Hospital pharmaceutical consumption [gbed-1a-1] Community [gp-1a-1] Hospital contribution to WWTP load [%]
General hospital Long term care
  DE LU FR NL UK-1 UK-3 UK-2 UK-4 UK-5 DE LU UK-1
Year 2011 2010 2010 Mean 2011 2011 2011 2011 2010      
Water usage [‘000 m3a-1] 73.0 51.4 157.2 87.6 63.8 47.4 3.1 9.4 -      
WWTP catchment  [‘000 p]                   77 47 14
Hospital flow contribution [%]                   0.8 1.5 6.9
Beds per 1000 inhabitants                   7.3 11.9 22.0
No. of beds 560 360 863 1076 265 318 34 120 -      
Diclofenac 7.07 1.62 1.93 0.50 3.26 3.98 0.30 0.19 0.65 2.9 5.5 8.5
Naproxen 0.00 8.73 2.18 0.07 3.98 1.85 8.87 0.44 1.34 1.2 11.2 5.3
Carbamaz 1.64 1.00 2.91 0.00 4.34 4.49 3.78 1.87 0.72 4.4 21.4 10.1
Atenolol 0.27 0.15 0.64 0.00 2.20 1.59 1.19 0.47 0.63 1.0 1.9 6.1
Bezafibrate 0.84 0.00 0.00 0.01 0.78 0.41 0.23 0.00 0.17 2.1 n.a. 8.0
Lidocaine 0.00 2.21 46.95 2.36 17.21 8.45 0.06 0.36 0.07 n.a. 61.2 81.3
Amoxicillin 22.73 92.52 67.05 47.49 72.26 125.37 8.53 21.52 1.87 1.0 n.a. 42.0
Ciprofloxacin 9.61 16.50 21.80 8.96 27.31 24.19 1.45 1.32 0.17 11.8 154.6 74.8
Clarithromycin 3.82 5.47 0.85 0.40 24.75 18.04 1.76 1.33 0.40 59.1 18.2 36.0
Sulfamethox. 3.32 0.33 13.39 5.37 0.00 15.07 0.00 1.33 0.03 4.7 53.0 0.0
Erythromycin 2.18 0.55 2.93 1.45 2.12 2.41 6.50 0.00 0.45 82.4 64.3 8.1
Diatrizoate 67.06 0.00 181.37 3.89 0.00 29.45 0.00 0.53 0.00 67.8 n.a. 0.0
Iopamidol 13.49 0.00 4.36 0.00 687.67 9.63 0.00 0.00 0.00 77.8 n.a. 100
Iopromide 0.00 0.00 0 248.42 4.26 0.00 0.00 0.00 0.00 0.1 n.a. 100
Cyclophosph. 0.31 0.48 1.79 1.94 0.00 8.45 0.00 0.00 0.00 < LOQ 12.7 0.0
Ifosfamide 0.10 0.28 0.71 0.03 0.18 0.00 0.00 0.00 0.00 < LOQ n.a. 100
During measurement campaigns: DE: Sampling period 31.01.2011 - 07.02.2011, n=7, 24h composite samples (flow proportional); LU: Sampling period 18.10.2010 - 22.10.2010, n=10, 24h composite samples (time proportional); FR: Sampling period 23.06.2010 - 12.07.2010, n=7, 24h composite samples (time proportional); UK: Sampling period 09.2010 - 02 - 2012, weekly composite samples (flow proportional). Hospitals:1 - Rural general, n=46; 2 - Rural long term, n=10; 3 - Urban general, n=48; 4 - Urban long term, n=37; 5 - Community prescribed in rural catchment, per head of population for calendar year 2010.
Calculated based on: DE and LU: Flow proportional sampling in hospital effluents and comparison with prescription data, sampling periods as above; UK: Dispensed pharmaceuticals to the rural hospital complex (inc. psychiatric and geriatric lodges but excluding outpatient prescriptions) compared to the community prescribed pharmaceuticals in the region (pro - rata for catchment size). Only calculated for hospitals that were sole (hospital) contributors to a monitored sewer flow.
n.a. = not analysed ; LOQ = limit of quantitation; substances detected but not quantifiable
Table 4: Annual pharmaceutical consumption and hospital contribution to load in sewers.