Research progress of occurrence,characteristics and fate of emerging contaminants in medical wastewater

doi:10.19965/j.cnki.iwt.2023-0770

Abstract

Abstract:

The issues of environment and health caused by emerging contaminants have become a worldwide focus. The sewage discharged from medical institutions is one of the important sources of emerging contaminants in the environment. During the current period of normalization of key infectious disease prevention and control, the concentration of emerging contaminants in medical wastewater has significantly increased, along with an increase of potential hazards to aquatic ecology. In response to such phenomena, the category and concentration of antibiotics,endocrine disrupting chemicals, and potential emerging contaminants in medical wastewater were discussed. The fate, removal rate, and contribution of emerging contaminants in medical wastewater to the environment was explored. Further the single compound toxicity and comprehensive toxicity of emerging contaminants in medical wastewater was elaborated. Finally, the current sewage discharge standards for medical institutions in China failure to control emerging contaminants was point out, the traditional sewage treatment processes were hard to effectively remove of emerging contaminants. Therefore, it was imperative to develop advanced techniques for standardized and tertiary treatment of medical wastewater.

Key words: medical wastewater, emerging contaminants, environmental contribution, environmental fate, environmental toxicity

摘要：

由新污染物引发的环境健康问题已成为全球的关注热点，医疗机构排放的污水是环境中新污染物的重要来源之一，针对当前重点传染病防控常态化时期医疗污水中新污染物浓度大幅提升、对自然水体及生态环境潜在危害增大等现象，综述了医疗污水中包含的抗生素、内分泌干扰素、潜在新污染物的种类和浓度，探讨了医疗污水中新污染物在环境中的去向、去除率及环境贡献量，进一步阐述了医疗污水中新污染物的单一化合物毒性及综合毒性，指出我国现有医疗机构污水排放标准未针对新污染物进行管控，而传统的污水处理工艺难以实现对新污染物的有效去除，针对医疗污水的规范化处理与深度处理新技术的研发势在必行。

关键词: 医疗污水, 新污染物, 环境贡献量, 环境归趋, 环境毒性

CLC Number:

X703

Kexin CHEN, Lingyun GU, Chunxiu YU, Zhaokun XIONG, Xuejie WANG, Fang LIU, Yi WU, Bo LAI. Research progress of occurrence,characteristics and fate of emerging contaminants in medical wastewater[J]. Industrial Water Treatment, 2024, 44(8): 1-12.

陈可欣, 辜凌云, 余春秀, 熊兆锟, 王学杰, 刘方, 吴怡, 赖波. 医疗污水中新污染物特征与环境归趋研究进展[J]. 工业水处理, 2024, 44(8): 1-12.

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URL: https://www.iwt.cn/EN/10.19965/j.cnki.iwt.2023-0770

https://www.iwt.cn/EN/Y2024/V44/I8/1

Figures/Tables 8

References 71

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药物种类		瑞士	哥伦比亚	挪威	西班牙	土耳其
镇痛剂/非甾体抗炎药	双氯芬酸	0.585±0.186	0.04	0.238~14.934	0.17~0.46	0.024~0.924
	吲哚美辛	0.064±0.080	NA	NA	0.31~4.1	NA
	甲芬那酸	0.491±0.142	NA	NA	0.1~0.5	NA
	安替比林	0.418±0.259	NA	NA	<LOD	NA
	萘普生	NA	NA	NA	0.34~3.2	0.168~3.247
	布洛芬	NA	NA	0.069~8.957	0.38~2.5	NA
	扑热息痛	NA	293.8	5.421~1 368.474	3.3~5.9	0.96~74.3
抗癫痫/精神类药	卡马西平	0.235±0.128	1.9	NA	0.64~1.2	0.002~5.351
	文拉法辛	0.681±0.275	0.0015	NA	NA	NA
	扑米酮	0.601±0.697	NA	NA	NA	NA
	加巴喷丁	14.9±18.7	NA	NA	NA	NA
	左乙拉西坦	0.551±0.345	NA	NA	NA	NA
	奥西泮	1.06±0.34	NA	NA	NA	NA
β受体阻滞剂	阿替洛尔	0.023±0.024	NA	NA	2.2~6.2	NA
	美托洛尔	0.596±0.227	NA	0.419~25.097	0.51~0.99	NA
	普萘洛尔	0.139±0.067	NA	NA	<LOD~0.094	NA
	索他洛尔	0.574±0.467	NA	NA	0.35~5.9	NA
利尿剂	呋塞米	2.46±0.75	NA	NA	6.4~18	NA
利尿剂	氢氯噻嗪	1.84±0.52	NA	NA	0.54~2.1	NA
抗癌类药	环磷酰胺	0.185±0.064	NA	<0.002~0.021	NA	0.484~4.607
抗癌类药	异环磷酰胺	<LOQ~0.600	NA	<0.002~0.338	NA	NA
抗病毒药	奥司他韦	0.036±0.045	NA	NA	NA	NA
抗病毒药	利托那韦	0.024±0.021	NA	NA	NA	NA
H2受体拮抗剂	雷尼替丁	0.454±0.247	NA	NA	0.24~2.2	NA
	缬沙坦	0.455±0.202	17.7	NA	NA	NA
	伊贝沙坦	NA	0.05	NA	NA	NA
参考文献		〔19〕	〔18〕	〔9〕	〔8〕	〔32〕
报道年份		2013	2019	2007	2012	2016

药物种类		瑞士	哥伦比亚	挪威	西班牙	土耳其
镇痛剂/非甾体抗炎药	双氯芬酸	0.585±0.186	0.04	0.238~14.934	0.17~0.46	0.024~0.924
	吲哚美辛	0.064±0.080	NA	NA	0.31~4.1	NA
	甲芬那酸	0.491±0.142	NA	NA	0.1~0.5	NA
	安替比林	0.418±0.259	NA	NA	<LOD	NA
	萘普生	NA	NA	NA	0.34~3.2	0.168~3.247
	布洛芬	NA	NA	0.069~8.957	0.38~2.5	NA
	扑热息痛	NA	293.8	5.421~1 368.474	3.3~5.9	0.96~74.3
抗癫痫/精神类药	卡马西平	0.235±0.128	1.9	NA	0.64~1.2	0.002~5.351
	文拉法辛	0.681±0.275	0.0015	NA	NA	NA
	扑米酮	0.601±0.697	NA	NA	NA	NA
	加巴喷丁	14.9±18.7	NA	NA	NA	NA
	左乙拉西坦	0.551±0.345	NA	NA	NA	NA
	奥西泮	1.06±0.34	NA	NA	NA	NA
β受体阻滞剂	阿替洛尔	0.023±0.024	NA	NA	2.2~6.2	NA
	美托洛尔	0.596±0.227	NA	0.419~25.097	0.51~0.99	NA
	普萘洛尔	0.139±0.067	NA	NA	<LOD~0.094	NA
	索他洛尔	0.574±0.467	NA	NA	0.35~5.9	NA
利尿剂	呋塞米	2.46±0.75	NA	NA	6.4~18	NA
利尿剂	氢氯噻嗪	1.84±0.52	NA	NA	0.54~2.1	NA
抗癌类药	环磷酰胺	0.185±0.064	NA	<0.002~0.021	NA	0.484~4.607
抗癌类药	异环磷酰胺	<LOQ~0.600	NA	<0.002~0.338	NA	NA
抗病毒药	奥司他韦	0.036±0.045	NA	NA	NA	NA
抗病毒药	利托那韦	0.024±0.021	NA	NA	NA	NA
H2受体拮抗剂	雷尼替丁	0.454±0.247	NA	NA	0.24~2.2	NA
	缬沙坦	0.455±0.202	17.7	NA	NA	NA
	伊贝沙坦	NA	0.05	NA	NA	NA
参考文献		〔19〕	〔18〕	〔9〕	〔8〕	〔32〕
报道年份		2013	2019	2007	2012	2016

ICM种类	类型	比利时	瑞士	西班牙	日本	土耳其
泛影酸	离子型	814±28	366±259	NA	NA	51.7±44.1
碘美普尔	非离子型	NA	430±466	424~2 093	8.662~14.657	6.1±15.4
碘帕醇	非离子型	NA	3 353±5 993	NA	14.066~26.336	13.9±22.8
碘普罗胺	非离子型	NA	118±108	NA	ND~0.272	797±939
碘羟拉酸	离子型	NA	342±204	NA	NA	NA
碘海醇	非离子型	NA	NA	NA	0.578~3.018	299±361
碘氟醇	非离子型	NA	NA	NA	ND~0.023	121±129
参考文献	—	〔37〕	〔19〕	〔38〕	〔39〕	〔40〕
报道年份	—	2011	2013	2015	2019	2021

ICM种类	类型	比利时	瑞士	西班牙	日本	土耳其
泛影酸	离子型	814±28	366±259	NA	NA	51.7±44.1
碘美普尔	非离子型	NA	430±466	424~2 093	8.662~14.657	6.1±15.4
碘帕醇	非离子型	NA	3 353±5 993	NA	14.066~26.336	13.9±22.8
碘普罗胺	非离子型	NA	118±108	NA	ND~0.272	797±939
碘羟拉酸	离子型	NA	342±204	NA	NA	NA
碘海醇	非离子型	NA	NA	NA	0.578~3.018	299±361
碘氟醇	非离子型	NA	NA	NA	ND~0.023	121±129
参考文献	—	〔37〕	〔19〕	〔38〕	〔39〕	〔40〕
报道年份	—	2011	2013	2015	2019	2021

药物种类	平均治疗剂量/（mg·d^-1）	城市污水中质量浓度/（ng·L^-1）		预计地表水质量浓度/（ng·L^-1）
药物种类	平均治疗剂量/（mg·d^-1）	母体	代谢物	预计地表水质量浓度/（ng·L^-1）
法匹拉韦	1 600	64	4 248	423.3
洛匹那韦	800	880	2 840	73.1
利巴韦林	2 473	2 102	5 440	740
瑞德西韦	110	430	2 120	55
氯喹	NA	857	NA	32
羟氯喹	NA	833	NA	78.3

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