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Considerable concern exists regarding the appearance and effects of trace and ultra trace pollutants in the aquatic environment. In this context, it is necessary to identify relevant hot spot wastewater - such as hospital wastewater - and to implement specific wastewater treatment solutions. Membrane bioreactor (MBR) technology seems to be a suitable pre-treatment approach for the subsequent advanced treatment by high pressure membrane systems such as nanofiltration (NF) and reverse osmosis (RO). This paper is based upon investigations on the first full scale MBR for separate treatment of hospital wastewater in Germany. In this study an NF as well as an RO module for further treatment of the MBR filtrate were tested. The removal efficiencies were assessed using the following target compounds: bezafibrate, bisoprolol, carbamazepine, clarithromycin, ciprofloxacin, diclofenac, ibuprofen, metronidazole, moxifloxacin, telmisartan and tramadol. In summary, the results of this study confirmed that MBR technology followed by an advanced treatment for trace pollutant removal is an adequate approach for specific treatment of hot spot wastewater such as hospital wastewater. In particular, it was shown that - comparing the tested NF and RO - only (a two stage) RO is appropriate to remove pharmaceutical residues from hospital wastewater entirely. The recommended yield of the 2-stage RO is 70% which results in a retentate sidestream of 9%. Our investigations proved that RO is a very efficient treatment approach for elimination of trace pollutants.

Membrane Bioreactors (MBR) are a very attractive option for the treatment of hospital wastewater and elimination of pharmaceuticals in high density urban areas. The present investigation showed that, depending on the substance, between 19% and 94% of the level of antibiotics found in the environment originate from hospitals. Because of their ecotoxic potential, hospital wastewaters can have a significant impact on the environment. The segregation of these wastewaters and their separate treatment at the source can reduce the entry of drugs in waterways and enable water reuse after adequate polishing treatment processes.

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