Hospital effluent: investigation of the concentrations and distribution of pharmaceuticals and environmental risk assessment

A study was conducted in an area in north, Italy, on the effluent of two different sized hospitals and the influent and effluent of the receiving municipal treatment plant of one of the examined hospitals. The aim was to investigate 73 selected pharmaceuticals, belonging to twelve different classes, comparing their occurrence in the effluent directly exiting the hospital with that, mixed with the local urban effluent, at the point of its entry and exit from the treatment plant. Consistent differences were found in the concentrations of some antibiotics, analgesics and lipid regulators in the two wastewaters, confirming that hospital effluents should not be considered as possessing the same pollutant nature as urban wastewater. Furthermore, analysis of percentage contributions of the hospital to the treatment plant influent evidences that hospitals represent one of the main sources of pollutants, in particular antibiotics, receptor antagonists and lipid regulators. Hence, an environmental risk assessment, performed on the effluent from the hospital and the influent and effluent from the treatment plant, revealed a high risk for 9 pharmaceuticals in hospital effluent and for 4 of the 9 substances in the treatment plant influent and effluent, with antibiotics being the most critical compounds in terms of contribution and potential environmental risk for the hospital.