John Wiley & Sons, Ltd.

The contribution of pharmaceutically‐active compounds from healthcare facilities to a receiving sewage treatment plant in Canada

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Concentrations and percent loadings of pharmaceutically‐active compounds (PhACs) and other emerging contaminants (ECs) released from healthcare facilities (2 hospitals and a long‐term‐care facility) to a sewage treatment plant (STP) in a large urban sewershed was evaluated. An additional hospital outside the sewershed was also monitored. Fourteen of the 24 steroids /hormones and 88 of the 117 PhACs and ECs were detected at least once. Commonly used substances including cotinine, caffeine and its metabolite1,7‐dimethylxanthine, ibuprofen and naproxen (analgesics), venlafaxine (antidepressant) and DEET (insect repellant) were detected in all samples at all sites. Concentrations detected in the large specialty hospital outside the sewershed were similar to those within the sewershed. Cytotoxic drugs (tamoxifen and cyclophosphamide) and x‐ray contrast media (iopamidol and diatrizoic acid) were infrequently detected in hospital effluents. Analysis for antibiotics indicated that azithromycin, clarithromycin, ciprofloxacin, erythromycin, ofloxacin and sulfamethoxazole were consistently detected in hospital wastewaters as was triclosan (antibacterial agent). Fifteen compounds individually contributed greater than one percent to the total PhAC and EC load to the STP from the 2 hospitals in the sewershed, and nine compounds in the STP effluent exceeded ecotoxicological criteria. This survey demonstrated that point source discharges from healthcare facilities in this sewershed make a small contribution to the overall PhAC and EC loading when compared to the total concentrations entering the receiving STP. This article is protected by copyright. All rights reserved

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