Occurrence and removal of PPCPs in municipal and hospital wastewaters in Greece

Source apportionment and specific-source-site risk of quinolone antibiotics for effluent-receiving urban rivers and groundwater in a city, China

There is a large surface-groundwater exchange downstream of wastewater treatment plants (WWTPs), and antibiotics upstream may influence sites downstream of rivers. Thus, samples from 9 effluent-receiving urban rivers (ERURs) and 12 groundwater sites were collected in Shijiazhuang City in December 2020 and April 2021. For ERURs, 8 out of 13 target quinolone antibiotics (QNs) were detected, and the total concentration of QNs in December and April were 100.6-4,398 ng/L and 8.02-2,476 ng/L, respectively. For groundwater, all target QNs were detected, and the total QNs concentration was 1.09-23.03 ng/L for December and 4.54-170.3 ng/L for April. The distribution of QNs was dissimilar between ERURs and groundwater. Most QN concentrations were weakly correlated with land use types in the system. The results of a positive matrix factorization model (PMF) indicated four potential sources of QNs in both ERURs and groundwater, and WWTP effluents were the main source of QNs. From December to April, the contribution of WWTP effluents and agricultural emissions increased, while livestock activities decreased. Singular value decomposition (SVD) results showed that the spatial variation of most QNs was mainly contributed by sites downstream (7.09%-88.86%) of ERURs. Then, a new method that combined the results of SVD and PMF was developed for a specific-source-site risk quotient (SRQ), and the SRQ for QNs was at high level, especially for the sites downstream of WWTPs. Regarding temporal variation, the SRQ for WWTP effluents, aquaculture, and agricultural emissions increased. Therefore, in order to control the antibiotic pollution, more attention should be paid to WWTP effluents, aquaculture, and agricultural emission sources for the benefit of sites downstream of WWTPs.

Metal nanostructures in polymeric matrices for optical detection and removal of heavy metal ions, pesticides and dyes from water

Water pollutants such as heavy metal ions, pesticides, and dyes pose a worldwide issue. Their presence in water resources interferes with the normal growth mechanisms of living beings and causes long or short-term diseases. For this reason, research continuously tends to develop innovative, selective, and efficient processes or technologies to detect and remove pollutants from water. This review provides an up-to-date overview on metal nanoparticles loaded in polymeric matrices, such as hydrogels and membranes, and employed as optical sensors and as removing materials for water pollutants. The synthetic pathways of nanomaterials loading into polymeric matrices have been analyzed, particularly focusing on noble metal nanoparticles, noble metal nanoclusters, and metal oxide nanoparticles. Moreover, the sensing properties of modified matrices towards water pollutants have been discussed in addition to the interaction mechanisms between the sensors and the toxic compounds. The last part of the review has been devoted to illustrating the separation mechanism and removal performance of membranes loaded with nanomaterials in the treatment and purification of water streams from different contaminants (heavy metals, dyes and pesticides).

Occurrence, bioaccumulation, fate, and risk assessment of emerging pollutants in aquatic environments: A review

Significant concerns on a global scale have been raised in response to the potential adverse impacts of emerging pollutants (EPs) on aquatic creatures. We have carefully reviewed relevant research over the past 10 years. The study focuses on five typical EPs: pharmaceuticals and personal care products (PPCPs), per- and polyfluoroalkyl substances (PFASs), drinking water disinfection byproducts (DBPs), brominated flame retardants (BFRs), and microplastics (MPs). The presence of EPs in the global aquatic environment is source-dependent, with wastewater treatment plants being the main source of EPs. Multiple studies have consistently shown that the final destination of most EPs in the water environment is sludge and sediment. Simultaneously, a number of EPs, such as PFASs, MPs, and BFRs, have long-term environmental transport potential. Some EPs exhibit notable tendencies towards bioaccumulation and biomagnification, while others pose challenges in terms of their degradation within both biological and abiotic treatment processes. The results showed that, in most cases, the ecological risk of EPs in aquatic environments was low, possibly due to potential dilution and degradation. Future research topics should include adding EPs detection items for the aquatic environment, combining pollution, and updating prediction models.

Time-dependent hormesis transfer from five high-frequency personal care product components to mixtures

There is potential for personal care products (PCPs) components and mixtures to induce hormesis. How hormesis is related to time and transmitted from components to mixtures are not clear. In this paper, we conducted determination of components in 16 PCP products and then ran frequent itemset mining on the component data. Five high-frequency components (HFCs), betaine (BET), 1,3-butanediol (BUT), ethylenediaminetetraacetic acid disodium salt (EDTA), glycerol (GLO), and phenoxyethanol (POE), and 14 mixtures were identified. For each mixture system, one mixture ray with the actual mixture ratios in the products was selected. Time-dependent microplate toxicity analysis was used to test the luminescence inhibition toxicity of five HFCs and 14 mixture rays to Vibrio qinghaiensis sp.-Q67 at 12 concentration gradients and eight exposure times. It is showed that BET, EDTA, POE, and 13 mixture rays containing at least one J-type component showed time-dependent hormesis. Characteristic parameters used to describe hormesis revealed that the absolute value of the maximum stimulatory effect (|Emin|) generally increased with time. Notably, mixtures composed of POE and S-type components showed greater |Emin| than POE alone at the same time. Importantly, the maximum stimulatory effective concentration, NOEC/the zero effective concentration point, and EC50 remained relatively stable. Nine hormesis transmission phenomena were observed in different mixture rays. While all mixtures primarily exhibited additive action, varying degrees of synergism and antagonism were noted in binary mixtures, with no strong synergism or antagonism observed in ternary and quaternary mixtures. These findings offer valuable insights for the screening of HFCs and their mixtures, as well as the study of hormesis transmission in personal care products.

Enhanced properties of a positive-charged nanofiltration membrane containing quaternarized chitosan through second interfacial polymerization for the removal of salts and pharmaceuticals

Nanofiltration (NF) membrane technology has been widely used in the removal of salts and trace organic pollutants, such as pharmaceuticals and personal care products (PPCPs), due to its superiority. A positive-charged composite NF membrane with an active skin layer was prepared by polyethyleneimine (PEI), trimethyl benzene chloride, and quaternate chitosan (HTCC) through second interfacial polymerization on the polyethersulfone ultrafiltration membrane. The physicochemical properties of the nanocomposite membrane were investigated using surface morphology, hydrophilicity, surface charge, and molecular weight cut-off (MWCO). The influence of the concentration and reaction time of PEI and HTCC was documented. The optimized membrane had a MWCO of about 481 Da and possessed a pure water permeability of 25.37 L·m-2·h-1·MPa-1. The results also exhibited salt rejection ability as MgCl2 > CaCl2 > MgSO4 > Na2SO4 > NaCl > KCl, showing a positive charge on the fabricated membrane. In addition, the membrane had higher rejection to atenolol, carbamazepine, amlodipine, and ibuprofen at 89.46, 86.02, 90.12, and 77.21%, respectively. Moreover, the anti-fouling performance and stability of the NF membrane were also improved.

Advances in identifying and managing emerging contaminants in aquatic ecosystems: Analytical approaches, toxicity assessment, transformation pathways, environmental fate, and remediation strategies

Emerging contaminants (ECs) are increasingly recognized as threats to human health and ecosystems. This review evaluates advanced analytical methods, particularly mass spectrometry, for detecting ECs and understanding their toxicity, transformation pathways, and environmental distribution. Our findings underscore the reliability of current techniques and the potential of upcoming methods. The adverse effects of ECs on aquatic life necessitate both in vitro and in vivo toxicity assessments. Evaluating the distribution and degradation of ECs reveals that they undergo physical, chemical, and biological transformations. Remediation strategies such as advanced oxidation, adsorption, and membrane bioreactors effectively treat EC-contaminated waters, with combinations of these techniques showing the highest efficacy. To minimize the impact of ECs, a proactive approach involving monitoring, regulations, and public education is vital. Future research should prioritize the refining of detection methods and formulation of robust policies for EC management.

A state-of-art-review on emerging contaminants: Environmental chemistry, health effect, and modern treatment methods

Pollution problems are increasingly becoming e a priority issue from both scientific and technological points of view. The dispersion and frequency of pollutants in the environment are on the rise, leading to the emergence have been increasing, including of a new class of contaminants that not only impact the environment but also pose risks to people's health. Therefore, developing new methods for identifying and quantifying these pollutants classified as emerging contaminants is imperative. These methods enable regulatory actions that effectively minimize their adverse effects to take steps to regulate and reduce their impact. On the other hand, these new contaminants represent a challenge for current technologies to be adapted to control and remove emerging contaminants and involve innovative, eco-friendly, and sustainable remediation technologies. There is a vast amount of information collected in this review on emerging pollutants, comparing the identification and quantification methods, the technologies applied for their control and remediation, and the policies and regulations necessary for their operation and application. In addition, This review will deal with different aspects of emerging contaminants, their origin, nature, detection, and treatment concerning water and wastewater.

ZnO nanostructured matrix as nexus catalysts for the removal of emerging pollutants

Water pollution stands as a pressing global environmental concern, elevating the significance of innovative, dependable, and sustainable solutions. This study represents an extensive review of the use of photocatalytic zinc oxide nanoparticles (ZnO NPs) for the removal of emerging pollutants from water and wastewater. The study examines ZnO NPs' different preparation methods, including physical, chemical, and green synthesis, and emphasizes on advantages, disadvantages, preparation factors, and investigation methods for the structural and morphological properties. ZnO NPs demonstrate remarkable properties as photocatalysts; however, their small dimensions pose an issue, leading to potential post-use environmental losses. A strategy to overcome this challenge is scaling up ZnO NP matrices for enhanced stability and efficiency. The paper introduces novel ZnO NP composites, by incorporating supports like carbon and clay that serve as photocatalysts in the removal of emerging pollutants from water and wastewater. In essence, this research underscores the urgency of finding innovative, efficient, and eco-friendly solutions for the removal of emerging pollutants from wastewater and highlights the high removal efficiencies obtained when using ZnO NPs obtained from green synthesis as a photocatalyst. Future research should be developed on the cost-benefit analysis regarding the preparation methods, treatment processes, and value-added product regeneration efficiency.

Pharmaceutical residues in the ecosystem: Antibiotic resistance, health impacts, and removal techniques

Hospital wastewater has emerged as a major category of environmental pollutants over the past two decades, but its prevalence in freshwater is less well documented than other types of contaminants. Due to compound complexity and improper operations, conventional treatment is unable to remove pharmaceuticals from hospital wastewater. Advanced treatment technologies may eliminate pharmaceuticals, but there are still concerns about cost and energy use. There should be a legal and regulatory framework in place to control the flow of hospital wastewater. Here, we review the latest scientific knowledge regarding effective pharmaceutical cleanup strategies and treatment procedures to achieve that goal. Successful treatment techniques are also highlighted, such as pre-treatment or on-site facilities that control hospital wastewater where it is used in hospitals. Due to the prioritization, the regulatory agencies will be able to assess and monitor the concentration of pharmaceutical residues in groundwater, surface water, and drinking water. Based on the data obtained, the conventional WWTPs remove 10-60% of pharmaceutical residues. However, most PhACs are eliminated during the secondary or advanced therapy stages, and an overall elimination rate higher than 90% can be achieved. This review also highlights and compares the suitability of currently used treatment technologies and identifies the merits and demerits of each technology to upgrade the system to tackle future challenges. For this reason, pharmaceutical compound rankings in regulatory agencies should be the subject of prospective studies.

Assessment of selected pharmaceuticals in Riyadh wastewater treatment plants, Saudi Arabia: Mass loadings, seasonal variations, removal efficiency and environmental risk

Despite increasing interest in pharmaceutical emissions worldwide, studies of environmental contamination with pharmaceuticals arising from wastewater discharges in Saudi Arabia are scarce. Therefore, this study examined occurrence, mass loads and removal efficiency for 15 pharmaceuticals and one metabolite (oxypurinol) from different therapeutic classes in three wastewater treatment plants (WWTPs), in Riyadh city in Saudi Arabia. A total of 144 samples were collected from the influents and effluents between March 2018 and July 2019 and analyzed using Solid Phase Extraction followed by triple quadrupole LC-MS/MS. The average concentrations in the influents and effluents were generally higher than their corresponding concentrations found either in previous Saudi Arabian or global studies. The four most dominant compounds in the influent were acetaminophen, ciprofloxacin, caffeine, and diclofenac, with caffeine and acetaminophen having the highest concentrations ranging between 943 and 2282 μg/L. Metformin and ciprofloxacin were the most frequently detected compounds in the effluents at concentrations as high as 33.2 μg/L. Ciprofloxacin had the highest mass load in the effluents of all three WWTPs, ranging between 0.20 and 20.7 mg/day/1000 inhabitants for different WWTPs. The overall average removal efficiency was estimated high (≥80), with no significant different (p > 0.05) between the treatment technology applied. Acetaminophen and caffeine were almost completely eliminated in all three WWTPs. The samples collected in the cold season generally had higher levels of detected compounds than those from the warm seasons, particularly for NSAID and antibiotic compounds. The estimated environmental risk from pharmaceutical compounds in the studied effluents was mostly low, except for antibiotic compounds. Thus, antibiotics should be considered for future monitoring programmes of the aquatic environment in Saudi Arabia.

Efficient Removal of Analgesic and Anti-Inflammatory Drugs from Sewage Treatment Plant Effluents Using Magnetite Nanoparticles Synthesized Red Mud

Due to the COVID-19 epidemic, the consumption of pharmaceuticals, especially paracetamol, has sharply increased on a global scale. The increasing concentration of analgesic and anti-inflammatory drugs (AAIDs) in the aquatic medium is a global problem for human and aquatic life. Therefore, simple and effective treatment options for removing AAIDs from wastewater after the COVID-19 pandemic are needed. The removal of AAIDs (acetaminophen, acetylsalicylic acid, codeine, diclofenac, ibuprofen, indomethacin, ketoprofen, mefenamic acid, naproxen, and phenylbutazone) from sewage treatment plant (STP) effluents by the prepared magnetite nanoparticles synthesized from red mud (mNPs-RM) is presented for the first time in this study. The removal efficiencies of AAIDs onto mNPs-RM were determined to be between 90% (diclofenac) and 100% (naproxen, codeine, and indomethacin). Acetaminophen (paracetamol) was used as a model compound in kinetic and isotherm model studies. The adsorption of acetaminophen was matched well with the pseudo second order kinetic model. Film diffusion governed its rate mechanism. The Freundlich isotherm model preferably fitted the adsorption data with an adsorption capacity of 370 mg/g at 120 min contact time at pH 7.0 at 25 °C. Furthermore, the regenerated mNPs-RM were used four times without affecting the adsorption capacity and the magnetic separability. mNPs-RM can be used as a simple, inexpensive and effective adsorbent for removing AAIDs from STP effluents. Also, low cost adsorbent obtained from industrial waste could be employed to replace the high cost activated carbons for the adsorption of other micro pollutants in STP effluents.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11270-023-06404-7.

Single and combined effects of caffeine and salicylic acid on mussel Mytilus galloprovincialis: Changes at histomorphological, molecular and biochemical levels

Caffeine (CAF) and salicylic acid (SA) are frequently detected in waterbody, though information on their biological impact is poor. This work assesses the effects of CAF (5ng/L to 10µg/L) and SA (0.05µg/L to 100µg/L) alone and combined as CAF+SA (5ng/L+0.05µg/L to 10µg/L+100µg/L) on mussel Mytilus galloprovincialis under 12-days exposure by histomorphology of digestive gland and oxidative stress defense at molecular and biochemical levels. Besides evaluating tissue accumulation, absence of histomorphological damage and haemocyte infiltration highlighted activation of defensive mechanisms. Up-regulation of Cu/Zn-sod, Mn-sod, cat and gst combined with increased catalase and glutathione S-transferase activity were found in CAF-exposed mussels, while SA reduced ROS production and mitochondrial activity. CAF+SA exposure induced differential responses, and the integrated biomarker response (IBR) revealed more pronounced effects of SA than CAF. These results enlarge knowledge on pharmaceuticals impact on non-target organisms, emphasizing the need for proper environmental risk assessment.

Reusable passive sampler with carbon nanotubes for monitoring contaminants in wastewater: Application, regeneration and reuse

Progress in excogitation suitable strategies for monitoring chemical compounds in wastewater is an essential step for further research into the occurrence, impact, and fate of the pollutants in the aquatic environment. At present, it is desirable to advance and use economical, environmentally friendly and non-labour intensive methods of environmental analysis. In this study, carbon nanotubes (CNTs) were successfully applied, regenerated, and reused as a sorbent in passive samplers for monitoring contaminants in treated and untreated wastewater at three wastewater treatment plants (WWTPs) located in different urbanization areas in northern Poland. Three cycles of chemical and thermal regeneration of used sorbents were performed. It was shown that it is possible to regenerate CNTs a minimum of three times and reuse them in passive samplers while maintaining the desired sorption properties. The obtained results confirm that the CNTs are perfectly in line with the main principles of green chemistry and sustainability. Carbamazepine, ketoprofen, naproxen, diclofenac, p-nitrophenol, atenolol, acebutolol, metoprolol, sulfapyridine and sulfamethoxazole were detected in each of the WWTPs, both in treated and untreated wastewater. The obtained data drastically show the inefficiency of the removal of contaminants by conventional WWTPs. More importantly, the results even indicate negative contaminant removal in most cases, i.e. higher concentrations (up to 863%) of these substances in the effluent compared to the influent.

Ibuprofen: Toxicology and Biodegradation of an Emerging Contaminant

The anti-inflammatory drug ibuprofen is considered to be an emerging contaminant because of its presence in different environments (from water bodies to soils) at concentrations with adverse effects on aquatic organisms due to cytotoxic and genotoxic damage, high oxidative cell stress, and detrimental effects on growth, reproduction, and behavior. Because of its high human consumption rate and low environmental degradation rate, ibuprofen represents an emerging environmental problem. Ibuprofen enters the environment from different sources and accumulates in natural environmental matrices. The problem of drugs, particularly ibuprofen, as contaminants is complicated because few strategies consider them or apply successful technologies to remove them in a controlled and efficient manner. In several countries, ibuprofen's entry into the environment is an unattended contamination problem. It is a concern for our environmental health system that requires more attention. Due to its physicochemical characteristics, ibuprofen degradation is difficult in the environment or by microorganisms. There are experimental studies that are currently focused on the problem of drugs as potential environmental contaminants. However, these studies are insufficient to address this ecological issue worldwide. This review focuses on deepening and updating the information concerning ibuprofen as a potential emerging environmental contaminant and the potential for using bacteria for its biodegradation as an alternative technology.

Occurrence of pharmaceuticals in the wastewater of a Greek hospital: Combining consumption data collection and LC-QTOF-MS analysis

In this article we applied drug consumption approach and chemical analysis in parallel to investigate the concentrations of a large number of pharmaceuticals in different streams of a General Hospital. Drugs consumption data was collected during two periods (Period 1, 2) and the predicted environmental concentrations (PECs) were estimated for the wastewater of a building housing specific medical services (Point A) and for the entire hospital (Point B). Hospital wastewater samples (HWW) samples were also collected from these points and periods and the measured environmental concentrations (MEC) were determined using UHPLC-ESI-QTOF-MS/MS. According to consumption data, the highest number of drugs was consumed in the departments of Hematology, Intensive Care Unit, Cardiology, Internal Medicine, and Oncology, while the number of active substances used in the hospital was 413 (Period 1) and 362 (Period 2). For most substances, much higher PEC and MEC values were found at the HWW of Point A indicating that on-site treatment of this stream could be examined in the future. The application of wide-scope target analysis allowed the quantification of 122 compounds, while 21 additional substances were identified using suspect screening. The highest mean concentrations in Period 1 were found for acetaminophen (1100 μg/L) and rifaximin (723 μg/L), while in Period 2 for iopromide (458 μg/L) and acyclovir (408 μg/L). Among the detected compounds, 19 metabolites were determined. Atenolol acid, 1-hydroxy-midazolam and clopidogrel carboxylic acid were quantified at concentrations much higher than parent compounds indicating the importance of metabolites' monitoring in HWW. Calculation of PEC/MEC ratio for 36 pharmaceuticals showed sufficient correlation of these values for 19 % to 33 % of the substances depending on the examined period and sampling point. The parallel collection of drugs consumption data and chemical analysis give a thorough picture of the substances present in HWW and their main sources, facilitating decision-making for their better management.

Determination of pharmaceuticals and metabolites in sludge and hydrochar after hydrothermal carbonization using sonication-QuEChERS extraction method and UHPLC LTQ/Orbitrap MS

Pharmaceuticals (PhACs) are an important group of emerging contaminants that are released continuously in the environment from wastewater treatments plants (WWTPs). They can produce biological effects even though at very low concentrations. Conventional WWTPs are not able to remove or degrade completely emerging pollutants resulting in the presence of PhACs in sewage sludge after wastewater treatment. PhACs are found in sludge at low ppb-ppt levels, and their analysis and detection is a difficult task due to the complexity of sewage sludge matrices. Hydrothermal carbonization is currently being proposed as a suitable conversion technology for sewage sludge management to recover valuable products and to be used for soil amendment. In this work, a modified quick, easy, cheap, effective, rugged, and safe (QuEChERS)-based methodology with a dispersive solid-phase extraction (d-SPE) clean-up followed by ultra-high-performance liquid chromatography coupled with high-resolution linear ion trap-Orbitrap mass spectrometry (UHPLC-LTQ/Orbitrap MS), operated in positive ionization mode, was adopted to investigate 33 multiclass pharmaceuticals in sewage sludge and in hydrochar produced after hydrothermal carbonization. The analytical method was first optimized studying various extraction parameters and finally validated in terms of linearity, recovery, intra and inter-day precisions, expanded uncertainty (%U)/Horrat ratio at three spiking levels, matrix-effects (ME), process efficiency (PE), and limits of detection and quantification. The developed methodology fulfilled all analytical requirements and was finally applied to sludge samples from the WWTP of Ioannina city where a group of antibiotics was detected at concentrations up to 15 ng g^-1 and psychiatric drugs such as amisulpride, clozapine, and citalopram were detected at higher concentration levels up to 205, 87.4 and 63.2 ng g^-1, respectively. The method was also applied to hydrothermally treated sludge sample under different reaction conditions. Most of the antibiotic compounds were not detected, and several psychiatric drugs such as mirtazapine, bupropion, valsartan, diazepam, and caffeine were found at concentrations below the LOQ.

Occurrence of Selected Emerging Contaminants in Southern Europe WWTPs: Comparison of Simulations and Real Data

Emerging contaminants (ECs) include a diverse group of compounds not commonly monitored in wastewaters, which have become a global concern due to their potential harmful effects on aquatic ecosystems and human health. In the present work, six ECs (ibuprofen, diclofenac, erythromycin, triclosan, imidacloprid and 17α-ethinylestradiol) were monitored for nine months in influents and effluents taken from four wastewater treatment plants (WWTPs). Except for the case of ibuprofen, which was in all cases in lower concentrations than those usually found in previous works, results found in this work were within the ranges normally reported. Global removal efficiencies were calculated, in each case being very variable, even when the same EC and facility were considered. In addition, the SimpleTreat model was tested by comparing simulated and real ibuprofen, diclofenac and erythromycin data. The best agreement was obtained for ibuprofen which was the EC with the highest removal efficiencies.

Acute ecotoxicological effects on daphnids and green algae caused by the ozonation of ibuprofen

Due to its ubiquitous presence in wastewaters, wastewater treatment plant effluents and even surface waters, the removal of the pharmaceutical ibuprofen from water is of special interest. Ozonation is widely applied for the treatment of micropollutants in wastewater treatment plants and is already known to also degrade ibuprofen. However, the formation of a wide range of transformation products during such oxidation steps might affect the aquatic environment. This study focuses on the acute ecotoxicological impact of the ibuprofen ozonation products on the two model organisms Daphnia magna and Desmodesmus subspicatus. For the identification of possibly ecotoxic products, a new workflow combining ecotoxicological testing, analytical methods and toxicity prediction was applied. Examination at different pH conditions with increasing ozone doses can point to respective products for further systematic examination. Seven ozonation products were confirmed in this study, two of them for the first time. Five previously postulated products were rejected. For pH 7 the inhibition of green algae growth was observed for mixtures oxidized with low ozone doses, while at pH 3 the mixtures with higher ozone doses caused toxic effects on the mobility of daphnids. Together with the analytical measurements in combination with ecotoxicity prediction, six products were identified which might have caused the toxic effect on green algae. However, no assignment to the observed toxic effects on daphnids was possible. The gained results indicate that mixture toxicity might play a role in oxidation processes and needs to be considered in ozonation studies concerning the ecotoxicological impact. Furthermore, the different observed toxicity for the two organisms underlines the importance of using multiple test systems for a comprehensive evaluation of the ecotoxicity during ozonation processes.

Critical review of technologies for the on-site treatment of hospital wastewater: From conventional to combined advanced processes

This review aims to assess different technologies for the on-site treatment of hospital wastewater (HWW) to remove pharmaceutical compounds (PhCs) as sustances of emerging concern at a bench, pilot, and full scales from 2014 to 2020. Moreover, a rough characterisation of hospital effluents is presented. The main detected PhCs are antibiotics and psychiatric drugs, with concentrations up to 1.1 mg/L. On the one hand, regarding the presented technologies, membrane bioreactors (MBRs) are a good alternative for treating HWW with PhCs removal values higher than 80% in removing analgesics, anti-inflammatories, cardiovascular drugs, and some antibiotics. Moreover, this system has been scaled up to the pilot plant scale. However, some target compounds are still present in the treated effluent, such as psychiatric and contrast media drugs and recalcitrant antibiotics (erythromycin and sulfamethoxazole). On the other hand, ozonation effectively removes antibiotics found in the HWW (>93%), and some studies are carried out at the pilot plant scale. Even though, some families, such as the X-ray contrast media, are recalcitrant to ozone. Other advanced oxidation processes (AOPs), such as Fenton-like or UV treatments, seem very effective for removing pharmaceuticals, Antibiotic Resistance Bacteria (ARBs) and Antibiotic Resistance Genes (ARGs). However, they are not implanted at pilot plant or full scale as they usually consider extra reactants such as ozone, iron, or UV-light, making the scale-up of the processes a challenging task to treat high-loading wastewater. Thus, several examples of biological wastewater treatment methods combined with AOPs have been proposed as the better strategy to treat HWW with high removal of PhCs (generally over 98%) and ARGs/ARBs (below the detection limit) and lower spending on reactants. However, it still requires further development and optimisation of the integrated processes.

Global groundwater vulnerability for Pharmaceutical and Personal care products (PPCPs): The scenario of second decade of 21st century

The global production of PPCPs have increased by multiple folds promoting excessive exposure of its metabolites to humans via different aquatic systems. The higher residence time of toxic precursors of these metabolites pose direct human health risk. Among the different aquatic systems, the contamination of groundwater by PPCPs is the most concerning threat. This threat is especially critical considering the lesser oxidizing potential of the groundwater as compared to freshwater/river water. A major challenge also arises due to excessive dependency of the world's population on groundwater, which is exponentially increasing with time. This makes the identification and characterization of spatial contamination hotspots highly probabilistic as compared to other freshwater systems. The situation is more vulnerable in developing countries where there is a reported inadequacy of wastewater treatment facilities, thereby forcing the groundwater to behave as the only available sequestrating sink for all these contaminants. With increased consumption of antibiotics and other pharmaceuticals compounds, these wastes have proven capability in terms of enhancing the resistance among the biotic community of the soil systems, which ultimately can become catastrophic and carcinogenic in near future. Recent studies are supporting the aforementioned concern where compounds like diclofenac (analgesic) have attained a concentration of 1.3 mgL^-1 in the aquifer systems of Delhi, India. The situation is far worse for developed nations where prolonged and indiscriminate usage of antidepressants and antibiotics have life threating consequences. It has been confirmed that certain compounds like ofloxacin (antibiotics) and bis-(2-ethylhexyl)phthalate are present in some of the most sensitive wells/springs of the United States and Mexico. The current trend of the situation has been demonstrated by integrating a comparative approach of the published literatures in last three years. This review provides first-hand information report for formulating a directive policy framework for tackling PPCPs issues in the groundwater system.

Removal of emerging pollutants by a 3-step system: Hybrid digester, vertical flow constructed wetland and photodegradation post-treatments

The removal of emerging pollutants from municipal wastewater was studied for the first time using a three-step pilot-scale system: 1) hybrid digester (HD) as first step, 2) subsurface vertical flow constructed wetland (VF) as second step, and 3) photodegradation (PD) unit as third step or post-treatment. The HD and VF units were built and operated in series with effluent recirculation at pilot scale. For the PD post-treatment, three alternatives were studied at lab-scale, i) UVC irradiation at 254 nm (0.5 h exposure time), ii) UVA irradiation at 365 nm using a TiO₂-based photocatalyst and iii) sunlight irradiation using a TiO₂-based photocatalyst, the last two for 1 and 2 h. Alternative iii) was also tested at pilot-scale. Degradation of nine compounds was evaluated: acetaminophen (ACE), caffeine (CAF), carbamazepine (CBZ), ketoprofen (KET), ibuprofen (IBU), diclofenac (DCL), clofibric acid (ACB), bisphenol A (BPA), and sotalol (SOT). Overall, the HD-VF-UVC system completely removed (>99.5 %) ACE, CAF, KET, IBU, DCL and ACB, and to a lesser extent SOT (98 %), BPA (83 %) and CBZ (51 %). On the other hand, the HD-VF-UVA/TiO₂ system (at 2 h) achieved >99.5 % removal of ACE, CAF, KET, IBU and DCL while ACB, BPA, CBZ and SOT were degraded by 83 %, 81 %, 78 % and 68 %, respectively. Working also at 2 h of exposure time, in summer conditions, the HD-VF-Sol/TiO₂ system achieved >99.5 % removal of ACE, CAF, KET, IBU, DCL and ACB, and to a minor extent BPA (80 %), SOT (74 %) and CBZ (69 %). Similar results, although slightly lower for SOT (60 %) and CBZ (59 %), were obtained in the pilot sunlight plus TiO₂ catalyst unit. However, the use of sunlight irradiation with a TiO₂-based photocatalyst clearly showed lower removal efficiency in autumn conditions (i.e., 47 % SOT, 31 % CBZ).

Thermal degradation of emerging contaminants in municipal biosolids: The case of pharmaceuticals and personal care products

The presence of emerging contaminants in water and wastewater resources is of ongoing concern for public health and safety. Pharmaceutical compounds are designed to be biologically active and therefore may have effects on nontarget organisms in terrestrial and aquatic environments, even at trace concentrations. The presence of pharmaceutical and personal care products (PPCPs) in wastewater treatment plants is reported in various countries worldwide, mostly in the levels of nanograms to micrograms per litre. The present study investigates the thermal degradation of municipal sewage sludge containing PPCPs at various heating rates. The examined characteristics of the samples include thermal decomposition behavior, volatile release characteristics, and pyrolytic product composition. Thermal characterization of the PPCPs was conducted using differential scanning calorimetry. The gaseous products and typical functional groups of the released volatiles detected by Fourier-transform infrared spectroscopy mainly contained CO₂, CO, small-chain hydrocarbons, and oxygen- and nitrogen-containing functional groups together with other species. In addition, the potential of bioenergy production was investigated as a spin-off opportunity during thermal degradation of biosolids. Study results showed that PPCP concentrations can be lowered significantly by thermal treatment of municipal biosolids. Antifungal/antibacterial agents together with opioids, in particular triclosan and tramadol, showed less resistance to thermal degradation while antibiotics could be more recalcitrant to heat treatment. The thermodynamic results provide an important reference for future reactor design and the thermochemical treatment of biosolids as well as their conversion to value-added products.

Removal of Carbamazepine in Aqueous Solution by CoS2/Fe2+/PMS Process

Carbamazepine (CBZ), as a typical pharmaceutical and personal care product (PPCP), cannot be efficiently removed by the conventional drinking water and wastewater treatment process. In this work, the CoS2/Fe2+/PMS process was applied for efficient elimination of CBZ. The CBZ removal efficiency of CoS2/Fe2+/PMS was 2.5 times and 23 times higher than that of CoS2/PMS and Fe2+/PMS, respectively. The intensity of DMPO-HO• and DMPO-SO4•− followed the order of Fe2+/PMS < CoS2/PMS < CoS2/Fe2+/PMS, also suggesting the CoS2/Fe2+/PMS process has the highest oxidation activity. The effects of reaction conditions (e.g., CoS2 dosage, Fe2+ concentration, PMS concentration, initial CBZ concentration, pH, temperature) and water quality parameters (e.g., SO42−, NO3−, H2PO4−, Cl−, NH4+, humic acid) on the degradation of CBZ were also studied. Response surface methodology analysis was carried out to obtain the best conditions for the removal of CBZ, which are: Fe2+ = 70 µmol/L, PMS = 240 µmol/L, CoS2 = 0.59 g/L. The sustainability test demonstrated that the repeated use of CoS2 for 8 successive cycles resulted in little function decrease (<10%). These findings suggest that CoS2/Fe2+/PMS may be a promising method for advanced treatment of tailwater from sewage treatment plant.

Trends in Fenton and photo-Fenton processes for degradation of antineoplastic agents in water matrices: current knowledge and future challenges evaluation using a bibliometric and systematic analysis

Antineoplastic agents present potential hazards to human health and the environment. For this reason, these compounds have attracted a great deal of attention from researchers in the environmental sciences field. In order to help guide future research, it is important to understand the current state of investigation of the occurrence of these microcontaminants and methods for their removal, especially focusing on Fenton and photo-Fenton processes applied to various aqueous matrices in which this class of pharmaceuticals is present. For this purpose, a systematic review of these topics was performed by bibliometric analysis of articles published during the last decade and available in the Scopus and Web of Science databases. This study enables visualization of the current panorama and trends in this field, providing a guide for future collaborative research and exchange of knowledge. Various strategies have been suggested to improve the efficiency of Fenton and photo-Fenton processes, mainly by means of the application of multiples additions of iron, the use of heterogeneous catalysts, and/or the use of chelating agents. Some studies have evaluated different radiation sources employed for photo-Fenton processes, such as solar and/or artificial radiation. In turn, the identification of transformation products generated by Fenton and photo-Fenton treatments, together with their evaluation by in silico (Q)SAR predictions or experimental toxicological bioassays, are related subjects that have been less reported in published works and that should be studied in depth. These subjects can support treatment evaluations that are more realistic, considering their limitations or potentials.

Histological endpoints and oxidative stress transcriptional responses in the Mediterranean mussel Mytilus galloprovincialis exposed to realistic doses of salicylic acid

Despite the availability of analytic data, little is known about the toxicity of salicylic acid (SA) on aquatic non-target organisms. The present study aimed at evaluating the impact of SA through a short-term exposure of the Mediterranean mussel Mytilus galloprovincialis to five environmentally relevant concentrations of SA. A set of suitable biomarkers was applied at selected time-points on mussel digestive glands, including histological observations and expression of oxidative stress related genes. The obtained results showed a conspicuous hemocytic infiltration among mussel digestive tubules, as confirmed also by a flow cytometric approach that revealed an increase of halinocytes and granulocytes. Interestingly, a significant dose and time dependent decrease in the expression levels of oxidative stress related genes was found in mussels exposed to SA except for the glutathione S-transferase gene that was significantly up-regulated in a time-dependent manner confirming its important role against oxidant species and in the metabolism of pharmaceuticals.

Critical review on negative emerging contaminant removal efficiency of wastewater treatment systems: Concept, consistency and consequences

Emerging contaminants (ECs) are not completely removed by wastewater treatment owing to their capabilities of making complexes, toxic derivatives, byproduct formation, and dynamic partitioning. Negative contaminant removal i.e., higher concentrations (up to 5731%) of these ECs in the effluent with respect to the influent sampled on the same occasions, is globally prevalent in almost all types of treatment systems. Conventional WWTPs showed the highest negative removal (NR) for Carbamazepine, and Carbadox. Conjugation-deconjugation, types of WWTPs, transformations, leaching, operational parameters, sampling schemes, and nature of substance governs the NR efficiencies. Among the various categories of micropollutants, pesticides and beta-blockers are reported to exhibit the maximum percentage of NR, posing threat to human and the environment. With > 200% of NR for beta-blockers, low blood-pressure related symptoms may likely to get more prevalent in the near future. Study red-flags this phenomenon of negative removal that needs urgent attention.

An assessment of hospital wastewater and biomedical waste generation, existing legislations, risk assessment, treatment processes, and scenario during COVID-19

Hospitals release significant quantities of wastewater (HWW) and biomedical waste (BMW), which hosts a wide range of contaminants that can adversely affect the environment if left untreated. The COVID-19 outbreak has further increased hospital waste generation over the past two years. In this context, a thorough literature study was carried out to reveal the negative implications of untreated hospital waste and delineate the proper ways to handle them. Conventional treatment methods can remove only 50%-70% of the emerging contaminants (ECs) present in the HWW. Still, many countries have not implemented suitable treatment methods to treat the HWW in-situ. This review presents an overview of worldwide HWW generation, regulations, and guidelines on HWW management and highlights the various treatment techniques for efficiently removing ECs from HWW. When combined with advanced oxidation processes, biological or physical treatment processes could remove around 90% of ECs. Analgesics were found to be more easily removed than antibiotics, β-blockers, and X-ray contrast media. The different environmental implications of BMW have also been highlighted. Mishandling of BMW can spread infections, deadly diseases, and hazardous waste into the environment. Hence, the different steps associated with collection to final disposal of BMW have been delineated to minimize the associated health risks. The paper circumscribes the multiple aspects of efficient hospital waste management and may be instrumental during the COVID-19 pandemic when the waste generation from all hospitals worldwide has increased significantly.

Effect of Operational Parameters on the Removal of Carbamazepine and Nutrients in a Submerged Ceramic Membrane Bioreactor

Pharmaceuticals and personal care products have raised significant concerns because of their extensive use, presence in aquatic environments, and potential impacts on wildlife and humans. Carbamazepine was the most frequently detected pharmaceutical residue among pharmaceuticals and personal care products. Nevertheless, the low removal efficiency of carbamazepine by conventional wastewater treatment plants was due to resistance to biodegradation at low concentrations. A membrane bioreactor (MBR) has recently attracted attention as a new separation process for wastewater treatment in cities and industries because of its effectiveness in separating pollutants and its tolerance to high or shock loadings. In the current research, the main and interaction effects of three operating parameters, including hydraulic retention time (12-24 h), dissolved oxygen (1.5-5.5 mg/L), and sludge retention time (5-15 days), on removing carbamazepine, chemical oxygen demand, ammonia nitrogen, and phosphorus using ceramic membranes was investigated by applying a two-level full-factorial design analysis. Optimum dissolved oxygen, hydraulic retention time, and sludge retention time were 1.7 mg/L, 24 h, and 5 days, respectively. The research results showed the applicability of the MBR to wastewater treatment with a high carbamazepine loading rate and the removal of nutrients.

Screen-Printed Voltammetric Sensors-Tools for Environmental Water Monitoring of Painkillers

The dynamic production and usage of pharmaceuticals, mainly painkillers, indicates the growing problem of environmental contamination. Therefore, the monitoring of pharmaceutical concentrations in environmental samples, mostly aquatic, is necessary. This article focuses on applying screen-printed voltammetric sensors for the voltammetric determination of painkillers residues, including non-steroidal anti-inflammatory drugs, paracetamol, and tramadol in environmental water samples. The main advantages of these electrodes are simplicity, reliability, portability, small instrumental setups comprising the three electrodes, and modest cost. Moreover, the electroconductivity, catalytic activity, and surface area can be easily improved by modifying the electrode surface with carbon nanomaterials, polymer films, or electrochemical activation.

Abundance, fate, and effects of pharmaceuticals and personal care products in aquatic environments

Pharmaceuticals and personal care products (PPCPs) are found in wastewater, and thus, the environment. In this study, current knowledge about the occurrence and fate of PPCPs in aquatic systems-including wastewater treatment plants (WWTPs) and natural waters around the world-is critically reviewed to inform the state of the science and highlight existing knowledge gaps. Excretion by humans is the primary route of PPCPs entry into municipal wastewater systems, but significant contributions also occur through emissions from hospitals, PPCPs manufacturers, and agriculture. Abundance of PPCPs in raw wastewater is influenced by several factors, including the population density and demography served by WWTPs, presence of hospitals and drugs manufacturers in the sewershed, disease burden of the population served, local regulations, and climatic conditions. Based on the data obtained from WWTPs, analgesics, antibiotics, and stimulants (e.g., caffeine) are the most abundant PPCPs in raw wastewater. In conventional WWTPs, most removal of PPCPs occurs during secondary treatment, and overall removal exceeds 90% for treatable PPCPs. Regardless, the total PPCP mass discharged with effluent by an average WWTP into receiving waters (7.35-20,160 g/day) is still considerable, because potential adverse effects of some PPCPs (such as ibuprofen) on aquatic organisms occur within measured concentrations found in surface waters.

Photocatalytic Degradation Pathways of the Valsartan Drug by TiO2 and g-C3N4 Catalysts

The photocatalytic degradation of the valsartan (VLS) pharmaceutical using TiO2 and g-C3N4 catalysts under simulated solar light is studied in this paper by high-resolution Orbitrap mass spectrometry. •OH radicals were the major oxidant species for the degradation of valsartan using TiO2, while positive holes (h+), followed by a much lesser amount of •OH radicals, were the major species in the case of g-C3N4. Valsartan degradation followed first order kinetics by both catalysts with TiO2 being the catalyst with the better photocatalytic efficiency. The transformation products (TPs) and their evolution profiles are identified and monitored, respectively, by means of LC-HRMS. Based on TPs identification, the degradation mechanisms are discussed. The major degradation pathways for g-C3N4 include decarboxylation and subsequent oxidation, hydroxylation, and cleavage of C–N bond, while for TiO2 cyclization, TPs are abundant and the hydroxylation occurs in the first stage products. The study highlights the complex nature of TPs formed during such processes, the different mechanisms involved and the necessity for the identification of TPs for the assessment of the treatment and the tracking of such TPs in different environmental compartments.

Occurrence of Pharmaceutically Active Compounds and Potential Ecological Risks in Wastewater from Hospitals and Receiving Waters in Sri Lanka

The presence of pharmaceutically active compounds (PACs) in the environment and their associated hazards is a major global health concern; however, data on these compounds are scarce in developing nations. In the present study, the existence of 39 non-antimicrobial PACs and six of their metabolites in wastewater from hospitals and adjacent surface waters in Sri Lanka was investigated from 2016 to 2018. The highest amounts of the measured chemicals, including the highest concentrations of atorvastatin (14,620 ng/L) and two metabolites, mefenamic acid (12,120 ng/L) and o-desmethyl tramadol (8700 ng/L), were detected in wastewater from the largest facility. Mefenamic acid, gemfibrozil, losartan, cetirizine, carbamazepine, and phenytoin were detected in all the samples. The removal rates in wastewater treatment were 100% for zolpidem, norsertaline, quetiapine, chlorpromazine, and alprazolam. There was substantial variation in removal rates of PACs among facilities, and the overall data suggest that treatment processes in facilities were ineffective and that some PAC concentrations in the effluents were increased. The estimated risk quotients revealed that 14 PACs detected in water samples could pose low to high ecological risk to various aquatic organisms. Compounds such as ibuprofen, tramadol, and chlorpromazine detected in untreated and treated wastewater at these facilities pose a high risk to several aquatic organisms. Our study provides novel monitoring data for non-antimicrobial PAC abundance and the associated potential ecological risk related to hospitals and urban surface waters in Sri Lanka and further offers valuable information on pre-COVID-19 era PAC distribution in the country. Environ Toxicol Chem 2022;41:298-311. © 2021 SETAC.

Fate of household and personal care chemicals in typical urban wastewater treatment plants indicate different seasonal patterns and removal mechanisms

Studies on the presence and fate of household and personal care chemicals (HPCCs) in wastewater treatment plants (WWTPs) are important due to their increasing consumption worldwide. The seasonal patterns and removal mechanisms of HPCCs are not well understood for WWTPs that apply different treatment technologies. To answer these questions, the sewage and sludge samples were taken from 10 typical WWTPs in Northeast China. Levels of UV filters in the influents in the warm season were significantly greater than that of the cold season (p < 0.05). Significant seasonal differences were found for the removals of many HPCCs. Results revealed that the highest removal efficiencies were found for linear alkylbenzene sulphonates with values ranging from 97.2% to 99.7%, and the values were 50.0%-99.9% for other HPCCs. The SimpleTreat model demonstrated that the studied WWTPs were operating with high efficiency at the time of sampling. The sorption of HPCCs to sludge can be strongly associated with their physicochemical parameters. Mass balance calculation suggested that sorption was the dominant mechanism for the removal of antimicrobials, while degradation and/or biotransformation were the other mechanisms for removing the most HPCCs in the WWTPs. This study real the factors influencing the seasonal patterns and removal mechanisms which imply the need for further studies to fully understands the plant and human health implications as sludge could be used in the municipal land application of biosolids.

Phycoremediation integrated approach for the removal of pharmaceuticals and personal care products from wastewater - A review

Pharmaceuticals and personal care products (PPCPs) are of emerging concerns because of their large usage, persistent nature which promised their continuous disposal into the environment, as these pollutants are stable enough to pass through wastewater treatment plants causing hazardous effects on all the organisms through bioaccumulation, biomagnification, and bioconcentration. The available technologies are not capable of eliminating all the PPCPs along with their degraded products but phycoremediation has the advantage over these technologies by biodegrading the pollutants without developing resistant genes. Even though phycoremediation has many advantages, industries have found difficulty in adapting this technology as a single-stage treatment process. To overcome these drawbacks recent research studies have focused on developing technology that integrated phycoremediation with the commonly employed treatment processes that are in operation for treating the PPCPs effectively. This review paper focuses on such research approaches that focused on integrating phycoremediation with other technologies such as activated sludge process (ASP), advanced oxidation process (AOP), Up-flow anaerobic sludge blanket reactor (UASBR), UV irradiation, and constructed wetland (CW) with the advantages and limitations of each integration processes. Furthermore, augmenting phycoremediation by co-metabolic mechanism with the addition of sodium chloride, sodium acetate, and glucose for the removal of PPCPs has been highlighted in this review paper.

Identification of micropollutants from graywater of different complexity and remediation using multilayered membranes

Graywater reuse is one of the important concepts in attaining water sustainability. A major challenge in this area is to realize various components present in graywater. The present study involves the identification of the chemical components of graywater collected from three different environments and to investigate the efficiency of removal of some of these chemical components using ultrafiltration membranes (polyelectrolyte multilayer (PEM) membranes). The chemical components were analyzed using liquid chromatography connected with quadrupole time-of-flight (UPLC-Q-ToF-MS). A number of micropollutants including surfactants and certain contaminants of emerging concern (CECs) were identified from these samples. Out of 16 compounds identified, 13 were surfactants and the remaining were caffeine, oxybenzone, and benzophenone. These surfactants are mostly the ingredients of various detergents. Low-pressure filtration studies of the collected samples were carried out utilizing chitosan/polyacrylic acid (CHI/PAA) multilayer membranes. A 5.5 bilayer membrane showed more than 95% rejection of the identified compounds in the selected samples and significant improvement in the water quality parameters. This demonstrates that the membrane used in this work is effective in the removal of various chemicals from graywater as well as enhancing the water quality.

A review on environmental occurrence, toxicity and microbial degradation of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

In recent years, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) have surfaced as a novel class of pollutants due to their incomplete degradation in wastewater treatment plants and their inherent ability to promote physiological predicaments in humans even at low doses. The occurrence of the most common NSAIDs (diclofenac, ibuprofen, naproxen, and ketoprofen) in river water, groundwater, finished water samples, WWTPs, and hospital wastewater effluents along with their toxicity effects were reviewed. The typical concentrations of NSAIDs in natural waters were mostly below 1 μg/L, the rivers receiving untreated wastewater discharge have often showed higher concentrations, highlighting the importance of effective wastewater treatment. The critical analysis of potential, pathways and mechanisms of microbial degradation of NSAIDs were also done. Although studies on algal and fungal strains were limited, several bacterial strains were known to degrade NSAIDs. This microbial ability is attributed to hydroxylation by cytochrome P450 because of the decrease in drug concentrations in fungal cultures of Phanerochaete sordida YK-624 on incubation with 1-aminobenzotriazole. Moreover, processes like decarboxylation, dehydrogenation, dechlorination, subsequent oxidation, demethylation, etc. also constitute the degradation pathways. A wide array of enzymes like dehydrogenase, oxidoreductase, dioxygenase, monooxygenase, decarboxylase, and many more are upregulated during the degradation process, which indicates the possibility of their involvement in microbial degradation. Specific hindrances in upscaling the process along with analytical research needs were also identified, and novel investigative approaches for future monitoring studies are proposed.

Enhanced bezafibrate degradation and power generation via the simultaneous PMS activation in visible light photocatalytic fuel cell

A collaborative system including peroxymonosulfate (PMS) activation in a photocatalytic fuel cell (PFC) with an BiOI/TiO₂ nanotube arrays p-n type heterojunction as photoanode under visible light (PFC(BiOI/TNA)/PMS/vis system) was established. Xenon lamp was used as the light source of visible light. A 4.6 times higher pseudo-first-order bezafibrate (BZF) degradation rate constant was achieved in this system compared with the single PFC(BiOI/TNA)/vis system. The radical quenching experiments revealed that the contribution of reactive oxidative species (ROS) followed the order of ¹O₂ ≈ h⁺ >> •OH > SO₄^•- >>O₂^•-. The EPR tests demonstrated that PMS addition enlarged the formation of ¹O₂, •OH and SO₄^•-, but suppressed O₂^•- yield. Interestingly, ¹O₂ was further proved to dominantly originated from the priority reaction between positive photoinduced holes (h⁺) and negatively charged PMS. Besides, N₂-purging tests and density functional theory calculation indicated that PMS probably reacted with residual photoinduced electron (e^-) on the more negative conduction band (CB) of BiOI to form •OH and SO₄^•-, but competed with dissolved oxygen. Other e^- transferred to the less negative CB of TNA through p-n junction will efficiently move to cathode through the external circuit. The greatly promoted power generation of PFC system was observed after PMS addition due to extra h⁺ consumption and efficient e^- separation and transfer. Besides, three possible pathways for BZF degradation were proposed including hydroxylation, fibrate chain substituent and amino bond fracture. This study can provide new insights into the mechanisms of PMS assisted photocatalysis and accompanying energy recovery.

Membrane bioreactors for hospital wastewater treatment: recent advancements in membranes and processes

Discharged hospital wastewater contains various pathogenic microorganisms, antibiotic groups, toxic organic compounds, radioactive elements, and ionic pollutants. These contaminants harm the environment and human health causing the spread of disease. Thus, effective treatment of hospital wastewater is an urgent task for sustainable development. Membranes, with controllable porous and nonporous structures, have been rapidly developed for molecular separations. In particular, membrane bioreactor (MBR) technology demonstrated high removal efficiency toward organic compounds and low waste sludge production. To further enhance the separation efficiency and achieve material recovery from hospital waste streams, novel concepts of MBRs and their applications are rapidly evolved through hybridizing novel membranes (non hydrophilic ultrafiltration/microfiltration) into the MBR units (hybrid MBRs) or the MBR as a pretreatment step and integrating other membrane processes as subsequent secondary purification step (integrated MBR-membrane systems). However, there is a lack of reviews on the latest advancement in MBR technologies for hospital wastewater treatment, and analysis on its major challenges and future trends. This review started with an overview of main pollutants in common hospital waste-water, followed by an understanding on the key performance indicators/criteria in MBR membranes (i.e., solute selectivity) and processes (e.g., fouling). Then, an in-depth analysis was provided into the recent development of hybrid MBR and integrated MBR-membrane system concepts, and applications correlated with wastewater sources, with a particular focus on hospital wastewaters. It is anticipated that this review will shed light on the knowledge gaps in the field, highlighting the potential contribution of hybrid MBRs and integrated MBR-membrane systems toward global epidemic prevention.

A Review of the Occurrence of Pharmaceutical Compounds as Emerging Contaminants in Treated Wastewater and Aquatic Environments

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In recent years, pharmaceutical compounds have emerged as potential contaminants in the aquatic matrices of the environment. High production, consumption, and limited removal through conventional treatment processes/wastewater treatment plants (WWTPs) are the major causes for the occurrence of pharmaceutical compounds in wastewater and aquatic environments worldwide. A number of studies report adverse health effects and risks to aquatic life and the ecosystem because of the presence of pharmaceutical compounds in the aquatic environment. This paper provides a state-of-the-art review of the occurrence of pharmaceutical compounds in treated wastewater from various WWTPs, surface water and groundwater bodies. Additionally, this review provides comprehensive information and pointers for research in wastewater treatment and waterbodies management.

Modified Single-Walled Carbon Nanotube Membranes for the Elimination of Antibiotics from Water

The hydrophilic and hydrophobic single-walled carbon nanotube membranes were prepared and progressively applied in sorption, filtration, and pertraction experiments with the aim of eliminating three antibiotics—tetracycline, sulfamethoxazole, and trimethoprim—as a single pollutant or as a mixture. The addition of SiO₂ to the single-walled carbon nanotubes allowed a transparent study of the influence of porosity on the separation processes. The mild oxidation, increasing hydrophilicity, and reactivity of the single-walled carbon nanotube membranes with the pollutants were suitable for the filtration and sorption process, while non-oxidized materials with a hydrophobic layer were more appropriate for pertraction. The total pore volume increased with an increasing amount of SiO₂ (from 743 to 1218 mm³/g) in the hydrophilic membranes. The hydrophobic layer completely covered the carbon nanotubes and SiO₂ nanoparticles and provided significantly different membrane surface interactions with the antibiotics. Single-walled carbon nanotubes adsorbed the initial amount of antibiotics in less than 5 h. A time of 2.3 s was sufficient for the filtration of 98.8% of sulfamethoxazole, 95.5% of trimethoprim, and 87.0% of tetracycline. The thicker membranes demonstrate a higher adsorption capacity. However, the pertraction was slower than filtration, leading to total elimination of antibiotics (e.g., 3 days for tetracycline). The diffusion coefficient of the antibiotics varies between 0.7–2.7 × 10⁻¹⁰, depending on the addition of SiO₂ in perfect agreement with the findings of the textural analysis and scanning electron microscopy observations. Similar to filtration, tetracycline is retained by the membranes more than sulfamethoxazole and trimethoprim.

Titanium Dioxide-Based Photocatalysts for Degradation of Emerging Contaminants including Pharmaceutical Pollutants

Contamination of the environment has been a growing problem in recent years. Due to the rapid growth in human population, the expansion of cities, along with the development of industry, more and more dangerous chemicals end up in the environment, especially in soil and water. For the most part, it is not possible to effectively remove chemicals through traditional remediation techniques, because those used in treatment plants are not specifically designed for this purpose. Therefore, new approaches for water remediation are in great demand. Many efforts have been focused on applications of photocatalysis for the remediation of chemical pollutants including drugs. Titanium(IV) oxide nanoparticles have particularly been considered as potential photocatalysts due to their favorable properties. In this article, we present the problem of emerging contaminants including drugs and discuss the use of photocatalysts based on titanium(IV) oxide nanoparticles for their degradation. A wide selection of materials, starting from bare TiO2, via its hybrid and composite materials, are discussed including those based on carbonaceous materials or connections with macrocyclic structures. Examples of photodegradation experiments on TiO2-based materials including those performed with various active pharmaceutical ingredients are also included.

Hospital Wastewater-Source of Specific Micropollutants, Antibiotic-Resistant Microorganisms, Viruses, and Their Elimination

Municipal wastewaters can generally provide real-time information on drug consumption, the incidence of specific diseases, or establish exposure to certain agents and determine some lifestyle consequences. From this point of view, wastewater-based epidemiology represents a modern diagnostic tool for describing the health status of a certain part of the population in a specific region. Hospital wastewater is a complex mixture of pharmaceuticals, illegal drugs, and their metabolites as well as different susceptible and antibiotic-resistant microorganisms, including viruses. Many studies pointed out that wastewater from healthcare facilities (including hospital wastewater), significantly contributes to higher loads of micropollutants, including bacteria and viruses, in municipal wastewater. In addition, such a mixture can increase the selective pressure on bacteria, thus contributing to the development and dissemination of antimicrobial resistance. Because many pharmaceuticals, drugs, and microorganisms can pass through wastewater treatment plants without any significant change in their structure and toxicity and enter surface waters, treatment technologies need to be improved. This short review summarizes the recent knowledge from studies on micropollutants, pathogens, antibiotic-resistant bacteria, and viruses (including SARS-CoV-2) in wastewater from healthcare facilities. It also proposes several possibilities for improving the wastewater treatment process in terms of efficiency as well as economy.

Spatio-Temporal Distribution and Influencing Factors of Human and Veterinary Pharmaceuticals in the Tributary Surface Waters of the Han River Watershed, South Korea

Human and veterinary pharmaceuticals are being increasingly used for disease treatment; hence, their distribution and factors influencing them in the aquatic environment need to be investigated. This study observed the effect of human and animal populations, usage, purchasing criteria (prescription vs. non-prescription), and land use to identify the spatio-temporal distribution of eight pharmaceuticals at twenty-four sites of the tributaries of the Han River watershed. In rural areas, the mean concentration (detection frequency) of non-prescription pharmaceuticals (NPPs) was higher (lower) compared to that of prescription pharmaceuticals (PPs); in urban areas, a reverse trend was observed. Pharmaceutical concentrations in urban and rural areas were mainly affected by wastewater treatment plants (WWTPs) and non-point sources, respectively; concentrations were higher downstream (4.9 times) than upstream of the WWTPs. The concentration distribution (according to the target) was as follows: human–veterinary > human > veterinary. Correlation between total concentration and total usage of the pharmaceuticals was high, except for NPPs. Most livestock and land use (except cropland) were significantly positively correlated with pharmaceutical concentrations. Concentrations were mainly higher (1.5 times) during cold seasons than during warm seasons. The results of this study can assist policymakers in managing pharmaceutical pollutants while prioritizing emerging pollutants.

Solid-phase optimisation for simultaneous determination of thirteen pharmaceuticals in Ethiopian water samples with HPLC-DAD detection: an initial assessment

Pharmaceutical consumption is increasing worldwide as it is essential to treat and prevent health issues but they end up in the environment. However, in many African countries like Ethiopia, the status of these compounds in various environmental samples is not very well known. In this study, a simple method for the extraction and determination of thirteen pharmaceutical compounds of different therapeutic classes in water samples using solid-phase extraction and HPLC-DAD was developed. Different parameters affecting extraction were optimised and obtained as hydrophilic-lipophilic balance (HLB) extraction cartridge, water sample pH of 5, elution solvent of 2% formic acid in water with methanol (20:80%, v/v), a sample volume of 150 mL and addition of 0.5% w/v EDTA in the sample. The limits of detection and quantification of the optimised method were in the range of 0.1-0.8 µg/L and 0.2-2.6 µg/L, respectively. The relative recovery in the spiked environmental water sample was in the range of 70-117% except for amoxicillin and acetylsalicylic acid in influent wastewater. The precision for all ranged from 0.3 to 11%. The proposed method was successfully tested for the detection and quantification of different environmental water samples collected from Addis Ababa, Ethiopia. Trimethoprim, caffeine and albendazole concentrations of 7.8 (1.1), 3.2 (0.4) and 2.1 (0.1) µg/L were quantified in hospital wastewater, respectively. The concentration of norfloxacin was found to be below the limit of quantification in the same water. Trimethoprim and ciprofloxacin were also found in the sewage treatment plant influent sample at a concentration of 0.5 (0.02) and 0.3 (0.01) µg/L, respectively.

A review on hospital wastewater treatment: A special emphasis on occurrence and removal of pharmaceutically active compounds, resistant microorganisms, and SARS-CoV-2

The hospital wastewater imposes a potent threat to the security of human health concerning its high vulnerability towards the outbreak of several diseases. Furthermore, the outbreak of COVID-19 pandemic demanded a global attention towards monitoring viruses and other infectious pathogens in hospital wastewater and their removal. Apart from that, the presence of various recalcitrant organics, pharmaceutically active compounds (PhACs), etc. imparts a complex pollution load to water resources and ecosystem. In this review, an insight into the occurrence, persistence and removal of drug-resistant microorganisms and infectious viruses as well as other micro-pollutants have been documented. The performance of various pilot/full-scale studies have been evaluated in terms of removal of biochemical oxygen demand (BOD), chemical oxygen demand (COD), total suspended solids (TSS), PhACs, pathogens, etc. It was found that many biological processes, such as membrane bioreactor, activated sludge process, constructed wetlands, etc. provided more than 80% removal of BOD, COD, TSS, etc. However, the removal of several recalcitrant organic pollutants are less responsive to those processes and demands the application of tertiary treatments, such as adsorption, ozone treatment, UV treatment, etc. Antibiotic-resistant microorganisms, viruses were found to be persistent even after the treatment of hospital wastewater, and high dose of chlorination or UV treatment was required to inactivate them. This article circumscribes the various emerging technologies, which have been used to treat PhACs and pathogens. The present review also emphasized the global concern of the presence of SARS-CoV-2 RNA in hospital wastewater and its removal by the existing treatment facilities.

Detailed characterization, antibiotic resistance and seasonal variation of hospital wastewater

This study investigates the presence of the different classes of micro-pollutants such as pharmaceutical active compounds (PhACs) (20 antibiotics, 8 analgesics and anti-inflammatories, 5 cytostatic agents, 7 β-blockers, 4 lipid regulators, 13 psychiatrics, 1 antidiabetic, 1 receptor antagonist, 1 local anaesthetic, 1 antihypertensive and their 5 metabolites), hormones (8 compounds), X-ray contrast agents (6 compounds), benzotriazoles (3 compounds) and pesticides (6 compounds), and antibiotic resistance in hospital wastewater (HWW) of a medical faculty in Istanbul, Turkey. In addition, the seasonal variations of the selected PhACs and X-ray contrast agents and antibiotic resistance were evaluated for 2 years in a total of eight samples. In the PhACs, sulfamethoxazole and its metabolite (4 N-acethyl-sulfamethoxazole) in the antibiotic group and paracetamol in the analgesic and anti-inflammatory group were found at 100% of frequency and the highest concentrations as 35, 43 and 210 μg/L, respectively. The mean concentrations of psychiatric compounds were found less than 0.25 μg/L except carbamazepine (1.36 μg/L). Bisphenol A in hormone group had the highest concentration up to 14 μg/L. In the hormone group compounds, 17-α-Ethinylestradiol and 17-β-Estradiol were detected at lower mean concentrations of 0.2 and 0.05 μg/L, respectively. 1H-benzotriazole had the highest concentration with the mean concentration of 24.8 μg/L in benzotriazole group compounds. The compounds in X-ray contrast agents group were noted as compounds detected at the highest concentration in HWW up to 3000 μg/L. Antibiotic resistance against azithromycin, clindamycin and trimethoprim-sulfamethoxazole antibiotics was observed around 50% in the winter period. The seasonal variation was detected for the most of the investigated PhACs, especially in antibiotic group which was in line with those significant differences in antibiotic resistance rates in the studied antibiotics between winter and summer seasons.

Removal efficiency of emerging micropollutants in biofilter wastewater treatment plants in tropical areas

We studied the removal of 61 emerging micropollutants, including illicit drugs, in a biofilter wastewater treatment plant located in the French Indies (Martinique). Raw wastewater concentrations were the highest for paracetamol followed by caffeine, naproxen, ibuprofen, its metabolite 2-hydroxyibuprofen, atenolol, ketoprofen, furosemide, methylparaben, cocaine, benzoylecgonine, and 11-nor-delta-9-carboxytetrahydrocannabinol (THC-COOH). The calculated removals were better than those reported in the literature, while the cumulative removal efficacy (i.e., removal of the total mass load) was estimated to be 92 ± 4%. However, this good performance may be partly explained by the removal of paracetamol (also named acetaminophen) and caffeine, which represented 86.4% of the total mass load. Our results point to the adsorption of some molecules on sludge, thus raising the question about local soil pollution from sludge spreading.

Prevalence and hazardous impact of pharmaceutical and personal care products and antibiotics in environment: A review on emerging contaminants

Antibiotic resistance is a global health emergency linked to unrestrained use of pharmaceutical and personal care products (PPCPs) as prophylactic agent and therapeutic purposes across various industries. Occurrence of pharmaceuticals are identified in ground water, surface water, soils, and wastewater treatment plants (WWTPs) in ng/L to μg/L concentration range. The prevalence of organic compounds including antimicrobial agents, hormones, antibiotics, preservatives, disinfectants, synthetic musks etc. in environment have posed serious health concerns. The aim of this review is to elucidate the major sources accountable for emergence of antibiotic resistance. For this purpose, variety of introductory sources and fate of PPCPs in aquatic environment including human and veterinary wastes, aquaculture and agriculture related wastes, and other anthropogenic activities have been discussed. Furthermore, genetic and enzymatic factors responsible for transfer and appearance of antibiotic resistance genes are presented. Ecotoxicity of PPCPs has been studied in environment in order to present risk imposed to human and ecological health. As per published literature reports, the removal of antibiotics and related traces being difficult, couples the possibility of emergence of antibiotic resistance and hence sustainability in global water resources. Therefore, research on environmental behavior and control strategies should be conducted along with assessing their chronic toxicity to identify potential human and ecological risks.

A review of pharmaceutical occurrence and pathways in the aquatic environment in the context of a changing climate and the COVID-19 pandemic

Active pharmaceutical ingredients (APIs) are increasingly being identified as contaminants of emerging concern (CECs). They have potentially detrimental ecological and human health impacts but most are not currently subject to environmental regulation. Addressing the life cycle of these pharmaceuticals plays a significant role in identifying the potential sources and understanding the environmental impact that pharmaceuticals may have in surface waters. The stability and biological activity of these "micro-pollutants" can lead to a pseudo persistence, with ensuing unknown chronic behavioural and health-related effects. Research that investigates pharmaceuticals predominantly focuses on their occurrence and effect within surface water environments. However, this review will help to collate this information with factors that affect their environmental concentration. This review focuses on six pharmaceuticals (clarithromycin, ciprofloxacin, sulfamethoxazole, venlafaxine, gemfibrozil and diclofenac), chosen because they are heavily consumed globally, have poor removal rates in conventional activated sludge wastewater treatment plants (CAS WWTPs), and are persistent in the aquatic environment. Furthermore, these pharmaceuticals are included in numerous published prioritisation studies and/or are on the Water Framework Directive (WFD) "Watch List" or are candidates for the updated Watch List (WL). This review investigates the concentrations seen in European Union (EU) surface waters and examines factors that influence final concentrations prior to release, thus giving a holistic overview on the source of pharmaceutical surface water pollution. A period of 10 years is covered by this review, which includes research from 2009-2020 examining over 100 published studies, and highlighting that pharmaceuticals can pose a severe risk to surface water environments, with each stage of the lifecycle of the pharmaceutical determining its concentration. This review additionally highlights the necessity to improve education surrounding appropriate use, disposal and waste management of pharmaceuticals, while implementing a source directed and end of pipe approach to reduce pharmaceutical occurrence in surface waters.

Simultaneous quantification of five pharmaceuticals and personal care products in biosolids and their fate in thermo-alkaline treatment

The presence of pharmaceuticals and personal care products (PPCPs) in biosolids applied to farmland is of concern due to their potential accumulation in the environment and the subsequent effects on humans. Thermo-alkaline hydrolysis (TAH) is a method used for greater stabilization of biosolids after anaerobic digestion. In this work, the effect of TAH on five selected PPCPs including fluoroquinolone antibiotics, ciprofloxacin (CIP), and ofloxacin (OFLX), and three commonly used antimicrobial agents, miconazole (MIC), triclosan (TCS) and triclocarban (TCC) was evaluated. At the onset, extraction and analytical methods were optimized for maximum simultaneous recovery and LC-MS quantification of the target PPCPs from both water and biosolids for improved accuracy. The compounds were detected in the range of 54 ± 3 to 6166 ± 532 ng/g in raw biosoilds collected from a local WWTP. Next, batch control adsorption experiments of the selected PPCPs were conducted in various sludges, which indicated about 89%-98% sorption of the PPCPs onto solid phase due to their high octanol-water coefficients. Subsequently, thermo-alkaline (pH 9.5, 75 °C, 45 min) hydrolysis (TAH) was conducted to determine the extent of degradation of these compounds in deionized (DI) water and biosolids due to treatment. The degradation of these compounds due to TAH ranged from 42% to 99% and 37%-41% in pure water and biosolids, respectively, potentially lowering their risk in the environment due to land application. A list of compounds for which the optimized analytical method potentially can be used for detection and quantification in environmental samples is provided in the supporting document.