Detection of pharmaceutical products in untreated hospital wastewater

Abstract

Medical-care institutions are a high source of pharmaceuticals compounds in urban wastewaters. A way to avoid the dispersal of pharmaceuticals into the environment could be to design dedicated sewage treatment plants capable of processing highly concentrated hospital and medical-care wastewaters. The present work is a survey conducted in Wallonia to further identify the most present and problematic compounds in wastewaters from medical-care institutions. An analytical method was first developed to simultaneously extract, detect and confirm 169 pharmaceutical products (PPs) in wastewater, including a purification/concentration step on an Oasis HLB® column and analysis by ultra-high performance liquid chromatography coupled to electrospray-tandem mass spectrometry. The method was validated to estimate precision and recovery. Samples were collected from hospitals, rest homes and other specialised institutions and analysed to identify PPs. Among the 45 compounds identified, 6 were selected as model compounds in hospital effluents for the design of a dedicated treatment on the basis of high concentration and occurrence, but also poor removal efficiency in urban wastewater treatment plants, persistence in the environment and potential ecotoxicity: carbamazepin, diclofenac, furosemide, lorazepam, tramadol and sulfamethoxazole.