Groundwater contamination by microbiological and chemical substances released from hospital wastewater: health risk assessment for drinking water consumers.

Contamination of natural aquatic ecosystems by hospital wastewater is a major environmental and human health issue. Disinfectants, pharmaceuticals, radionuclides and solvents are widely used in hospitals for medical purposes and research. After application, some of these substances combine with hospital effluents and, in industrialised countries, reach the municipal sewer network. In certain developing countries, hospitals usually discharge their wastewater into septic tanks equipped with diffusion wells. The discharge of chemical compounds from hospital activities into the natural environment can lead to the pollution of water resources and risks for human health. The aim of this article is to present: (i) the steps of a procedure intended to evaluate risks to human health linked to hospital effluents discharged into a septic tank equipped with a diffusion well; and (ii) the results of its application on the effluents of a hospital in Port-au-Prince. The procedure is based on a scenario that describes the discharge of hospital effluents, via septic tanks, into a karstic formation where water resources are used for human consumption. COD, Chloroform, dichlomethane, dibromochloromethane, dichlorobromomethane and bromoform contents were measured. Furthermore, the presence of heavy metals (chrome, nickel and lead) and faecal coliforms were studied. Maximum concentrations were 700 NPP/100 ml for faecal coliforms and 112 mg/L for COD. A risk of infection of 10(-5) infection per year was calculated. Major chemical risks, particularly for children, relating to Pb(II), Cr(III), Cr(VI) and Ni(II) contained in the ground water were also characterised. Certain aspects of the scenario studied require improvement, especially those relating to the characterisation of drugs in groundwater and the detection of other microbiological indicators such as protozoa, enterococcus and viruses.