Hospital Wastewater Treatment Research Articles

Dynamics of antimicrobial resistance and susceptibility profile in full-scale hospital wastewater treatment plants.

Drug resistance has become a matter of great concern, with many bacteria now resist multiple antibiotics. This study depicts the occurrence of antibiotic-resistant bacteria (ARB) and resistance patterns in five full-scale hospital wastewater treatment plants (WWTPs). Samples of raw influent wastewater, as well as pre- and post-disinfected effluents, were monitored for targeted ARB and resistance genes in September 2022 and February 2023. Shifts in resistance profiles of Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii antimicrobial-resistant indicators in the treated effluent compared to that in the raw wastewater were also worked out. Ceftazidime (6.78 × 105 CFU/mL) and cefotaxime (6.14 × 105 CFU/mL) resistant species showed the highest concentrations followed by ciprofloxacin (6.29 × 104 CFU/mL), and gentamicin (4.88 × 104 CFU/mL), in raw influent respectively. WWTP-D employing a combination of biological treatment and coagulation/clarification for wastewater decontamination showed promising results for reducing ARB emissions from wastewater. Relationships between treated effluent quality parameters and ARB loadings showed that high BOD5 and nitrate levels were possibly contributing to the persistence and/or selection of ARBs in WWTPs. Furthermore, antimicrobial susceptibility tests of targeted species revealed dynamic shifts in resistance profiles through treatment processes, highlighting the potential for ARB and ARGs in hospital wastewater to persist or amplify during treatment.

HPB-Chip: An accurate high-throughput qPCR-based tool for rapidly profiling waterborne human pathogenic bacteria in the environment

Waterborne pathogens are threatening public health globally, but profiling multiple human pathogenic bacteria (HPBs) in various polluted environments is still a challenge due to the absence of rapid, high-throughput and accurate quantification tools. This work developed a novel chip, termed the HPB-Chip, based on high-throughput quantitative polymerase chain reactions (HT-qPCR). The HPB-Chip with 33-nL reaction volume could simultaneously complete 10,752 amplification reactions, quantifying 27 HPBs in up to 192 samples with two technical replicates (including those for generating standard curves). Specific positive bands of target genes across different species and single peak melting curves demonstrated high specificity of the HPB-Chip. The mixed plasmid serial dilution test validated its high sensitivity with the limit of quantification (LoD) of averaged 82 copies per reaction for 25 target genes. PCR amplification efficiencies and R2 coefficients of standard curves of the HPB-Chip averaged 101 % and 0.996, respectively. Moreover, a strong positive correlation (Pearson’ r: 0.961–0.994, P < 0.001) of HPB concentrations (log10 copies/L) between HPB-Chip and conventional qPCR demonstrated high accuracy of the HPB-Chip. Subsequently, the HPB-Chip has been successfully applied to absolutely quantify 27 HPBs in municipal and hospital wastewater treatment plants (WWTPs) after PMA treatment. A total of 17 HPBs were detected in the 6 full-scale WWTPs, with an additional 19 in the hospital WWTP. Remarkably, Acinetobacter baumannii, Legionella pneumophila, and Arcobacter butzler were present in the final effluent of each municipal WWTP. Overall, the HPB-Chip is an efficient and accurate high-throughput quantification tool to comprehensively and rapidly quantify 27 HPBs in the environment.

Extended-spectrum β-lactamase-producing bacteria and their resistance determinants in different wastewaters and rivers in Nepal

Wastewaters serve as significant reservoirs of antibiotic resistant bacteria. Despite the evidence of antimicrobial resistance in wastewaters and river water in Kathmandu, direct linkage between them is not discussed yet. This study investigated the prevalence of extended-spectrum β-lactamase (ESBL)-producing bacteria and associated resistance genes in wastewaters and river water. Out of 246 bacteria from wastewaters, 57.72% were ESBL producers and 77.64% of them were multidrug resistant (MDR). ESBL producing E. coli was dominant in municipal and hospital wastewaters (HWW) as well as in river water while K. pneumoniae was common in pharmaceutical wastewater. The blaSHV and blaTEM genes were prevalent and commonly co-occurred with aac(6')-Ib-cr in K. pneumoniae isolated pharmaceutical wastewater. blaCTX-M carrying E. coli from hospital co-harbored aac(6')-Ib-cr while that from municipal influent and river water co-harbored qnrS. Whole genome sequencing data revealed the presence of diverse ARGs in bacterial isolates against multiple antibiotics. In average, an E. coli and a K. pneumoniae isolate contained 55.75 ± 0.96 and 40.2 ± 5.36 ARGs, respectively. Multi-locus sequence typing showed the presence of globally high-risk clones with wider host range such as E. coli ST10, and K. pneumoniae ST15 and ST307 in HWW and river indicating frequent dissemination of antimicrobial resistance in wastewater of Kathmandu. Whole genome sequence data aligned with phenotypic antibiograms and resistance genes detected by PCR in selected isolates. The presence of significant plasmid replicons (IncF, IncY) and mobile genetic elements (IS903, IS26) indicate high frequency of spreading antibiotic resistance. These findings indicate burden and dissemination of antimicrobial resistance in the environment and highlight the need for effective strategies to mitigate the antibiotic resistance.

Miscanthus x giganteus biochar: Effective adsorption of pharmaceuticals from model solution and hospital wastewater

This study investigated the adsorption of pharmaceuticals, including atenolol (AT), 17-α-ethinylestradiol (EE2), and sulfamethoxazole (SMX), in model solutions and in the effluent from a hospital wastewater treatment plant. The pharmaceuticals were adsorbed on biochar prepared from Miscanthus x giganteus biomass obtained from the phytoremediation of contaminated or marginal soil. The feedstock was pyrolyzed at 360 °C (M-3) and 500 °C (M-5). The representation of functional groups, specific surface area, porosity, and pore volume were lower for M-5. Pore diameters were comparable, but their depth decreased for M-5. The specific surface area and porosity surface area of M-5 were 30 times higher after 4 h of shaking compared to properties without shaking. The biochar leachate pH was 9.8 ± 1.0 (M-3), and 11.1 ± 1.1 (M-5). No desorption of potentially risk organic compounds was detected. M-3 was generally a better adsorption material. The removal of EE2, AT and SMX was greater than 90%, 70% and 30 % respectively after 4 h in model waters. There was no evidence of a linear relationship between the sorption efficiency of pharmaceuticals and the biochar dose. Sorption experiments with real wastewater from a hospital wastewater treatment plant demonstrated high removal rates of monitored pharmaceuticals, including e.g. SMX (80%), trimethoprim (91%), venlafaxine (100%), clarithromycin (96%), tramadol (93%), diclofenac (86%). It was proven that the efficiency of the adsorption process is influenced not only by the dose or physico-chemical properties of the biochar, but also by the initial concentration of the pharmaceutical and its properties. The presence of other components of real wastewater, which can cause competitive sorption and overlapping of active centers on the surface of the biochar, also decreased the efficiency. The results demonstrate that both biochars are suitable for tertiary or quaternary water treatment for pharmaceutical removal. Due to the lower energetic, and therefore economic, costs of pyrolysis, a lower pyrolysis temperature can be preferred.

Simultaneous degradation of pharmaceutical contaminants and sterilization in real hospital wastewater by a highly efficient electrocatalytic ozonation process: Performance, mechanism and application

Herein, this work investigated an electrocatalytic ozonation (ECO) strategy using stainless steel-graphite plates as cathode–anode for the degradation of the pharmaceutical pollutant dexamethasone (DXMS) and the treatment of real hospital wastewater. The reaction kinetic constant of the ECO degradation of DXMS (0.387 min−1) was 4 times higher than that of single ozone (0.087 min−1). The established efficient ECO system successfully degraded pharmaceutical contaminants and had excellent bactericidal effects against pathogenic microorganisms (Escherichia coli). The results of scavenging experiments, chemical probe experiments, and electron paramagnetic resonance (EPR) analysis indicated that the newly generated 1O2 in the ECO system achieved the synergistic effect of the combined EC-ozonation process. More to the point, the ECO system has a high removal rate of chemical oxygen demand (COD) and total organic carbon (TOC) for real hospital wastewater treatment. After 60 min treatment of the ECO system, the COD removal of hospital wastewater ranged from 70 % to 88.91 %, and the TOC removal ranged from 52.05 % to 71.81 %. The ECO system developed in this work has the capacity for simultaneous degradation of pharmaceutical contaminants and sterilization of pathogenic microorganism for hospital wastewater treatment.

Wastewater treatment from a typical multisystem hospital using chemically modified banana peels: Taguchi parametric optimization and characterization

The study aims to develop an eco-friendly solution for addressing contaminants in hospital wastewater. To achieve this, banana peel, a cost-effective and easily available agricultural waste, was chemically modified using sulfuric acid and sodium hydroxide. The hospital wastewater was analyzed using an Atomic Absorption Spectrometer to identify the presence of heavy metals. The physicochemical properties were measured and compared against the standards set by the World Health Organization (WHO). Scanning electron microscopy and Fourier-transform infrared spectroscopy were used to characterize the chemically modified banana peel. Batch adsorption was conducted with the wastewater using the prepared adsorbent. The effect of contact time, mixing rate, temperature, and adsorbent dosage was examined to know the removal efficiency of the adsorbent. The experimental design incorporates Taguchi OA design to optimize the process. The total heavy metals discovered in the wastewater were As, Cd, Fe, Cu, Ni, Cr, Pb, Mn and Zn. The percentage of Cd, Fe, Cu, Ni, Cr and Pb removed were 79.5%, 87.9%, 56.9%, 89.0%, 88.5% and 93.5%, respectively, at temperature, adsorbent dosage, mixing rate and contact time of 30 °C, 3 g, 700 rpm and 60 min, respectively. The physicochemical properties remain within the acceptable WHO range except the turbidity. At optimum point, the percentage removal of Cd, Fe, Cu, Ni, Cr, Pb and Zn were 64.3%, 80.5%, 51.4%, 82.3%, 72.4%, 86.6% and 72.1%, respectively; while, the conductivity, pH, TDS, and turbidity value were, respectively, 20.57 mS/cm, 6.8, 10.16 mg/l, and 86.31 NTU. Characterization revealed the existence of active functional groups on the adsorbent surface enhancing the hospital wastewater treatment and change in its morphological structure after the treatment was noticed. In conclusion, the modified banana peel was effective for the treatment of hospital wastewater.

Electrochemical Treatment for Real Hospital Wastewater and its Future Prospect

&lt;p&gt;Purpose: This study investigates the efficacy of electrochemical remediation techniques in treating hospital wastewater, focusing on parameters including turbidity, color, BOD, COD, DO, coliform, and E. coli. Design/Methodology/Approach: The study conducts a comprehensive analysis of various pollutant parameters, evaluating the impact of contact time on pollutant reduction. Electrochemical methods are explored for their potential in mitigating these parameters. Conclusions: The findings demonstrate the effectiveness of electrochemical techniques in reducing a range of pollutant parameters, with significant reductions observed in turbidity (up to 99%), color (51%), BOD (99%), COD (60%), and microbial contaminants such as E. coli and coliform (up to 48%). Notably, the study reveals that higher voltage doesn't consistently result in superior performance. Limitations/Consequences of Research: While the study showcases promising results, certain limitations and challenges are acknowledged, including the need for further research to address these constraints and optimize electrochemical remediation processes. Practical Value: The study highlights the practical potential of electrochemical techniques as an effective means of wastewater treatment in hospital settings, offering insights into their application and benefits for environmental sustainability. Originality and Significance of Results: This research contributes novel insights into the application of electrochemical methods for hospital wastewater treatment, emphasizing their efficacy in reducing various pollutant parameters and providing a foundation for future research directions in this field.&lt;/p&gt;

Performance of Microfiltration Membranes to Turn Processed Water from Hospital Wastewater Treatment Plants (WWTP) into Clean Water

Problems arise when there are tax fees on groundwater use by hospitals. This will, of course, burden the hospital's operational costs. The solution to reducing groundwater use is the use of microfiltration membranes. Microfiltration membranes can be used to recycle wastewater into clean water so that it can be collected and used for cleaning, washing, and watering gardens. They can reduce groundwater taxes and hospital groundwater use. The research objectives are to know the efficiency of reducing wastewater recycling equipment from the wastewater treatment plant (WWTP) outlet using a microfiltration membrane. The research methodology used was a quasi-experiment in laboratories and workshops, with a pre-test (before treatment) and post-test (after treatment) design. Stage one Microfiltration Membrane is a medium for processing wastewater into clean water in the first stage. Stage two, Microfiltration Membrane, is a medium for processing wastewater into clean water. In the second stage, it ensures that clean water quality is met. The results that the efficiency of reducing the wastewater recycling equipment from the WWTP outlet using Microfiltration Membrane for pH 7%, Temperature 6%, Turbidity 64%, Colour 85%, Dissolved Solids (TDS) 40%, Nitrate 70%, Nitrite 94%, dissolved Iron (Fe) 33%, Manganese 60%, Cadmium 50%, Lead 43%, Fluoride 46%, Cyanide 96%, Hardness (CaCO3) 11%. In conclusion, all the parameters studied experienced a decrease in concentration. This research suggests conducting further research to reduce the current research discharge so that the parameter reduction can be more significant.

Evaluation of Hospital Wastewater Treatment Using Sewage Treatment Plant for Heavy Metals, Radionuclides, and Some Pharmaceuticals: A Case Study

This is the first study in Oman to evaluate the efficiency of a sewage treatment plant (STP) for hospital wastewater (HWW) treatment for heavy metals, radionuclides, and some selected pharmaceuticals. A sewage treatment plant (STP) at Sultan Qaboos University (SQU) receives HWW, from Sultan Qaboos University Hospital (SQUH), and municipal wastewater from non-medical facilities at SQU. Representative samples of HWW (before mixing with municipal wastewater at STP), STP-treated wastewater (TWW), and STP mixing sludge, were collected and analyzed. A method for analyzing pharmaceuticals including metformin, atenolol, chlorpheniramine, triprolidine, diphenhydramine, and citalopram was developed and validated using LC-MS-MS. HWW and TWW show low concentrations of heavy metals. Radionuclides found in HWW include Cs137, K40, Ra226, Th234, I131, Tl208, Zn65 Ac228, Sb125, Bi124 and Be7. Diphenhydramine (2.24 mg/L), chlorpheniramine (0.293 mg/L) and atenolol (0.0260 mg/L) were found in HWW. Heavy metals, radionuclides, and pharmaceuticals were found less in TWW than in HWW. STP sewage sludge showed higher levels of these pollutants than HWW or TWW. Concentrations of diphenhydramine, chlorpheniramine, and citalopram were 137, 0.950, and 169 mg/kg, respectively in dried sewage sludge. The study confirms the ineffectiveness of STP treatment to completely remediate HWW. HWW should be considered hazardous and requires physico-chemical treatment before mixing with municipal wastewater. Keywords: Hospital, pharmaceuticals, radionuclides, heavy metals, wastewater.

Enhancing pollutants removal in hospital wastewater: Comparative analysis of PAC coagulation vs. bio-contact oxidation, highlighting the impact of outdated treatment plants

While the effectiveness of Poly-Aluminum Chloride (PAC) coagulation for pollutant removal has been documented across various wastewater scenarios, its specific application in hospital wastewater (HWW) treatment to remove conventional pollutants and hazardous genetic pollutants has not been studied. The research compared three hospital wastewater treatment plants (HWTPs) to address a knowledge gap, including the PAC coagulation-sodium hypochlorite disinfection process (PAC-HWTP), the biological contact oxidation-precipitation-sodium hypochlorite process (BCO-HWTP), and a system using outdated equipment with PAC coagulation (ODE-PAC-HWTP). Effluent compliance with national discharge standards is assessed, with BCO-HWTP meeting standards for direct or indirect discharge into natural aquatic environments. ODE-PAC-HWTP exceeds pretreatment standards for COD and BOD5 concentrations. PAC-HWTP effluent largely adheres to national pretreatment standards, enabling release into municipal sewers for further treatment. Metagenomic analysis reveals that PAC-HWTP exhibits higher removal efficiencies for antibiotic resistance genes, metal resistance genes, mobile genetic elements, and pathogens compared to BCO-HWTP and ODE-PAC-HWTP, achieving average removal rates of 45.13%, 57.54%, 80.61%, and 72.17%, respectively. These results suggests that when discharging treated HWW into municipal sewers for further processing, the use of PAC coagulation process is more feasible and cost-effective compared to BCO technologies. The analysis emphasizes the urgent need to upgrade outdated equipment HWTPs.

Environmental risk assessment of selected pharmaceuticals in hospital wastewater in nothern Vietnam

Pharmaceuticals are progressively employed in both human and veterinary medicine and increasingly recognized as environmental contaminants. This study investigated the occurrence of selected pharmaceuticals in influent and effluent of wastewater treatment plants of 12 hospitals in Hanoi and 3 northern cities of Vietnam during dry and rainy seasons. In addition, environmental risk of pharmaceuticals in both hospital influents and effluents were evaluated based on risk quotients (RQs). Nine selected pharmaceutical compounds including sulfamethoxazole (SMX), naproxen (NPX), diclofenac (DCF), ibuprofen (IBU), acetaminophen (ACT), carbamazepine (CBM), iopromide (IOP), atenolol (ATN), and caffeine (CAF) were frequently detected in most influent and effluent wastewaters of 12 investigated hospitals. Detected compound levels exhibited a wide range, from as low as 1 ng/L for DCF to as high as 61,772 ng/L for ACT. Among these compounds, ACT, CAF, SMX, and IOP were consistently detected at substantial concentrations in both influents and effluents. This investigation also highlighted potential risks posed by SMX, ACT, and CAF residues present in influents and effluents of hospital wastewater treatment plants (WWTPs) to aquatic ecosystem. These finding are expected to provide scientific-based evidence for the development of hospital waste management and environmental management programs in Vietnam.

Potential of hospital wastewater treatment using locally isolated Chlorella sp. LH2 from cocoon wastewater

Chlorella sp. is able to grow and transform inorganic and organic contaminants in wastewater to create biomass. In the present study, Chlorella sp. LH2 isolated from cocoon wastewater was able to thrive in hospital wastewater, then remove nutrients and eliminate E. coli ATCC 8739. The results indicated that optimal cultivation conditions of Chlorella sp. LH2 in hospital wastewater were pH of 8, light:dark cycle of 16:8 at 30oC. The inhibitory effect of chlorination on algae growth was accompanied with the chlorine concentration. BOD5:COD ratio of 0.77 indicated biodegradability of hospital wastewater. The untreated and treated wastewatee samples were collected to investigated the nutrient removal efficiency after 10 days. Untreated and treated results were192 ± 8.62 mg/l 23.91 ± 2.19 mg/l for BOD5; 245 ± 9.15 mg/l and 47.31 ± 5.71 mg/l for COD. The treated value met the required standards for hospital wastewater treatment. The removal efficiency total nitrogen and total phosphorus were 68.64% and 64.44% after 10 days, respectively. Elimination of E. coli ATCC 8739 after 7 days by Chlorella sp. LH2 was 88.92%. The results of this study suggest the nutrients and pathogens removal potential of Chlorella sp. LH2 in hospital wastewater for further practical applications.

Treatment of hospital wastewater using aerobic granular sludge technology: Removal performance and microbial dynamics

Hospital wastewater contains several contaminants of emerging concern that cannot be removed by conventional treatment processes. Many of these emerging contaminants are pharmaceutical compounds, which are found in hospital wastewater at high loads. The presence of these toxics affects to the performance of biological processes in receiving wastewater treatment plants. This research evaluated the capability of the aerobic granular sludge technology to remove pharmaceutical compounds from hospital wastewater in a single chamber, which to date has not been investigated with real hospital wastewater. Despite the high non-biodegradable organic matter content, COD and BOD5 removal reached 75 % and 100 %, respectively. Nitrogen removal ranged from 70 %–90 %, and phosphate removal was maximum 50 %. The technology was able to efficiently remove antibiotics, antiepileptic and antidepressant drugs, whereas non-steroidal anti-inflammatory drugs were removed and released under oscillating patterns. The granular biomass increased in size, but it reduced the settling velocity. Bacterial and fungal communities were acclimated to pharmaceutical inlet, whereas the archaeal population had a progressive adaptation over time. The aerobic granular sludge technology is therefore a viable approach to enhance the disposal of real hospital wastewater prior to discharge into the urban wastewater network.

Evaluation of Eichhornia crassipes, Pistia stratiotes and Vetiver zizanoides in Phytoremediation of a Hospital Wastewater Effluent

The study assessed the physicochemical parameters from a hospital wastewater treatment plant in Zaria, using a standard method for water and wastewater examination and its phytoremediation by hydroponic treatment method using Eichhornia crassipes (water hyacinth), Pistia stratiotes (Water lettuce) and Vetiveria zizanoides (Vetiver grass). Results recorded were analyzed by one-way Analysis Of Variance at 95% confidence, multiple comparison tests, and quantitative linear relationship. The study showed higher concentrations of Electrical Conductivity (EC) (951.83 µs/cm), Phosphate (PO4) (64.46 mg/l), Biological Oxygen Demand (BOD) (244.90 mg/l), Chemical Oxygen Demand (COD) (625.50 mg/l), Total Suspended Solid (TSS) (27.30 mg/l), Potassium (K) (40.67mg/l) above the permissible limit standard by WHO and FAO, Phytoremediation showed there was significant difference at P ≤ 0.05 in reduction capacity across treatment between water hyacinth, water lettuce and vetiver grass for EC (49.8, 41.6 and 51.4%), TDS (51.3, 47.0 and 63.0%), PO4 (49.0, 45.3 and 53.0%), COD (47.3, 48.4 and 57.1%), NO3 (51.6, 43.1 and 64.6%), TSS (49.5, 42.7 and 60.3%), NH3 (44.7, 40.8 and 53.2%), SO4 (53.9, 47.2 and 62.8%). Plant analysis results showed higher concentrations of contaminant in the roots of water hyacinth than in the shoot, higher in the shoot of vetiver grass than its roots, and an even distribution in roots and shoots of water lettuce. Therefore, the three plants can be used effectively in the phytoremediation of wastewater contaminants due to cost-effectiveness, eco-friendliness, and the emerging cheaper technology for a lasting solution to the problems of water contamination to both humans and the environment.

Deciphering the removal of antibiotics and the antibiotic resistome from typical hospital wastewater treatment systems

Hospital wastewater treatment systems (HWTSs) are a significant source and reservoir of antibiotic resistance genes (ARGs) and a crucial hub for transmitting ARGs from clinical to natural environments. However, there is a lack of research on the antibiotic resistome of clinical wastewater in HWTSs. In this study, we used metagenomics to analyze the prevalence and abundance of ARGs in five typical HWTSs. A total of 17 antibiotics from six categories were detected in the five HWTSs; β-lactam antibiotics were found at the highest concentrations, with up to 4074.08 ng·L−1. We further found a total of 21 ARG types and 1106 subtypes of ARGs with the highest percentage of multi-drug resistance genes (evgS, msbA, arlS, and baeS). The most abundant last-resort ARGs were mcr, which were detected in 100 % of the samples. HWTSs effluent is a major pathway for the transmission of last-resort ARGs into urban wastewater networks. The removal of antibiotics, antibiotic-resistant bacteria, and ARGs from HWTSs was mainly achieved by tertiary treatment, i.e., chlorine disinfection, but antibiotics and ARGs were still present in the HWTSs effluent or even increased after treatment. Moreover, antibiotics and heavy metals (especially mercury) in hospital effluents can exert selective pressure for antibiotic resistance, even at low concentrations. Qualitative analyses based on metagenome-assembled genome analysis revealed that the putative hosts of the identified ARGs are widely distributed among Pseudomonas, Acidovorax, Flavobacterium, Polaromonas, and Arcobacter. Moreover, we further assessed the clinical availability of ARGs and found that multidrug ARGs had the highest clinical relevance values. This study provides new impulses for monitoring and removing antibiotics and ARGs in the hospital sewage treatment process.

Potential Environmental Impacts of a Hospital Wastewater Treatment Plant in a Developing Country

Assessing the quality of a hospital wastewater treatment process and plant is essential, especially if the presence of chemical and biological toxic compounds is considered. There is less literature on hospital wastewater treatment in developing countries because of a lack of managerial awareness and stakeholder cooperation, accompanied by the limited capacity of investment meant to upgrade the existing infrastructures. Limited access to data further hampers the reliable analysis of hospital wastewater treatment plants (WWTPs) in developing countries. Thus, based on the possibility of collecting a sufficient amount of primary (i.e., field) data, this study performed an assessment of the potential impacts generated by the WWTP of Quaid-Azam International Hospital in Islamabad (Pakistan) considering its construction and operational phases. The major identified impacts were attributed to the energy mix used to operate the plant. Marine ecotoxicity was the most impactful category (34% of the total potential impacts accounted for), followed by human carcinogenic toxicity (31%), freshwater toxicity (18%), terrestrial ecotoxicity (7%), and human non-carcinogenic toxicity (4%). An analysis of potential impacts was combined with an assessment of potential damage according to an endpoint approach. In particular, the endpoint analysis results indicated that human health damage (quantified as DALY) was mainly dependent on the “fine PM (particulate matter) formation” category (51%), followed by “global warming and human health” (43%). Other categories related to human health impacts were human carcinogenic toxicity (3%), water consumption (2%), and human non-carcinogenic toxicity (1%). The other impact categories recorded a percentage contribution lower than 1%. With respect to ecosystem damage, “global warming and terrestrial ecosystems” played a major role (61%), followed by terrestrial acidification (24%), ozone formation (10%), water consumption (5%), and freshwater eutrophication (1%). This study’s findings support an increase in awareness in the hospital management board while pointing out the need to further implement similar studies to improve the quality of decision-making processes and to mitigate environmental impacts in more vulnerable regions. Finally, this research evidenced the need to overcome the existing general constraints on data availability. Consequently, further field work, supported by hospital managers in developing countries, would help in enhancing managerial procedures; optimizing treatment plant efficiency; and facilitating the implementation of circular options, such as sludge management, that often remain unexplored.

Hospital Wastewater Screening and Treatment Using Two Novel Magnetic Iron Nanocomposites

Hospital Wastewater Screening and Treatment Using Two Novel Magnetic Iron Nanocomposites

Characteristics of Microplastics in a Hospital Wastewater Treatment Plant Effluent and Hazard Risk Assessment

Characteristics of Microplastics in a Hospital Wastewater Treatment Plant Effluent and Hazard Risk Assessment

Airborne ARGs/MGEs from two sewage types during the COVID-21: Population, microbe interactions, cytotoxicity, formation mechanism, and dispersion

During the COVID-2021 epidemic, a large number of antibiotics were used for clinical treatment in hospitals or daily prevention. Sewage from hospital sewage treatment centers (HSTC) and wastewater treatment plants (WWTP) produced a lot of antibiotic-resistance genes/mobile genetic elements (ARGs/MGEs). In this study, the sewage and bioaerosol in the biochemical tank (BT) of an HSTC and a WWTP were sampled throughout the year. The results showed that the average absolute abundance of sewage in BT of WWTP (BTW-W) was higher than sewage in BT of HSTC (BTW-H). Sewage was an important source of microorganisms and ARGs/MGEs in the air of BT. Microorganisms and MGEs were the factors affecting the differences in ARGs/MGEs. Cytotoxicity experiment proved that the cytotoxicity changed from Grade III to Grade IV with the increase in drug-resistant Escherichia coli concentration. According to the formation mechanism formula, the average generation rate of ARGs/MGEs in BT of HSTC was lower than that in WWTP. The diffusion range of ARGs/MGEs of HSTC was larger than that of WWTP. According to the above results, this study found that when people were far away from BT, the health risk of HSTC caused by the diffusion of bioaerosol was higher than WWTP; When people were close to BT, the health risk of WWTP was higher than HSTC due to the aeration of BT. This study provided a basis for public protection of ARGs. In the future, the elimination of airborne ARGs and crowd protection can be further studied in detail.

Effectiveness of wastewater treatment plant at the removal of nutrients, pathogenic bacteria, and antibiotic-resistant bacteria in wastewater from hospital source.

This study is aimed at assessing the effectiveness of hospital's wastewater treatment plant (WWTP) in removing nutrients, pathogenic bacteria, and addressing antibiotic resistance using a case study of a tertiary hospital in Ibadan, Nigeria. During the dry and wet seasons in the month of July and December, respectively, samples were collected, and analyzed using standard guidelines to examine significant physicochemical parameters of the WTTP; to evaluate the removal efficiency of biological oxygen demand (BOD) and chemical oxygen demand (COD), and to examine the prevalence of pathogenic and antibiotic-resistant bacteria. The results of this study showed that during the dry season, certain parameters exceeded acceptable limits, including temperature, total suspended solids (TSS), total dissolved solids (TDS), phosphate, and nitrate. Although there were reductions in BOD (1555mg/L to 482mg/L) and COD levels (3160mg/L to 972mg/L), they remained above acceptable limits by World Health Organization. In the wet season, the level of COD (20mg/L) in the effluent was within acceptable limit, while the BOD (160mg/L) was above the acceptable limit. The WWTP effectively removed nutrients and reduced the microbial load, as evident from the absence of fecal coliforms in the effluent in both seasons. In respect to BOD removal efficiency, the level of purification of wastewater by the WWTP was 69% during the dry season, while the removal efficiency of COD was 83.54% which showed the efficiency of the WWTP at the removal of COD. However, antibiotic resistance was still present. The study concludes that while the WWTP effectively addressed nutrients and microbial load, additional measures such as tertiary treatment methods like chlorination and UV radiation are necessary to tackle antibiotic resistance. This is crucial to prevent the release of antibiotic-resistant bacteria into the environment, safeguarding human health, animals, plants, and overall environmental well-being.