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Removal of Pharmaceuticals from Water
It is important to consider and characterize the efficiency of pharmaceutical removal during wastewater and drinking-water treatment processes. Various treatment options have been investigated for the removal/reduction of drugs (e.g., antibiotics, NSAIDs, analgesics) using conventional or biological treatments, such as activated sludge processes or bio-filtration, respectively. The efficiency of these processes ranges from 20–90%.
In the past three decades, pharmaceutical residues have been discovered in almost all environmental matrices on every continent . Approximately 3000 pharmaceutical substances are used in the European Union. Pharmaceuticals have been detected in groundwater, urban wastewater, surface water, and drinking water in a range of ng to μg per litre . Because of their low biodegradability and high hydrophilicity, pharmaceuticals are difficult to eliminate from water systems using conventional wastewater treatment techniques . Therefore, their disposal in wastewater treatment plants is a major concern . Indeed, pharmaceuticals are considered the most significant groups of environmental pollutants of special concern. The most consumed type of pharmaceutical products may differ from one country to another. For example, in Spain, antihistamines, analgesics, and antidepressants are the most consumed based on the National Health System . However, in Italy, antibiotics, sulphamethoxazole, ofloxacin and ciprofloxacin, β-blocker atenolol, antihistaminic ranitidine, diuretics furosemide, hydrochlorothiazide, and steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are the most detected pharmaceuticals in sewage treatment plants . Klein et al.  reported that Tunisia was considered the second-highest consumer of antibiotics in 76 countries analyzed between the years 2000–2015, and consumption was estimated at around 47 defined daily doses per 1.000 inhabitants per day.
Many studies have shown that wastewater treatment plants (WWTPs) do not totally remove pharmaceutical compounds . More than 100 different drugs have been found in the aquatic environment . Antibiotics and NSAIDs were reported in surface water samples from various countries at concentrations ranging from 5 to 150 µg/L . Castiglioni et al.  noted that there is a difference in concentrations in pharmaceutical compounds in WWTPs between winter and summer. This is mainly due to greater attenuation and lower use of pharmaceuticals in summer. Thus, pharmaceuticals and their metabolites are detected regularly in aquatic and terrestrial environments . Hence, tertiary treatment is needed to eliminate these emerging pollutants. Today, countries are facing high COVID-19 pandemic incidence rates and struggling to manage the dramatic increase in medical waste production by healthcare facilities, in particular with respect to pharmaceutical products. For instance, Wuhan inhabitants in China (~11 M) produced ten times more daily medical waste than the previous average (200 tons on a single day, 24 February 2020). A drastic increase in medical waste was also reported in other parts of the world, such as in Catalonia, Spain, and in China, with increments of 350% and 370%, respectively . Recent studies indicated that the COVID-19 pandemic has led to an increase in waste generation by an average of 102.2 % in both private and public hospitals . In addition, the hazardous waste volume in the hospitals’ investigations has increased by an average of 9% in the amount of medical waste and by 121% compared to the first wave and before the epidemic COVID-19 .
The hydrophobic/hydropholic nature of pharmaceutical compounds facilitates their interaction with microplastics, frequently present in surface water and playing the role of a vector of pharmaceuticals within aqueous environments through π–π interactions . The literature cites about 160 pharmaceutical compounds that have been recently found in the water surface and wastewater . There are already approaches and strategies for minimizing this issue that proved their efficiencies and estimates to be implemented and prioritized in the near future. Currently, the accuracy of techniques for pharmaceutical removal from wastewater differs from drugs to other (80–100%). With this purpose, the development of new technology such as combined techniques based on an in situ census is still needed.
2. Removal of Pharmaceuticals during Wastewater Treatment
2.1. Conventional Treatments
2.2. Biological Removal of the Pharmaceuticals
2.3. Electrocoagulation Process
2.4. Sorption Process for the Removal of Pharmaceutical Products
3. Various Methods for the Removal of Pharmaceuticals from Waters
The removal of pharmaceuticals depends on different water treatment processes that result in different efficiencies. Wastewater treatment plants are not designed to completely remove pharmaceuticals . Adsorption has advantages over other methods because of its simple design that can involve low investment in terms of both initial cost and space required . Adsorption processing for water remediation includes low capital investment, applicability at low adsorbate concentrations, suitability for batch or continuous processing, and the ability to reuse and regenerate adsorbents. Adsorption is a low consuming energy process that can be very efficient and lead to a removal of up to 90%, but it has a mild operation condition. With the Fenton process, it is possible to treat large volumes of wastewaters (need of large electrodes or cell stacks). The greatest advantage of photocatalysis lies in the use of the semiconductor TiO 2, which is non-hazardous, eco-friendly, inexpensive, and stable . Indeed, in a quick and very high percentage of organic matter, degradation can be reached and can be more remarkable under sunlight irradiation and using in situ cathodic production of H 2O 2. However, this process presents many disadvantages such as the need for acidic conditions with a pH value near to 3.0. Thus, a neutralization is requested after the treatment, leading to the production of a large amount of sludge. Special attention should be paid to the formation of halogenated byproducts. According to Patel et al. , an advanced oxidation process can lead to a high degradation of pharmaceuticals, but it is difficult to apply on a wide scale of WWTPs due to the oxidative byproducts and high operation cost. A common problem to all AOPs is their high cost, mainly because of the high demand for electrical energy .
The entry is from 10.3390/app11146659
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