Hospital-associated effluents: the masked environmental threat that needs urgent attention and action

Emerging contaminants (ECs) are contained in hospital wastewater (HWW), including pharmaceutical active compounds, personal care products, endocrine-disrupting compounds, and hormones. Antibiotics, X-ray contrast agents, disinfectants, and pharmaceuticals are examples of problematic compounds found in hospital wastewater. Many of these chemical compounds are resistant to standard wastewater treatment systems. If not treated properly, these contaminants might enter natural aquatic and terrestrial ecosystems, consequently jeopardizing the environment and human health. Regular wastewater treatment facilities are not intended to treat all chemicals and biological pollutants; thus, these toxic substances can be released into aquatic environments. Therefore, suitable processes and innovative technologies should be employed to avoid the release of ECs into aquatic habitats. Though for wastewater treatment, the required rules and legislation are available, efficiently removing ECs from HWW necessitates the usage of sophisticated and novel treatment knowledge. This review summarizes a compilation of the types of contaminants released from healthcare facilities, national and international guidelines, and HWW management, and provides a comprehensive understanding of traditional and contemporary strategies for efficiently managing HWW. A critical assessment of the present breakthroughs, gaps in understanding, and future research goals is also provided.