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WATER MANAGEMENT JAKOB SØHOLM – SEGMENT DIRECTOR, GRUNDFOS BIOBOOSTER A/S, DENMARK


Improving management of hospital waste water


Jakob Søholm discusses the importance of improving sustainability in hospital waste water management and offers an insight into a pioneering project in Denmark.


Worldwide, there is growing recognition of the threat of micro pollutants such as bacteria, viruses, hormones and Active Pharmaceutical Ingredients (APIs) in the wider environment, as these are difficult to remove by conventional waste water treatments.


A pioneering project in Denmark is leading the way for a better approach to hospital waste water treatment that can deal effectively with some of the most challenging and hazardous pollutants in waste water and increase sustainability in hospital waste water management.


Hospital waste water poses a risk Hospital waste water contains a complex mixture of hazardous pharmaceuticals, harmful pathogens and antibiotic resistant bacteria (see Table 1). Municipal sewage treatment plants are not designed to deal with pharmaceutical products and antibiotic resistant bacteria mainly excreted from patients. Consequently, these substances are now being detected in waterways. Even at very low concentrations these


can affect animal life. Oestrogens, for example, can cause hermaphroditic fish, while some painkillers are poisonous to trout, and certain psycho-pharmaceuticals can affect fish and animal behaviour. Importantly, it also poses a direct


threat to the public when exposed to raw sewage, as a consequence of heavy rain and overflow events, as well as for those working in the sewers and at the waste water treatment plants. In particular, antibiotic resistant


Top view of the Herlev Hospital and the waste water treatment plant


bacteria pose an increasing threat to public health as high usage of antibiotics automatically leads to formation of resistant bacteria, which ends up in the waste water. The hospitals often turn out to be significant sources of use of antibiotics and hazardous pharmaceuticals which ends up in the waste water. For example, in Copenhagen, Denmark, the usage of the four biggest hospitals and a new greenfield hospital under construction has been mapped, which shows that these hospitals contribute up to 79% of the antibiotics usage in their respective catchment areas and hundreds of kilograms of hazardous pharmaceuticals (see Table 2).


Jakob Søholm


Jakob Søholm is an experienced Segment Director, working with new business development and sales within membrane-based waste water and re-use solutions for the public sector. Jakob believes that decentralised treatment of waste water at large points sources like hospitals, is the best solution from both an economical and sustainability point of view. Jakob has been


overall responsible for securing and executing the largest Public Private Innovation project with the capital region of Copenhagen covering the development of a full-scale wastewater treatment plant for removal of pharmaceuticals and bacteria at Herlev Hospital.


IFHE DIGEST 2020


Looking for solutions Since 2013, the authorities have started to include requirements relating to hazardous pharmaceuticals and bacteria in Danish hospital waste water discharge permits.


Danish municipalities (which regulate hospital discharge permits in Denmark) have developed methods to rank hospitals according to their importance as sources, so that the regulatory focus is on the most significant. Only the major sources are required to install their own waste water treatment plant. The ranking system takes into account both the total consumption of hazardous pharmaceuticals, as well as the hospital’s antibiotics consumption compared to the consumption in the rest of the catchment area.


The Herlev innovation project The capital region of Copenhagen and Grundfos, a private technology company, signed a public-private innovation agreement in 2012, with the aim to develop and demonstrate a technological solution to this problem in full scale at the Herlev Hospital and set the standard for future regulation of hospital waste water in Denmark (potentially in other countries as well).


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