Hospital wastewaters comprise the effluents of various services: general (kitchen, internal laundry, heating and cooling systems), diagnostic (laboratories, radiology departments, outpatients’ departments, transfusion centres) and wards (general medicine, surgery, specialities, haemodialysis, etc.). Due to the nature and quantity of the micropollutants they harbour, such as active substances of medicines and their metabolites, chemicals, heavy metals, disinfectants, sterilizers and radioactive markers, which are typically present at concentrations of μg/L, they should be earmarked for special consideration. By law, however, hospital effluents are often considered to be in the same pollutant class as urban wastewaters, and so are generally discharged into (municipal) sewage networks, collected at a wastewater treatment plant and co-treated along with them. However, although dilution of hospital effluents with urban wastewaters usu-ally results in a reduction of the pharmaceutical compound content in the final ef-fluent (from μg/L to ng/L), it does not affect the total load, that is, the quantity re-leased daily into the receiving water body. This chapter analyses the differences between the effluent of hospitals and urban settlements in terms of hydraulic and pollutant load, and discusses whether distinction should be made between these two types of wastewaters and evaluates potential strategies for management of hospital effluents (co-treatment or dedi-cated strategies). Finally it presents and discusses the most appropriate treatment for hospital wastewaters, based on the results of the recent research into the re-moval of pharmaceutical compounds from wastewaters.
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