#IFHEcongress2018

Jakob SøholmSegment DirectorGrundfos BioBooster A/SMember of FSTA Denmarkjasoeholm@Grundfos.com

Improving sustainability in hospital wastewater management – a Danish case study

#IFHEcongress2018

Why • Hospital wastewater pose a risc• Significant source of pollution

How to do it• On-site treatment

What do you get out of it• Economics• Sustainability• More benefits

Agenda

#IFHEcongress2018

Grundfos is a global leader in advanced pump solutions and a trendsetter in water technology.

We contribute to global sustainability by pioneering technologies that improve quality of life for people and care for the planet.

Turnover 3,441 mio EUR in 201718,776 Employees+55 countries

HQ in Denmark

Grundfos in brief

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a 100% subsidiary of Grundfos working with wastewater treatment solutions based on our own membrane technology.

Developed a full solution for hospital wastewater treatment concept in a public private partnership with the Capital Region of Copenhagen from 2012 – 2016 at the Herlev Hospital.

…AND NOW WE ARE READY TO BEGIN

…and Grundfos BioBooster

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The Herlev Hospital at a glance

Local water stream Kagsåen

• Biggest emergency hospital in Copenhagen

• Many specialities• Research• 949 beds• 6,300 employees

WWTP

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Hospital wastewater characterizationParameters Raw untreated wastewater

Toxic and persistent antibiotics, painkillers and cytostatics

Factor 10-300 exceeding of effect limits (PNECFreshwater) for water living organisms

Contrast media (e.g. iomeprol) High concentration (2,5-7 mg/l)

Antibiotic resistant bacteria High occurrence of antibiotic resistant bacteria

Norovirus High concentration (1.7x105)

Eco-toxity: Fish fry (zebra fish) 100 % mortality within 96 hours

Eco-toxity: Crustacean (daphnies) No offspring (all test animals died)

Estrogenic activity (A-YES) Estrogen effects (Factor 7-10 exceeding inland water EQS)

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Hospital wastewater pose a risc

PNEC = Predictable No Effect Concentration (no negative impact on living organisms)

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Hospitals in the capital region of Copenhagen (1,6 mio inhabitants)

Discharges to Lynetten WWTPServing 750.000 People

Discharges to Avedøre Holme WWTPServing 275.000 People

Discharges to Damhusåen WWTPServing 350.000 People

New Northern Sealand HospitalDischarges to Solrødgård WWTPServing 100.000 People

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Hospitals can be significant sources of pollutionHospital No. of

bedsA: Highly

hazardous pharmaceuticals

(Major >100)[kg/yr]

B: Hazardous pharmaceuticals

(Major >500)[kg/yr]

Sum of exceedance of

limit values (Major >20)[MC/GLV]*

Antibiotics contribution

(excl. penicillins) (Major > 20 )

[%]

Classification as point source

MinorMedium

MajorNew Northern Zealand

670 130 989 NA 79 Major source

Hvidovre 800 111 818 25 27 Major source

New Bispebjerg 860 108 708 48 and 172 8 Major source

Rigshospitalet 1,100 436 1,381 105 28 Major source

New Herlev 950 181 700 104 18 Major source

* Measured Concentration / Guiding Limit Value for discharge to public sewer

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In operation since May 2014

• Max capacity 650 m3/day • Annual volume (2016) = 142.000 m3

• Building measures only 15x33 meters• 2 tanks each ø 9 m x 6 m tall

• No odour or noise complaints since start-up

The Herlev Hospital wastewater treatment plant

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1. Screening 1.5 mm2. Flow equalization and biological process3. Membrane filtration_200 nm4. Ozonation + Granular Active Carbon5. Air treatment on all air emissions

Complete solution•Water treatment•Safe and odour free air emissions•Incineration of bio-sludge/screenings

The Herlev Hospital wastewater treatment plant

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Some learnings

• Radioactivity• Inlet pump blockings• Membrane intactness and ozonation vital for

GAC operations.

The Herlev Hospital wastewater treatment plant

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Excellent effluent water quality

Effluent quality meets drinking water quality except for a few elements (Phosphorous, Chloride, Potassium, Natrium).

Parameter Raw untreated sewage Final outlet from plant

Toxic and persistent antibiotics, painkillers and cytostatics

Factor 10-300 exceeding of effect limits for water living organisms

All below effect limits for water living organisms

X-ray contrast media (eg iomeprol) High concentration (2,5-7 mg/l) 99% removal

Antibiotic resistant bacteria High level of multi-resistant bacteria No bacteria

Ecotox effect - Fish fry (zebra fish) 100 % mortality within 96 hours 0 % mortality

Ecotox effect - Crustaceans (daphnies) No offspring (all daphnies died) Survives like in clean water

Hormone disrupting effects Estrogene effects No estrogene effects

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Investment cost around 1 EUR/m3

Around 4.5 mio EUR has been spent in building this plant.The Hospital depreciates the cost over 30 years.Around 4.5 mio m3 of wastewater will be treated during these 30 yearsOperation and maintenance around 2 EUR/m3

In total for an on-site advanced WWTP around 3 EUR/m3

Todays price for discharge to public sewer with conventional treatment 3.4 EUR/m3

So better does not always equal more expensive☺3 EUR = 4.85 AUD = 3.53 USD (24.09.2018)

Economics

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Water re-use• Safe on drinking water resources by re-using the

re-claimed water on-site• Potential re-use purposes

• Cooling towers

• Technical water

• Irrigation and other recreational purposes

The Herlev Hospital will re-use 15.000 m3 (10%) annually in their cooling towers.

More sustainability 1

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Energy recovery

• Often a lot of energy is used for building heating and hot water production.

• Some of this heat is lost via the wastewater.• Energy can be saved by recovering this heat.

At the Herlev Hospital, the wastewater has an all year round temperature between 16-25°C – if used for heating water, the possible savings is around 1 EUR/m3 of wastewater.

More sustainability 2

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More life in local water streams

• Often discharging to a public WWTP means transporting the wastewater many kilometers for final discharge into a large marine recipient.

• This means less water and life in the small local fresh water streams.

At the Herlev Hospital, the wastewater will be discharged to a small local water stream – Kagsåen/Harrestrup Å – which suffers from draught during the summer season

More sustainability 3

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Reduce the number of carry-over infections.

The wastewater can be used to determine and benchmark the state of health of the hospital in relation to antibiotic resistant bacteria.

Herlev Hospital and DHI are running a project where they combine DNA analyzes from the wastewater and from inpatients to identify sources of resistant bacteria. They try to develop an early warning system for faster localization of the sources of infection in order to reduce the number of carry-over infections.

More benefits

#IFHEcongress2018

On-site wastewater treatment often is considered “not our responsibility” but actually it will reduce risks for people and the

environment, it may bring economical savings, it can improve sustainability of operations and it can bring potentially life saving

information to the hospital.

So why keep thinking like that…..

Closing comment