Trends, new insights and perspectives in the treatment of hospital effluents

Recently, investigations of hospital effluent management and treatment have not only interested research groups with acquired experience in the field but have also attracted the interest of new groups over the world. The most recent literature provides new insights into the occurrence of pharmaceuticals and other contaminants of emerging concern, pathogens, viruses, antibiotic resistant bacteria and genes in hospital effluent in various new developing and developed countries. It also provides information on the effective removal of key compounds (mainly antibiotics, analgesics, beta-blockers and chemotherapy drugs) by means of enhanced biological treatments and advanced oxidation processes. The current debate among the scientific community is mainly about the proper treatment to reduce the spread of antibiotic resistant bacteria and genes, and about the feasibility (from a technical and economic point of view) of treatment trains tested at lab and pilot scale.