Over the last few decades, the occurrence of pharmaceutical products (PPs)in the environment has become a worldwide issue of increasing environmental concern. They are of particular interest since some of these substances are produced and used in large quantities, and many of them may end up in the aquatic environment, where there are persistent or pseudo-persistent1, 2 and toxic to non-target organisms. They also have the potential for bioaccumulation in organisms of different trophic levels, becoming an important threat to wildlife and by the way a spelling trouble for drinking water industry.
Sources and pathways have been well identified: metabolic excretion from patient (wastewater and hospital effluents, septic tanks), industrial activity (industrial wastewater and waste), livestock activities (waste lagoons, manure application to soil), as well as indirectly by improper disposal, untreated sewage.
Risk assessment, for both animal and human is not yet conclusive (except for some substances) leading difficult for decision maker to build an adapted regulation. In spite of this lack, lot of projects have been launched to decrease the presence of PPs in the environment. Some of them addresses health care establishments (hospital, senior residences, ….) asking for the implementation of a treatment processes or a change in the medical practices. Such proposal is not well accepted because of the generated provisional costs.
In our work, we propose to develop an impact indicator allowing the establishment to monitor their activity and the produced wastes in term of pharmaceutical residues. Based on a multicriteria calculation (taking into account data on consumption, excretion, water volume, … ) this indicator aims to be consider as an alert system and a support for decision making in the management of the environmental risk of the healthcare activity. The indicator was developped from several french establishements.