Skip to main content

Hospital Wastewater: Existing Regulations and Current Trends in Management

  • Chapter
  • First Online:
Hospital Wastewaters

Part of the book series: The Handbook of Environmental Chemistry ((HEC,volume 60))

Abstract

Wastewater refers to any water whose quality has been compromised by human activities. It includes liquid waste discharged from domestic homes, agricultural commercial sectors, pharmaceutical sectors, and hospitals. Hospital wastewater (HWW) can contain hazardous substances, such as pharmaceutical residues, chemical hazardous substances, pathogens, and radioisotopes. Due to these substances, hospital wastewater can represent a chemical, biological, and physical risk for public and environmental health. Nevertheless, very frequently there are no legal requirements for hospital effluent treatment prior to its discharge into the municipal collector or directly onto surface water after pretreatment.

In this chapter a brief introduction about the role of hospital wastewater on the environmental contamination was reported. Subsequently the main principles on the hospital wastewater reported in different legislation around the world have been addressed. Moreover the main content reported in the WHO guidelines, EPA guidelines, and guidelines about radionuclide releases to the environment from hospitals was described. A case study of excellence on hospital wastewater management was also illustrated. The chapter ends with some brief final remarks.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 299.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 379.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fekadu S, Merid Y, Beyene H, Teshome W, Gebre-Selassie S (2015) Assessment of antibiotic- and disinfectant-resistant bacteria in hospital wastewater, South Ethiopia: a cross-sectional study. J Infect Dev Ctries 9(2):149–156

    Article  Google Scholar 

  2. 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

    Article  CAS  Google Scholar 

  3. Santos LH, Gros M, Rodriguez-Mozaz S, Delerue-Matos C, Pena A, Barceló D, Montenegro MC (2013) Contribution of hospital effluents to the load of pharmaceuticals in urban wastewaters: identification of ecologically relevant pharmaceuticals. Sci Total Environ 461–462:302–316

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  6. Maheshwari M, Yaser NH, Naz S, Fatima M, Ahmad I (2016) Emergence of ciprofloxacin-resistant extended-spectrum β-lactamase-producing enteric bacteria in hospital wastewater and clinical sources. J Glob Antimicrob Resist 5:22–25

    Article  Google Scholar 

  7. Varela AR, André S, Nunes OC, Manaia CM (2014) Insights into the relationship between antimicrobial residues and bacterial populations in a hospital-urban wastewater treatment plant system. Water Res 54:327–336

    Article  CAS  Google Scholar 

  8. Ministry of Environment and Forest, Government of India, New Deli (1986) The Environment (Protection) Act. N° 29 of 1986

    Google Scholar 

  9. Ministry of Environment & Forests (1998) Bio-medical waste (management & handling) rules, 1998 S.O.630(E), [20/7/1998]

    Google Scholar 

  10. EU (1991) European Union. Council Directive 91/271/EEC of 21 May 1991 concerning urban waste-water treatment

    Google Scholar 

  11. EU (1998) European Union. Commission Directive 98/15/EC of 27 February 1998 amending Council Directive 91/271/EEC with respect to certain requirements established in Annex I thereof (Text with EEA relevance)

    Google Scholar 

  12. EU (2008) European Union. Directive 2008/98/EC of the European Parliament and of the Council of 19 November 2008 on waste and repealing certain Directives (Text with EEA relevance)

    Google Scholar 

  13. Decreto 57/2005, de 30 de junio, por el que se revisan los Anexos de la Ley 10/1993, de 26 de octubre, sobre Vertidos Líquidos Industriales al Sistema Integral de Saneamiento

    Google Scholar 

  14. Decreto n 26042-S-MINAE (1997) Reglamento de Vertido y Aguas Residuales. La Gaeta n. 117, Jueves 19 de junio de 1997

    Google Scholar 

  15. Federal Ministry for the Environment, Nature Conservation and Nuclear Safety, Germany (2004) Promulgation of the New Version of the Ordinance on Requirements for the Discharge of Waste Water into Waters (Waste Water Ordinance – AbwV) of 17 June 2004

    Google Scholar 

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

    Google Scholar 

  17. D.P.R. 19 Ottobre 2011 n. 227. Regolamento per la semplificazione di adempimenti amministrativi in materia ambientale gravanti sulle imprese, a norma dell'articolo 49, comma 4-quater, del decreto-legge 31 maggio 2010, n. 78, convertito, con modificazioni, dalla legge 30 luglio 2010, n. 122. Pubblicato nella Gazz. Uff. 3 febbraio 2012, n. 28

    Google Scholar 

  18. Decreto Legislativo (D. Lgs.) 3 aprile 2006, n. 152. Norme in materia ambientale. Gazzetta Ufficiale n. 88. Suppl. Ord. n. 96 del 14 aprile 2006

    Google Scholar 

  19. National Standard of the People’s Republic of China (1998) Integrated wastewater discharge standard GB 8978–88. Date of Approval: Oct. 4, 1996. Date of Enforcement: Jan 1, 1998

    Google Scholar 

  20. The Socialist Republic of Vietnam (2014) Law of environmental protection. No. 55/2014/QH13

    Google Scholar 

  21. The Socialist Republic of Vietnam (2010) National Technical Regulation on Health Care Wastewater. QCVN 28:2010/BTNMT

    Google Scholar 

  22. WHO (1999) In: Prüss A, Giroult E, Rushbrook P (eds) Safe management of wastes from health-care activities

    Google Scholar 

  23. WHO (2014) In: Chartier Y et al. (eds) Safe Management of wastes from health-care activities, 2 edn

    Google Scholar 

  24. Clean Water Act (1972) Federal Water Pollution Control Act, 33 U.S.C. 1251 et seq

    Google Scholar 

  25. EPA (2016) Preliminary 2016 effluent guidelines program plan. EPA.821-R-16-001, Washington DC, USA

    Google Scholar 

  26. Mattsson S, Bernhardsson C (2013) Release of patients after radionuclide therapy: radionuclide releases to the environment from hospitals and patients. In: Mattsson S, Hoeschen C (eds) Radiation protection in nuclear medicine. Springer, Heidelberg, Berlin

    Chapter  Google Scholar 

  27. IAEA (2009) Release of patients after radionuclide therapy. International Atomic Energy Agency, Safety Reports Series No. 63, Vienna

    Google Scholar 

  28. ICRP (2004) International Commission on Radiological Protection. Release of patients after therapy with unsealed radionuclides. Ann ICRP 34(2):1–79

    Article  Google Scholar 

  29. ICRP (2013) Release of patients after therapy with unsealed radionuclides. Ann ICRP 42(4):341

    Article  Google Scholar 

  30. SIPIBEL (2014) Effluents hospitaliers et stations d’épuration urbaines: caractérisation, risques et traitabilité. Site Pilote de Bellecombe. Presentation et premiers resultants (www.graie.org/Sipibel/publications/sipibel-presentation-effluentsmedicaments. pdf, also: http://www.graie.org/Sipibel/publications.html)

  31. SIPIBEL-RILACT (2015) Mise en evidence de solutions pour limiter les rejets pollutants d’un etablissement de soins: Etude au Centre Hospitalier Alpes Léman (http://www.graie.org/Sipibel/rilact.html)

  32. NoPILLS (2015) NoPILLS report. Interreg IV NEW project partnership 2012–2015. http://www.no-pills.eu/

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elisabetta Carraro .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Carraro, E., Bonetta, S., Bonetta, S. (2017). Hospital Wastewater: Existing Regulations and Current Trends in Management. In: Verlicchi, P. (eds) Hospital Wastewaters. The Handbook of Environmental Chemistry, vol 60. Springer, Cham. https://doi.org/10.1007/698_2017_10

Download citation

Publish with us

Policies and ethics