In the last three decades, pharmaceuticals research has increased tremendously to offer safe and healthy life, though it emerged as a new threat to the environment. These pharmaceutical residues pose a threat to the public health, and ecological balance, particularly in surface water located in agricultural catchments are facing more serious challenges. If these pharmaceutical residues left untreated could contaminate soil, water and may lead to serious outbreaks. However, many conventional treatments are integrated into wastewater treatment plants (WWTP's), but there is a lack of dedicated treatment in eliminating pharmaceutical residues. Thus, dedicated on-site treatment at source (such as Hospitals and pharmaceutical industries) is essentially needed before discharging effluent to sewers or water bodies. Furthermore, the potential impact of pharmaceutical compounds even in trace concentration is more severe than the other pollutants present in the environment. In contrast, very limited knowledge about how such compounds and their kinetics directly impacts the environment and long-term impacts on humans. Traces of antibiotic compounds in the aquatic environment lead to resistant bacterial strains, exhibit threat to organisms and human health, hence affecting treatment. The recent literature reported that the pharmaceutical residues enter the environment in trace level. But, in long terms, these pharmaceuticals, even in trace concentration, has a potential threat to human health and terrestrial ecosystem. In this review article, we summarize the pharmaceutical residues potential to cause disease outbreaks in community and eco-toxicological impacts on aquatic organisms. Herein, we have reviewed the literature to draw worldwide attention on rising pharmaceutical residues in the environment and associated impacts, disease outbreaks and eco-hazards. KeywordsPharmaceutical • Hospital wastewater • Wastewater treatment • Eco-toxicological impacts • Environmental risk Editorial responsibility: Hari Pant.

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In extreme situations with a large number of victims, field hospitals are deployed to provide patients with medical treatment. The large number of patients with different types of medications used generates the problem of hospital waste accumulation, including hospital wastewater (HWW). Wastewater is water having compromised characteristics that adversely affect the environment. Many countries do not have strict regulations regarding the disposal of hospital effluent, which contains pathogens, toxic chemicals and radioisotopes. The disposal of such substances poses a serious threat to public health and the environment. This paper discusses the possibilities of field hospital wastewater management development. Micropollutants, including pharmaceuticals, are found in different ecosystem elements, like soil, surface and ground water, drinking water as well as treated effluent from conventional wastewater treatment plants. Wastewater discharged from different health facilities, with varying concentrations of pharmaceuticals, is often mixed with municipal sewage, thus remains untreated even after passing through conventional treatment plants. Extensive experience in the application of different types of HWW treatment methods allows the development of an optimal treatment scenario for field hospital wastewater problem resolution, including the combination of Microbiological Reactor and Fenton Process technologies. They are applicable in the case of low wastewater flow rate values, specific for field hospital conditions.

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