Country Management approach Notes Direct discharge Wastewater treatment Denmark ✔   In Denmark there is no limit for the total activity that can be discharged (that is controlled by limits for purchase and use.) However, dilution of 131I discharges to 0.1 MBq/l required at the point where the hospital drain meets the municipal sewer. Finland ✔   Discharge limits from institutions do not apply to patient excrete that may be freely discharged to sewer as long as discharges at any one time do not exceed 100 MBq and that over the course of a year does not exceed 100 GBq. Sweden ✔   Free release to sewer is the preferred option. Decision based on direct measurements at a large hospital. External radiation exposure to sewer worker of ~2 µSv calculated on basis of 50 GBq 131I per year direct release to sewer.

Table 2: List of countries that allow direct discharge of patient excreta after dilution [Punt 2010].