REQUIMTE, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal.
Sci Total Environ. 2013 Sep 1;461-462:302-16. doi: 10.1016/j.scitotenv.2013.04.077. Epub 2013 Jun 1.
The impact of effluent wastewaters from four different hospitals: a university (1456 beds), a general (350 beds), a pediatric (110 beds) and a maternity hospital (96 beds), which are conveyed to the same wastewater treatment plant (WWTP), was evaluated in the receiving urban wastewaters. The occurrence of 78 pharmaceuticals belonging to several therapeutic classes was assessed in hospital effluents and WWTP wastewaters (influent and effluent) as well as the contribution of each hospital in WWTP influent in terms of pharmaceutical load. Results indicate that pharmaceuticals are widespread pollutants in both hospital and urban wastewaters. The contribution of hospitals to the input of pharmaceuticals in urban wastewaters widely varies, according to their dimension. The estimated total mass loadings were 306 g d(-1) for the university hospital, 155 g d(-1) for the general one, 14 g d(-1) for the pediatric hospital and 1.5 g d(-1) for the maternity hospital, showing that the biggest hospitals have a greater contribution to the total mass load of pharmaceuticals. Furthermore, analysis of individual contributions of each therapeutic group showed that NSAIDs, analgesics and antibiotics are among the groups with the highest inputs. Removal efficiency can go from over 90% for pharmaceuticals like acetaminophen and ibuprofen to not removal for β-blockers and salbutamol. Total mass load of pharmaceuticals into receiving surface waters was estimated between 5 and 14 g/d/1000 inhabitants. Finally, the environmental risk posed by pharmaceuticals detected in hospital and WWTP effluents was assessed by means of hazard quotients toward different trophic levels (algae, daphnids and fish). Several pharmaceuticals present in the different matrices were identified as potentially hazardous to aquatic organisms, showing that especial attention should be paid to antibiotics such as ciprofloxacin, ofloxacin, sulfamethoxazole, azithromycin and clarithromycin, since their hazard quotients in WWTP effluent revealed that they could pose an ecotoxicological risk to algae.
对来自四家不同医院（一家大学医院[1456 张病床]、一家综合医院[350 张病床]、一家儿科医院[110 张病床]和一家妇产医院[96 张病床]）的废水与城市废水一起进入同一污水处理厂（WWTP）后，对接收城市废水中的废水的影响进行了评估。在医院废水和 WWTP 废水（进水和出水）中评估了属于多个治疗类别的 78 种药物的出现情况，以及从药物负荷的角度来看，每家医院对 WWTP 进水的贡献。结果表明，药物是医院和城市废水中的广泛污染物。根据医院的规模，医院对城市废水中药物输入的贡献差异很大。估算的总质量负荷分别为大学医院 306 g/d、综合医院 155 g/d、儿科医院 14 g/d 和妇产医院 1.5 g/d，这表明最大的医院对药物的总质量负荷贡献更大。此外，对每个治疗组的个别贡献进行分析表明，非甾体抗炎药、镇痛药和抗生素是输入最高的组之一。对于像扑热息痛和布洛芬这样的药物，去除效率可以超过 90%，而对于β-阻断剂和沙丁胺醇则无法去除。估计进入受纳地表水的药物总质量负荷为 5 至 14 g/d/1000 居民。最后，通过对不同营养级（藻类、水蚤和鱼类）的危害系数来评估从医院和 WWTP 废水中检测到的药物对环境造成的风险。从不同基质中鉴定出几种药物对水生生物具有潜在危害性，这表明应特别注意抗生素，如环丙沙星、氧氟沙星、磺胺甲恶唑、阿奇霉素和克拉霉素，因为它们在 WWTP 废水中的危害系数表明它们可能对藻类产生生态毒性风险。
