Management of the effluent of a large hospital situated in a small town. A case study

Hospitals are the main source of pharmaceutical compounds (PhCs) released into the environment. Generally, their discharges are co-treated with domestic wastewaters, resulting in a decrement of the recalcitrant compounds concentrations in the final effluent due to water dilution. However, as many PhCs resist normal treatments, pollutant load does not change. This paper compares the chemical characteristics of hospital and domestic wastewaters (macro-pollutants as well as main PhCs) on the basis of an in-depth literature review. It then discusses the most adequate treatments for hospital discharges and in particular reports the case study for designing a (new) treatment plant for the effluent of the large hospital in Ferrara (900 beds), located in the first outskirts of the town, in a small urban and industrial centre of about 2000 inhabitant equivalents. Design options (dedicated treatment or co-treatment) are compared, adopted sequence of treatments is discussed and costs for the intervention are given.