The current treatment of wastewater has unintended negative environmental impacts. Conventional methods frequently involve the use of harmful chemicals, generate disinfectant by-products, consume significant amounts of energy, and produce wastes requiring additional efforts for safe disposal. Water stress exacerbated by contaminants of emerging concern (CECs) and climate change, is further straining aging treatment systems. A slow sand filter (SSF), with ligno-cellulosic layers, offers a novel, promising, and economic alternative for wastewater reclamation. This review examines the key SSF characteristics, obtained from recent studies, and explores the use of sustainable materials such as ligno-cellulose, as a treatment companion. The optimal SSF design includes a bed depth of >0.6 m, particle effective size (D10) between 0.15 mm and 0.40 mm, and a uniformity coefficient (CU grain size ratio) of ≤2.0. It is established that SSF’s characteristic biolayer of microorganisms enhances contaminant removal via biodegradation. While biofilm-based removal of micropollutants is a proven mechanism, further research is needed to address CEC challenges. For example, the inclusion of sawdust in SSF filter layers can reduce energy consumption compared to conventional methods and can be recycled through thermal conversion, aligning with circular economy principles. This approach has the potential to improve wastewater treatment in emerging economies, contributing to the achievement of the UN Sustainability Goals.
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