elucidation of biotransformation of diclofenac and 4 hydroxydiclofenac during biological wastewater treatment. J Hazard Mater 301:443–452

    CAS  Article  Google Scholar 

  8. Boxall ABA et al (2012) Pharmaceuticals and personal care products in the environment: what are the big questions? Environ Health Perspect 120:1221–1229

    Article  Google Scholar 

  9. Carraro E, Bonetta S, Bertino C, Lorenzi E, Gilli G (2016) Hospital effluents management: chemical, physical, microbiological risks and legislation in different countries. J Environ Manag 168:185–199

    CAS  Article  Google Scholar 

  10. Cavalié P (2014) Analyse des ventes de médicaments en France en 2013. http://www.ansm.fr

  11. Chonova T, Keck F, Labanowski J, Montuelle B, Rimet F, Bouchez A (2016) Separate treatment of hospital and urban wastewaters: a real scale comparison of effluents and their effect on microbial communities. Sci Total Environ 542:965–975

    CAS  Article  Google Scholar 

  12. Chonova T, Lecomte V, Bertrand-Krajewski J-L, Dagot C, Lévi Y, Perrodin Y, Labanowski J, Wiest L, Gonzalez-Ospina A, Bouchez A, Cournoyer B, Sebastian C (2017) The SIPIBEL project: treatment of both hospital and urban wastewater in a conventional urban wastewater treatment plant, Environmental Science and Pollution Research, accepted

  13. Der Beek TA, Weber FA, Bergmann A, Hickmann S, Ebert I, Hein A, Kuster A (2016) Pharmaceuticals in the environment—global occurrences and perspectives. Environ Toxicol Chem 35:823–835

    Article  Google Scholar 

  14. Dray S, Dufour AB (2007) The ade4 package: implementing the duality diagram for ecologists. J Stat Softw 22:1–20

    Article  Google Scholar 

  15. European Commission (1991) Directive 91/271/EEC of the council of the European communities of 21st May 1991 concerning urban waste water treatment to protect the water environment from the adverse effects of discharges of urban waste water and from certain industrial discharges. Off J Eur Communities 135:40–52

    Google Scholar 

  16. Eymery F, Choubert J-M, Lepot B, Gasperi J, Lachenal J, Coquery M (2011) Guide technique opérationnel : Pratiques d’échantillonnage et de conditionnement en vue de la recherche de micropolluants prioritaires et émergents en assainissement collectif et industriel, Première version. Irstea/Cemagref

  17. Falas P, Wick A, Castronovo S, Habermacher J, Ternes TA, Joss A (2016) Tracing the limits of organic micropollutant removal in biological wastewater treatment. Water Res 95:240–249

    CAS  Article  Google Scholar 

  18. Fernández M, Fernández M, Laca A, Laca A, Diaz M (2014) Seasonal occurrence and removal of pharmaceutical products in municipal wastewaters. J Environ Chem Eng 2:495–502

    Article  Google Scholar 

  19. Goulle JP, Saussereau E, Mahieu L, Cellier D, Spiroux J, Guerbet M (2012) Importance of anthropogenic metals in hospital and urban wastewater: its significance for the environment. Bull Environ Contam Toxicol 89:1220–1224

    CAS  Article  Google Scholar 

  20. Gros M, Petrovic M, Barcelo D (2006) Development of a multi-residue analytical methodology based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) for screening and trace level determination of pharmaceuticals in surface and wastewaters. Talanta 70:678–690

    CAS  Article  Google Scholar 

  21. Guerra P, Kim M, Shah A, Alaee M, Smyth SA (2014) Occurrence and fate of antibiotic, analgesic/anti-inflammatory, and antifungal compounds in five wastewater treatment processes. Sci Total Environ 473:235–243

    Article  Google Scholar 

  22. Kleywegt S, Pileggi V, Lam YM, Elises A, Puddicomb A, Purba G, Di Caro J, Fletcher T (2016) The contribution of pharmaceutically active compounds from healthcare facilities to a receiving sewage treatment plant in Canada. Environ Toxicol Chem 35:850–862

    CAS  Article  Google Scholar 

  23. Kosma CI, Lambropoulou DA, Albanis TA (2010) Occurrence and removal of PPCPs in municipal and hospital wastewaters in Greece. J Hazard Mater 179:804–817

    CAS  Article  Google Scholar 

  24. Kovalova L, Siegrist H, Singer H, Wittmer A, McArdell CS (2012) Hospital wastewater treatment by membrane bioreactor: performance and efficiency for organic micropollutant elimination. Environ Sci Technol 46:1536–1545

    CAS  Article  Google Scholar 

  25. Kummerer K, Erbe T, Gartiser S, Brinker L (1998) AOX emissions from hospital into municipal wastewater. Chemosphere 36:2437–2445

    CAS  Article  Google Scholar 

  26. Kummerer K (2001) Drugs in the environment: emission of drugs, diagnostic aids and disinfectants into wastewater by hospitals in relation to other sources—a review. Chemosphere 45:957–969

    CAS  Article  Google Scholar 

  27. Lachassagne D, Soubrand M, Casellas M, Gonzalez-Ospina A, Dagot C (2015) Impact of sludge stabilization processes and sludge origin (urban or hospital) on the mobility of pharmaceutical compounds following sludge landspreading in laboratory soil-column experiments. Environ Sci Pollut Res 22:17135–17150

    CAS  Article  Google Scholar 

  28. Lecomte V (2016) Rapport SIPIBEL 2011–2015: résultats de quatre années de suivi, d'études et de recherches, sur le site pilote de Bellecombe, accessed in www.graie.org/Sipibel/publications

  29. Le Bonté S, Pons M-N, Potier O, Rocklin P (2008) Relation between conductivity and ion content in urban wastewater. Revue des Sciences de l'Eau 21:429–438

    Article  Google Scholar 

  30. Nagarnaik PM, Mills MA, Boulanger B (2010) Concentrations and mass loadings of hormones, alkylphenols, and alkylphenol ethoxylates in healthcare facility wastewaters. Chemosphere 78:1056–1062

    CAS  Article  Google Scholar 

  31. Noguera-Oviedo K, Aga DS (2016) Lessons learned from more than two decades of research on emerging contaminants in the environment. J Hazard Mater 316:242–251

    CAS  Article  Google Scholar 

  32. Oliveira TS, Murphy M, Mendola N, Wong V, Carlson D, Waring L (2015) Characterization of pharmaceuticals and personal care products in hospital effluent and waste water influent/effluent by direct-injection LC-MS-MS. Sci Total Environ 518:459–478

    Article  Google Scholar 

  33. Ort C, Lawrence MG, Reungoat J, Eaglesham G, Carter S, Keller J (2010) Determining the fraction of pharmaceutical residues in wastewater originating from a hospital. Water Res 44:605–615

    CAS  Article  Google Scholar 

  34. Petrie B, McAdam EJ, Lester JN, Cartmell E (2014) Assessing potential modifications to the activated sludge process to improve simultaneous removal of a diverse range of micropollutants. Water Res 62:180–192

    CAS  Article  Google Scholar 

  35. Pico Y, Barcelo D (2015) Transformation products of emerging contaminants in the environment and high-resolution mass spectrometry: a new horizon. Anal Bioanal Chem 407:6257–6273

    CAS  Article  Google Scholar 

  36. Radjenovic J, Petrovic M, Barcelo D (2009) Fate and distribution of pharmaceuticals in wastewater and sewage sludge of the conventional activated sludge (CAS) and advanced membrane bioreactor (MBR) treatment. Water Res 43:831–841

    CAS  Article  Google Scholar 

  37. Santos LHMLM, Gros M, Rodriguez-Mozaz S, Delerue-Matos C, Pena A, Barcelo D, Montenegro MCBSM (2013) Contribution of hospital effluents to the load of pharmaceuticals in urban wastewaters: identification of ecologically relevant pharmaceuticals. Sci Total Environ 461:302–316

    Article  Google Scholar 

  38. Stadler LB, Su LJ, Moline CJ, Ernstoff AS, Aga DS, Love NG (2015) Effect of redox conditions on pharmaceutical loss during biological wastewater treatment using sequencing batch reactors. J Hazard Mater 282:106–115

    CAS  Article  Google Scholar 

  39. Taylor PJ (2005) Matrix effects: the Achilles heel of quantitative high-performance liquid chromatography-electrospray-tandem mass spectrometry. Clin Biochem 38:328–334

    CAS  Article  Google Scholar 

  40. Tuc DQ, Elodie MG, Pierre L, Fabrice A, Marie-Jeanne T, Martine B, Joelle E, Marc C (2017) Fate of antibiotics from hospital and domestic sources in a sewage network. Sci Total Environ 575:758–766

    Article  Google Scholar 

  41. Verlicchi P, Galletti A, Petrovic M, Barcelo D (2010) Hospital effluents as a source of emerging pollutants: an overview of micropollutants and sustainable treatment options. J Hydrol 389:416–428

    CAS  Article  Google Scholar 

  42. Verlicchi P, Al Aukidy M, Galletti A, Petrovic M, Barcelo D (2012a) Hospital effluent: investigation of the concentrations and distribution of pharmaceuticals and environmental risk assessment. Sci Total Environ 430:109–118

    CAS  Article  Google Scholar 

  43. Verlicchi P, Al Aukidy M, Zambello E (2012b) Occurrence of pharmaceutical compounds in urban wastewater: removal, mass load and environmental risk after a secondary treatment—a review. Sci Total Environ 429:123–155

    CAS  Article  Google Scholar 

  44. Verlicchi P, Al Aukidy M, Zambello E (2015) What have we learned from worldwide experiences on the management and treatment of hospital effluent?—an overview and a discussion on perspectives. Sci Total Environ 514:467–491

    CAS  Article  Google Scholar 

  45. Willers HC, Tenhave PJW, Derikx PJL, Arts MW (1993) Temperature-dependency of nitrification and required anoxic volume for denitrification in the biological treatment of veal calf manure. Bioresour Technol 43:47–52

    CAS  Article  Google Scholar 

  46. Yu Y, Wu L, Chang AC (2013) Seasonal variation of endocrine disrupting compounds, pharmaceuticals and personal care products in wastewater treatment plants. Sci Total Environ 442:310–316

    CAS  Article  Google Scholar 

  47. Zhou XF, Zhang YL, Shi L, Chen JB, Qiang ZM, Zhang TC (2013) Partitioning of fluoroquinolones on wastewater sludge. Clean: Soil, Air, Water 41:820–827

    CAS  Google Scholar 

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Acknowledgements

The authors thank the SIPIBEL field observatory on the hospital’s effluents and urban wastewater treatment plants for displaying data and measurements and the European Union, the Rhone-Mediterranean Corsica water agency, the Rhône Alpes Region, the ONEMA, and the French Ministry of Environment for their support.

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Correspondence to Laure Wiest.

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Highlights

– Hospital and urban effluents are compared

– Impact of hospital wastewater on activated sludge treatment is studied

– Seasonal variations of pharmaceuticals removal efficiency are demonstrated

Responsible editor: Philippe Garrigues

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Wiest, L., Chonova, T., Bergé, A. et al. Two-year survey of specific hospital wastewater treatment and its impact on pharmaceutical discharges. Environ Sci Pollut Res 25, 9207–9218 (2018). https://doi.org/10.1007/s11356-017-9662-5

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Keywords

  • Pharmaceuticals
  • Antibiotics
  • Wastewater treatment
  • Hospital wastewater
  • Removal