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

Nadeem A. Khan, Viola Vambol, Sergij Vambol, Borys Bolibrukh, Mika Sillanpaa, Fazlollah Changani, Ali Esrafili, Mahmood Yousefi

Research output: Contribution to journalReview articlepeer-review

38 Citations (Scopus)


Laboratories, dialysis units, and other similar facilities are important sources of negative contribution to wastewater from healthcare facilities. They dispose of pharmaceutical residues as well as unsafe pollutants such as pharmaceutical remainders, hazardous chemical agents, pathogens, as well as radio-isotopes. Wastes from these departments may contain traces of pathogenic and cytotoxic microorganisms, as well as radioactive isotopes. This state of wastewater poses a chemical, physical and biological threat to the environment due to the significant amount of hazardous pollutants. It also poses a high risk to public health. Unfortunately, the juridical and legal system does not oblige them to take care of hospital effluents' safety before being discharged into the general sewer system or the environment. Since the risk associated with wastewater composition from medical institutions is enormous, leading us to ensure high-end preparation and treatment of such wastewater before it is discharged into the sewer. Many countries do not have strict standards and legal responsibility to discharge high-hazard pollutants like those found in wastewater from medical institutions. Consequently, it is time for concern since there are increasing amounts of such effluents, and there is currently no legislative regulation and high-quality treatment for emerging contaminants. Unfortunately, even many developed countries do not regulate pharmaceutical residues at the legislative level. For this reason, this review aims to highlight key points in current regulations, legislation, and guidelines for the control of hazardous pharmaceutical wastewater and emerging contaminants. This review also purposes to focus the practitioners’ attention to the development and strengthening of legislative norms regarding the medical institution's effluent.

Original languageEnglish
Article number105874
JournalJournal of Environmental Chemical Engineering
Issue number5
Publication statusPublished - Oct 2021
Externally publishedYes


  • Emerging contaminants
  • Hazardous pollutants
  • Legislative regulation
  • Public health
  • Risk
  • Treatment
  • Wastewater

ASJC Scopus subject areas

  • Chemical Engineering (miscellaneous)
  • Waste Management and Disposal
  • Pollution
  • Process Chemistry and Technology


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