An assessment of hospital wastewater and biomedical waste generation, existing legislations, risk assessment, treatment processes, and scenario during COVID-19

Abstract

Hospitals release significant quantities of wastewater (HWW) and biomedical waste (BMW), which hosts a wide range of contaminants that can adversely affect the environment if left untreated. The COVID-19 outbreak has further increased hospital waste generation over the past two years. In this context, a thorough literature study was carried out to reveal the negative implications of untreated hospital waste and delineate the proper ways to handle them. Conventional treatment methods can remove only 50%–70% of the emerging contaminants (ECs) present in the HWW. Still, many countries have not implemented suitable treatment methods to treat the HWW in-situ. This review presents an overview of worldwide HWW generation, regulations, and guidelines on HWW management and highlights the various treatment techniques for efficiently removing ECs from HWW. When combined with advanced oxidation processes, biological or physical treatment processes could remove around 90% of ECs. Analgesics were found to be more easily removed than antibiotics, β-blockers, and X-ray contrast media. The different environmental implications of BMW have also been highlighted. Mishandling of BMW can spread infections, deadly diseases, and hazardous waste into the environment. Hence, the different steps associated with collection to final disposal of BMW have been delineated to minimize the associated health risks. The paper circumscribes the multiple aspects of efficient hospital waste management and may be instrumental during the COVID-19 pandemic when the waste generation from all hospitals worldwide has increased significantly.

Heavy metals assessment of hospital wastewater during COVID-19 pandemic

“…For example, Hg was detected because of its use in treatment diuretics, disinfectants, and diagnostic agents [42], [49]. Ba is commonly used in hospitals for organ functioning effects, biochemical data, and computed tomography sensitivity [36]. Table 1 explains the previous studies which have mentioned the occurrence of heavy metals in hospital wastewater.…”

“…Although they appear in water in trace amounts, heavy metals are considered the most toxic and widespread components in wastewater effluent [33], [34]. Amongst, Hg and Ba are detected continuously in HWW because of their utilization in diuretic agents in treatment, organ functioning effect, diagnostic agents, and disinfectants [35], [36], which are discharged within 24 h of usage [5]. The treated effluent from the hospital has flowed to the river, where some people live near the body of water.…”

Dependency of sanitation infrastructure on the discharge of faecal coliform and SARS-CoV-2 viral RNA in wastewater from COVID and non-COVID hospitals in Dhaka, Bangladesh

“…Healthcare facilities (HCFs) in low- and middle-income countries (LMICs) are very often the hub of infectious diseases whenever there is an outbreak ( Allegranzi et al, 2011 ; Unicomb et al, 2018 ). Wastewater discharged from HCFs contains pathogenic microorganisms along with drug residues, toxic chemicals, and radioactive substances ( Al Aukidy et al, 2018 ; Al-Gheethi et al, 2018 ; Majumder et al, 2021 ; Parida et al, 2022 ). In many LMICs, these pathogens, and substances from HCFs, are either discharged into the municipal sewage system or directly into surface water without pre-treatment, which contributes to significant health hazard risks to the community ( Majumder et al, 2021 ).…”

Treatment of Hospital Wastewater Using Activated Sludge with Extended Aeration

“…Hospitals play an essential role in human welfare through the health services they provide, but they are also responsible for generating large volumes of wastewater (Parida et al, 2022). In developed countries, a hospital generates 400-1200 L of wastewater per bed per day, while in developing countries a hospital generates 200-400 L/ capita/day compared to 100-400 L/capita/day of domestic wastewater generation (Kumari et al, 2020).…”