Hospital wastewater (HWW) contains plenty of persistent compounds, dangerous substances, and pathogenic microorganisms, such as antibiotics, psychiatric drugs, β-receptor blockers, anesthetics, analgesics, anti-inflammatory drugs, and X-ray contrast agents.
Graphical abstract. Credit: Frontiers of Environmental Science & Engineering (2022). DOI: 10.1007/s11783-022-1558-z Endocrine disrupting chemicals (EDCs) are among the high-risk substances in HWW. Progesterones, as typical representative compounds of steroid hormone EDCs, are capable of entering and accumulating in the human body through the food chain. Due to their incomplete removal, natural and synthetic progesterones can enter surface waters continuously with the discharge of the effluent from HWW treatment stations, which may cause adverse effects on the aquatic environment and organisms. In addition, progesterones can react with albumin and corticosteroid protein in the human body, causing damage to multiple systems, such as the endocrine system, immune system, reproductive system, and nervous system. Natural and synthetic progesterones and their metabolites were widespread in various water bodies. In a surface water environment, the concentrations of progesterones were usually in the range of nanogram per liter, while in wastewater or livestock farm runoff, the concentrations of progesterones were up to microgram per liter. Two methods are often used to remove the pollutants and pathogenic microorganisms in HWW treatment. The first method combines primary filtration treatment (PFT) with disinfection and the treated effluent is discharged into the urban pipe network and mixed with other urban sewage for further treatment in the MWTP. In the second method, HWW was treated by PFT, secondary biological treatment (SBT), and disinfection in that order, and the effluent can…