Screening, prioritization, and identification of key toxic substances in hospital wastewater

• Published in: Journal of hazardous materials Vol. 496; p. 139352
• Main Authors: Niu, Jiangqi, Ma, Chunmeng, Li, Xue, Dong, Qian, Liu, Yan, Wang, Hui
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.09.2025
• Subjects: Hospital wastewater; Identification; Key toxic substances; Non-target screening; Prioritization; Prioritization; Identification; Non-target screening; Hospital wastewater; Key toxic substances
• ISSN: 0304-3894; 1873-3336; 1873-3336
• DOI: 10.1016/j.jhazmat.2025.139352

Hospital wastewater (HWW) is a significant source of pollutants in aquatic environments and potentially toxic to ecosystems. To provide a scientific basis for the effective management and pollution control of HWW, this study selected a special psychiatric hospital (Hospital 1) and a medium general hospital (Hospital 2) on the basis of previous research, both with high environmental risk (mixed risk quotient values of effluent wastewater exceeding 1), as the subjects. Using ultraperformance liquid chromatography quadrupole time-flight mass spectrometry (UPLC-QTOF-MS), a total of 126 and 301 suspected substances were identified in wastewater effluent from Hospital 1 and Hospital 2, respectively, with 141 substances listed in existing regulatory frameworks. Through a multi-criteria evaluation (weighted by exposure, persistence, and toxicity), 32 key substances were prioritized for quantitative analysis via ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Results revealed 27 substances across 12 categories, with concentration ranges of 0.0013 (spirapril) ∼ 2.49 μg/L (carbamazepine) (Hospital 1) and 0.0025 (citalopram) ∼ 13.09 μg/L (iomeprol) (Hospital 2). Hospital 2 exhibited greater substance diversity and higher concentrations. The identification of key toxic substances revealed significant differences in the toxicity contribution categories between the two types of HWW. In Hospital 1, psychiatric drugs (PDs) accounted for up to 97 % of the toxicity in wastewater (0.029 ∼ 2.5 μg/L), while Hospital 2 showed significant contributions from antibiotics (54.79 %, 0.0097 ∼ 3.3 μg/L) and PDs (44.68 %, 0.025 ∼ 0.31 μg/L). Additionally, six key toxic substances were identified in wastewater from both hospitals. It is recommended that hospitals prioritize the control of these substances to mitigate their potential impacts on the environment and ecosystems. [Display omitted] •The UPLC-QTOF-MS analysis identified 427 suspected substances in hospital wastewater.•A multi-criteria evaluation prioritized key substances in hospital wastewater.•Substance concentrations in general hospital wastewater were higher (19.64 µg/L).•Six key substances were identified as the primary contributors of toxicity.