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Arzneirückstände in der aquatischen Umwelt
PILLS Final Conference19th / 20th September 2012
Conclusions of the PILLS project
Dr. Nafo Folie 1
Conclusions of the PILLS projectDr. Issa Nafo, Emschergenossenschaft
Dr. Alex Cornelissen, CRTE Henri Tudor
(on behalf of the PILLS partners)
Arzneirückstände in der aquatischen Umwelt
Aspects of the topics of PILLS
0,25
0,5
0,75
1
Risks for the environment
Risks of spreading antibiotic resistant
bacteria
Environmental impacts waste
Operation experiences and
Local aspects
Dr. Nafo Folie 2
0 impacts waste water treatment
Efficiency of the waste water
treatment process
Energy consumption of the
waste water treatment process
Costs of waste water treatment
process
experiences and responsibilities
Arzneirückstände in der aquatischen Umwelt
Clarithromycin
Sulfamethoxazole
Erythromycin
Diatrizoate
Iopamidol
Iopromide
Cyclophosphamide
Ifosfamide
Hospital is a hot spot for pharmaceutical emission
Hospital contribution to pharmaceutical loads in investigated catchment areas (%)
Dr. Nafo Folie 3
Diclofenac
Naproxen
Carbamazepine
Atenolol
Bezafibrate
Lidocaine
Amoxicillin
Ciprofloxacin
0 20 40 60 80 100 120 140 160%
6.1 to 14.1 beds per 1,000 inhabitants
Arzneirückstände in der aquatischen UmweltRaw hospital waste water has a higher ecotoxicity potential compared to municipal waste water
Endpoints Raw municipal
waste water
Effluent of municipal
waste water treatment
plant
Raw hospital
waste water
Viability of cells
Estrogen effects (EE2 equivalent) 19.7 ng/L 43 ng/L
Mutagenic effects
Antibiotic effects
Dr. Nafo Folie 4
Antibiotic effects
Inhibition of bacteria
luminescence (concentration factor
EC50)
0.72 – 1.26 fold 33.85 fold 0.26 – 0.84 fold
Inhibition of algae photosynthesis
(concentration factor EC50) 12.07 fold 1.97 fold
Inhibition of algae growth rate 34 % 64-88 %
Mortality of scuds 100% 100% > 50%
no negative effects weak or moderate effects strong negative effects
Arzneirückstände in der aquatischen UmweltRaw hospital is a hot spot for antibiotic resistant bacteria
Dr. Nafo Folie 5
Antibiotic resistant bacteria in the investigated hospital waste water and municipal waste water
Arzneirückstände in der aquatischen UmweltRisk of spreading pathogens and antibioticresistant bacteria into receiving waters?
Municipal waste
water treatment plant
Household
Production
Dr. Nafo Folie 6
Hospital
River
Combined sewer
overflow
Arzneirückstände in der aquatischen Umwelt
Local aspects are important to decide on any treatment implemented
Dr. Nafo Folie 7
-CHEM Esch sur Alzette, Luxembourg -RVH Belfast, Northern Ireland
Arzneirückstände in der aquatischen Umwelt
Good effluent quality of MBR (COD, N, P)Efficient removal of some compoundsHalf of the analyzed compounds removed to < 50%
Clarithromycin
Sulfamethaxozole
Erythromycin
Diatrizoate
Iopamidol
Iopromide
Cyclosphosphamide
Ifosfamide
Dr. Nafo Folie 8
Diclofenac
Naproxen
Carbamazepine
Atenolol
Bezafibrate
Lidocaine
Ciprofloxacin
Clarithromycin
-100 -80 -60 -40 -20 0 20 40 60 80 100
Removal efficiency in MBR in %
Arzneirückstände in der aquatischen Umwelt
Efficient removal of resistantIntegrons by MBR
GAC
Dr. Nafo Folie 9
Arzneirückstände in der aquatischen Umwelt
Naproxen
Carbamazepine
Atenolol
Bezafibrate
Lidocaine
Ciprofloxacin
Clarithromycin
Sulfamethaxozole
Erythromycin
Diatrizoate
Iopamidol
Iopromide
Cyclosphosphamide
Ifosfamide
0.45 - 1.28 g Ozone/g DOC
Removal efficiencies of ozone and activated carbon are mostly similar
Dr. Nafo Folie 10
Diclofenac
Naproxen
0 10 20 30 40 50 60 70 80 90 100
Diclofenac
Naproxen
Carbamazepine
Bezafibrate
Atenolol
Lidocaine
Ciprofloxacin
Clarithromycin
Sulfamethaxozole
Erythromycin
Diatrizoate
Iopamidol
Iopromide
Cyclosphosphamide
Ifosfamide
0 10 20 30 40 50 60 70 80 90 100
Removal efficiency in %
fresh GAC or 20 - 23 mg PAC/ Litre
Arzneirückstände in der aquatischen Umwelt
Evidence of increased toxicity after ozonation,more research needed on this topic
Bioassays Endpoints Effluent of
MBR
MBR + O3 MBR + O3
+ SF
MBR +
PAC/SF
A-YES test (AQUA 1.0)Estrogenicity (EE2
equivalent)0.235 ng/L 0.261 ng/L 0.176 ng/L 0.079 ng/L
Ames test (Salmonella
thyphimurium, strain YG7108)
Mutagenicity (No. of histidine
revertants)↑ ↘
Dr. Nafo Folie 11
Bacteria test (Vibrio fischeri)Inhibition of luminescence
(concentration factor EC50)↓ ↓ ↘ ↓
Algae growth test (72hr)
growth rate inhibition,
average for dilutions 80%
and 50% wastewater
↓ ↗
no negative effects weak or moderate effects strong negative effects
Arzneirückstände in der aquatischen Umwelt
Life Cycle Assessment methodologies have beenmuch improved
-Impact of pharmaceuticals is negligible using current data
-Ozone and activated carbon better than UV (1,2,3)
-Upgraded WWTPs better
-0,01
0
0,01
0,02
0,03
0,04
O3min AC O3min-AC
EF
I (m
PE
)
0,03
0,04
EF
I (m
PE
)
0
0,04
0,08
0,12
0,16
CC UC CC-UC
EF
I (m
PE
)
0,1
0,15
EF
I (m
PE
)
1 4
Comparison of Eco-Efficiency Indicators (EFI)
Dr. Nafo Folie 12
-Upgraded WWTPs better than conventional WWTPs (4)
-Upgraded WWTPs better than treatment at hospital (5)
-But treatment at hospital versus WWTP inconclusive (6)
0
0,01
0,02
O3max AC O3max-AC
EF
I (m
PE
)
-0,01
0
0,01
0,02
0,03
0,04
0,05
O3max UVmin O3max-UVmin
EF
I (m
PE
)
-0,05
0
0,05
0,1
0,15
CC C+Dmin CC-(C+Dmin)
EF
I (m
PE
)
-0,1
-0,05
0
0,05
UC C+Dmin UC-(C+Dmin)
EF
I (m
PE
)
2
3 6
5
Arzneirückstände in der aquatischen UmweltDifferent requirement for a hospital plant: Odourand noise protection incur high energy consumption and large costs
Dr. Nafo Folie 13
Exhaust air
treatment
Exhaust air
collection
system
Arzneirückstände in der aquatischen Umwelt
Energy consumption can vary significantly
AC
UV
Air treatment **
Dr. Nafo Folie 14
* Including all components except the advanced treatment processes and air treatment** max value: exhaust air treatment by Photoionisation incl. air collection system and heating
0 0,5 1 1,5 2 2,5
MBR*
O3
Kwh/m³
Arzneirückstände in der aquatischen Umwelt
Costs are dominated by components which arenecessary for the biological treatment
Variable costs
MBR*
+GAC
+O3
+UV/H2O2
Dr. Nafo Folie 15
0 0,5 1 1,5 2 2,5 3 3,5 4
Investment costs
€/m³
* Including all components except the advanced treatment processes
Arzneirückstände in der aquatischen Umwelt
0,25
0,5
0,75
1
Risks for the environment
Risks of spreading antibiotic resistant
bacteria
Environmental impacts waste
Operation experiences and
Local aspects
Aspects of the topics of PILLS
Dr. Nafo Folie 16
0 impacts waste water treatment
Efficiency of the waste water
treatment process
Energy consumption of the
waste water treatment process
Costs of waste water treatment
process
experiences and responsibilities
Arzneirückstände in der aquatischen Umwelt
Reducing load of pharmaceuticals
Spreading of antibiotic Resistant Bacteria
Improvement pharmaceutical removal
Investigation necessity
Improving footprint of treatment plant
Future Work and Research Needs
Dr. Nafo Folie 17
pharmaceutical removal technologies
Reducing energy consumption
Eliminating uncertainties in LCA
Reducing costs
Investigation necessity of air treatment
Arzneirückstände in der aquatischen Umwelt
Thank to all the supporters of the PILLS project
www.pills-project.eu
Dr. Jochen Stemplewski and Dr. Emanuel Grün, Kirsten Adamczak, Can Aksüt, Klaus Baumers, Eva Böhling, Carsten Bräuer, Bernhard Hehn, Dirk Hellmich, Eberhard
Holtmeier, Till Möller, Issa Nafo, Ekkehard Pfeiffer, Ulrike Raasch, Prof. Burkhard Teichgräber, Michael Walkstein, Ingo Werner, Daniel Wischniewski, Peter Weingarten and
Frank Netz (Marienhospital Gelsenkirchen) Herr Lange, Regina Di Febo, Julianne Joseph (Municipality of Gelsenkirchen, Referat Umwelt), Jörg Alda, Dietmar Loch, Andreas
Schiffers (Tutthas & Meyer Ingenieurgesellschaft mbH), Christian Högel, Susanne Zander-Hauck, Harald Jakobs, Hans-Dietrich Eschke, Joanna Will (joint laboratory of
Ruhrverband, Emschergenossenschaft and Lippeverband), Monika Hammers-Wirtz (gaiac at the RWTH Aachen University), Axel Magdeburg (BiK Frankfurt), Jochen Türk (IUTA
Duisburg), Prof. Elke Dopp, Jessica Richard (IWW Mülheim), Herman Evenblij, Hans Huijsman, Dirk Kievit, Jan Luijten, Warry Meuleman, Arjan de Mink, Mirabella Mulder
(Mirabella Mulder Waste Water Management), Karl Borger (Vitens), Martijn Tas (Vitens), Jacques van Paassen (Vitens), Evert-Jan van den Brandhof (RIVM), Wilko Verweij
(RIVM), Marja Woutersen (RIVM), Erik Steenbergen (RIVM), Nico Wortel (Pharmafilter) and the Isala Clinics, Waterboard Groot Salland, Innovatieprogramma KRW, Province
Dr. Nafo Folie 18
Overijssel, the Municipality Zwolle, Vitens, STOWA., Alain Arend, Martina Arenz, Emmanuel Becker, Enrico Benetto, Alex Cornelissen, Melanie Guiton, Elorri Igos, Collins Jury,
Kai Klepiszewski, Guy Kneip, Christian Köhler, Oliver O’Nagy, Paul Schosseler, Silvia Venditti, Ministry of higher Education and Research, Daniel Cardao, Henri Hinterscheid,
Marcel Klesen, André Weidenhaupt, Jean-Paul Lickes, Luc Zwank, Prof. Johannes Pinnekamp, Silvio Beier, Christopher Keysers, David Montag
Silvio Canonica, Andreas Eggmann (Hospital Baden), Jack Eugster, Cornelia Kienle (Ecotox Center, Eawag/EPFL), Lubomira Kovalova, Judit Lienert, Christa S. McArdell,
Ruedi Moser (Hunziker Betatech AG), Michael Schärer (FOEN), Hansruedi Siegrist, Michael Thomann (Holinger AG, Liestal), Urs von Gunten, Heinz Wernli (Hospital Baden),
Federal Office for the Environment, Swiss State Secretariat for Education and Research (SER)/COST Cantons AG, BE, BL, GE, SG, SH, SO, SZ, TG, VD, ZH; Prof. A. Reller,
University of Augsburg, Kantonsspital Baden, Federal Office for Spatial Development (ARE), Colin Dalglish, Karin Helwig, Colin Andrew Hunter, JiaQian Jiang, John
MacLachlan, Moyra McNaughtan, Ole Pahl, Joanne Roberts, Dainis Sudmalis, Zhengwei Zhou, Bill Dickie, Bill Glass, Philip Grieve, Hugh Hamill, Victoria Hepworth, Jed Mather,
Kevin Milne, Jenny Webb, Mark Heggie, Andrew Rawlins, Ian Ridgway, Ashley Roberts, Scottish Water, Ken Allinson, Brian Ellor, Mark Haffey, Archie Johnston, Harry Keddie,
Willie Lindsay, George O’Sullivan, Stuart Pheasant, Adam Zyndul, Olivier Barraud, Magali Casellas, Christophe Dagot, Corinne Maftah, Marie-Cécile Ploy, Thibault Stalder,
Dupuytren Hospital, the city of Limoges, Joint Technical Secretariat of the NWE Interreg programme: Daniel von Hugo, Isabelle Lecroart , Scientific Board members: Florian
Keil, Thomas Schwartz (KIT Karlsruhe), Thomas Steger-Hartmann (Bayer Health Care) and Pim de Voogt (IBED University of Amsterdam).
… and you for your attention!
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