used for lipid control, and psychiatric drugs are the top four families present in raw
sewage, with a total concentration of up to 1.5 mg/L in the case of analgesic/antiinflammatory drugs and 1 mg/L for β-blockers. The highest concentration of an
individual drug was reported for acetaminophen in Portugal with a concentration of
0.6 mg/L [61].
Removal efficiency is class-dependent with contrast agents, analgesic/antiinflammatory drugs, psychiatric drugs, and antihypertensives being the four most
detected therapeutic classes (Fig. 3). Contrast agents were detected with total
concentrations as high as up to 0.094 mg/L, and the analgesic/anti-inflammatory
drugs were presented at 0.037 mg/L. The highest concentrations, reported for
iopromide (contrast agent), valsartan (antihypertensive), and gabapentin (psychiatric
drug), were reported in Portugal and Germany at 0.085, 0.015, and 0.012 mg/L
[59, 62].
WWTPs typically employ primary and secondary treatment systems, with aerobic
and anaerobic treatment [32, 63]; nevertheless, those processes are able to reduce
partially the pharmaceuticals concentration from the wastewater, because WWTPs
are not designed for complete removal of this type of contaminants in water.
Advanced wastewater treatments such as photocatalysis, sonolysis, or advances
oxidation processes can be implemented to reduce considerably the load of pharmaceuticals in wastewater effluents, but investments into installation of full scale at
elevated operational costs hamper their widespread implementation [32, 63].
Fig. 3 Total concentration of families of pharmaceuticals reported in influents and effluents studies
in European wastewater treatment plants. Sources: [31, 56–62]
18
N. Montemurro et al.
sewage, with a total concentration of up to 1.5 mg/L in the case of analgesic/antiinflammatory drugs and 1 mg/L for β-blockers. The highest concentration of an
individual drug was reported for acetaminophen in Portugal with a concentration of
0.6 mg/L [61].
Removal efficiency is class-dependent with contrast agents, analgesic/antiinflammatory drugs, psychiatric drugs, and antihypertensives being the four most
detected therapeutic classes (Fig. 3). Contrast agents were detected with total
concentrations as high as up to 0.094 mg/L, and the analgesic/anti-inflammatory
drugs were presented at 0.037 mg/L. The highest concentrations, reported for
iopromide (contrast agent), valsartan (antihypertensive), and gabapentin (psychiatric
drug), were reported in Portugal and Germany at 0.085, 0.015, and 0.012 mg/L
[59, 62].
WWTPs typically employ primary and secondary treatment systems, with aerobic
and anaerobic treatment [32, 63]; nevertheless, those processes are able to reduce
partially the pharmaceuticals concentration from the wastewater, because WWTPs
are not designed for complete removal of this type of contaminants in water.
Advanced wastewater treatments such as photocatalysis, sonolysis, or advances
oxidation processes can be implemented to reduce considerably the load of pharmaceuticals in wastewater effluents, but investments into installation of full scale at
elevated operational costs hamper their widespread implementation [32, 63].
Fig. 3 Total concentration of families of pharmaceuticals reported in influents and effluents studies
in European wastewater treatment plants. Sources: [31, 56–62]
18
N. Montemurro et al.