In recent years, the widespread detection of pharmaceuticals and personal care products (PPCPs) in aquatic environments has become a global concern, and wastewater discharged from hospitals is an important source. This study investigated the occurrence, removal efficiency and risk assessment of 74 commonly used pharmaceutical active compounds (PhACs), including 58 antibiotics, seven psychiatric drugs, four nonsteroidal anti-inflammatory drugs, three β-blockers and two lipid regulators, at wastewater treatment plants (WWTPs) in 11 hospitals. A total of 51 PhACs were detected in the wastewater effluents of 11 hospitals, with concentrations of 0.00089 (alprenolol) ∼ 69 µg/L (acetaminophen) in the influent samples and 0.00057 (alprenolol) ∼ 5.7 µg/L (theophylline) in the effluent samples. Under the same scales, the concentrations of PhACs in the influent of psychiatric hospital WWTP were 1.16 times and 2.28 times greater than those of general hospital and infectious disease hospital, respectively, and the concentrations in small and large hospitals were comparable and were approximately 1.73 times greater than those in medium hospitals, suggesting the influence of the hospital type and scale on the discharge characteristics of PhACs. The removal efficiency of PhACs ranged from negative to 100 %. The removal efficiency of the membrane bioreactor (MBR) was 53.98 %, which was better than that of the biological contact oxidation (BCO). An environmental risk assessment revealed that the PhACs detected in hospital wastewater might pose potential risks to the aquatic environment. In addition, attention should be paid to the management of wastewater discharge in special hospitals and small and medium hospitals. This study provides a basis for the management and control of PhACs in hospitals in China.
Keywords: Environmental risk assessment; Hospital wastewater; PPCPs; Pharmaceutical active compounds; Removal efficiency.
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