Many novel treatment technologies, usually representing a pre-treatment prior to the biological degradation process, have been developed in order to improve the recycling and reuse of sewage sludge. Among all the methods available, a chemical (alkaline) and a thermal treatment have been considered in this study. The behaviour of 13 substances belonging to different therapeutic classes (musks, tranquillisers, antiepileptic, anti-inflammatories, antibiotics, X-ray contrast media and estrogens) has been studied during the anaerobic digestion of sewage sludge combined with these pre-treatments (advanced operation) in comparison with the conventional process. Two parameters have been analysed: the temperature (mesophilic and thermophilic conditions) and the sludge retention time. While organic matter solubilization was higher with the alkaline process (55–80%), no difference between both pre-treatments was observed concerning volatile solids solubilization (up to 20%). The removal efficiencies of solids and organic matter during anaerobic digestion ranged from 40–70% and 45–75%, respectively. The higher removal efficiencies of pharmaceuticals and personal care products were achieved for the antibiotics, Naproxen and the natural estrogens (>80%). For the other compounds, the values were in the range 20–70%, except for Carbamazepine, which was not removed at any condition tested.

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