With the growth in production and use of chemicals and the fact that many end up in the aquatic environment, there is an increasing need for advanced water treatment technologies that can remove chemicals of emerging concern (CECs) from water. The current lack of a homogenous approach for testing advanced water treatment technologies hampers the interpretation and evaluation of CEC removal efficiency data, and hinders informed decision making by stakeholders with regard to which treatment technology could satisfy their specific needs. Here a data evaluation framework is proposed to improve the use of current knowledge in the field of advanced water treatment technologies for drinking water and wastewater, consisting of a set of 9 relevance criteria and 51 reliability criteria. The two criteria sets underpin a thorough, unbiased and standardised method to select studies to evaluate and compare CEC removal efficiency of advanced water treatment technologies in a scientifically sound way. The relevance criteria set was applied to 244 papers on removal efficiency, of which only 20% fulfilled the criteria. The reliability criteria were applied to the remaining papers. In general these criteria were fulfilled with regards to information on the target compound, the water matrix and the treatment process conditions. However, there was a lack of information on data interpretation and statistics. In conclusion, a minority of the evaluated papers are suited for comparison across techniques, compounds and water matrixes. There is a clear need for more uniform reporting of water treatment studies for CEC removal. In the future this will benefit the selection of appropriate technologies.

Little is known about the significance of hospitals as point sources for emission of organic micropollutants into the aquatic environment. A mass flow analysis of pharmaceuticals and diagnostics used in hospitals was performed on the site of a representative Swiss cantonal hospital. Specifically, we analyzed the consumption of iodinated X-ray contrast media (ICM) and cytostatics in their corresponding medical applications of radiology and oncology, respectively, and their discharge into hospital wastewater and eventually into the wastewater of the municipal wastewater treatment plant. Emission levels within one day and over several days were found to correlate with the pharmacokinetic excretion pattern and the consumed amounts in the hospital during these days. ICM total emissions vary substantially from day to day from 255 to 1259 g/d, with a maximum on the day when the highest radiology treatment occurred. Parent cytostatic compounds reach maximal emissions of 8-10 mg/d. A total of 1.1%, 1.4%, and 3.7% of the excreted amounts of the cytostatics 5-fluorouracil, gemcitabine, and 2′,2′-difluorodeoxyuridine (main metabolite of gemcitabine), respectively, were found in the hospital wastewater, whereas 49% of the total ICM was detected, showing a high variability among the compounds. These recoveries can essentially be explained by the high amount administered to out-patients (70% for cytostatics and 50% for ICM); therefore, only part of this dose is expected to be excreted on-site. In addition, this study emphasizes critical issues to consider when sampling in hospital sewer systems. Flow proportional sampling over a longer period is crucial to compute robust hospital mass flows.