Mass Flows of X-ray Contrast Media and Cytostatics in Hospital Wastewater

Weissbrodt, David, Kovalova, Lubomira, Ort, Christopher, Pazhepurackel, Vinitha, Moser, Ruedi, Hollender, Juliane, Siegrist, Hansruedi and Mcardell, Christa S. (2009) Mass Flows of X-ray Contrast Media and Cytostatics in Hospital Wastewater. Environmental Science & Technology, 43 13: 4810-4817. doi:10.1021/es8036725

Author Weissbrodt, David
Kovalova, Lubomira
Ort, Christopher
Pazhepurackel, Vinitha
Moser, Ruedi
Hollender, Juliane
Siegrist, Hansruedi
Mcardell, Christa S.
Title Mass Flows of X-ray Contrast Media and Cytostatics in Hospital Wastewater
Journal name Environmental Science & Technology   Check publisher's open access policy
ISSN 0013-936X
Publication date 2009-05
Year available 2009
Sub-type Article (original research)
DOI 10.1021/es8036725
Volume 43
Issue 13
Start page 4810
End page 4817
Total pages 8
Editor Jerald Schnoor
Place of publication United States
Publisher American Chemical Society
Collection year 2010
Language eng
Subject C1
Abstract Little is known about the significance of hospitals as point sources for emission of organic micropollutants into the aquatic environment. A mass flow analysis of pharmaceuticals and diagnostics used in hospitals was performed on the site of a representative Swiss cantonal hospital. Specifically, we analyzed the consumption of iodinated X-ray contrast media (ICM) and cytostatics in their corresponding medical applications of radiology and oncology, respectively, and their discharge into hospital wastewater and eventually into the wastewater of the municipal wastewater treatment plant. Emission levels within one day and over several days were found to correlate with the pharmacokinetic excretion pattern and the consumed amounts in the hospital during these days. ICM total emissions vary substantially from day to day from 255 to 1259 g/d, with a maximum on the day when the highest radiology treatment occurred. Parent cytostatic compounds reach maximal emissions of 8−10 mg/d. A total of 1.1%, 1.4%, and 3.7% of the excreted amounts of the cytostatics 5-fluorouracil, gemcitabine, and 2′,2′-difluorodeoxyuridine (main metabolite of gemcitabine), respectively, were found in the hospital wastewater, whereas 49% of the total ICM was detected, showing a high variability among the compounds. These recoveries can essentially be explained by the high amount administered to out-patients (70% for cytostatics and 50% for ICM); therefore, only part of this dose is expected to be excreted on-site. In addition, this study emphasizes critical issues to consider when sampling in hospital sewer systems. Flow proportional sampling over a longer period is crucial to compute robust hospital mass flows.
Keyword mass flows
hospital wastewater
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Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
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Created: Tue, 20 Apr 2010, 14:27:25 EST by Hong Lee on behalf of Advanced Water Management Centre