Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Hospital effluent”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1999

European hospitals as a source for platinum in the environment in comparison with other sources.

The concentration of platinum in the sewage of five European hospitals originating from excreted antineoplastic drugs, cisplatin and carboplatin, was analyzed in a short term study to provide an order of magnitude of Pt emissions from hospitals into aquatic environments. These emissions were compared with a rough estimation of emissions by cars. The average daily concentrations in the hospital effluents were approximately < 10-601 ng l-1 Pt (20-3580 ng l-1 in 2-h mixed samples). As expected from consumption data, the daily average concentrations should range from < 10-710 ng l-1 Pt. Platinum emitted by hospitals is 3.3-12.3% (1.3-14.3 kg per year) the estimated amount emitted by cars equipped with catalytic converters in the different European countries. Compared to platinum emissions from other sources, the effluents of hospitals are a minor source of platinum in municipal sewage, but they should not to be disregarded. Other possible sources for the emission of platinum into the environment should be considered in further investigations.

Antineoplastic Agents↗
PubMed2003

Promoting resistance by the emission of antibiotics from hospitals and households into effluent.

OBJECTIVE: There is growing concern about bacterial resistance to antimicrobials. The majority of antibiotics used are only partially metabolized after administration, and are released via patient excreta into the municipal sewage system. Data on the use of antibiotics and their emission into hospital effluent are not available. METHODS: Antibiotic consumption in Germany was calculated on the basis of five hospitals of varying size and medical service spectrum and on prescriptions issued by medical practitioners. The predicted environmental concentration (PEC) was calculated for hospital effluent and for municipal sewage. The PECs were compared both with published minimum inhibitory concentrations (MIC50) for sensitive pathogenic bacteria and with the predicted no-effect concentrations (PNECs). RESULTS: The amount of antibiotics emitted into hospital effluent may reach and exceed the MIC50 of susceptible pathogenic bacteria. The PEC/PNEC ratio is highest for hospital effluent (in some cases 10-20 times the MIC50) and frequently > 1 for municipal sewage. PECs are high enough for some compounds to have a PEC/PNEC ratio > 1 even in surface water. CONCLUSION: The volume of antibiotics used in hospitals and private households and released into effluent and municipal sewage indicates a selection pressure on bacteria. Steps should be taken to reduce the risk by proper handling of antibiotics and their residues both in hospitals and by private users.

Anti-Bacterial Agents↗
PubMed2001

Drugs in the environment: emission of drugs, diagnostic aids and disinfectants into wastewater by hospitals in relation to other sources--a review.

After administration, pharmaceuticals are excreted by the patients into wastewater. Unused medications are sometimes disposed of in drains. The drugs enter the aquatic environment and eventually reach drinking water if they are not biodegraded or eliminated during sewage treatment. Additionally, antibiotics and disinfectants are supposed to disturb the wastewater treatment process and the microbial ecology in surface waters. Furthermore, resistant bacteria may be selected in the aeration tanks of STPs by the antibiotic substances present. Recently, pharmaceuticals have been detected in surface water, ground water and drinking water. However, only little is known about the significance of emissions from households and hospitals. A brief summary of input by different sources, occurrence, and elimination of different pharmaceutical groups such as antibiotics, anti-tumour drugs, anaesthetics and contrast media as well as AOX resulting from hospital effluent input into sewage water and surface water will be presented.

Anesthetics↗
PubMed2000

Distribution of oxytetracycline resistance plasmids between aeromonads in hospital and aquaculture environments: implication of Tn1721 in dissemination of the tetracycline resistance determinant tet A.

Oxytetracycline-resistant (OT(r)) mesophilic aeromonads were recovered from untreated hospital effluent (72 isolates) and from fish farm hatchery tanks (91 isolates) at sites within the English Lake District, Cumbria, England. The transfer of OT(r) plasmids from these isolates was investigated. Using Escherichia coli J53-1 as a recipient, 11 isolates from the hospital site and 6 isolates from the fish farm site transferred OT(r) plasmids (designated pFBAOT1 to 17). Original isolates were identified using fatty acid methyl ester and fluorescent amplified fragment length polymorphism comparisons as either Aeromonas hydrophila HG3 (eight isolates), A. veronii b.v. sobria HG8 (six isolates), and A. caviae HGB5 (one isolate). One isolate remained unidentified, and one could not be assigned a taxonomic designation beyond the genus level. Plasmids pFBAOT1 to -17 were screened for the presence of the tetracycline resistance determinants Tet A to E and Tet G. Only determinant Tet A (10 plasmids) was detected in these plasmids, with 7 tet gene determinants remaining unclassified. In all cases, Tet A was located on a 5.5-kb EcoRI restriction fragment. Hybridization with inc-rep probes N, P, Q, W, and U showed pFBAOT3, -4, -5, -6, -7, -9, and -11, from the hospital environment, to be IncU plasmids. Further, restriction fragment length polymorphism (RFLP) analyses and DNA probing demonstrated that pFBAOT plasmids were closely related to IncU OT(r) plasmids pASOT, pASOT2, pASOT3, pRAS1 (originally isolated from A. salmonicida strains from fish farms in Scotland and Norway, respectively), and pIE420 (isolated from a German hospital E. coli strain). In addition, DNA analyses demonstrated that plasmids pRAS1 and pIE420 had identical RFLP profiles and that all fragments hybridized to each other. The presence of tetracycline resistance transposon Tn1721 in its entirety or in a truncated form in these plasmids was demonstrated. These results provided direct evidence that related tetracycline resistance-encoding plasmids have disseminated between different Aeromonas species and E. coli and between the human and aquaculture environments in distinct geographical locations. Collectively, these findings provide evidence to support the hypothesis that the aquaculture and human compartments of the environment behave as a single interactive compartment.

Aeromonas↗
PubMed1985

The role of immunoassay in the analysis of microcontaminants in water samples.

Concentrations of natural and synthetic steroids and an anticancer drug (methotrexate) have been determined in water by adapting established immunoassay procedures. The limits of detection for the assays used were 10 ng/liter for norethisterone, 5 ng/liter for ethinyl estradiol and progesterone, and 6.25 ng/liter for methotrexate. Results below the level of detection were obtained in all the samples examined (8 river samples and 6 potable supply samples) except for 2 river samples (17 ng/liter) for norethisterone, and 1 river sample and 1 potable water sample for progesterone (6 ng/liter). A concentration of 1 microgram/liter of methotrexate was found in a sample of hospital effluent. There appears to be no evidence of adverse effects from reused water resources which may be contaminated from the normal use of such highly active therapeutic agents.

Ethinyl Estradiol↗
PubMed2000

Characterization of oxytetracycline-resistant heterotrophic bacteria originating from hospital and freshwater fishfarm environments in England and Ireland.

This ecotaxonomic study compared the antibiotic tolerance among culturable oxytetracyline-resistant (Ot(r)) heterotrophic strains isolated from two aquatic environments representing human activities in health care and aquaculture, namely hospital effluents and freshwater fishfarms. Using a standardized methodology, samples taken in England and Ireland were analyzed to determine the antibiotic tolerance profiles of two groups of culturable Ot(r) bacterial isolates at the intergeneric and intrageneric level comprising heterotrophs (189 strains) and mesophilic Aeromonas spp. (153 strains), respectively. Antibiogram data of heterotrophic isolates revealed that Irish hospital strains comprised higher frequencies of multi-tolerance than those originating from fishfarm environments whereas a reverse correlation was found among the English heterotrophs. Polyphasic identification of the isolates using fatty acid analysis and API 20E profiling showed that this difference arose from the unique taxonomic diversity within each heterotrophic strain set. Acinetobacter (27%) and Brevundimonas (22%) were predominant among the Irish Ot(r) fishfarm isolates, whereas isolates originating from the English aquaculture site almost entirely consisted of Stenotrophomonas maltophilia (86%) exhibiting high frequencies of tolerance to ampicillin and streptomycin. Within both the English and the Irish Ot(r) Aeromonas strain sets, on the other hand, the hospital strain sets displayed higher numbers of multi-tolerant isolates than to fishfarm isolates although country-specific differences were observed for individual antimicrobial agents. The typical occurrence of kanamycin-tolerant aeromonads in the Irish hospital site could to some extent be linked to the typical presence of A. hydrophila DNA hybridization group (HG) 3 strains as determined by fatty acid analysis and fluorescent amplified fragment length polymorphism (FAFLP) fingerprinting. Essentially, these data indicate that tolerance profiles in a specific environment of one country do not necessarily reflect the corresponding tolerance profiles of the same type of environment in another country, and this mainly as a result of the unique taxonomic composition of each site. Ot(r) representatives of Acinetobacter, S. maltophilia, and A. veronii biovar sobria HG8 were common to most if not all of the four sites under study, indicating that these three taxa may serve as potential indicator organisms for monitoring antibiotic tolerance among indigenous bacterial populations in various aquatic environments.

Aeromonas↗
PubMed2000

Drugs, diagnostic agents and disinfectants in wastewater and water--a review.

After administration pharmaceuticals are excreted by the patients into the aquatic environment via wastewater. Unused medications are sometimes disposed of in drains. The drugs may enter the aquatic environment and eventually reach drinking water, if they are not biodegraded or eliminated during sewage treatment. Additionally, antibiotics and disinfectants are assumed to disturb the wastewater treatment process and the microbial ecology in surface waters. Furthermore, resistant bacteria may be selected in the aeration tanks of sewage treatment plants by the antibiotic substances present. Since the 1980s, data on the occurrence of pharmaceuticals in natural surface waters and the effluents of sewage treatment plants have been reported. More recently, pharmaceuticals have been detected in ground and drinking water. However, only little is known about the risk imposed on humans by pharmaceuticals and their metabolites in surface and drinking water. An overview of input, occurrence, elimination (e.g. biodegradability) and possible effects of different pharmaceutical groups such as anti-tumour drugs, antibiotics and contrast media as well as AOX resulting from hospitals effluent input into sewage water and surface water is presented.

Anti-Bacterial Agents↗
PubMed2006

Determination of UV filters and antimicrobial agents in environmental water samples.

Although there is increasing concern about residues from personal care products entering the aquatic environment and their potential to accumulate to levels that pose a health threat to humans and wildlife, we still know little about the extent and magnitude of their presence in the aquatic environment. In this study we describe a procedure for isolation, and subsequent determination, of compounds commonly added to personal care products. The compounds of interest include UV filters with the commercial name Eusolex (homosalate, 4-methylbenzylidenecamphor, benzophenone-3, octocrylene, butylmethoxydibenzoylmethane, ethylhexyl methoxycinnamate) and two common anti-microbial agents, clorophene and triclosan. Water samples were filtered, acidified, and extracted by use of solid-phase extraction. Extracted compounds were then derivatised before analysis by gas chromatography-mass spectroscopy. By use of our method we obtained limits of detection of 13-266 ng L(-1) for UV filters, and 10-186 ng L(-1) for triclosan and clorophene. Recoveries were 82-98% for deionised water and 50-98% for natural water (seawater, pool water, lake water, and river water). Samples collected in Slovenia included seventeen recreational waters (seawater, pool water, lake water, and river water; August 2004) and four wastewaters (January 2005). The most abundant UV filter was benzophenone-3 (11-400 ng L(-1)). Of the two anti-microbial agents studied, trace amounts, only, of triclosan were present in the river Kolpa (68 ng L(-1)) and in an hospital effluent (122 ng L(-1)).

Anti-Infective Agents↗
PubMed2005

Biodegradability of the X-ray contrast compound diatrizoic acid, identification of aerobic degradation products and effects against sewage sludge micro-organisms.

Pharmaceuticals and contrast media have been detected in hospital effluents, sewage treatment plants, surface water, and ground water. Only little is known about their elimination during sewage treatment and effects of possible biotransformation products against bacteria. The modified Zahn-Wellens test (ZWT, OECD 302 B) and a test simulating biological sewage treatment (modified OECD 303 A test) were used to assess the biodegradability of the widely used ionic iodinated contrast agent diatrizoic acid (diatrizoate). Effects against sewage sludge bacteria were studied in the two test systems by monitoring the biomarkers quinones, polyamines, phospholipids and adenosine triphosphate. Diatrizoate was biotransformed into 2,4,6-triiodo-3,5-diamino-benzoic acid in the ZWT. 2,4,6-Triiodo-3,5-diamino-benzoic acid was stable under the test conditions of the ZWT. Diatrizoate was not eliminated in the OECD 303 A simulation test. It was not adsorbed by the sewage sludge. No effects of the test compound or its aerobic transformation products against the bacteria present in the sewage sludge were detected using phospholipids, quinones, polyamines, and adenosine triphosphate as biomarkers.

Aerobiosis↗
PubMed1997

Analysis of benzalkonium chloride in the effluent from European hospitals by solid-phase extraction and high-performance liquid chromatography with post-column ion-pairing and fluorescence detection.

A highly reproducible and specific method for the analysis of the quaternary ammonium compound, benzalkonium chloride, in effluents from European hospitals is presented. Benzalkonium chloride was extracted with end-capped RP-18 solid-phase cartridges and was selectively eluted. The resulting solution was analyzed by high-performance liquid chromatography (HPLC). After elution from the analytical column of the HPLC system, 9,10-dimethoxyanthracene-2-sulfonate was added continuously as a fluorescence marker, forming a hydrophobic ion-pair with benzalkonium chloride. The ion-pair was analyzed by fluorescence detection. The method was applied to highly complex effluent samples from different sized European hospitals. The measured concentrations were between 0.05 and 6.03 mg/l. The amounts emitted per bed and year were 4.5-362 g and did not correlate with the size of the hospital. The total amounts were 2.6-909 kg/year.

Anthracenes↗
PubMed2005

Ecotoxicological risk assessment of hospital wastewater: a proposed framework for raw effluents discharging into urban sewer network.

In hospitals a large variety of substances are in use for medical purposes such as diagnostics and research. After application, diagnostic agents, disinfectants and excreted non-metabolized pharmaceuticals by patients, reach the wastewater. This form of elimination may generate risks for aquatic organisms. The aim of this study was to present: (i) the steps of an ecological risk assessment and management framework related to hospital effluents evacuating into wastewater treatment plant (WWTP) without preliminary treatment; and (ii) the results of its application on wastewater from an infectious and tropical diseases department of a hospital of a large city in southeastern France. The characterization of effects has been made under two assumptions, which were related to: (a) the effects of hospital wastewater on biological treatment process of WWTP, particularly on the community of organisms in charge of the biological decomposition of the organic matter; (b) the effects on aquatic organisms. COD and BOD5 have been measured for studying global organic pollution. Assessment of halogenated organic compounds was made using halogenated organic compounds absorbable on activated carbon (AOX) concentrations. Heavy metals (arsenic, cadmium, chrome, copper, mercury, nickel, lead and zinc) were measured. Low most probable number (MPP) for faecal coliforms has been considered as an indirect detection of antibiotics and disinfectants presence. For toxicity assessment, bioluminescence assay using Vibrio fischeri photobacteria, 72-h EC50 algae growth Pseudokirchneriella subcapitata and 24-h EC50 on Daphnia magna were used. The scenario allows to a semi-quantitative risk characterization. It needs to be improved on some aspects, particularly those linked to: long term toxicity assessment on target organisms (bioaccumulation of pollutants, genotoxicity, etc.); ecotoxicological interactions between pharmaceuticals, disinfectants used both in diagnostics and in cleaning of surfaces, and detergents used in cleaning of surfaces; the interactions into the sewage network, between the hospital effluents and the aquatic ecosystem.

Anti-Bacterial Agents↗
PubMed1992

[Waste water pollutants due to the use of disinfectants in the hospital].

It is assumed that the antiseptic effect of disinfectants in effluents from hospitals can severely disturb the growth of microorganisms in the different stages of aeration of sewage plants. Regular biological catabolism could therefore be damaged. The impact of substances on the waste water depends on the concentration of disinfectants they contain. Consequently this essay first examines the expected quantities of antiseptic substances in the effluent of a medium-sized hospital (440 Beds). The effluents treated here however showed a low concentration of disinfectants and it could be proved that these quantities do not have any harmful effects on the examined parameters such as BOD (Biochemical Oxygen Demand), COD (Chemical Oxygen Demand) and pH-value.

Disinfectants↗
PubMed2004

Accumulation and distribution of platinum and rhodium in the European eel Anguilla anguilla following aqueous exposure to metal salts.

The platinum group metals (PGM) Pt and Rh are emitted into the environment mainly by catalytic exhaust gas converters of cars and by effluents of hospitals, which use Pt based anti-cancer drugs. However, there is still a lack of information on the availability of these precious metals to the biosphere. As PGM accumulate in sediments of aquatic ecosystems we focused our study on the uptake of the noble metals by European eels, Anguilla anguilla. Therefore, eels were exposed in tap water and humic water containing Pt(4+) and Rh(3+) at a concentration of 170 and 260 microg/l, respectively. After an exposure period of 6 weeks the mean Pt levels in bile, liver, kidney and intestine of the exposed eels ranged between 68 ng/g and 840 ng/g and the mean Rh levels between 35 ng/g and 155 ng/g whereas the PGM levels of the unexposed controls were below the detection limit of 50 ng/g for Pt and 5 ng/g for Rh. Rh was also taken up by gill and spleen. No PGM uptake was found for muscle and blood. The pattern of metal distribution within the eel differed between Pt and Rh and was dependent on the water type. Due to their accumulation capacity for PGM eels are suitable as accumulation indicators to detect PGM pollution in aquatic ecosystems.

Anguilla↗
PubMed1998

Efficacy of sequential early systemic and inhaled corticosteroid therapy in the prevention of chronic lung disease of prematurity.

In order to assess the efficacy of a combination of systemic and nebulized corticosteroids in reducing the incidence and severity of chronic lung disease (CLD) in very low birthweight (VLBW) infants, 60 ventilator-dependent infants < or = 1500 g were randomly assigned to receive either steroids or placebo as of 7 d. The steroid group (n = 30, GA = 25.8 +/- 1.6 weeks, BW = 731 +/- 147 g) received systemic dexamethasone for 3 d, followed by nebulized budesonide for 18 d. Control infants (n = 30, GA = 25.9 +/- 1.8 weeks, BW = 796 +/- 199 g) received systemic and inhaled saline. Steroid-treated infants required less ventilatory support between 9 and 17 d (p < 0.01), and had greater lung compliance at 10 d (p = 0.01), but not subsequently. CLD incidence at 36 weeks was 45.5% vs 56.0% in controls, and fewer steroid-treated infants required dexamethasone rescue (23.3% vs 56.7%, p = 0.017). Survival to discharge was similar (73.3% vs 83.3%), as were the durations of mechanical ventilation, supplemental oxygen use, and hospitalization. Tracheal effluent elastase/albumin ratios and serum cortisol values did not differ between groups, and no adverse effects were noted. We conclude that early dexamethasone administration was associated with improved pulmonary function, which was not sustained with nebulized budesonide. However, the steroid regimen studied reduced the need for dexamethasone rescue in infants with CLD.

Administration, Inhalation↗
PubMed2006

Microbial fuel cells for wastewater treatment.

Microbial fuel cells (MFCs) are emerging as promising technology for the treatment of wastewaters. The potential energy conversion efficiencies are examined. The rates of energy recovery (W/m3 reactor) are reviewed and evaluated. Some recent data relating to potato-processing wastewaters and a hospital wastewater effluent are reported. Finally, a set of process configurations in which MFCs could be useful to treat wastewaters is schematized. Overall, the MFC technology still faces major challenges, particularly in terms of chemical oxygen demand (COD) removal efficiency.

Anaerobiosis↗
PubMed1991

The epidemiological relationship between Salmonella isolated from poultry meat and sewage effluents at a long-stay hospital.

Between February 1988 and March 1989 chicken carcases delivered to the kitchen of a long stay psycho-geriatric hospital were screened every week for salmonella contamination. While 214 of 477 (45%) individual carcases carried one or more salmonella types, every single consignment examined contained affected carcases. Simultaneously, sewers draining the residential accommodation and excluding kitchen effluent, were also monitored. Thirty out of 79 (38%) of Moore's swabs were positive for salmonella. There was a statistically significant association between the salmonella types isolated from chicken and those isolated from sewers the following week. Following a change in kitchen policy to order only cooked chicken there was a significant reduction in the isolation of salmonella from the sewers.

Animals↗
PubMed1998

AOX-emissions from hospitals into municipal waste water.

Adsorbable organically bound halogens (AOX) are mostly persistent in the environment, and accumulate in the food web. Some of them are toxic to humans and other organisms. AOX were measured in the effluents from six German hospitals of different size and departments like internal medicine and ear-nose and throat (ENT) as well as from laundry, kitchen and laboratory. The concentrations in the day time mixed samples of the total effluent were 0.13 mg l(-1)-0.94 mg l-1 (phi = 0.43 mg l-1). For the separately investigated departments the lowest concentrations were found in the effluent from laundry and kitchen (0.015 mg l-1), and the highest ones in the effluents from the medical departments (0.12-1.71 mg l-1, phi 0.95 mg l-1 during the week and 0.06-0.10 mg l-1 at the week-end) and the laboratories (0.05-14.2 mg l-1, phi 2.73 mg l-1). The AOX concentration in night time mixed samples were 0.07-0.41 mg l-1 (phi = 0.41 mg l-1) for the total effluents and 0.25-2.64 mg l-1 (phi = 1.11 mg l-1) for medical departments. Concentrations expected by computing the input of AOX attributable to pharmaceuticals were between 11% and 16% for two hospitals and 7.7% for an ENT department. One additional important source of AOX in hospital effluents may be x-ray contrast media containing a iodine carbon bond.

Adsorption↗
PubMedDate not supplied

[Evaluation of bacterial and polluting loads of effluent from activated sludge wastewater treatment plants in Yaounde, Cameroon].

Activated sludge wastewater treatment plants in Yaounde are plagued by failures in their operation. A microbiological and physico-chemical study was carried out on wastewater effluent of an hospital, university campus, and two residential areas made up of more than 2,000 apartments connected to two collective sewase systems. Wastewater sampling was performed in the form of daily cycles during which composite samples were made every two hours with samples collected every half hour. Variables measured included incoming flow rates, suspended solids, pH, electrical conductivity, ammonia nitrogen, total Kjeldahl nitrogen (combination of ammonia and organic nitrogen) and total reactive phosphorus, BOD5 and COD. Microorganisms were isolated on selective culture media using membrane filter procedures. The results obtained show that effluent discharged in receiving waters are, in general, not treated. The suspended solids contents of raw sewage range from 120 to 2,600 mg/l. In General Hospital a mean value of suspended solids of 31.8 mg/l was obtained for treated wastewater. pH values of both raw and treated sewage range from 6 to 8.5 units. Mean values of the conductivity of treated and raw wastewater range from 449.7 to 1,038.3 microseconds/cm. The TKN contents of untreated wastewater are comprised between 36 and 259.2 mg/l. These values range from 5 to 20 mg/l for treated effluent in the General Hospital plant. Large amounts of total hydrolysable phosphorus varying from 3.8 to 27.9 mg/l are present in wastewater from the plants. Influent BOD5 of Grand Messa, Cite Verte and university campus wastewater range from 110 to 530 mgO2/l. Values recorded indicate an important input of organic matter to receiving waters. In the case of biotic components, test germs densities registered in the influent of Grand Messa and those of Cite Verte are comprised between 9 x 106 and 88 x 107 CFU/100 ml for fecal coliforms, and between 9 x 105 and 74 x 107 CFU/100 ml for fecal streptococci. The densities of Aeromonas hydrophila in Grand Messa and Cite Verte influent fluctuate between 30 x 106 and 65 x 108 CFU/100 ml. Influent of university campus harbour 10 x 105. Densities of Pseudomonas aeruginosa remain below 70 x 105 CFU/100 ml. Treated effluent BOD5 values range from 48 to 150 mgO2/l. Such values indicate an inefficient treatment. The decrease in bacterial densities is limited to 2 logarithmic units. Treated effluent still harbour 10 x 103 to 10 x 105 CFU/100 ml for fecal coliforms, and 20 x 102 to 12 x 104 CFU/100 ml for fecal streptococci. These values range from 10 x 104 to 50 x 105 CFU/100 ml for Aeromonas hydrophila. Pseudomonas aeruginosa densities remain in general below 40 x 104 CFU/100 ml. Discharges from these wastewater treatment plants are responsible for the permanent fecal contamination of the environment and a lack of proper hygiene. Furthermore, they produce overfertilization of receiving waters.

Aeromonas hydrophila↗