Hospital effluent guidelines and legislation scenario around the globe: A critical review

Inactivation of Bacteria and Residual Antimicrobials in Hospital Wastewater by Ozone Treatment

“…In these reports, the wastewater that has undergone processes such as the removal of solids by primary treatments such as sand filtration, the removal of organic matter by secondary treatments such as biological treatments, and disinfection after discharge into the water environment has been considered [ 58 , 59 , 60 ]. Moreover, as it is generally difficult to perform studies on hospital wastewater, the diversity and prevalence of antimicrobial-resistant bacteria and antimicrobials in hospital wastewaters have been evaluated only in a few studies worldwide [ 7 , 8 , 12 ]. The present study clarifies the effect of direct ozonation on hospital wastewater without pretreatment, and the treatment included fine ozone bubbles to achieve high removal efficiency; this has not been reported previously.…”

“…The discharge of treated water into aquatic environments, such as rivers, lakes, and oceans, creates new environmental pollution problems [ 5 , 6 ]. The water pollution control law in Japan for discharges to general wastewater by organizations, such as hospitals, regulates pH, heavy metals, the coliform group, etc., but does not set regulatory values for pathogenic bacteria or antimicrobial-resistant bacteria, as in other countries [ 7 , 8 ]. At municipal wastewater treatment plants located in Japan, treated wastewater is discharged in compliance with the regulations on the coliform group (<3000 viable bacteria count/mL).…”

“…However, in areas where a confluence system is adopted, rainwater flows into the same waterway as sewage and the wastewater is discharged into rivers and the ocean without sufficient treatment, during rainy weather. It is, therefore, important to understand the actual situation of AMR originating from hospital wastewater, evaluate its risk, and consider effective countermeasures for assessing and solving the AMR problem, not only at the environmental site but also at the clinical site [ 7 , 8 , 9 , 10 , 11 ].…”

“…In addition, it is expected that information on AMR inherent in hospital wastewater, as environmental AMR in the medical field, will not only support nosocomial infection control measures for the early detection and prevention of nosocomial infection strains that may occur, but will also enable discussions on the fundamental measures to be taken against AMR. However, owing to the associated difficulties, limited studies have been conducted on hospital wastewaters worldwide [ 7 , 8 , 12 ].…”

Medical waste generation, handling and crime statistics' analysis in this activity field: a case study of the Poltava region (Ukraine)

“…-Formation and implementation of a regional plan for the municipal solid waste management, including medical waste (Aung et al, 2019;Barua & Hossain, 2021;Safranov et al, 2021); -Features of administrative and legal regulation of medical waste management (Parida et al, 2019;Mao et al, 2020;Khan N.A. et al, 2021;Strelchenko & Bukhtiyarova, 2021); -Energy, environmental and economic aspects of waste disposal technologies (Zamparas et al, 2019), etc.…”