Pharmaceuticals in Wastewater from Hospitals, Elderly Care Homes, and Other Point Sources in Uppsala : Occurrences and Suitable Treatment Technologies

Sammanfattning

Pharmaceutical residues have emerged as persistent micropollutants in aquaticenvironments due to widespread human consumption and incomplete removal duringconventional wastewater treatment. This thesis investigates the occurrence anddistribution of pharmaceutical residues in wastewater from various upstream sources,including nursing homes, hospitals, student housing, and an animal research facilityin Uppsala and Västerås, Sweden. The study aims to quantify pharmaceutical loads,identify significant contributors to pharmaceutical pollution, and propose suitableonsite treatment technologies for mitigating emissions at the point of source. Comprehensive datasets from 28 upstream locations including nursing homes,hospitals, student housing, and animal research facilities and also 7 pumping stationsand 2 wastewater treatment plants, were analyzed, incorporating pharmaceuticalconcentration measurements, flow data, population statistics, and physicochemicalproperties of 30 pharmaceuticals. Mass balance estimations and per-capita loadcalculations were used to map the distribution of pharmaceutical residues and assesscontributions from individual sources. The results revealed that hospitals and nursinghomes are critical point sources, discharging high concentrations and loads ofpharmaceuticals, particularly non-steroidal anti-inflammatory drugs (NSAIDs),antibiotics, and psychoactive compounds. These substances were identified asenvironmentally hazardous due to their persistence, bioaccumulation potential(log Kow ≥ 3), and ecotoxicological effects on aquatic organisms. Based on physicochemical characteristics and source-specific loads, suitable onsitetreatment technologies were evaluated. Advanced oxidation processes (e.g., ozonation,UV/H₂O₂), membrane bioreactors (MBR), and activated carbon adsorption wereidentified as promising solutions for high-contributing sources, offering high removalefficiencies and compatibility with decentralized treatment needs. This research highlights the significance of upstream pharmaceutical pollutionmanagement and demonstrates the value of source mapping in supporting wastewaterorganizations to prioritize mitigation measures. Implementing targeted onsitetreatment at hospitals and nursing homes can substantially reduce pharmaceuticalemissions into aquatic environments, complementing centralized treatment plantsand advancing sustainable water management strategies.