Hospital wastewater in Iran: a systematic review and challenges for proper management during coronavirus disease (۲۰۱۹) pandemic

Healthcare facilities are vital establishments to improve the public health, but with poor waste and wastewater management, may turn into a potential health risk. The fecal-oraltransmission potential of SARS-CoV-۲ and the role of the wastewater as a potential sourceof infection, more than ever highlights the importance of proper wastewater managementduring the COVID-۱۹ pandemic. This systematic review represents a picture of the currentstate of hospital wastewater (HWW) management in Iran; an upper-middle income countrywith a paucity of proper data concerning HWW management and further provides suggestions for hospital wastewater management during COVID-۱۹ pandemic in the country. We reviewed ۳۱ papers that published from ۲۰۰۵-۲۰۲۰ evaluated ۱۶۳ hospitals from ۸۲ cities and ۱۷ provinces. HWW generation in Iran varies from ۳۵۴ to ۱۸۹۲ liter per bed per day (۸۳۹±۳۶۳ L/bed/d). BOD, COD and TSS in the raw HWW were in the range of ۱۱۹-۱۲۷۰, ۲۰۵-۱۶۱۱ and ۵۸-۴۶۴ mg/L, respectively. Total coliforms and/or total fecal coliforms were in the range of ۱۰۵-۱۰۸ (MPN/۱۰۰ mL). ۴۴.۲ % of hospitals had an active WWTP at the time of the study from which, only ۱۵.۳ % complied with discharge standards. More than ۵۵ % of the hospitals in Iran use no disinfection, and less than ۷ % comply with the discharge requirements. HWW management in Iran is very poor and there has been no improvement in HWW management within the last decade. To best respond to this pandemic, responsible authorities should address wastewater management in hospitals.

کلیدواژه ها:

Medical wastewater ، Healthcare wastewater ، SARS-CoV-۲ ، Activated sludge ، Chlorination