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In the early 1950s there were only a few wastewater treatment plants in Sweden but today there are more than 2 000 municipal plants designed to remove organic material and nutrients. Chemical phosphorus removal was introduced in the 1970s and extended nitrogen removal was introduced in many plants in the 1990s. Extended nitrogen removal is restricted to southern Sweden, where it is mainly found at larger plants and at plants in coastal areas. In Sweden, most of the domestic wastewater generated in urban areas is transported to wastewater treatment plants. Therefore, wastewater treatment plants have a unique potential to serve as a barrier for discharge of environmentally hazardous micropollutants. There are three main ways generic pharmacy online net phentermine for removal of micropollutants at wastewater treatment plants: sorption to particulate matter, biological degradation/transformation and evaporation. The effectiveness of the treatment depends on the inherent properties of the pollutant, as well as by the treatment processes and the operation of the plant.

In Sweden there are more than 450 wastewater treatment plants dimensioned for more than 2 000 person equivalents, and these plants treat approximately 90% of the wastewater volume from urban areas. In this chapter the main techniques and their efficiency to remove organic matter, nutrients, and other pollutants including pharmaceuticals are discussed. It is concluded that Swedish wastewater treatment comprises a broad spectrum of treatment technologies that are known to remove pharmaceuticals to a greater or lesser extent. There is also variability in the removal efficiency for different types of pharmaceuticals.

Given this variability it is crucial that any decision on supplementing current wastewater treatment technologies with the aim to reduce pharmaceuticals should rely on an assessment of the environmental risks associated with these substances. Furthermore, the present wastewater treatment and the possibility to integrate new technologies must also be considered in such decisions. In the final chapter, chapter 9 (The vision - sustainable pharmaceutical management in a sustainable society, by Ake Wennmalm, Bengt-Erik Bengtsson and Bo Gunnarsson) the process towards a sustainable development and use of pharmaceuticals is discussed.

It is argued that sustainability in this area should be characterised by managing economic, environmental and social issues, and include the entire life cycle of the pharmaceutical, from development and production to use and disposal. Driving forces, fore and against a sustainable development are discussed, such as market forces, demands from consumers and prescribers, political decisions, and novel decision mechanisms including globally acting international and non-political organisations. Finally a number of positive examples are presented, such as research efforts contributing to new knowledge about risks, the recently introduced European legislation requiring environmental risk assessments for new human pharmaceuticals, and a requirement for all member states to establish take-back systems for unused or expired medicines. It is furthermore noted that generic pharmacy online net phentermine the European Commission has stated that "generic pharmacy online net phentermine Pollution of waters and soils with pharmaceutical residues is an emerging environmental problem and also an emerging public health concern". Some significant Swedish initiatives are also mentioned: screening of pharmaceuticals in Swedish surface waters, launched by the Swedish Environmental Protection Agency, and two proposals from the Swedish Medical Products Agency: first to include environmental aspects in the criteria for Good Manufacturing Practice (GMP) and second to change current legislation generic pharmacy online net phentermine so that environmental risks should be allowed to serve as a basis for refusal of a marketing application. References 1.Huggett DB, Cook JC, Ericson JF, Williams RT. A theoretical model for utilizing mammalian pharmacology and safety data to prioritize potential impacts of human pharmaceuticals to fish.



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