How to Deal with Pharmaceuticals in Wastewater for Reuse?

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Water reuse for different purposes is aligned with good water practices, especially in the case of water intensive sectors, such as agriculture and the industry.

Water reuse for different purposes is aligned with good water practices, especially in the case of water intensive sectors, such as agriculture and the industry. Nonetheless, the presence of newly emerged contaminants inserts the need for more strict water treatment to protect the quality of the water being used in these sectors. 

These “Contaminants of Emerging Concern” (CECs) pose an unbearable burden on our conventional water treatment systems, which are now considered inefficient in removing these novel pollutants. The situation rings an alert signal for us to start moving towards new water treatment technologies capable of preventing irreversible damages in the environment and quite possibly in future human health.  

Pharmaceuticals and their increased use in a world with increasing population is a good example of CECs.   

Pharmaceuticals and the Environment 

CECs possess physicochemical properties that allow them, their parent compounds, or their degraded derivatives to persist in the environment for some time, depending on their biodegradability[1]. For this reason, addressing these contaminants as special substances is vital to remove them from effluents. The good news is, we already have the means to face the challenge and protect our freshwater sources. 

Some studies targeting the effects of pharmaceuticals on the environment, have reached interesting results. Substances such as Carbamazepine, Valporic acid, Pheytoin, Diazepan, and Lamotrigine in agriculture irrigation water were found to induce accumulation of stress-related proteins in plants’ leaves and roots tissues, to avoid metabolic modifications and restore homeostasis[2].  

How Do Pharmaceuticals Enter Water Bodies? 

Unimaginable amounts of pharmaceuticals enter the environment each year. Around 836 ton of acetylsalicylic acid, 622 ton of paracetamol, 517 ton of metformin, 345 ton of ibuprofen, 88 ton of carbamazepine were found in Germany’s water bodies, and about 35 ton of naproxen was observed in England’s in 2001[3]. Some like acetylsalicylic acid, and diclofenac were found at concentrations of 0.22 and 3.02 mg/L respectively in Germany, Canada, Brazil, Greece and France water bodies[4]. These figures are only a starting point to illustrate what the current situation could be nowadays. 

These drugs are not always completely metabolized, and their residues are excreted through defecation or urinary systems of humans and animals, as unchanged form and at significant concentration levels. This is indeed one of their ways to enter water bodies, but they also come from poorly treated or untreated wastewater effluents by domestic treatment plants, pharma industries, hospitals and agricultural runoff[3], like shown in Figure 1. 

Figure 1 Fate and transport of pharmaceuticals in the environment (adapted from [5])
Figure 1 Fate and transport of pharmaceuticals in the environment (adapted from [5])

As seen, pharmaceuticals can easily enter our water bodies. Even by inappropriate disposal practices, such as flushing unwanted drugs down toilets and sinks, and discarding them into household waste[5]. This points to us also being able to play our role by thinking twice before getting rid of them and instead disposing them in a safe way. 

Pharmaceuticals In Water and Human Risks 

Table 1 shows some CECs, their application and their possible consequences in human health with as their concentration increase in water bodies. 

Table 1 Some of the most common medicines present in wastewater bodies. Adapted from [1]
Table 1 Some of the most common medicines present in wastewater bodies. Adapted from [1]

Some studies report the incidence of mental retardation, physical abnormalities, cancers and reproductive problems as consequences to human health. It has also been found to lower agricultural productivity as well as livestock and fish death[3]. However, it seems like there is still time to get hands on the problem before it reaches a point of irreversible consequences.  

Studies executed by the World Human Organization (WHO) in Australia, the US, and UK concluded that the presence of pharmaceuticals in water do not represent a threat to human health yet The concentrations at which pharmaceuticals were found in the studied water bodies are 1000 times below the minimum therapeutic dose[5]Also, drinking water production plants in developed countries, such as Belgium, use multiple barriers to remove pharmaceuticals and trace contaminants to acceptable levels for human consumption. In such countries, tap water is safe for human consumption. Technological advances through innovation and adopting a multi-barrier approach even enable us to treat toilet wateralong with the excreted micro pollutants such as pharmaceuticalsup to drinking water quality. 

How Can We Remove Pharmaceuticals From Wastewater? 

Fortunately, both technology and nature offer us different ways to start treating our effluents and secure a future CECs-free water supply system.  

Nature provides us with wetlands as a potential solution to remove pharmaceuticals from wastewater. Executed research proves that constructed wetlands are capable of removing certain compounds in a range from 21% to around 93% efficiency depending on the substance, and they perform the removal by mechanisms of photolysis, plant uptake, microbial degradation and sorption to the soil[6]. 

On the flip side, advanced wastewater treatment processes are also capable of removing these substances from our effluents. Methods such as ozonation, UV radiation, activated carbon and reverse osmosis, among others shown in Table 2 are designed to ensure a safe effluent disposal in order to keep our water sources CECs-free.   

Table 2 Advanced wastewater treatments methods and their range of substance removal efficiency. Adapted from [5]
Table 2 Advanced wastewater treatments methods and their range of substance removal efficiency. Adapted from [5]

Water Experts and BOSAQ count on advanced knowledge and technology to remove pharmaceuticals from wastewater, and help hospitals, the pharma industry and wastewater treatment plants to ensure a proper and CECs-free disposal of wastewater. We invite you to be part of the movement and keep our natural water sources with low CECs levels and ensure a safe water supply to future generations. 


[1] C. Ferreiro et al., ‘Contaminants of Emerging Concern Removal in an Effluent of Wastewater Treatment Plant under Biological and Continuous Mode Ultrafiltration Treatment’, Sustainability, vol. 12, no. 2, Art. no. 2, Jan. 2020, doi: 10.3390/su12020725. 

[2] R. Gorovits, I. Sobol, K. Akama, B. Chefetz, and H. Czosnek, ‘Pharmaceuticals in treated wastewater induce a stress response in tomato plants’, Sci. Rep., vol. 10, no. 1, Art. no. 1, Feb. 2020, doi: 10.1038/s41598-020-58776-z. 

[3] V. Chander et al., ‘Pharmaceutical Compounds in Drinking Water’, J. Xenobiotics, vol. 6, no. 1, Jun. 2016, doi: 10.4081/xeno.2016.5774. 

[4] J. F. Narvaez V. and C. Jimenez C., ‘PHARMACEUTICAL PRODUCTS IN THE ENVIRONMENT: SOURCES, EFFECTS AND RISKS’, Vitae, vol. 19, no. 1, pp. 93–108, Apr. 2012, Accessed: Feb. 05, 2021. [Online]. Available: 

[5] World Health Organization, ‘Pharmaceuticals in drinking water’, World Health Organization, France, 2012. Accessed: Feb. 05, 2021. [Online]. Available: 

[6] H. Ilyas, I. Masih, and E. D. van Hullebusch, ‘Pharmaceuticals’ removal by constructed wetlands: a critical evaluation and meta-analysis on performance, risk reduction, and role of physicochemical properties on removal mechanisms’, J. Water Health, vol. 18, no. 3, pp. 253–291, Mar. 2020, doi: 10.2166/wh.2020.213. 

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