Hospital wastewater is water generated during the activities of a hospital. It possesses
characteristic physical, chemical, and biological properties. Elevated concentrations of
pharmaceuticals, excreted by patients during treatment (antibiotics, anticonvulsants,
antineoplastic agents, hormones, lipid regulators, non-steroidal anti-inflammatory
drugs, psychotherapeutics, and others), are found in these waters. These compounds can
be present in wastewater either as original substances or as metabolites. When
introduced into the environment, these compounds, even in small concentrations, can
have a long-term impact on organisms and pose a potential hazard. The World Health
Organization recommends treating hospital wastewater at its source, and the European
Union prescribes a Watch List of substances whose presence in surface waters member
states should verify. In Slovenia, legislation mandates regular operational monitoring of
industrial wastewater generated by hospitals, but the presence of pharmaceuticals is not
assessed. A review of operational monitoring reveals discrepancies among Slovenian
hospitals regarding which wastewater they classify as industrial. Wastewaters subject to
operational monitoring vary between hospitals. Sanitary wastewater, despite the
presence of pharmaceuticals excreted by patients, is often excluded from monitoring.
Based on the examination of operational monitoring in Slovenian hospitals, we propose
several changes to Slovenian legislation: include the measurement of various
pharmaceutical quantities in operational monitoring, provide a more precise definition
of what constitutes industrial wastewater in hospitals, and change legislation to require
the mandatory treatment of hospital wastewater at the source, thereby reducing the
environmental risk posed by such waters.
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