Elimination of micropollutants during post-treatment of hospital wastewater with powdered activated carbon, ozone, and UV

Effective methods for the decontamination of healthcare waste: Ozone and UV-C radiation process

Human-generated waste, including infectious healthcare waste, poses significant risks to public health and the environment. The COVID-19 pandemic has increased the global production of infectious waste, emphasizing the need for safe and sustainable waste management practices. While autoclaves are commonly used for on-site disposal, alternative methods like ozone gas and UV-C radiation offer environmentally friendly options that effectively eliminate pathogens without leaving toxic residues. Inadequate waste management can contribute to disease transmission, while open burning releases harmful pollutants. This study investigated the effectiveness of different disinfection agents - ozone gas and UV-C radiation - on infectious solid waste contaminated with bacteria. The bacterial indicators examined were Staphylococcus aureus, Bacillus subtilis, and Pseudomonas aeruginosa. The experimental methods included operating each ozone and UV-C radiation individually and simultaneously using ozone gas and UV-C radiation. The study also investigated exposure times and various concentrations of ozone gas. The findings demonstrated that the simultaneous application of ozone gas and UV-C radiation was the most effective method for decontaminating infectious solid waste and targeting the selected bacteria. The concentration of ozone gas ranged from 165 to 5000 ppm, depending on generation time and treatment chamber volume, while exposure times varied from 1 to 180 minutes. In applying UV-C rays, complete elimination of S. aureus was observed after 60 minutes up to 6-log, while the reduction of B. subtilis and P. aeruginosa were 2-log and 3-log, respectively. Ozone gas had the ability to inactivate all strains, but when ozone gas and UV-C rays were used simultaneously, this process was accelerated and improved. The total reduction in the bacterial load was 8-log. Considering the increase in population and the subsequent increase in waste generation, adopting an environmentally friendly waste management method can be very advantageous.Implications: This study highlights the effectiveness of simultaneously applying ozone gas and UV-C radiation for decontaminating infectious solid waste, offering an environmentally friendly alternative to traditional thermal treatments like autoclave and incineration. By optimizing ozone concentrations and exposure times, this method reduces disease transmission risks and minimizes environmental impact. These findings are crucial, especially during outbreaks such as the COVID-19 pandemic, providing scalable, sustainable waste management solutions for healthcare facilities. Implementing these techniques can protect public health and the environment, setting a new standard for safe infectious waste disposal worldwide, mitigating hazardous pollutants, and reduce the exposure risk of bio-hazardous residues.

Hospital wastewater treatment methods and its impact on human health and environments

The scientific development and economic advances have led to the identification of many pathogenic agents in hospital effluents. Hospital wastewaters are qualitatively similar to municipal wastewaters, with the difference that these wastewaters contain toxic and infectious substances and compounds that can be dangerous for the health of the environment, employees of these centers, and the entire community. Therefore, in the last few years, it has been emphasized that all hospitals and medical and health centers should have a treatment facility for their produced wastewater so that the health of the society and people is not threatened. An issue that is not paid attention to has become one of the environmental problems and concerns of the world today. The present study focused on the investigate hospital wastewater treatment methods and its impact on human health and the environment. In this narrative study, the first literature search was performed with four hundred and twenty-three articles were retrieved based on PubMed, Elsevier, Web of science, Spring, and Google Scholar databases. The results of this study showed that wastewater from hospitals and medical centers can play a significant impress in polluting soil and aquatic environments and spreading infectious diseases. According to the mentioned contents, collection and treatment of hospital wastewater is essential. In addition, if hospital wastewater enters the wastewater collection network without knowing its characteristics or with incomplete treatment and finally enters the municipal wastewater treatment plant. It causes many problems, including disturbing the balance of the biological system of the treatment plant. Purification and disposal of hospital wastewater is considered a vital action based on environmental standards. The results of this study also showed that the treatment methods of this type of hospital wastewater can play a significant role in reducing the spread of diseases caused by hospital wastewater treatment, including infectious diseases. The results of this study can be very useful for politicians, the managers of the Ministry of Energy and Health and the Environmental Organization in choosing the appropriate methods and process to reduce hospital wastewater and increase the efficiency of hospital wastewater treatment plants.

A review on hazards and treatment methods of released antibiotics in hospitals wastewater during the COVID-19 pandemic

Drugs and related goods are widely used in order to promote public health and the quality of life. One of the most serious environmental challenges affecting public health is the ongoing presence of antibiotics in the effluents generated by pharmaceutical industries and hospitals. Antibiotics cannot be entirely removed from wastewater using the traditional wastewater treatment methods. Unmetabolized antibiotics generated by humans can be found in urban and livestock effluent. The antibiotic present in effluent contributes to issues with resistance to antibiotics and the creation of superbugs. Over the recent 2 years, the coronavirus disease 2019 pandemic has substantially boosted hospital waste volume. In this situation, a detailed literature review was conducted to highlight the harmful effects of untreated hospital waste and outline the best approaches to manage it. Approximately 50 to 70% of the emerging contaminants prevalent in the hospital wastewater can be removed using traditional treatment strategies. This paper emphasizes the numerous treatment approaches for effectively eliminating emerging contaminants and antibiotics from hospital wastewater and provides an overview of global hospital wastewater legislation and guidelines on hospital wastewater administration. Around 90% of ECs might be eliminated by biological or physical treatment techniques when used in conjunction with modern oxidation techniques. According to this research, hybrid methods are the best approach for removing antibiotics and ECs from hospital wastewater. The document outlines the many features of effective hospital waste management and might be helpful during and after the coronavirus disease 2019 outbreak, when waste creation on all hospitals throughout the globe has considerably increased.

New Perspectives on the Interactions between Adsorption and Degradation of Organic Micropollutants in Granular Activated Carbon Filters

The removal of organic micropollutants in granular activated carbon (GAC) filters can be attributed to adsorption and biological degradation. These two processes can interact with each other or proceed independently. To illustrate the differences in their interaction, three 14C-labeled organic micropollutants with varying potentials for adsorption and biodegradation were selected to study their adsorption and biodegradation in columns with adsorbing (GAC) and non-adsorbing (sand) filter media. Using 14CO2 formation as a marker for biodegradation, we demonstrated that the biodegradation of poorly adsorbing N-nitrosodimethylamine (NDMA) was more sensitive to changes in the empty bed contact time (EBCT) compared with that of moderately adsorbing diclofenac. Further, diclofenac that had adsorbed under anoxic conditions could be degraded when molecular oxygen became available, and substantial biodegradation (≥60%) of diclofenac could be achieved with a 15 min EBCT in the GAC filter. These findings suggest that the retention of micropollutants in GAC filters, by prolonging the micropollutant residence time through adsorption, can enable longer time periods for degradations than what the hydraulic retention time would allow for. For the biologically recalcitrant compound carbamazepine, differences in breakthrough between the 14C-labeled and nonradiolabeled compounds revealed a substantial retention via successive adsorption-desorption, which could pose a potential challenge in the interpretation of GAC filter performance.

Ecological impact of pharmaceutical pollutants and options of river health improvements - A risk analysis-based approach

Pharmaceuticals are one of the emerging pollutants (EPs) in river waters across the world. Due to their toxic effects on aquatic organisms, they have drawn the global attention of the scientific community concerned with river ecosystems. This paper reviews the existing occurrence data for various pharmaceutical pollutants (PPs) reported in river waters in some part of the world and their ecological impacts. Using algae, macroinvertebrates (MI), and fish as biotic indicator groups in water to reflect river health conditions, an attempt has been made to assess the ecological risk due to the presence of PPs in the water environment. After ascertaining the predicted no-effect concentration (PNEC) of PPs for selected groups of aquatic organisms, the risk quotient (RQ) is estimated based on their measured environmental concentration (MEC). When MEC > PNEC and RQ > 1 for any of the biotic indicator, ecologically it is 'high risk' condition. The determination of PNEC uses a minimum assessment factor (AF) of 10 due to uncertainty in data over the no observed effect level (NOEL) or lowest observed effect level (LOEL). Accordingly, MEC 10 times higher than PNEC, (RQ = 10) represents a threshold risk concentration (RCT) beyond which adverse effects may start showing observable manifestations. In the present study, a new classification system of 'high risk' conditions for RQ = 1-10 has been proposed, starting from 'moderately high' to 'severely high'. For RQ > 10, the ecological condition of the river is considered 'impaired'. For river health assessment, in the present study, the whole range of physico-chemical characteristics of river water quality has been divided into three groups based on their ease of measurement and frequency of monitoring. Dissolved oxygen related parameters (DORPs), nutrients (NTs), and EPs. PPs represent EPs in this study. A framework for calculating separate indicator group score (IGS) and the overall river health index (RHI) has been developed to predict indicator group condition (IGC) and river health condition (RHC), respectively. Color-coded hexagonal pictorial forms representing IGC and RHC provide a direct visible perception of the existing aquatic environment and a scientific basis for prioritization of corrective measures in terms of treatment technology selection for river health improvements. The analyses indicate that many rivers across the world are under 'high risk' conditions due to PPs having MEC > PNEC and RQ > 1. Up to RCT, (where RQ = 10), the 'high risk' condition varies from 'moderately high' to 'severely high'. In many instances, RQ is found much more higher than 10, indicating that the ecological condition of river may be considered as 'impaired'. Algae is the most frequently affected group of biotic indicators, followed by MI and fish. A review of treatment methods for selection of appropriate technology to reduce the pollution load, especially PPs from the wastewater streams has been summarized. It appears that constructed wetlands (CWs) are at present the most suitable nature-based solutions, particularly for the developing economies of the world, to reduce the concentrations of PPs within limits to minimize the ecological impacts of pharmaceutical compounds on biotic indicators and restore the river health condition. Some suggestive design guidelines for the CWs have also been presented to initiate the process.

Comprehensive analysis of a widely pharmaceutical, furosemide, and its degradation products in aquatic systems: Occurrence, fate, and ecotoxicity

Many pharmaceutical compounds end up in the environment due to incomplete removal by wastewater treatment plants (WWTPs). Some compounds are sometimes present in significant concentrations and therefore represent a risk to the aquatic environment. Furosemide is one of the most widely used drugs in the world. Considered as an essential drug by the World Health Organization, this powerful loop diuretic is used extensively to treat hypertension, heart and kidney failure and many other purposes. However, this important consumption also results in a significant release of furosemide in wastewater and in the receiving environment where concentrations of a few hundred ng/L to several thousand have been found in the literature, making furosemide a compound of great concern. Also, during its transport in wastewater systems and WWTPs, furosemide can be degraded by various processes resulting in the production of more than 74 by-products. Furosemide may therefore present a significant risk to ecosystem health due not only to its direct cytotoxic, genotoxic and hepatotoxic effects in animals, but also indirectly through its transformation products, which are poorly characterized. Many articles classify furosemide as a priority pollutant according to its occurrence in the environment, its persistence, its elimination by WWTPs, its toxicity and ecotoxicity. Here, we present a state-of-the-art review of this emerging pollutant of interest, tracking it, from its consumption to its fate in the aquatic environment. Discussion points include the occurrence of furosemide in various matrices, the efficiency of many processes for the degradation of furosemide, the subsequent production of degradation products following these treatments, as well as their toxicity.

Anticancer drugs impact the performance and prokaryotic microbiome of an aerobic granular sludge system operated in a sequential batch reactor

Increased concerns exist about the presence of anticancer drugs in wastewater. However, knowledge of the impacts of anticancer drugs on the performance of the system and microbial communities during wastewater treatment processes is limited. We examined the effect of three anticancer drugs commonly detected in influents of wastewater treatment plants applied at three different concentration levels on the performance, efficiency of anticancer drug removal, and prokaryotic microbiome in an aerobic granular sludge system (AGS) operated in a sequential batch reactor (SBR). We showed that an AGS can efficiently remove anticancer drugs, with removal rates in the range of 53-100% depending on the type of drug and concentration level. Anticancer drugs significantly decreased the abundance of total bacterial and archaeal communities, an effect that was linked to reduced nitrogen removal efficiency. Anticancer drugs also reduced the diversity, altered the prokaryotic community composition, reduced network complexity, and induced a decrease of a wide range of predicted bacterial functions. Specific bacterial taxa responsive to the addition of anticancer drugs with known roles in nitrification and denitrification were identified. This study shows anticancer drugs should be monitored in the future as they can induce changes in the performance and microbiome of wastewater treatment technologies.

A thorough analysis of the occurrence, removal and environmental risks of organic micropollutants in a full-scale hybrid membrane bioreactor fed by hospital wastewater

The Urban Wastewater Treatment Directive recent draft issued last October 2022 pays attention to contaminants of emerging concern including organic micropollutants (OMPs) and requires the removal of some of them at large urban wastewater treatment plants (WWTPs) calling for their upgrading. Many investigations to date have reported the occurrence of a vast group of OMPs in the influent and many technologies have been tested for their removal at a lab- or pilot-scale. Moreover, it is well-known that hospital wastewater (HWW) contains specific OMPs at high concentration and therefore its management and treatment deserves attention. In this study, a 1-year investigation was carried out at a full-scale membrane bioreactor (MBR) treating mainly HWW. To promote the removal of OMPs, powdered activated carbon (PAC) was added to the bioreactor at 0.1 g/L and 0.2 g/L which resulted in the MBR operating as a hybrid MBR. Its performance was tested for 232 target and 90 non-target OMPs, analyzed by UHPLC-QTOF-MS using a direct injection method. A new methodology was defined to select the key compounds in order to evaluate the performance of the treatments. It was based on their frequency, occurrence, persistence to removal, bioaccumulation and toxicity. Finally, an environmental risk assessment of the OMP residues was conducted by means of the risk quotient approach. The results indicate that PAC addition increased the removal of most of the key OMPs (e.g., sulfamethoxazole, diclofenac, lidocaine) and OMP classes (e.g., antibiotics, psychiatric drugs and stimulants) with the highest loads in the WWTP influent. The hybrid MBR also reduced the risk in the receiving water as the PAC dosage increased mainly for spiramycin, lorazepam, oleandomycin. Finally, uncertainties and issues related to the investigation being carried out at full-scale under real conditions are discussed.

Occurrence of iodinated contrast media (ICM) in water environments and their control strategies with a particular focus on iodinated by-products formation: A comprehensive review

Iodinated contrast media (ICM), one of the pharmaceutical and personal care products (PPCPs), are frequently detected in various water bodies due to the strong biochemical stability and recalcitrance to conventional water treatment. Additionally, ICM pose a risk of forming iodinated by-products that can be detrimental to the aquatic ecosystem. Consequently, effectively removing ICM from aqueous environments is a significant concern for environmental researchers. This article provides a comprehensive review of the structural characteristics of ICM, their primary source (e.g., domestic and hospital wastewater), detected concentrations in water environments, and ecological health hazards associated with them. The current wastewater treatment technologies for ICM control are also reviewed in detail with the aim of providing a reference for future research. Prior researches have demonstrated that traditional treatment processes (such as physical adsorption, biochemical method and chemical oxidation method) have inadequate efficiencies in the removal of ICM. Currently, the application of advanced oxidation processes to remove ICM has become extensive, but there are some issues like poor deiodination efficiency and the risk of forming toxic intermediates or iodinated by-products. Conversely, reduction technologies have a high deiodination rate, enabling the targeted removal of ICM. But the subsequent treatment issues related to iodine (such as I- and OI-) are often underestimated, potentially generating iodinated by-products during the subsequent treatment processes. Hence, we proposed using combined reduction-oxidation technologies to remove ICM and achieved synchronous control of iodinated by-products. In the future, it is recommended to study the degradation efficiency of ICM and the control efficiency of iodinated by-products by combining different reduction and oxidation processes.

Adsorption on activated carbon combined with ozonation for the removal of contaminants of emerging concern in drinking water

The presence of Contaminants of Emerging Concern (CECs) in drinking water is raising concern for potential negative effects on human health. Ozonation and adsorption on activated carbon are the most suitable processes for CECs removal in drinking water treatment plants (DWTPs). This study aims at evaluating the performance of ozonation and adsorption as in-series processes compared to those of the stand-alone processes, focusing on 18 compounds representative of various CECs families. No CECs spike was performed to evaluate the effectiveness of these processes towards CECs at their environmental concentrations. Adsorption isotherms were performed on water samples collected before and after the full-scale ozonation in a DWTP, testing different combinations of ozone and activated carbon doses. Generally, the combination of the two processes was beneficial (83% average removal) compared to adsorption and ozonation alone (71% and 34% average removal respectively). The effect of ozonation on adsorption depends on CECs reactivity with ozone, since ozonation improves the adsorption performance of poorly-oxidizable CECs, but worsens that of well-oxidizable compounds. The removal of organic matter, investigated by absorbance at 254 nm and fluorescence, by ozonation reduces competition for the subsequent CECs removal by adsorption (up to 20% increase of total CECs adsorption). Finally, the removal of both absorbance and fluorescence seems to be a good proxy variables for total CECs adsorption, with different relationships depending on the presence of ozonation. Conversely, it is not effective for ozonation, since the relationship depends on the reactivity of the specific CEC with ozone.

Mussel-inspired antibacterial sponge for highly efficient water purification and sterilization

With the current expansion of urban areas and industrial development, the increasing discharge of wastewater containing bacteria poses a threat to human health. Although substantial advancements have been made in antibacterial materials, there is still a need for an efficient method that can thoroughly remove bacteria through sterilization and adsorption during wastewater treatment. Here, we report a mussel-inspired antibacterial sponge with outstanding antibacterial efficiency exceeding 95% and a high removal ratio of the bacterial corpses for water purification after contacting for 30 min. The high-efficient antibacterial performance is attributed to the stable releasing property of Ag+ and the charge interaction with quaternary amine salts. Combining the key features, including high-efficient, synergistic mechanism, and corpse capture, the antibacterial sponge shows excellent disinfection effects. This study provides a new method for water purification without bacterial residue.

Characterization of urban sources of antibiotics and antibiotic-resistance genes in a Dutch sewer catchment

A one year study was conducted in the city of Nijmegen, The Netherlands, to characterize various urban sources of antibiotics and antibiotic resistant genes (ARGs) in wastewater within a single sewer catchment. Prevalence of ermB, tet(W), sul1, sul2, intl1, and 16S rRNA gene was determined at 10 locations within the city. Sampling locations included a nursing home, a student residence, a hospital and an industrial area, among others. Wastewater concentrations of 23 antibiotics were measured using passive sampling. Additionally, excreted loads of 22 antibiotics were estimated based on ambulatory prescription and clinical usage data. Genes sul1 and intl1 were most abundant across most locations. Ciprofloxacin and amoxicillin together contributed over 92 % of the total estimated antibiotic selective pressure at all sampling points. The present study highlights the prominent role that hospitals can have in the prevalence and proliferation of ARGs in urban wastewater. Furthermore, results suggest that even short-term changes in the therapeutic regimen prescribed in hospitals may translate into shifting ARG abundance patterns in hospital wastewater. The methods applied present an opportunity to identify emission hotspots and prioritize intervention options to limit ARG spread from urban wastewater to the environment.

Anticancer drugs drive changes in the performance, abundance, diversity, and composition of eukaryotic communities of an aerobic granular sludge system

Anticancer drugs are emerging contaminants that are being increasingly detected in urban wastewater. However, there is limited knowledge on the use of biological wastewater treatments, such as granular sludge systems (AGSs), to remove these substances and on their impacts on the general performance of the system and the eukaryotic communities in the granules. We investigated the impacts of three anticancer drugs commonly found in wastewater treatment plants and applied at three different concentrations on the removal efficiency of anticancer drugs, physicochemical parameters, and the eukaryotic microbiome of an AGS operated in a sequential batch reactor (SBR). Anticancer drugs applied at medium and high concentrations significantly decreased the removal efficiency of total nitrogen, the granular biomass concentration, and the size and setting velocity of granules. However, these effects disappeared after not adding the drugs for about a month thus showing the plasticity of the system to return to original levels. Regardless of the concentration of anticancer drugs tested, the AGS technology was effective in removing these substances, with removal rates in the range of 68.5%-100%. The presence of anticancer drugs at medium and high concentrations significantly decreased the abundance of total fungi, an effect that was linked to changes in the physicochemical parameters. Anticancer drugs also induced decreases in the diversity of the eukaryotic community, altered the community composition, and reduced the network complexity when applied at medium and high concentrations. Taxa responsive to the presence of anticancer drugs were identified. The diversity and composition of the eukaryotic microbiome returned to original diversity levels after not adding the drugs for about a month. Overall, this study increases our understanding of the impacts of anticancer drugs on the performance and eukaryotic microbiome of an AGS and highlights the need for monitoring these substances.

Ozonation of Gabapentin in Water─Investigating Reaction Kinetics and Transformation Mechanisms of a Primary Amine Using Isotopically Labeled Ozone

Aliphatic amines are abundant micropollutants in wastewater treatment plant effluents. In order to mitigate such micropollutants, ozonation is one of the most commonly employed advanced treatment processes. Current research regarding ozone efficiency is heavily focusing on reaction mechanisms of different contaminant groups, including structures with amine moieties as reactive sites. This study analyzes pH-dependent reaction kinetics and pathways of gabapentin (GBP), an aliphatic primary amine with an additional carboxylic acid group. The transformation pathway was elucidated applying a novel approach using isotopically labeled ozone (18O) and quantum chemistry calculations. While the direct reaction of GBP with ozone is highly pH-dependent and slow at pH 7 (13.7 M-1 s-1), the rate constant of the deprotonated species (1.76 × 105 M-1 s-1) is comparable to those of other amine compounds. Pathway analysis based on LC-MS/MS measurements revealed that ozonation of GBP leads to the formation of a carboxylic acid group and simultaneous nitrate formation, which was also observed in the case of the aliphatic amino acid glycine. Nitrate was formed with a yield of approximately 100%. Experiments with 18O-labeled ozone demonstrated that the intermediate aldehyde does most likely not include any oxygen originating from ozone. Furthermore, quantum chemistry calculations did not provide an explanation for the C-N scission during GBP ozonation without ozone involvement, although this reaction was slightly more favorable than for respective glycine and ethylamine reactions. Overall, this study contributes to a deeper understanding of reaction mechanisms of aliphatic primary amines during wastewater ozonation.

Occurrence, fate, and potential risk of pharmaceutical pollutants in agriculture: Challenges and environmentally friendly solutions

In recent years, pharmaceutical active compounds (PhACs) have attained global prevalence. The behavior of PhACs in agricultural soils is complex and depends on several factors, such as the nature of the compounds and their physicochemical characteristics, which affect their fate and potential threats to human health, ecosystems, and the environment. The detection of residual pharmaceutical content is possible in both agricultural soils and environmental matrices. PhACs are commonly found in agricultural soil, with concentrations varying significantly, ranging from as low as 0.048 ng g-1 to as high as 1420.76 mg kg-1. The distribution and persistence of PhACs in agriculture can lead to the leaching of these toxic pollutants into surface water, groundwater, and vegetables/plants, resulting in human health risks and environmental pollution. Biological degradation or bioremediation plays a critical role in environmental protection and efficiently eliminates contamination by hydrolytic and/or photochemical reactions. Membrane bioreactors (MBRs) have been investigated as the most recent approach for the treatment of emerging persistent micropollutants, including PhACs, from wastewater sources. MBR- based technologies have proven to be effective in eliminating pharmaceutical compounds, achieving removal rates of up to 100%. This remarkable outcome is primarily facilitated by the processes of biodegradation and metabolization. In addition, phytoremediation (i.e., constructed wetlands), microalgae-based technologies, and composting can be highly efficient in remediating PhACs in the environment. The exploration of key mechanisms involved in pharmaceutical degradation has revealed a range of approaches, such as phytoextraction, phytostabilization, phytoaccumulation, enhanced rhizosphere biodegradation, and phytovolatilization. The well-known advanced/tertiary removal of sustainable sorption by biochar, activated carbon, chitosan, etc. has high potential and yields excellent quality effluents. Adsorbents developed from agricultural by-products have been recognized to eliminate pharmaceutical compounds and are cost-effective and eco-friendly. However, to reduce the potentially harmful impacts of PhACs, it is necessary to focus on advanced technologies combined with tertiary processes that have low cost, high efficiency, and are energy-saving to remove these emerging pollutants for sustainable development.

Micropollutant Removal Efficiency of Advanced Wastewater Treatment Plants: A Systematic Review

Introduction

Various review papers have been published regarding the occurrence and fate of micropollutants (MPs). MPs in the aquatic environment are still not well reviewed to generate comprehensive summaries with a special focus on their removal from wastewater using conventional and advanced treatment processes. Therefore, this review aimed to provide a synopsis of the efficiency of the advanced wastewater treatment plants in the removal of MPs.

Materials and methods

A systematic search of published literature was conducted on the National Library of Medicine (NLM) database, Web of Science, Joanna Briggs Institute (JBI) database, Scopus, and Google Scholar, based on studies with evidence of removal of MPs in the wastewater treatment process. Screening of the published articles was made using pre-specified inclusion and exclusion criteria.

Results

Amongst the 1545 studies searched, 21 full-length articles were analyzed that showed 7 treatment options related to the removal of MPs from wastewater. MPs from wastewater effluents were successfully and effectively removed by advanced treatment techniques. Advanced Oxidation Processes (AOPs), membrane processes, and adsorption processes have all been shown to be potential solutions for the removal of MPs in advanced treatment plants (WWTPs). But, there are 2 critical issues associated with the application of the advanced treatment options which are high operational cost and the formation of dangerous by-products and concentrated residues.

Conclusion

This study identified that the removal of MPs using WWTPs was commonly incomplete with varying removal efficiency. Therefore, the adaptation and scale-up of the cost-effective and efficient combined wastewater treatment technology are vital to creating an absolute barrier to MPs emissions.

Pharmaceuticals in hospital wastewaters: an analysis of the UBA's pharmaceutical database

The presence of pharmaceuticals in hospital wastewaters (HWW) has been a focus of interest for researchers in the last decades. Certain therapeutic classes, such as X-ray contrast media, broad-spectrum antimicrobials and cytotoxics among others, are mainly used in hospitals-health care facilities. This study is focused on available studies monitoring the presence of pharmaceuticals in HWW around the world. To that end, the last available version (v3. 2021) of the "Pharmaceuticals in the Environment" database published by the Federal German Environment Agency (Umweltbundesamt) has been used. Almost half of all studies included (107) have been conducted in Europe. Pharmaceuticals have been monitored in HWW in 38 different countries across all five continents. The country with the greatest number of studies is Brazil (11), followed by Spain (8), China (7), and France (6). Our analysis revealed that 271 different pharmaceuticals have been detected at least once in HWW. The five drugs with more studies showing a positive detection are ciprofloxacin (38), sulfamethoxazole (36), diclofenac (34), ibuprofen (29), and trimethoprim (27). A total of 47 out of 271 drugs are considered in the NIOSH "Hazardous drug" list. However, monitoring data for some widely used drugs in hospital settings such as muscle relaxants, anesthetics, and antidotes is lacking. In conclusion, this study provides the first large-scale metadata analysis for the pharmaceuticals in HWW worldwide.

Global trends in the research and development of medical/pharmaceutical wastewater treatment over the half-century

The COVID-19 pandemic has severely impacted public health and the worldwide economy. The overstretched operation of health systems around the world is accompanied by potential and ongoing environmental threats. At present, comprehensive scientific assessments of research on temporal changes in medical/pharmaceutical wastewater (MPWW), as well as estimations of researcher networks and scientific productivity are lacking. Therefore, we conducted a thorough literature study, using bibliometrics to reproduce research on medical wastewater over nearly half a century. Our primary goal is systematically to map the evolution of keyword clusters over time, and to obtain the structure and credibility of clusters. Our secondary objective was to measure research network performance (country, institution, and author) using CiteSpace and VOSviewer. We extracted 2306 papers published between 1981 and 2022. The co-cited reference network identified 16 clusters with well-structured networks (Q = 0.7716, S = 0.896). The main trends were as follows: 1) Early MPWW research prioritized sources of wastewater, and this cluster was considered to be the mainstream research frontier and direction, representing an important source and priority research area. 2) Mid-term research focused on characteristic contaminants and detection technologies. Particularly during 2000-2010, a period of rapid developments in global medical systems, pharmaceutical compounds (PhCs) in MPWW were recognized as a major threat to human health and the environment. 3) Recent research has focused on novel degradation technologies for PhC-containing MPWW, with high scores for research on biological methods. Wastewater-based epidemiology has emerged as being consistent with or predictive of the number of confirmed COVID-19 cases. Therefore, the application of MPWW in COVID-19 tracing will be of great interest to environmentalists. These results could guide the future direction of funding agencies and research groups.

Understanding the cometabolic degradation of sulfadiazine by an enriched ammonia oxidizing bacteria culture from both extracellular and intracellular perspectives

Antibiotics are widely used drugs in the world and pose serious threats to ecosystems and human health. Although it has been reported that ammonia oxidizing bacteria (AOB) can cometabolize antibiotics, little has been reported on how AOB would respond to the exposure of antibiotics on extracellular and enzymatic levels, as well as the impact of antibiotics on the bioactivity of AOB. Therefore, in this study, a typical antibiotic, sulfadiazine (SDZ), was selected, and a series short-term batch tests using enriched AOB sludge were conducted to investigate the intracellular and extracellular responses of AOB along the cometabolic degradation process of SDZ. The results showed the cometabolic degradation of AOB made the main contribution to SDZ removal. When the enriched AOB sludge was exposed to SDZ, ammonium oxidation rate, ammonia monooxygenase activity, adenosine triphosphate concentration and dehydrogenases activity were negatively affected. The amoA gene abundance increased 1.5 folds within 24 h, which may enhance the uptake and utilization of substrates and maintain stable metabolic activity. In the tests with and without ammonium, the concentration of total EPS increased from 264.9 to 231.1 mg/gVSS to 607.7 and 538.2 mg/gVSS, respectively, under the exposure to SDZ, which was mainly contributed by the increase of proteins in tightly bound extracellular polymeric substances (EPS) and polysacharides in tightly bound EPS and soluble microbial products. The proportion of tryptophan-like protein and humic acid-like organics in EPS also increased. Moreover, SDZ stress stimulated the secretion of three quorum sensing signal molecules, C4-HSL (from 140.3 to 164.9 ng/L), 3OC6-HSL (from 17.8 to 42.4 ng/L) and C8-HSL (from 35.8 to 95.9 ng/L) in the enriched AOB sludge. Among them, C8-HSL may be a key signal molecule that promoted the secretion of EPS. The findings of this study could shed more light on the cometabolic degradation of antibiotics by AOB.

A critical assessment of SARS-CoV-2 in aqueous environment: Existence, detection, survival, wastewater-based surveillance, inactivation methods, and effective management of COVID-19

In early January 2020, the causal agent of unspecified pneumonia cases detected in China and elsewhere was identified as a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was the major cause of the COVID-19 outbreak. Later, the World Health Organization (WHO) proclaimed the COVID-19 pandemic a worldwide public health emergency on January 30, 2020. Since then, many studies have been published on this topic. In the present study, bibliometric analysis has been performed to analyze the research hotspots of the coronavirus. Coronavirus transmission, detection methods, potential risks of infection, and effective management practices have been discussed in the present review. Identification and quantification of SARS-CoV-2 viral loads in various water matrices have been reviewed. It was observed that the viral shedding through urine and feces of COVID-19-infected patients might be a primary mode of SARS-CoV-2 transmission in water and wastewater. In this context, the present review highlights wastewater-based epidemiology (WBE)/sewage surveillance, which can be utilized as an effective tool for tracking the transmission of COVID-19. This review also emphasizes the role of different disinfection techniques, such as chlorination, ultraviolet irradiation, and ozonation, for the inactivation of coronavirus. In addition, the application of computational modeling methods has been discussed for the effective management of COVID-19.

Performance of a Pilot-Scale Continuous Flow Ozone-Based Hospital Wastewater Treatment System

Antimicrobial resistance (AMR) is becoming a global concern. Recently, research has emerged to evaluate the human and environmental health implications of wastewater from medical facilities and to identify acceptable wastewater treatment methods. In this study, a disinfection wastewater treatment system using an ozone-based continuous flow system was installed in a general hospital located in Japan. The effectiveness of antimicrobial-resistant bacteria (ARB) and antimicrobials in mitigating the environmental impact of hospital wastewater was evaluated. Metagenomic analysis was conducted to characterize the microorganisms in the wastewater before and after treatment. The results demonstrated that ozone treatment enables effective inactivation of general gut bacteria, including Bacteroides, Prevotella, Escherichia coli, Klebsiella, DNA molecules, and ARGs, as well as antimicrobials. Azithromycin and doxycycline removal rates were >99% immediately after treatment, and levofloxacin and vancomycin removal rates remained between 90% and 97% for approximately one month. Clarithromycin was more readily removed than the other antimicrobials (81-91%), and no clear removal trend was observed for ampicillin. Our findings provide a better understanding of the environmental management of hospital wastewater and enhance the effectiveness of disinfection wastewater treatment systems at medical facilities for mitigating the discharge of pollutants into aquatic environments.

Analyzing the potential environmental impact of NIOSH list of hazardous drugs (group 2)

For the first time, several pharmaceuticals have been defined as priority substances in the new proposal of the revision of the Water Framework Directive (WFD). Consequently, environmental quality standards have been determined for several drugs. This is the case with the antiepileptic carbamazepine, which is considered as hazardous in healthcare settings by The National Institute for Occupational Safety and Health (NIOSH). This organism considers as such drugs that have shown teratogenicity, carcinogenicity, genotoxicity or other developmental, reproductive, or organ toxicity at low doses in studies with animals or humans. This study has been focused on the non-carcinogenic drugs classified in group 2, and their presence in the environment. This group contains many different therapeutic agents such as antineoplastics, psychoactive drugs, immunosuppressants and antivirals, among others. Of the 116 drugs included in the list, 26 have been found in aquatic environmental matrices. Certain drugs have received most attention (e.g., the antiepileptic carbamazepine, progesterone and the antidepressant paroxetine) while others completely lack environmental monitoring. Carbamazepine, fluconazole, paroxetine and warfarin have been found in invertebrates' tissues, whereas carbamazepine, oxazepam and paroxetine have been found in fish tissues. The main aim of the NIOSH's hazardous drug list is to inform healthcare professionals about adequate protection measures to prevent occupational exposure to these pharmaceuticals. However, this list contains useful information for other professionals and researchers such as environmental scientists. The paucity of relevant environmental data of certain hazardous pharmaceuticals might be important to help in the prioritization of compounds that may demand further research.

Infrared spectroscopy: the key to elucidating the sorption mechanism of surfactants, dyes and pharmaceuticals on mineral composite material

There is a global problem with the effective purification of wastewater containing organic compounds, including dyes, pharmaceuticals and surfactants. Therefore, technologies for the removal of pollutants are still being explored. One of the promising methods could be the application of mineral sorbent composite based on lignite and bentonite. However, it is crucial to comprehensively recognize the mechanisms responsible for immobilizing organic compounds using mineral composite sorbents. The purpose of this work was to prepare and investigate the sorption mechanism of lignite-bentonite composite (BL) sorbents for the removal of dyes: Rhodamine B (RB), Remazol Brilliant Blue R (RBBR), pharmaceuticals: ibuprofen (IB), sulfamethoxazole (STX) and surfactant sodium dodecylbenzenesulfonate (SDBS). The quantitative sorption results have been performed using the high-performance liquid chromatography (HPLC) method. The application of infrared (IR) spectroscopy method was crucial to describe the sorption mechanism. After completing the sorption test, the spectra for the sorbents revealed bands associated with adsorbed RB, RBBR, IB, STX, and SDBS on the BL sorbent. Because lignite is predominated in BL composite, the sorption capacity and mechanism strictly correspond to its sorption properties rather than to bentonite ones. The spectra results indicate that the physical sorption process related to electrostatic forces, hydrogen bonding, and dispersion interactions are predominantly responsible for the immobilization of organic compounds tested on mineral sorbents. The X-ray diffraction (XRD) results indicate the ion exchange process involved in the case of RB adsorption on the bentonite sample. Nevertheless, the sorption mechanism was complex because of the extensive sorption properties of mineral composite and the different chemical properties of the tested organic compounds. The results of our spectroscopic studies help interpret the sorption mechanisms of organic compounds on mineral materials.

Investigation of anthropogenic gadolinium in tap water of polish cities: Gdańsk, Kraków, Warszawa, and Wrocław

In urban areas where tap water is often produced by a purification of water supplied from a river bank filtration, a significant fraction of gadolinium (Gd) total pool is of an anthropogenic origin. It happens because Gd-based contrast agents used in Magnetic Resonance Imaging (MRI) are not removed during wastewater treatment and they are discharged to the environment and returned to the water cycle. Despite the growing number of MRI examinations worldwide, little is known about the anthropogenic Gd in Polish surface water as well as drinking water. The aim of this pilot study was to gain information about the occurrence of emergent pollution as Gd in potable water available for inhabitants of Polish municipal areas. Tap water samples from Gdańsk, Kraków, Wrocław and Warszawa were analyzed by an inductively coupled plasma quadrupole mass spectrometry after their preconcentration by a seaFAST-pico chromatographic system. In this study, the sum of REE was in the range registered in the drinking waters of European urban regions (usually below 100 ng/L). The highest values of the sum of REE total concentrations were observed in the tap water samples collected in Warszawa (37.7 ng/L) and Wrocław (35.9 ng/L and 32.9 ng/L), where water supplies originate from the Wisła River and Oława River, respectively. The highest total Gd concentration was observed in the tap water of Warszawa city where the anthropogenic Gd fraction represented about 90% of the total Gd. The lowest values of the sum REE were registered in tap waters of Gdańsk (sum of REE below 2.2 ng/L) with up to 17% of the anthropogenic Gd. Thus, our study showed the occurrence of the anthropogenic Gd in all analyzed tap waters.

Anticancer drugs in wastewater and natural environments: A review on their occurrence, environmental persistence, treatment, and ecological risks

The consumption of anticancer drugs (also known as chemotherapy drugs or antineoplastic drugs) has augmented over the last decades due to increased cancer incidence. Although there is an increasing concern about the presence of pharmaceutical compounds in natural environments and urban/domestic wastewater, anticancer drugs used in chemotherapy and anticancer medication have received less attention. In this review, the occurrence, environmental persistence, and known and potential ecological impacts of anticancer drugs is discussed. This review shows that these compounds are being increasingly detected in effluents of hospitals, influents and effluents of wastewater treatment plants, river surface water and sediments, groundwater, and even drinking water. Anticancer drugs can impact aquatic organisms such as algae, crustaceans, rotifers, and fish and may promote changes in soil and water microbial communities that may alter ecosystem functioning. Our knowledge of technologies for the removal of anticancer drugs is still limited, and these drugs can be dispersed in nature in a diffuse way in an uncontrolled manner. For this reason, an improved understanding of the presence, persistence, and ecological impacts of anticancer drugs in wastewater and natural environments is needed to help design management strategies, protect aquatic microorganisms, and mitigate potential ecological impacts.

Peracetic acid activation via the synergic effect of Co and Fe in CoFe-LDH for efficient degradation of pharmaceuticals in hospital wastewater

As an oxidant, peracetic acid (PAA) is gradually applied in advanced oxidation processes (AOPs) for pollutants degradation due to its high oxidation and low toxicity. In this study, the prepared Co₂Fe₁-LDH showed excellent PAA activation ability for efficient degradation of various pharmaceuticals with a removal efficiency ranging from 82.3% to 100%. Taking sulfamethoxazole (SMX) as a model pharmaceutical, it's found that organic radical (R-O^•) with high concentration of 5.27 × 10^-13 M is the dominant ROS responsible for contaminants degradation. Further analysis demonstrated that bimetallic synergistic effect between Co and Fe can improve electron transfer ability of Co₂Fe₁-LDH, resulting in the accelerated conversion of Co from +3 to +2 valence state with a high reaction rate (4.3 × 10¹-1.483 × 10² M^-1 s^-1) in this system. Density functional theory (DFT) reveals that C1, C3, C5 and N11 with higher ƒ⁰ and ƒ^-values concentrated on aniline group of SMX are the main attack sites, which is consistent with the results of degradation products. Besides, Co₂Fe₁-LDH/PAA system can effectively reduce biological toxicity after reaction, due to lower biotoxicity of degradation products and the carbon sources provided by PAA. In application, Co₂Fe₁-LDH/PAA system was capable of resisting the influence of water matrix and effectively removing pollutants in actual hospital wastewater. Importantly, this study comprehensively evaluated the ability of Co₂Fe₁-LDH/PAA system to remove organics and improve the biodegradability of actual hospital wastewater, providing guidance for application of PAA activation system.

Post-treatment disinfection technologies for sustainable removal of antibiotic residues and antimicrobial resistance bacteria from hospital wastewater

The World Health Organization (WHO) has identified antimicrobial resistance bacteria and its spread as one of the most serious threats to public health and the environment in the twenty-first century. Different treatment scenarios are found in several countries, each with their own regulations and selection criteria for the effluent quality and management practices of hospital wastewater. To prevent the spread of disease outbreaks and other environmental threats, the development of sustainable treatment techniques that remove all antibiotics and antimicrobial resistant bacteria and genes should be required. Although few research based articles published focusing this issues, explaining the drawbacks and effectiveness of post-treatment disinfection strategies for eliminating antibiotic residues and antimicrobial resistance from hospital wastewater is the reason of this review. The application of conventional activated sludge (CAS) in large scale hospital wastewater treatments poses high energy supply needs for aeration, capital and operational costs. Membrane bioreactors (MBR) have also progressively replaced the CAS treatment systems and achieved better treatment potential, but membrane fouling, energy cost for aeration, and membrane permeability loss restrict their performance at large scale operations. In addition, the membrane process alone doesn't completely remove/degrade these micropollutants; as a substitute, the pollutants are being concentrated in a smaller volume, which requires further post-treatment. Therefore, these drawbacks should be solved by developing advanced techniques to be integrated into any of these or other secondary wastewater treatment systems, aiming for the effective removal of these micropollutants. The purpose of this paper is to review the performances of post-treatment disinfection technologies in the removal of antibiotics, antimicrobial resistant bacteria and their gens from hospital wastewater. The performance of advanced disinfection technologies (such as granular and powered activated carbon adsorption, ozonation, UV, disinfections, phytoremediation), and other integrated post-treatment techniques are primarily reviewed. Besides, the ecotoxicology and public health risks of hospital wastewater, and the development, spreading and mechanisms of antimicrobial resistant and the protection of one health are also highlighted.

Study of the Influence of the Wastewater Matrix in the Adsorption of Three Pharmaceuticals by Powdered Activated Carbon

The use of powdered activated carbon (PAC) as an absorbent has become a promising option to upgrade wastewater treatment plants (WWTPs) that were not designed to remove pharmaceuticals. However, PAC adsorption mechanisms are not yet fully understood, especially with regard to the nature of the wastewater. In this study, we tested the adsorption of three pharmaceuticals, namely diclofenac, sulfamethoxazole and trimethoprim, onto PAC under four different water matrices: ultra-pure water, humic acid solution, effluent and mixed liquor from a real WWTP. The adsorption affinity was defined primarily by the pharmaceutical physicochemical properties (charge and hydrophobicity), with better results obtained for trimethoprim, followed by diclofenac and sulfamethoxazole. In ultra-pure water, the results show that all pharmaceuticals followed pseudo-second order kinetics, and they were limited by a boundary layer effect on the surface of the adsorbent. Depending on the water matrix and compound, the PAC capacity and the adsorption process varied accordingly. The higher adsorption capacity was observed for diclofenac and sulfamethoxazole in humic acid solution (Langmuir isotherm, R² > 0.98), whereas better results were obtained for trimethoprim in the WWTP effluent. Adsorption in mixed liquor (Freundlich isotherm, R² > 0.94) was limited, presumably due to its complex nature and the presence of suspended solids.

Cross-Linked and Doped Graphene Oxide Membranes with Excellent Antifouling Capacity for Rejection of Antibiotics and Salts

Graphene oxide (GO) membranes have suffered from the instability of water permeability and low rejection of pollutant separation. In this paper, a reasonable modification protocol for GO nanosheets at the molecular level was proposed. A molecular cross-linking strategy was adopted to regulate the interlayer spacing of GO nanosheets, and nanofiltration membranes with high water stability and excellent antifouling capacity were prepared, which could effectively reject antibiotics and salts. The GO₁-MPD_0.5 (the mass ratio of GO nanosheets to MPD is 1:0.5) and GO/GO₁-MPD_0.5-0.25 (the doping ratio of GO₁-MPD_0.5 is 25%) membranes had stable water permeability of 4.22 ± 0.06 and 3.65 ± 0.11 L m^-2 h^-1 bar^-1, and the rejection rates for ciprofloxacin (CIP) and ofloxacin (OFX) were 93.35 ± 3.62 and 95.48 ± 2.97 and 85.89 ± 6.52 and 88.21 ± 3.67%, respectively. Molecular dynamics simulations well explained the high water stability of membranes, and the cross-linked hydrophobic benzene ring played a role in the rejection of pollutant molecules. Moreover, the GO₁-MPD_0.5 membrane showed excellent antifouling capacity and the flux recovery ratio (FRR) was more than 98%. This paper provides a new idea for the design of nanofiltration membranes with high stability and good rejection permeability at the molecular level and provides a prospect for the application of nanofiltration membranes in practical water treatment and water purification.

A critical review over the removal of paracetamol (acetaminophen) from synthetic waters and real wastewaters by direct, hybrid catalytic, and sequential ozonation processes

Paracetamol (PCT) or acetaminophen is a widely prescribed drug to treat fever and mild to moderate pain. The PCT uptake by animals and humans is not complete, being excreted through their urine to contaminate the aquatic/natural environments. Trace amounts of this drug have been found in sewage sludge, hospital wastewaters, wastewater plant treatments, surface waters, and even drinking water. PCT denatures proteins and oxidize lipids in cells with damage of their genetic code. Its toxicity over macrophytes, protozoan, algae, bacteria, and fishes has been reported. Ozonation methods have been proposed as efficient treatments to solve this pollution. This comprehensive and critical review is focused on the application of ozonation processes to remove PCT polluted water from different sources, like natural waters, synthetic waters, and real wastewaters. The fundamentals, operating variables, and best results by direct ozonation and hybrid catalytic ozonation are described, with attention to produced reactive oxygen species and their oxidative action. Single ozonation, catalytic modification of materials, and hybrid non-catalytic processes are detailed as direct ozonation methods. Ozonation with metal-based catalysts and photolytic and photocatalytic ozonation as hybrid catalytic methods are analyzed. Sequential non-biological and biological treatments with ozone and ozonation for wastewater remediation in treatment plants are described. Reaction sequences proposed for PCT mineralization are finally discussed, showing the initial formation of hydroquinone and 2-hydroxy-4-(N-acetyl)-aminophenol and their consecutive evolution to ultimate carboxylic acids like oxalic and oxamic. The ability of the methods to destroy these acids and their iron- and/or copper-complexes explains their mineralization performance.

Hospital wastewater treatment and the role of membrane filtration - removal of micropollutants and pathogens: A review

Dissemination of multiresistant bacteria and high concentrations of micropollutants by hospitals and other medical facilities can be significantly reduced by a wide variety of on-site treatment approaches. Membrane filtration technologies, ranging from microfiltration to reverse osmosis, have been adapted in many studies and offer multiple purposes in advanced wastewater treatment configurations. While the direct rejection of pharmaceutical compounds and pathogens can only be achieved with nanofiltration and reverse osmosis processes, porous membranes are known for their pathogen removal capabilities and can be used in combination with other advanced treatment approaches, such as oxidation and adsorption processes. This review was conducted to systematically assess studies with membrane filtration technologies that are used as either stand-alone or hybrid systems for the treatment of hospital wastewater. In this review, four different databases were screened with a pre-set of search strings to thoroughly investigate the application of membrane filtration technology in hospital wastewater treatment. Hybrid systems that combine multiple treatment technologies seem to be the most promising way of consistently removing micropollutants and pathogens from hospital wastewater, but additional economic assessments are needed for an extensive evaluation.

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.

Synchronous removal of pharmaceutical contaminants and inactivation of pathogenic microorganisms in real hospital wastewater by electro-peroxone process

Herein, a highly efficient electro-peroxone (E-peroxone) process with graphite felt as ozone diffusion electrode (ODE) was developed for the synchronous removal of pharmaceutical contaminants and inactivation of pathogenic microorganisms in real hospital wastewater. Under optimal conditions, the total organic carbon (TOC) removal rate of real hospital wastewater could reach 93.9%. Importantly, 126 pharmaceutical compounds (antibiotics, antivirals, analgesics, antiepileptics, hormones, and others) were determined in hospital wastewater by using ultra performance liquid chromatography combined with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS/MS). 110 pharmaceutical compounds could be efficiently degraded in E-peroxone system. Concurrently, the microbial community analysis through high-throughput sequencing showed that E-peroxone process exhibited an excellent disinfection effect in real hospital wastewater. Escherichia coli as a bacterial indicator could be completely inactivated in E-peroxone process·H2O2 and hydroxyl radical (OH) were found in E-peroxone system based on the results of chemical probe experiments and electron paramagnetic resonance (EPR) analysis. The in-situ generation of H2O2 from cathodic oxygen reduction in ODE can react with ozone to produce OH, and realize high efficiencies for the elimination of pharmaceutical and sterilization. This work established a green and effective way without extra addition of chemical reagents for high-efficiency treatment of real hospital wastewater.

Inactivation of biohazards in healthcare wastewater by E-Beam and Gamma irradiation: a comparative study

The main objective of this study is to evaluate the effect of irradiation by Gamma rays and Electron Beam (E-Beam) on naturally occurring microorganisms shed in healthcare wastewater issued from multi-specialties hospital. We examined the susceptibility of naturally occurring total indicator bacteriophages towards Gamma rays and E-Beam irradiation to evaluate their appropriateness as viral indicators for healthcare wastewater quality control. Results showed that healthcare wastewater is a rich matrix containing bacteriophages surrogates of pathogenic waterborne viruses (4.5 Log10 PFU/100 mL for SOMCPH and 2.3 Log10 PFU/100 mL for FRNAPH), antibiotic resistant bacteria (Mean concentrations from 2.3 to 5.5 Log10 CFU/100 mL), molds and yeasts (2.7 Log10 CFU/100 mL), and spores of Clostridium perfringens (Mean concentration of 3.3 Log10 CFU/100 mL). After E-Beam irradiation, naturally occurring bacteria in healthcare wastewater showed lower resistance patterns (D10 values ranging between 0.21 ± 0.005 and 0.59 ± 0.005) compared to those obtained after Gamma irradiation (D10 values ranging between 0.25 ± 0.015 and 0.70 ± 0.0001). Spores of Clostridium perfringens were the most resistant assayed microbes either after E-Beam (D10 values of 3.74 ± 0.005) or Gamma irradiation (D10 values of 4.77 ± 0.025) of collected samples. According to inactivation patterns, a dose of 10 kGy was sufficient for a complete inactivation of spores. Bacteriophages isolated from healthcare wastewater showed the same resistance patterns as those previously obtained in urban treated sewage and were inactivated using higher doses than waterborne bacteria (D10 values of SOMCPH 1.46 ± 0.057; D10 values of FRNAPH 1.03 ± 0.057). Their resistance to irradiation treatment in such complex matrix corroborates their use to survey the viral quality of healthcare wastewater before their discharge in the urban sanitation network. D10 value analysis showed that bacteria and bacteriophages inactivation by E-Beam irradiation required lower doses than those required for their inactivation using Gamma rays. According to inactivation patterns, a dose of 7 kGy was sufficient for total inactivation of both pathogenic bacteria and viruses. Thus, E-Beam irradiation seems to be an efficient physical pre-treatment process for healthcare wastewater treatment prior to its discharge in urban sanitation system to ensure compliance with environmental standards and protect public health.

Removal of micropollutants using a membrane bioreactor coupled with powdered activated carbon - A statistical analysis approach

The occurrence of micropollutants in wastewater is largely documented as well as the environmental risk posed by their residues in the aquatic environment. Many investigations have been carried out and plan to study and improve their removal efficiency in existing wastewater treatment plants. At the same time, efforts are being made to develop new technologies or upgrade existing ones to increase the removal of a selection of micropollutants. Due to the great variability in their chemical and physical properties, it would be advisable to find representative compounds or identify the factors which most influence the removal mechanisms under specific conditions. This study analyses the removal efficiencies of a great number of micropollutants in wastewater treated in a membrane bioreactor coupled with powdered activated carbon (PAC), which was the subject of a review article we have recently published. The main operational parameters (i.e. PAC dosage, PAC retention time and sludge retention time) and compound physico-chemical properties (i.e. octanol-water distribution coefficient, charge and molecular weight) were first selected on the basis of a dedicated screening step and then an attempt was carried out to clarify their influence on the removal of micropollutants from wastewater during its treatment. To this end, a statistical analysis, mainly based on exploratory methods (cluster analysis and principal component analysis) and regression analysis, was carried out to compare and discuss the different results published in the scientific literature included in the cited review article. It emerged, that, based on the collected dataset, micropollutant charge and LogD_ow seem to play the most important role in the removal mechanisms occurring in MBR coupled with PAC.

Removal of antibiotics from wastewaters by membrane technology: Limitations, successes, and future improvements

Antibiotics and related pharmaceuticals are applied to enhance public health and life quality. A major environmental concern is wastewaters from pharmaceutical industries, which contain significant amounts of antibiotics. Pharmaceutical industries apply conventional processes (biological, filtration, coagulation, flocculation, and sedimentation) for wastewater treatment, but these approaches cannot remove antibiotics completely. Moreover, unmetabolized antibiotics released by humans and animals are dangerous for municipal and effluent wastewater. Besides, antibiotic resistance is another challenge in treatment of wastewater for superbugs. This comprehensive study summarizes different techniques for antibiotic removal with an emphasis on membrane technology in individual and hybrid systems such as chemical, physical, biological, and conditional-based strategies. A combination of membrane processes with advanced oxidation processes (AOPs), adsorption, and biological treatments can be the right solution for perfect removal. Furthermore, this review briefly compares different procedures for antibiotic removal, which can be helpful for further studies with their advantages and drawbacks.

Characterizing Powdered Activated Carbon Treatment of Surface Water Samples Using Polarity-Extended Non-Target Screening Analysis

Advanced wastewater treatment such as powdered activated carbon (PAC) reduces the load of organic micropollutants entering the aquatic environment. Since mobile and persistent compounds accumulate in water cycles, treatment strategies need to be evaluated for the removal of (very) polar compounds. Thereby, non-targeted analysis gives a global picture of the molecular fingerprint (including these very polar molecules) of water samples. Target and non-target screening were conducted using polarity-extended chromatography hyphenated with mass spectrometry. Samples treated with different types and concentrations of PAC were compared to untreated samples. Molecular features were extracted from the analytical data to determine fold changes, perform a principal component analysis and for significance testing. The results suggest that a part of the polar target analytes was adsorbed but also some byproducts might be formed or desorbed from the PAC.

Ozonation of 14C-labeled micropollutants - mineralization of labeled moieties and adsorption of transformation products to activated carbon

Ozonation transformation products (OTPs) are largely unknown compounds that are formed during the ozonation of micropollutants, and it is uncertain to which extent these compounds can be removed by subsequent adsorption to activated carbon. Thus, ¹⁴C-labeled micropollutants were ozonated to generate ¹⁴C-labeled OTPs, for which the adsorption of the sum of all ¹⁴C-labeled OTPs to activated carbon could be determined, based on the adsorption of the labeled carbon. Further, ¹⁴CO₂ traps were used to examine the mineralization of ¹⁴C-labeled moieties during ozonation. ¹⁴CO₂-formation revealed a partial mineralization of the ¹⁴C-labeled moieties in all compounds except for propyl-labeled bisphenol A and O-methyl-labeled naproxen. A similar degree of mineralization was noted for different compounds labeled at the same moiety, including the carboxylic carbon in diclofenac and ibuprofen (∼40% at 1 g O₃/g DOC) and the aniline ring in sulfamethoxazole and sulfadiazine (∼30% at 1 g O₃/g DOC). Aromatic ring cleavage was also confirmed for bisphenol A, sulfamethoxazole, and sulfadiazine through the formation of ¹⁴CO₂. The adsorption experiments demonstrated increased adsorption of micropollutants to powdered activated carbon after ozonation, which was connected to a decreased adsorption of dissolved organic matter (DOM). Conversely, the OTPs showed a substantial and successive decline in adsorption at increased ozone doses for all compounds, likely due to decreased hydrophobicity and aromaticity of the OTPs. These findings indicate that adsorption to activated carbon alone is not a viable removal method for a wide range of ozonation transformation products.

Ozonation and UV photolysis for removing anticancer drug residues from hospital wastewater

The present study investigates the use of UV light and the ozone process for doxorubicin, daunorubicin, epirubicin, and irinotecan degradation. The process was carried out using different pH values in hospital wastewater. The use of UV radiation reduces the concentration of anticancer drugs, but in all cases, this technology was not able enough to remove on the whole these contaminants from hospital wastewater. The best condition was achieved when using pH 9 for most of the analytes. Doxorubicin, daunorubicin, and epirubicin were degraded at 97.3%, 88.3%, and 99.0%, respectively. Irinotecan showed the lowest degradation, just 55.6%; a slightly higher degradation (63.8%) was obtained when pH 5 was used. Complete removal of doxorubicin, daunorubicin, epirubicin, and irinotecan was achieved when ozone treatment was used for all the pH studied. The results indicated that UV light and the ozone process can be used as a tertiary treatment to reduce the concentration of anticancer drugs in the effluents. Ozonation, therefore, proved to be more efficient than the photolysis process, when considering the percentual degradation of the original compounds in shorter timespans.

A review on the removal of phthalate acid esters in wastewater treatment plants: from the conventional wastewater treatment to combined processes

In the past decades, phthalate acid esters (PAEs), as a new class of recalcitrant environmental contaminant, have attracted increasing concern due to their potential hazards to reproductive system. wastewater treatment plants (WWTPs) are generally regarded as a crucial barrier to prevent a variety of contaminants from introducing into aquatic environment. This paper reviews the occurrence, fate, and removal efficacy of six widely appearing PAEs in conventional wastewater treatment. PAEs removal appears to be compound- and process-dependent. Advanced treatment processes, including activated carbon, advanced oxidation process (AOPs), membrane filtration, and membrane bioreactor, show good performance in PAEs elimination, but many methods have been commercially limited by toxic byproducts, high operation, and maintenance costs. Even though combined processes are qualified as a promising alternative, further studies are required to optimize these processes, especially the competitiveness between technique and economy.

Iodide sources in the aquatic environment and its fate during oxidative water treatment - A critical review

Iodine is a naturally-occurring halogen in natural waters generally present in concentrations between 0.5 and 100 µg L^-1. During oxidative drinking water treatment, iodine-containing disinfection by-products (I-DBPs) can be formed. The formation of I-DBPs was mostly associated to taste and odor issues in the produced tap water but has become a potential health problem more recently due to the generally more toxic character of I-DBPs compared to their chlorinated and brominated analogues. This paper is a systematic and critical review on the reactivity of iodide and on the most common intermediate reactive iodine species HOI. The first step of oxidation of I^- to HOI is rapid for most oxidants (apparent second-order rate constant, k_app > 10³ M^-1s^-1 at pH 7). The reactivity of hypoiodous acid with inorganic and organic compounds appears to be intermediate between chlorine and bromine. The life times of HOI during oxidative treatment determines the extent of the formation of I-DBPs. Based on this assessment, chloramine, chlorine dioxide and permanganate are of the highest concern when treating iodide-containing waters. The conditions for the formation of iodo-organic compounds are also critically reviewed. From an evaluation of I-DBPs in more than 650 drinking waters, it can be concluded that one third show low levels of I-THMs (<1 µg L^-1), and 18% exhibit concentrations > 10 µg L^-1. The most frequently detected I-THM is CHCl₂I followed by CHBrClI. More polar I-DBPs, iodoacetic acid in particular, have been reviewed as well. Finally, the transformation of iodide to iodate, a safe iodine-derived end-product, has been proposed to mitigate the formation of I-DBPs in drinking water processes. For this purpose a pre-oxidation step with either ozone or ferrate(VI) to completely oxidize iodide to iodate is an efficient process. Activated carbon has also been shown to be efficient in reducing I-DBPs during drinking water oxidation.

Employing electro-peroxone process for degradation of Acid Red 88 in aqueous environment by Central Composite Design: A new kinetic study and energy consumption

The Azo dyes are primarily employed in textile industries to produce high amounts of colored organic and inorganic wastewater. Therefore, their treatments are critical. In this research, the removal and mineralization of Acid red 88 (AR88), as a widely used mono Azo dye, was inspected by the Electro-peroxone(E-peroxone) method. It is a coupling of electrochemically produced H₂O₂ and ozone that can produce robust hydroxyl radicals. The Central Composite Design (CCD) was applied to explore the influence of operational variables on the removal of AR88 as a response. The optimal conditions predicted by the CCD were as the following; Applied current at 0.7 A, pH at 7.35, O₃ Flowrate at 1.03 L min^-1 and the concentration of AR88 at 527.29 mg. L^-1. The Pareto chart showed that the concentration of AR88 has a significant influence on the response. At the predicted optimal conditions, the actual and predicted AR 88 removal were 95.4 and 92.96%, respectively. The removal of COD after 45 min was 70% representing the excessive efficiency of E-peroxone in mineralization of AR88. The E-peroxone follows the pseudo-first-order kinetics (k_{obs-E-peroxone} = 6.56 × 10^-2 min^-1), which was more remarkable than the single ozonation, and electrolysis. The calculated specific energy consumption (SEC) in the E-peroxone was 40.14 kWh/Kg AR 18 removal, which was lower than the individual ozonation, and electrolysis methods. The operative production of H₂O₂ from O₂ at the cathode is the critical factor in the high removal of AR88 in this process.

Detoxifying SARS-CoV-2 antiviral drugs from model and real wastewaters by industrial waste-derived multiphase photocatalysts

The use of antiviral drugs has surged as a result of the COVID-19 pandemic, resulting in higher concentrations of these pharmaceuticals in wastewater. The degradation efficiency of antiviral drugs in wastewater treatment plants has been reported to be too low due to their hydrophilic nature, and an additional procedure is usually necessary to degrade them completely. Photocatalysis is regarded as one of the most effective processes to degrade antiviral drugs. The present study aims at synthesizing multiphase photocatalysts by a simple calcination of industrial waste from ammonium molybdate production (WU photocatalysts) and its combination with WO₃ (WW photocatalysts). The X-ray diffraction (XRD) results confirm that the presence of multiple crystalline phases in the synthesized photocatalysts. UV-Vis diffuse reflectance spectra reveal that the synthesized multiphase photocatalysts absorb visible light up to 620 nm. Effects of calcination temperature of industrial waste (550-950 °C) and WO₃ content (0-100%) on photocatalytic activity of multiphase photocatalysts (WU and WW) for efficient removal of SARS-CoV-2 antiviral drugs (lopinavir and ritonavir) in model and real wastewaters are studied. The highest k₁ value is observed for the photocatalytic removal of ritonavir from model wastewater using WW4 (35.64 ×10^-2 min^-1). The multiphase photocatalysts exhibit 95% efficiency in the photocatalytic removal of ritonavir within 15 of visible light irradiation. In contrast, 60 min of visible light irradiation is necessary to achieve 95% efficiency in the photocatalytic removal of lopinavir. The ecotoxicity test using zebrafish (Danio rerio) embryos shows no toxicity for photocatalytically treated ritonavir-containing wastewater, and the contrary trend is observed for photocatalytically treated lopinavir-containing wastewater. The synthesized multiphase photocatalysts can be tested and applied for efficient degradation of other SARS-CoV-2 antiviral drugs in wastewater in the future.

Phyto-mediated photocatalysis: a critical review of in-depth base to reactive radical generation for erythromycin degradation

Erythromycin (ERY), designated as a risk-prioritized macrolide antibiotic on the 2015 European Union watch list, is the third most commonly used antibiotic, most likely due to its ability to inhibit the protein. ERY has revealed record-high aquatic concentrations threatening the entire ecosystem and hence demands priority remedial measures. The inefficiency of various conventional ERY degradation methodologies opened up a gateway to advanced technologies. The conventional approach comprising of a chemically formulated, single photocatalyst has a major drawback of creating multiple environmental stresses. In this context, photocatalysis is grabbing tremendous attention as an efficient and cost-effective antibiotic treatment approach. Several studies have ascertained that ZnO, TiO₂, Fe₃O₄, and rGO nanoparticles possess remarkable pollution minimizing operational capabilities. Additionally, composites are found much more effective in antibiotic removal than single nanoparticles. In this review, an attempt has been made to provide a comprehensive baseline for efficient reactive radical production by a phyto-mediated composite kept under a certain source of irradiation. Considerable efforts have been directed towards the in-depth investigation of rGO-embedded, phyto-mediated ZnO/TiO₂/Fe₃O₄ photocatalyst fabrication for efficient ERY degradation, undergoing green photocatalysis. This detailed review provides photocatalytic nanocomposite individualities along with a hypothetical ERY degradation mechanism. It is assumed that derived information presented here will provoke innovative ideas for water purification incorporating green photocatalysis, initiating the construction of high-performance biogenic hierarchical nanocatalysts.

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.

Pharmaceutical compounds used in the COVID-19 pandemic: A review of their presence in water and treatment techniques for their elimination

During the COVID-19 pandemic, high consumption of antivirals, antibiotics, antiparasitics, antiprotozoals, and glucocorticoids used in the treatment of this virus has been reported. Conventional treatment systems fail to efficiently remove these contaminants from water, becoming an emerging concern from the environmental field. Therefore, the objective of the present work is to address the current state of the literature on the presence and removal processes of these drugs from water bodies. It was found that the concentration of most of the drugs used in the treatment of COVID-19 increased during the pandemic in water bodies. Before the pandemic, Azithromycin concentrations in surface waters were reported to be in the order of 4.3 ng L-1, and during the pandemic, they increased up to 935 ng L-1. Laboratory scale studies conclude that adsorption and advanced oxidation processes (AOPs) can be effective in the removal of these drugs. Up to more than 80% removal of Azithromycin, Chloroquine, Ivermectin, and Dexamethasone in aqueous solutions have been reported using these processes. Pilot-scale tests achieved 100% removal of Azithromycin from hospital wastewater by adsorption with powdered activated carbon. At full scale, treatment plants supplemented with ozonation and artificial wetlands removed all Favipiravir and Azithromycin, respectively. It should be noted that hybrid technologies can improve removal rates, process kinetics, and treatment cost. Consequently, the development of new materials that can act synergistically in technically and economically sustainable treatments is required.

Inactivation of Antibiotic-Resistant Bacteria in Wastewater by Ozone-Based Advanced Water Treatment Processes

The inactivating effect of ozone (O₃)-based advanced oxidation processes (AOPs) (O₃/H₂O₂, O₃/UV, and O₃/UV/H₂O₂ systems) on antimicrobial-resistant bacteria (AMRB) and antimicrobial-susceptible bacteria (AMSB) in sewage treatment plant (STP) wastewater was investigated. The AMRB were grouped into six classes: carbapenem-resistant Enterobacteriaceae (CRE), extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E), multidrug-resistant Acinetobacter (MDRA), multidrug-resistant Pseudomonas aeruginosa (MDRP), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE); these classes constituted the World Health Organization (WHO) global priority list of AMRB. The results indicate that O₃-based advanced wastewater treatment inactivated all AMRB and AMSB (>99.9%) after 10 min of treatment, and significant differences (p < 0.5) were not observed in the disinfection of AMRB and AMSB by each treatment. Altered taxonomic diversity of micro-organisms based on 16S rRNA gene sequencing via O₃/UV and O₃/UV/H₂O₂ treatment showed that advanced wastewater treatments not only inactivated AMRB but also removed antimicrobial resistance genes (AMRGs) in the wastewater. Consequently, this study recommends the use of advanced wastewater treatments for treating the STP effluent, reducing environmental pollution, and alleviating the potential hazard to human health caused by AMRB, AMSB, and infectious diseases. Overall, this study provides a new method for assessing environmental risks associated with the spread of AMRB and AMSB in aquatic environments, while keeping the water environment safe and maintaining human health.