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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 compound 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 on the basis of an experimental investigation for macro-pollutants and literature data for PhCs. A membrane biological reactor pilot plant fed by a hospital effluent is tested in order to evaluate the feasibility of treating these kinds of wastewaters with membrane systems. The paper then presents the possible scenarios in the management of the effluent of a large hospital situated in a small town. In particular, it reports on a case study of designing a (new) treatment plant for the effluent of the 900 bed hospital in Ferrara, Northern Italy, located on the outskirts of the town. Finally, costs for the intervention are given.

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