The study refers to experimental investigations carried out on two hospitals of medium-large size (300 beds for hospital A and 900 beds for hospital B), situated in the Province of Ferrara, Northern Italy and on the raw wastewaters entering the municipal wastewater treatment plant (WWTP) of the town of Ferrara (120 000 inhabitants). A first investigation, between 2007 and 2008, focused on the concentrations of macropollutants (BOD5, COD, SS, nitrogen and total phosphorus compounds, E. coli) in the effluent of hospital A and on the differences with urban ones. In a second experimental phase (in September 2009 and March 2010), the final effluent of the two hospitals as well as the influent to Ferrara WWTP have been subjected to an analytical campaign, aiming to identify the occurrence of 73 pharmaceutical compounds which are widely dispensed and administrated in hospitals and households: 12 analgesics/anti-inflammatories, 25 antibiotics, 1 anti-diabetic, 3 anti-hypertensives, 3 barbitures, 2 beta-agonists, 9 beta-blockers, 1 diuretic, 9 lipid regulators, 5 psychiatric drugs, 4 receptor antagonists, 1 antineoplastic. On 73 compounds tested, a number varying between 48 and 57 has been detected in the hospital effluents and in the raw influent to the WWTP, resulting in a percentage of occurrence ranging between 72 and 74 %. A discussion is reported referring to the differences found between the influent to the WWTP of Ferrara and the two hospitals effluents in terms of macropollutants and of the main pharmaceuticals in order to evaluate if it is correct to consider hospital effluents of the same pollutant nature of urban raw wastewaters as it is widely considered by law. To Moreover, the ratios between average concentrations of the different therapeutic classes in hospital and in urban wastewaters have been evaluated, resulting between 1.1 (for anti-diabetic compounds) and 13.6 for diurectics with an average value of 5.4. Finally, the mass loadings of the main therapeutic classes for the hospital B have been assessed as well as for the influent of the WWTP of Ferrara. It emerged that with respect to the total loading influent to the WWTP, hospital B contributes for 38 % for receptor antagonists and 29 % for antibiotics and diuretics. For the other classes, the contributions are lower, between 1.9 and 9 %. This means that the co-treatment of hospital effluents at a municipal WWTP results in a general dilution of hospital wastewaters. A proper and accurate management of these wastewaters and of their treatment is required and an evaluation of the hospital mass balance with respect to its catchment area (on a local wide) is necessary in order to safeguard and protect the final receiving water body, especially when it is then used for irrigation purposes.

HOSPITAL AS A SOURCE OF EMERGING CONTAMINANTS (PHARMACEUTICALS): RESULTS OF AN INVESTIGATION ON ITS FINAL EFFLUENT CHEMICAL CHARACTERISTICS

VERLICCHI, Paola;AL AUKIDY, Mustafa Kether;
2011

Abstract

The study refers to experimental investigations carried out on two hospitals of medium-large size (300 beds for hospital A and 900 beds for hospital B), situated in the Province of Ferrara, Northern Italy and on the raw wastewaters entering the municipal wastewater treatment plant (WWTP) of the town of Ferrara (120 000 inhabitants). A first investigation, between 2007 and 2008, focused on the concentrations of macropollutants (BOD5, COD, SS, nitrogen and total phosphorus compounds, E. coli) in the effluent of hospital A and on the differences with urban ones. In a second experimental phase (in September 2009 and March 2010), the final effluent of the two hospitals as well as the influent to Ferrara WWTP have been subjected to an analytical campaign, aiming to identify the occurrence of 73 pharmaceutical compounds which are widely dispensed and administrated in hospitals and households: 12 analgesics/anti-inflammatories, 25 antibiotics, 1 anti-diabetic, 3 anti-hypertensives, 3 barbitures, 2 beta-agonists, 9 beta-blockers, 1 diuretic, 9 lipid regulators, 5 psychiatric drugs, 4 receptor antagonists, 1 antineoplastic. On 73 compounds tested, a number varying between 48 and 57 has been detected in the hospital effluents and in the raw influent to the WWTP, resulting in a percentage of occurrence ranging between 72 and 74 %. A discussion is reported referring to the differences found between the influent to the WWTP of Ferrara and the two hospitals effluents in terms of macropollutants and of the main pharmaceuticals in order to evaluate if it is correct to consider hospital effluents of the same pollutant nature of urban raw wastewaters as it is widely considered by law. To Moreover, the ratios between average concentrations of the different therapeutic classes in hospital and in urban wastewaters have been evaluated, resulting between 1.1 (for anti-diabetic compounds) and 13.6 for diurectics with an average value of 5.4. Finally, the mass loadings of the main therapeutic classes for the hospital B have been assessed as well as for the influent of the WWTP of Ferrara. It emerged that with respect to the total loading influent to the WWTP, hospital B contributes for 38 % for receptor antagonists and 29 % for antibiotics and diuretics. For the other classes, the contributions are lower, between 1.9 and 9 %. This means that the co-treatment of hospital effluents at a municipal WWTP results in a general dilution of hospital wastewaters. A proper and accurate management of these wastewaters and of their treatment is required and an evaluation of the hospital mass balance with respect to its catchment area (on a local wide) is necessary in order to safeguard and protect the final receiving water body, especially when it is then used for irrigation purposes.
hospital effluent; municipal wastewaters; chemical characterization; pharmaceuticals; macro-parameters; comparisons
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11392/1430527
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