Country Management approach Notes Direct discharge Wastewater treatment Greece ✔ ✔ Direct discharge to sewer allowed, provided that the wastewater is readily dispersible in water and the maximum concentration of radioactive substances is not greater than 3.7 MBq/l. For 131I thyroid post-operatory therapy wastewater decay storage prior to discharge to sewer is required to meet this criterion. Republic of Ireland ✔ ✔ Both direct discharge to sewer and use of holding tanks are currently employed. Hospitals are granted with authorisation on activity being administered. Spain ✔ ✔ Clearance levels are used to determine disposal routers. Where activities are above clearance levels waste should be stored for decay. Great Britain ✔ ✔ Direct discharge to sewer allowed, but sites are required to demonstrate BPM and that the critical group dose constraint of 300 µSv/y is not exceeded. Consideration being given to use of delay thanks for new facilities undertaking treatment of large numbers of patients with 131I.

Table 3: List of countries that permit both approaches to patient excreta management [Punt 2010].