Risk Management of Emerging Compounds and Pathogens in the Water Cycle

BMBF funding measure

Handbook of good practice Contents

1 Introduction 4 5 Management concepts for dealing with micropollutants and pathogens 54 in the water cycle

2 Occurrence of micropollutants, pathogens and antibiotic resistances 8 Key messages 54 in the water cycle 5.1 Introduction 55 Key messages 8 5.2 Development and implementation of management concepts within RiSKWa 58 2.1 Chemical contaminants 8 5.3 Development of measures for avoiding/reducing risks 61 2.2 Microbiological contaminants 19 5.4 Bibliography 66 2.3 Bibliography 23

6 Communication and educational measures 67 3 Risk characterization und risk assessment: drinking water, wastewater, 24 ground and surface water Key messages 67

Key messages 24 6.1 Introduction 67

3.1 Toxicological and eco-toxicological assessment 25 6.2 Public relations 69

3.2 Microbiological assessment 33 6.3 Risk communication/risk perception 73

3.3 Mobility and persistence 36 6.4 Crisis communication 76

3.4 Bibliography 38 6.5 Consultations 79 6.6 Education 79 4 Technologies for reducing organic micropollutants and pathogens 39 6.7 Bibliography 82 in aquatic environments

Key messages 39 Annex 84 4.1 Introduction 40

4.2 Technologies for the elimination of organic micropollutants and pathogens 41

4.3 Technologies for the reclamation and treatment of drinking water – 46 micropollutants and pathogens

4.4 Application of emission reduction technologies in wastewater treatment 48

4.5 Conclusion 52

4.6 Bibliography 52

2 3 © corky46 - Fotolia 1 Introduction 4 residues ofpharmaceuticals,tracespollutantsornewly spreading pathogens. changing worldnewdisruptive factorscontinuallyarise,alsofrom privatehouseholds: andrapidly also everyindividualcitizencan, andmust,contribute.Duetoourmodern pollutants andpathogensinterms ofboth,theirassessmentandelimination.But and toaddress theirconsequences.Themainchallenge to copewithisthediversityof and technologiesavailabletoidentify, assessandeliminaterisksasearlypossible, operators are managingall these resources withforesight. Theyusethelatestmethods sourced. To ensure thisalsointhefuture, waterutilitiesandwastewatertreatment plant Drinking watermust be clean – just likethe rivers, lakes and groundwater from which itis treatment and thereby facilitatedthediscus - data ontheimpact ofadvancedwastewater of unknownsubstances.Others collected panded thetodateverydifficult detection in thiscontext,someoftheprojects ex- for exampleinthefieldof“micropollutants”: RiSKWa produced interesting innovations, and testedthemunderreal-life conditions. evaluation, technologyandmanagement, herein. Theydevelopednew approaches for sectors, elaboratedthe results presented water management,healthcare andpublic dialog withallrelevant stakeholdersfrom and practicecooperatedcloselyand,in a years, scientists,industry, publicauthorities ter Cycle, RiSKWa): over a period of five Compounds andPathogensintheWa- (RiSKWa)“ (RiskManagementofEmerging Krankheitserregern imWasserkreislauf agement vonneuenSchadstoffenund the BMBF funding measure “Risikoman These challengeswere addressed within well. of antibioticresistances isontheriseas wastewater treatment plants. Therelevance gens assomeofthemare noteliminatedin change altertheriskpotentialofpatho- for the future. Climate and demographic environment represents animportanttask ing theireffects onhumanhealthandthe and accumulateinthefoodchain.Assess- water. Someofthemare notbiodegradable detected inverysmallconcentrationsthe micropollutants”. They cannowadaysbe amounts are referred toas“anthropogenic made andfoundintheenvironment insmall not normallyoccurinnature butare man- finishes. Allthesesubstanceswhichdo and flame retardants from textileswithsuch sunscreens, detergents,butalsobiocides fragrances, pharmaceuticals,hormones, problem, likeforexampleshampoosand day commoditiesare meanwhilecausinga aviewtochemicalsubstances, every- With 1 Introduction work ofthishandbookgoodpractice. experience reaching wellbeyondtheframe- projects acquired extensive knowledgeand further insights–afterall,alljoint research projects. Suchdialogwillcertainlyprovide list of thecoordinators of the joint research the RiSKWa experts:Table 1.1showsa Interested usersare invitedtoalsocontact cal application. the solutionsoffered byRiSKWa for practi- of thishandbookwithaquickoverviewon projects. Thisstructure provides theusers main results ofthetwelvejointresearch the practitioners.Theyare followedbythe is preceded byRiSKWa’s keymessagesto phases ofriskmanagement.Eachchapter thorities. Itisstructured alongthedifferent andpublicau- agement, localgovernments all actorsinwaterandwastewater man- This handbookofgoodpracticeaddresses water conservation. Concrete casestudiesillustrateapreventive pollutants andpathogensintowaterbodies. measures toavoidandreduce theinputof “water”, it recommends various optional able managementofourvaluableresource compiled inthishandbook.Forasustain- ter managementpracticehasnowbeen communication”. Thequintessenceforwa- identification”, “riskmanagement“and insights and progress in the fields of “risk Overall, thefundingmeasure produced new RiSKWa aswell. tional measures were centralelementsof substances. Communicationandeduca- for aneasydetectionandevaluationofsuch new processes were developedthatallow tion againstharmfuleffects ofpathogens is tobeintroduced inthefuture. Asprotec- sion onwhetherandwhere suchtreatment 5 RiSKWa-Handbook of good practice 1 Introduction

Table 1.1: Overview on the joint research projects, broken down by their thematic priorities

Name of the joint research project Project coordinator Name of the joint research project Project coordinator

Urban areas Catchment areas

ASKURIS: Anthropogenic trace organic Prof. Dr. Martin Jekel Sichere Ruhr (Safe Ruhr): Bathing water and Dr.-Ing. Wolf Merkel compounds and pathogens in the urban TU Berlin drinking water for the Ruhr Area IWW Water Centre, water cycle; assessment, barriers and risk email: [email protected] Mülheim an der Ruhr communication email: [email protected]

SAUBER+: Innovative concepts and Prof. Dr. Johannes Pinnekamp SchussenAktivplus: Reduction of micro- Prof. Dr. Rita Triebskorn technologies for the separate treatment RWTH Aachen pollutants and bacteria by further treatment Eberhard-Karls-University, Tübingen of wastewater from healthcare facilities email: [email protected] of wastewater treatment plant effluents and email: [email protected] mixed water from rain overflow basins of ANTI-Resist: Analysis of antibiotics and Prof. Dr. Joachim Fauler different sizes to further improve the water antibiotic resistances in the urban wastewater TU Dresden quality of the River Schussen, a tributary to and development of suitable strategies and email: [email protected] Lake Constance an early warning and monitoring system taking the example of the City of Dresden

Drinking water supply

Rural areas PRiMaT: Preventive risk management Dr. Frank Sacher in drinking water supply TZW: DVGW Water Technology Center, AGRO: Risk management of micropollutants PD. Dr. Tobias Licha Karlsruhe and pathogens in rural karst catchments Georg-August-University, Göttingen email: [email protected] email: [email protected] RiMaTH: Risk management of drinking water Dr. Wolfgang Fritzsche Risk AGuA: Risks posed by wastewater from Prof. Dr. Wolfgang Dott in building installations – fast detection Leibnitz Institute of Photonic intensive animal farming for ground and RWTH Aachen methods for bacterial contaminants and Technologies e.V., Jena surface water in agricultural areas email: [email protected] monitoring of decontamination measures email: [email protected] aachen.de TOX-BOX: Hazard-based risk management Dr. Tamara Grummt of anthropogenic trace substances for Federal Environmental Agency (UBA), Catchment areas protection of the drinking water supply Bad Elster email: [email protected] TransRisk: Characterization, communication Prof. Dr. Thomas Ternes and minimization of risks associated with the German Federal Institute of Hydrology, occurrence of emerging contaminants and Koblenz pathogens in the urban water cycle email: [email protected]

RISK-IDENT: Assessment of previously Dr. Marion Letzel unknown anthropogenic trace contaminants Bavarian Environment Agency, and action strategies for risk management in Wielenbach aquatic systems email: [email protected]

6 7 2 Occurrence of micropollutants, pathogens and antibiotic resistances in the water cycle

2 Occurrence of micropollutants, pathogens tal compartments soil, groundwater and A heavy metal screening of three biogas surface water. A nationwide screening of plants confirmed that, with the exception of and antibiotic resistances in the water cycle biogas plants only in isolated cases pro- copper and zinc which are regularly used as duced antibiotics concentrations of more animal feed additives, no further metal ions than 1 mg/kg of utilized waste. Especially are found in relevant concentrations. How- for representatives from the generic group ever, the copper and zinc concentrations in Authors: Prof. Dr. Thomas Ternes, Dr. Frank Sacher, Dr. Marion Letzel, Prof. Dr. Martin Exner, of tetracyclines, a reduced concentration each sample were two to five times higher Prof. Dr. Thomas Schwartz downstream of the biogas plant was found. than the precautionary values specified for Studies involving the spiking of antibiotics clay and silt-containing soils. The low bio- to manure showed that chlortetracycline, availability of the heavy metals in addition tetracycline, sulfamethazine and sulfadi- suggests a concentration in the farmland. Key messages azine can partially be eliminated in the fermentation process (cf. Fig. 2.1). Analyses ANTI-Resist analyzed the release of fre- of the transport behavior of antibiotics also quently prescribed antibiotics into the urban Key message 1: With the results from tibiotic resistances identified in the context revealed that 90-100% sorb relatively well wastewater taking the example of the City RiSKWa modern and fast methods for of RiSKWa can be found in the entire urban to soil particles or are degraded. Only a of Dresden. Besides identifying the relevant detecting and quantifying anthropogenic water cycle (wastewater – surface water– very small portion enters the adjacent water antibiotics from outpatient and inpatient micropollutants, pathogens, and antibiotic groundwater – drinking water). bodies via surface runoff and soil erosion. treatment also adequate analytical methods resistances are available. Numerical modeling has shown, however, for the detection and quantification of the Key message 5: Wastewater systems are that even a minor transport leads to the original substances in wastewater, sewage Key message 2: With the introduction of important point sources for the discharge spreading of these substances into other sludge, sediment, biofilm from the waste- new methods and the newly developed, of pathogens, clinically relevant antibiotic environmental compartments. water system and surface water were de- publicly accessible database “STOFF- resistances, pharmaceutical residues, and veloped [Schubert et al. 2015]. IDENT”, emerging micropollutants relevant many other micropollutants into the aquat- for the aquatic environment and their trans- ic environment. Prescription numbers allow formation products can be identified and for a first estimate of the release of human quantified. pharmaceuticals into the municipal wastewater. Key message 3: In the medium to long term, molecular biological methods can Key message 6: Emerging micropollut- complement the standardized culture tech- ants as well as pathogens, and antibiotic niques for a faster and more distinct identi- resistances need to be taken into account fication of microbiological risks. and partly integrated into present and future regulatory frameworks such as the Key message 4: Many of the micropollut- German Wastewater Directive. ants, pathogens, and clinically relevant an-

2.1 Chemical contaminants focused on the occurrence of micropollutants in different compartments of the water Occurrence of micropollutants in the cycle. water cycle RiskAGua analyzed the emission and A number of joint research projects within persistence of veterinary pharmaceuticals the BMBF funding measure RiSKWa have and their distribution in the environmen- Fig. 2.1: Application of liquid manure (© Margit Power-Fotolia)

8 9 RiSKWa-Handbook of good practice 2 Occurrence of micropollutants, pathogens and antibiotic resistances in the water cycle

Thanks to a small sample volume and a sulfamethoxazole is good while it is rather river Schussen were investigated. In total, In the influent of a constructed wetland, quick LC-MS/MS method it was possible poor for easily biodegradable compounds. the water samples were tested for approx. besides the typical wastewater-borne sub- to perform a 15-month monitoring program The emissions of easily degradable antibi- 140 micropollutants of which, on average, stances also micropollutants, like for exam- with daily sampling at various sampling otics can therefore not be estimated with around 55 were detected in the three waste- ple the herbicide mecoprop, were detected points in the Dresden-Kaditz wastewater sufficient degree of precision without a water treatment plant inlets under analysis. which are washed away and/or mobilized treatment plant (population equivalent PE chemical analysis. In addition, it must also The scope of the analyses covered the sub- during periods of heavy rainfall. In the river 740,000). The catchment area of the Dres- be noted that, in the case of mixed water, stance groups benzotriazoles, complexing Schussen (cf. Fig. 2.3), around 30 micropo- den-Kaditz wastewater treatment plant is the antibiotics adsorbed in the sewage sys- agents, pesticides, active pharmaceutical llutants could be detected on average up- mainly of an urban nature so that it can be tem are released again to the inlet as a result ingredients, X-ray contrast media, antibiot- stream of the Ravensburg wastewater treat- rightfully assumed that antibiotic emissions of remobilization, shearing and elution pro- ics, endocrine disrupting compounds, tri- ment plant and approx. 35 micropollutants from industry and commerce are negligible. cesses. In rainy weather, the combination of alkyl phosphates, aliphatic amines, artificial downstream of the plant. After implementing An examination of the antibiotic concentra- higher particulate and dissolved concentra- sweeteners and perfluorinated compounds. the fourth treatment stage, the number of tions measured in the influent and effluent tions leads to a higher load for the wastewa- The number of positive findings was re- positive findings in the surface water down- of the wastewater treatment plant produced ter treatment plant (cf. Fig. 2.2) and also to duced by 17-34% in conventional waste- stream of the wastewater treatment plant antibiotic-specific elimination rates with a an increased substance discharge into the water treatment, whereby the concentration was slightly reduced. In the river Schussen, high degree of fluctuation. For macrolide an- adjacent waters. level of the micropollutants detected was the highest micropollutant concentrations of tibiotics (clarithromycin, azithromycin, rox- significantly reduced overall. This was in EDTA, guanyl urea, acesulfame, iomeprol ithromycin) and trimethoprim, the long-term particular owed to a few compounds such and metformin were measured, thus reflect- study showed no, or only very small, elim- as the chelating agent nitrilotriacetic acid ing the impact of urban wastewater. inations. Cefuroxim, by contrast, was elimi- or the two artificial sweeteners cyclamate nated to a substantial degree (Medianinfluent and saccharin which were in some cases

1621 ng/l; Medianeffluent 598 ng/l) [Ross- detected in the three-digit µg/l range at the mann et al. 2014]. In this context, it must wastewater treatment plant influent, but can be mentioned that cefuroxim, besides the be easily degraded in the biological waste- penicillins piperacillin, penicillin V and amox- water treatment stage. A commercial-scale icillin, ranks among the most frequently pre- treatment with powdered activated carbon Fig. 2.2: Municipal wastewater treatment plant scribed antibiotics in the catchment area of (© Ruhrverband, Essen) in the Ravensburg wastewater treatment the Dresden-Kaditz wastewater treatment plant resulted in a reduction in the number plant (on average 0.95 mg/inhabitant) as it The joint research project SAUBER+ exam- of detected micropollutants from 56 sub- is frequently used in both, outpatient and ined the emission of pharmaceutical resistances found in the influent to 41 found in inpatient treatment, while the prescribed dues from healthcare facilities. The project the effluent of the biological treatment stage volumes of macrolides and trimethoprim focused not on general hospitals, but on a to just 24 substances in the effluent of the Fig. 2.3: River Schussen in Baden-Wuerttemberg amount to only 0.07 to 0.28 mg/inhabitant psychiatric clinic, a nursing care home as activated carbon stage. (© University Tübingen) [Marx & Kühn, 2014]. well as a clinic specializing in orthopedics. With regard to the pharmaceuticals concen- Tab. 2.1: Concentrations [µg/l] of seven sartans as well as of carbamazepine and acesulfame in Bavarian wastewater treatment plant effluents, surface waters and one bank filtrate well By correlating the prescription volumes with trations it showed that, with a few excep- data on metabolism and excretion it is pos- tions, the emissions from the health care fa- n cande- epro- irbe- lo- olme- telmi- val- carba- ace- sible to forecast the amount of antibiotics cilities examined were lower than those from sartan sartan sartan sartan sartan sartan sartan mazepine sulfame released into the wastewater [Timpel et al. private households. Wastewater 2015]. The hydrodynamic sewer system treatment 30 0.46 0.73 1.25 0.21 0.74 0.68 1.10 0.65 25 simulation allowed for a high-resolution In the framework of the joint research pro- plant effluent display of the antibiotics load at the inlet ject SchussenAktivplus, the effects of Surface waters 8 0.085 0.039 0.043 0.015 0.068 0.053 0.13 0.088 1.14 of the central wastewater treatment plant an extended wastewater treatment and Bank filtrate 8 0.031

10 11 RiSKWa-Handbook of good practice 2 Occurrence of micropollutants, pathogens and antibiotic resistances in the water cycle

In the joint research project RISK-IDENT, formed. The measured concentrations of The substance groups were used as indi- category. The impact of road traffic via run- wastewater treatment plant effluents, sur- micropollutants from different origins were cators for the impact of (I) municipal waste- off water on the wastewater of WWTPs was face waters and bank filtrates were tested found to be within the usual range for ur- water treatment plants (WWTP) (including measured using the indicator substance for numerous drugs, biocides, industrial ban wastewaters (from ng/l to ca. 30 µg/l in wastewater seepage in the sewer system group of benzothiazoles, but was mainly chemicals and pesticides. In addition to single cases). due to leaking sewers), (II) discharges from found at concentrations in the middle range. indicator substances such as carbamaze- road traffic and (III) agriculture. In the influent The values for pesticide metabolites attest pine and acesulfame, which are measured Dilution of the urban wastewater in the Lake and effluent of municipal WWTP, the waste- to the impact of agriculture in all groups of in routine analyses, also so far less known Tegel water cycle can be easily quantified water indicators sweeteners, pharmaceu- sampling sites. This is probably attributable substance groups were analyzed. One ex- by way of persistent organic micropollut- ticals, melamine and benzotriazoles were to the predominantly agricultural character ample are the antihypertensive sartans, ants such as carbamazepine. In the drink- found to be nearly all positive at the highest of the Donauried region used as a model site the consumption of which has strongly in- ing water produced from Lake Tegel via creased in recent years. Table 2.1 shows bank filtration and artificial groundwater Tab. 2.2: Use of indicators to assess the release of anthropogenic micropollutants in the region under the mean concentrations of the seven most recharge, some persistent micropollutants analysis frequently detected sartans and of the indi- can be found which were sometimes al- Groups of Sampling site Indicator group cator substances carbamazepine and ace- ready known before the start of the project sampling sites Wastewater Road sulfame. (e.g. carbamazepine). However, also several Agriculture Treatment Plants Traffic new substances, like for example gabapen- All sartans were found in the wastewater tin and valsartan acid with concentrations of treatment plant effluents at concentrations up to 1 µg/l were detected. ranging between 0.2 and 1.1 µg/l. Via the surface waters in which all sartans were In the joint research project TransRisk, ana- Nitrate Pesticide Melamine Metabolites Sweeteners measured in concentrations similar to those lytical methods for 84 individual substances Drugs/RCM Benzotriazoles of the indicator substance carbamazepine, were developed. The analyzed micropollut- Benzothiazoles in particular candesartan and olmesartan ants can be divided into the following sub- reach the bank filtrate. The other – structur- stance groups (number of micropollutants Influent WWTP Langenau + + + + o o - Influent WWTP Steinhäule + + + + + o - ally similar – sartans are largely separated indicated in brackets): sweeteners (5), phar- Raw wastewater by bank filtration. The poor biodegradabili- maceuticals, including X-ray contrast media Wastewater of Clinical + + o + - o - ty and the lower sorption due to the lower (RCM) (64), melamine (2), benzotriazoles (3), Health Center Ulm K -value of candesartan and olmesartan benzothiazoles (6), pesticide metabolites D Treated Effluent WWTP Langenau + + o + o o o must be mentioned as a possible reason for (4) and nitrate (1). The occurrence of the wastewater Effluent WWTP Steinhäule + + + + o o o this [Bayer et al., 2014]. organic micropollutants in the water cycle Storm water basin with a view to the impact of point sources - - o - o o o In the joint research project ASKURIS, the was measured seven times at 20 sampling Road runoff Schammenbach water Storm water basin with occurrence of organic micropollutants in a sites in the water protection area “Donau - - - - - o o semi-closed urban water cycle in Berlin was ried-Hürbe”. For an indicative evaluation of overflow Rammingen examined where the main emission source all measurements performed in the project Ochsenhölzle o - o - - o + was treated urban wastewater. In the case (around 10,000 individual values), a param- Hotspots Nerenstetten o - - - - o o of Lake Tegel (average wastewater content eter sum was formed for each substance groundwater Lone, spring - - - - - o o approx. 30%), extensive target and non-tar- group, i.e. the concentrations of the individ- get analyses (i.e. analyses for known and ual substances of a group were aggregated. Danube, Leipheim o o o o - - o unknown substances using special analyt- For each sampling site and each parameter Criteria for the categorization (median concentration): ical techniques, cf. “Identification of emerg- sum, the median was divided into three cat- (-): < 0.1 µg/l For nitrate: (-): < 10 mg/l ing micropollutants by non-target analysis”) egories. The results are shown in Tab. 2.2. (o): 0.1 – 1 µg/l (o): 10 – 50 mg/l on a long list of already known substances and of new emerging substances were per- (+): > 1 µg/l (+): > 50 mg/l

12 13 RiSKWa-Handbook of good practice 2 Occurrence of micropollutants, pathogens and antibiotic resistances in the water cycle

for this analysis. In the sampling site group The analyses attested to a long-term con- Occurrence and formation of metabolized to carbon dioxide or biogen- road runoff water, the parameter sums were tamination with highly persistent substanc- transformation products ic digestible substances, but only slightly only slightly higher for melamine and ben- es such as the herbicide atrazine which was transformed. In most cases, this transfor- zothiazoles. The occurrence of pesticide banned in Germany in 1991 (up to 5.8 ng/l) Transformation products (TPs) of micro- mation leads to TPs with a higher polarity metabolites and nitrate clearly shows the or the sweetener acesulfame (ca. 20 ng/l in pollutants are increasingly moving into the than the original substances. The following impact of extraneous water from agricultur- the runoff during dry weather periods). At focus of scientific interest. TPs result from enzyme-catalyzed reactions were observed al origins, for example from field boundary the Gallus spring, a method for the quanti- abiotic or biotic transformations of anthro- in activated sludge treatment, for example: drainage. A heterogeneous situation was fication of fresh contamination with untreat- pogenic compounds in living organisms, mono- and dihydroxylations, alcohol and al- found for the group “Hotspots groundwa- ed wastewater was established using the wastewater treatment plants, the environ- dehyde oxidations, hydrolysis of esters and ter“. The wastewater indicators, which in wastewater indicator caffeine. Moreover, ment and also in water treatment. Frequent- amides, decarboxylations, N-dealkylations the case of the sampling sites at a landfill the ratio of the concentrations of valsartan ly, several TPs are formed from a single and N-deacetylations. Given their high po- can probably be attributed to substances and its transformation product valsartan substance, thus significantly increasing the larity, the TPs that formed during wastewa- inside the landfill, as well as the indicators acid was identified as a promising indicator number of substances in the water cycle (cf. ter treatment often directly enter the surface for agriculture were both found to be posi- for the performance of a wastewater treat- Fig. 2.5). waters and from there in some cases also tive. In the surface waters of the rivers Nau ment plant. Generally, a significantly lower the groundwater as well as, in singular cas- and Danube used as receiving waters, the detection frequency of wastewater-borne The active pharmaceutical ingredients and es, the drinking water. wastewater impact could be clearly detect- micropollutants was found in comparison to metabolites excreted by humans as well ed using the corresponding indicators. An the values measured in the year 2010. Most as the large number of chemicals used in Some of the TPs that are formed during agricultural impact could equally be verified. probably, this drop in wastewater contam- households and industrial plants enter the wastewater treatment are toxicologically Only the water from the spring of the river ination is attributable to sewer moderniza- municipal wastewater treatment plants precarious (e.g. N-nitrosodimethylamine, Lone did not show any significant wastewa- tion and an upgrading of the storm water via wastewater. In the WWTPs, many of NDMA). For the risk assessment it is there- ter impact. basin with overflow in the catchment area. these substances are not mineralized, i.e. fore mandatory to integrate the formation

To document the increased vulnerability of karstic aquifers, specific contamination sources and scenarios in the catchment area at the model site Gallus spring (cf. Fig. 2.4) in the Swabian Alb region were identified, characterized and systematically analyzed in the joint research project AGRO. The spring water was monitored for a total of more than 50 different organic micropollutants such as pharmaceuticals, pesticides, corrosion inhibitors, stimulants and sweeteners. 38% of the substances were detected at least once. The concentrations ranged between 1.1 ng/l and (in rare cases) over 100 ng/l. The most frequently detected substances were the pesticides and pesticide metabolites metazachlor, atrazine and desethyl atrazine, the stimulant caffeine and its metabolites, the antiepileptic drug carbamazepine as well as the X-ray contrast media iohexol and iopromide. Fig. 2.4: Gallus spring (© AGRO) Fig. 2.5: Formation of transformation products in the urban water cycle

14 15 RiSKWa-Handbook of good practice 2 Occurrence of micropollutants, pathogens and antibiotic resistances in the water cycle

and removal of (eco-)toxicologically relevant TransRisk examined the transformation of In another example, the antiviral drug acy- ble oxidation product COFA (N-(4-carba- TPs into the monitoring programs. However, biocides and active pharmaceutical ingre- clovir was transformed to a single TP, name- moyl-2-imino-5-oxoimidazolidin)formami- for the vast majority of the micropollutants it dients in biological wastewater treatment ly carboxy-acyclovir, upon contact with ac- do-N-methoxyacetic acid) by ozonation. is as yet not known to which TPs they are from laboratory-scale via pilot-scale to full- tivated sludge. Carboxy-acyclovir can be This oxidation product also showed an transformed in biological wastewater treat- scale. In this context, the complete trans- found in surface waters at concentrations of increased algal toxicity. COFA was found ment. formation pathway was elucidated in each up to 2 µg/l, in the groundwater (up to 0.25 in the lower nanogram per liter range in case, whereby the mass balances from µg/l) as well as in the drinking water (up to the drinking water downstream of a water One focus of the projects RISK-IDENT the original substance to the metabolites 0.040 µg/l). treatment step using ozonation and acti- and TransRisk was on identifying the mi- excreted by humans through to the TPs vated carbon. Moreover, COFA can also cropollutant TPs that form in the biological formed in the WWTPs could be closed. In In the PRiMaT and TransRisk projects also be formed in significant concentrations (> wastewater treatment stage. To this effect, addition to mass-spectrometric methods TPs that form by ozonation were identified, 1 µg/l) during the ozonation of wastewa- the TPs of selected micropollutants such and nuclear magnetic resonance (NMR) quantified and evaluated as to their eco ter. However, COFA was not eliminated by as sartans, the metabolites of carbamaz- spectroscopy also computer-assisted pre- toxicological effects (cf. Chapter 3). bio-active granular activated carbon (GAC) epine and the antiviral drug acyclovir were diction models were used to identify the filters and biofilm filters which established identified. Using various eco-toxicological TPs and the transformation pathways. One In the TransRisk project, carboxy-acyclovir after the ozonation step. tests it was also examined to which extent example is the main metabolite of carba- was for example transformed to the sta- the transformation products formed are mazepine, 10,11-dihydro-10,11-dihydrox- eco-toxicologically relevant (cf. Chapter 3). ycarbamazepine (DiOHCBZ), which could be detected in WWTPeffluents as well as In the joint research project RISK-IDENT, in surface waters and even in the drinking the transformation processes of various water [Kaiser et. al, 2014]. In some instanc- micropollutants were examined in labora- es, the concentrations of DiOHCBZ were tory-scale WWTPs and in aquifer columns. even higher than those of the active phar- The tests focused on numerous pharma- maceutical carbamazepine. Also the main ? ? ? ? ceuticals, biocides, industrial chemicals, metabolite of the anticonvulsant oxcarbaze- and pesticides. The TPs that are formed pine, 10,11-dihydro-10-hydroxycarbamaz- from these original substances were then epine (10OHCBZ), could be found in the forecast using in-silico methods and, in a effluents of municipal WWTPs and German next step, analyzed in the WWTP processes rivers and streams. These metabolites and and column eluates by non-target screening oxcarbazepine were further transformed (cf. “Identification of emerging micropollut- in activated sludge treatment. Seven TPs ants by non-target analysis”). Sartans, for could be identified in this process. The TPs example, were degraded at varying degrees of DiOHCBZ, 10OHCBZ and oxcarbaze- in lab-scale WWTPs; in the process, numer- pine could be quantified in WWTP effluents ous TPs are formed, some of which could as well as in rivers and streams, in ground- be identified (valsartan acid, amino-valsar- water and even in the drinking water. In tan, irbesartan-TP446). The reference sub- addition to the original substances, in par- stances of individual TPs were synthesized ticular 9-carboxy-acridine (9-CA-ADIN) was and the TPs were included in the water found at concentrations of up to 0.92 µg/l monitoring programs of the pertinent au- in WWTP effluents and of up to 0.19 µg/l in thorities. In this context, TP446 of the active the drinking water. Also other TPs, such as ingredient irbesartan was found in concen- BaQD (1-(2-benzoic acid)-(1H,3H)-chinazo- trations of up to 0.44 µg/l in WWTP effluents lin-2,4-dion) and acridone were detected in Fig. 2.6: In unpolluted groundwater around 1,000 signals were detected by non-target analysis which and of up to 0.09 µg/l in Bavarian rivers. relevant concentrations in those samples. can only seldom be assigned to known substances. Wastewater samples produce a multiple of the signal number found in groundwater samples.

16 17 RiSKWa-Handbook of good practice 2 Occurrence of micropollutants, pathogens and antibiotic resistances in the water cycle

Under the PRiMaT project, a strategy for To simplify the evaluation of water samples, Over and beyond this, also so far uniden- far unknown substances were identified in analyzing ozonated waters with regard to the project RISK-IDENT developed the tified substances such as gabapentin, pre- influents and effluents of municipal WWTPs. TP formation was developed. For the an- STOFF-IDENT database. For nearly 8,000 gabalin and valsartan acid were identified in Using reference materials, it was possible to alytical characterization, an ion chromato- chemical substances it provides substance the joint research project ASKURIS using confirm the presence of the pharmaceutical graphic separation was combined with a properties such as molecular mass, molec- polar separating agents in combination with residues lamotrigine, lamotrigine-N2-glucu- total of five different detectors. With these ular formula, chemical structure or the hy- high-resolution mass spectrometry. ronide, sulpiride and amisulpride in WWTP combinations it was possible to identify and drophobicity required for standardizing the effluents as well as in rivers and streams. quantify TPs, to calculate element-specific retention time. This database in particular In the joint research project RISK-IDENT, mass balances and also to draw conclu- lists substances that are relevant for the several substances typically found in sur- sions as to the degree of oxidative degra- aquatic environment. These include chemi- face waters and bank filtrates that had so 2.2 Microbiological contaminants dation. For acesulfame, for example, three cals that were registered in the framework of far been disregarded could be identified oxidation products were detected after the REACH Directive as well as pesticides, with the help of STOFF-IDENT and refer- This chapter in many respects refers to ex- UV-radiation which could be identified as biocides and pharmaceuticals and their ence substances. Examples include trans- planations given in the RiSKWa status pa- acetate, amidosulfonic acid and carboxylic TPs. After project completion the Bavarian formation products of the antihypertensive per “Bewertungskonzepte der Mikrobiologie acid of acesulfame. Environment Agency will continue to oper- irbesartan, vulcanization accelerators, UV mit den Schwerpunkten neue Krankheitser- ate and update this database and make it filter substances as well as other industri- reger und Antibiotikaresistenzen“ (Microbio Identification of emerging micropollutants available to the public free of charge. al chemicals. As a result of these findings, logical risk assessment concepts with a fo by non-target analysis some of the newly identified substances cus on emerging pathogens and antibiotic STOFF-IDENT was tested on surface water have now been included in the official water resistance), which comprises the results of Around the world, more than 100 million and bank filtrate samples where around 267 monitoring program. the RiSKWa interdisciplinary topic “Bewer- substances are known. Of these, more than substances were identified of which 38.2% tungskonzepte der Mikrobiologie“ (Microbi 100,000 are produced on an industrial scale were pharmaceuticals, 37.8% REACH In the framework of TransRisk, a new group ological risk assessment concepts) [Exner & and have the potential to be hazardous for chemicals, 16.5% pesticides and 7.5% oth- of substances relevant for the aquatic en- Schwartz, 2015]. the environment. The largest part of these er substances. According to the validations vironment, the quaternary phosphonium micropollutants and their TPs are current- performed to date, an identification proba- compounds (QPVs), was identified with Occurrence of pathogenic and ly not captured in routine analyses. At the bility of around 70% can be achieved with the help of non-target analysis and STOFF- opportunistic-pathogenic same time, modern analytical methods STOFF-IDENT. IDENT. This substance group includes microorganisms such as liquid chromatography in combina- methyltriphenylphosphonium cation, ethyl- tion with high-resolution and accurate mass Another database used in this context is triphenylphosphonium cation and methox- In the joint research projects SchussenAk- spectrometry offer a growing number of op- DAIOS (Database Assisted Identification of ymethyltriphenylphosphonium cation. For tivplus and TransRisk, wastewater treat- tions for identifying unknown substances in Organic Substances). In the framework of these quaternary phosphonium compounds ment plants with conventional treatment the water or determining known substanc- the joint research project ASKURIS, DAIOS a quantitative LC-MS/MS method was de- technology and various designs were ex- es. With so-called “non-target analyses” was re-programmed for a more efficient veloped and validated [Schlüsener et al., amined for E. coli, enterococci, staphylo- thousands of mostly unknown substances identification, optimized user-friendliness 2015]. QPVs were primarily found at higher cocci, and Pseudomonas aeruginosa con- are detected (cf. Fig. 2.6). A special chal- and a simplified extension of the database. concentrations in rivers containing treated centrations. High frequencies (abundances) lenge in this context is the efficient use of In this way, two complementary databas- wastewaters from the chemical industry. of opportunistic-pathogenic bacteria were the measurement data to determine the struc- es are now available: while STOFF-IDENT Specifically, high concentrations of QPVs detected in the influents of municipal waste- ture and unequivocally assign a substance. mainly contains physico-chemical data, were detected in the small rivers of the Hes- water treatment plants and, in particular, in DAIOS provides, inter alia, information on sian Ried region with concentrations of up hospital effluents, whereby staphylococci In the joint research project ASKURIS, a degradation pathways and MS/MS frag- to 2.5 µg/l ethyltriphenylphosphonium cati- (S. aureus and coagulase-negative staph- procedure for non-target analysis was de- ments. In the follow-up project FOR-IDENT, on, for example. Save for one exception, the ylococci, CNS) were more frequently found veloped in collaboration with the equipment both databases will be combined on one QPVs were not detectable in the effluents of in hospital effluents. The elimination perfor- manufacturers to evaluate the data on or- work platform together with additional soft- municipal WWTPs. This supports the thesis mance of the WWTPs for the mentioned ganic micropollutants in the water cycle ware tools. that QPVs mainly enter the aquatic environ- bacteria groups amounted to up to 2 log collected with modern analytical equipment. ment via industrial WWTPs. Furthermore, so levels. Specifically, the reduction potential

18 19 RiSKWa-Handbook of good practice 2 Occurrence of micropollutants, pathogens and antibiotic resistances in the water cycle

was of up to 90% for enterococci and of up In the context of the joint research project E. coli and intestinal enterococci. Also the Occurrence of microorganisms resistant to 50% for Enterobacteriaceae, for example. Sichere Ruhr, the water of the river Ruhr concentrations of coliphages and various to antibiotics No elimination by conventional wastewa- was analyzed for microbial contamination. human pathogenic viruses (adeno-, polyo- ter treatment was found for P. aeruginosa. The Ruhr is contaminated by fecal mat- ma-, entero-, and rotaviruses) did not cor- Culture methods applied in the joint re- Fig. 2.7 shows bacterial colonies on a selec- ter from numerous wastewater treatment relate. search projects SchussenAktivplus and tive culture medium. plants, which explains the high number of ANTI-Resist showed that, for opportunistic positive findings for E. coli, coliform bac- Under the SchussenAktivplus project, pathogenic bacteria, the share of pheno- teria, coliphages, and aeromonads. With the populations of E. coli, enterococci, and typically identified antibiotics resistances for regard to enteral viruses, mainly the data staphylococci in two surface water bodies certain bacteria groups in the wastewater relating to rota-, noro-, and enteroviruses were examined in a culture process. While treatment plant was growing while in other are interesting from the viewpoint of infec- the population counts of E. coli and entero- groups the share of resistant isolates was tiology. In line with the occurrence of the cocci were 0.6 to 0.8 log levels lower than declining. Given the significantly lower live respective infections among the population, in the wastewater treatment plant effluents, colony counts of microorganisms in the rota- and noroviruses can be evidenced in the population count of staphylococci was wastewater treatment plant effluent as com- surface waters, especially during the winter about one log level higher. pared to the influent, the – absolute – con- season. As a consequence of the different centration of opportunistic microorganisms influents from wastewater plants and also Moreover, in the framework of the PRiMaT resistant to antibiotics in the effluent was via diffuse discharge paths, higher con- joint research project, comparative meas- lower than in the influent of the wastewater centrations of pathogens in the receiving urements on PCR-based test methods treatment plants. Antibiotic resistant isolates water can be found especially after strong were conducted in the laboratories of dif- that also showed multiple resistances were rains. After precipitations, the Ruhr is con- ferent institutions, e.g. for the determination detected irrespective of the sampling point taminated to such an extent that the hy- of adenoviruses. The results showed a very and season. Fig. 2.7: Selective cultivation of pathogenic gienically acceptable bathing water quality good correlation. The average deviation for microorganisms (© T. Schwartz, Karlsruhe Institute of Technology (KIT)) required for public bathing can only seldom adenoviruses amounted to 0.4 log levels. In the joint research project TransRisk, the be achieved. During the bathing season, for abundances of clinically relevant antibiot- The analyses performed in the framework example, just under 15% of the E. coli dis- In the joint research project RiMaTH, new ic resistance genes were quantified in the of the TransRisk project produced a clear charge into the Ruhr originates from diffuse methods for detecting pathogens in the total population of hospital effluents and reduction of the overall bacterial load of up discharge paths close to the surface water, drinking water of building installations were wastewater treatment plants using molec- to 90% as a result of ozone treatment. For especially from agriculture, and around 60% developed/validated. The main focus was ular-biological methods. The highest abun- the specific bacteria markers, a reduction from the overflows of various rain reservoirs on Legionella. A comparative study of the dances of antibiotic resistance genes were after ozone treatment of up to 2 log levels and other not clearly identifiable sources. legally permitted enumeration method for measured in hospital effluents. Also in the for enterococci and 0.2 log levels for En Legionella in potable water (by culture as per effluents of wastewater treatment plants a terobacteriaceae at a specific ozone dose In the joint research project Sichere Ruhr, ISO 11731] and [DIN EN ISO 11731-2) and relative increase in the frequencies of cer- of 0.85 mg/g DOC was found. The reduc- 184 samples were examined over a peri- an already standardized quantitative PCR tain resistances within the total population tion efficiency was significantly lower for od of 15 months. In this process, Crypto method ISO/TS 12869 was performed. In as compared to the influent was found. Pseudomonas aeruginosa, albeit against sporidia were found in 29% of all samples the framework of the comparative study, the backdrop of a lower abundance in the and Giardia in 78% of the samples. During around 3,000 samples from drinking water Also in the framework of the joint research original population. In the framework of the the entire period covered by the study, rota- installations in buildings across Germany project ANTI-Resist the resistances in SchussenAktivplus project, ozonation of viruses were found in 9.8% of the samples. were tested in parallel for Legionella spp. raw sewage and treated wastewater were treated wastewater resulted in an additional Noro- and enteroviruses were detected in and Legionella pneumophila using the cul- quantified by means of molecular-biological reduction in the range of 0.3 (staphylococci) 29.5% and 22.3% of the samples, respec- ture method and qPCR. In around 84% of methods. The analyses produced a higher to 1 log level for E. coli and enterococci tively. The statistical evaluation of the data the samples, the results of the culture meth- abundance of clinically relevant antibiotic compared to the wastewater treatment did not show any correlation between the od matched those of the qPCR method. resistance genes for E. coli, the frequency plant effluent after conventional cleaning. pathogen concentrations measured and of which in addition also showed a seasonal the abundances of the indicator organisms pattern.

20 21 RiSKWa-Handbook of good practice 2 Occurrence of micropollutants, pathogens and antibiotic resistances in the water cycle

The joint research projects ANTI-Resist, Under the joint research projects AGRO and 2.3 Bibliography TransRisk and SchussenAktivplus evi- TransRisk the water of a karstic spring and Bayer, A.; Asner, R.; Schüssler, W.; Kopf, W.; Weiß, K.; Sengl, M.; Letzel, M. (2014): Behavior of sartans denced that hospital effluents and municipal anthropogenically contaminated ground- (antihypertensive drugs) in wastewater treatment plants, their occurrence and risk for the aquatic environment. wastewaters are important sources for the water measuring points were analyzed for Environ Sci Pollut Res Int. 2014 Sep; 21(18):10830-9. doi: 10.1007/s11356-014-3060-z. discharge of bacteria with antibiotic resist- antibiotic resistances. It showed that antibi- DIN EN ISO 11731-2:2008-06: Wasserbeschaffenheit – Nachweis und Zählung von Legionellen – Teil 2: ances into the environment. Fig. 2.8 shows otic resistances were found at all measuring Direktes Membranfiltrationsverfahren mit niedriger Bakterienzahl (ISO 11731-2:2004); Deutsche Fassung EN ISO 11731-2:2008, Beuth Verlag, Berlin. the fluorescence micrograph of a bacterial points and that an increased turbidity – e.g. Exner, M.; Schwartz, T. (Eds) (2015): RiSKWa-Statuspapier „Bewertungskonzepte der Mikrobiologie mit den flock from an effluent after live-dead staining. after strong rains or spring runoff – corre- Schwerpunkten neue Krankheitserreger und Antibiotikaresistenzen“ – Ergebnisse des Querschnittsthemas In the framework of TransRisk and Schus- lated with a rise in the number of antibiotic „Bewertungskonzepte der Mikrobiologie“, DECHEMA, Frankfurt am Main. senAktivplus, the efficiency of ozonation as resistance genes found. www.bmbf.riskwa.de/de/downloads/RISKWA_Statuspapier_Mikrobiologie_2015_10_30.pdf. an additional wastewater treatment step for (RiSKWa status paper “Microbiological risk assessment concepts with a focus on emerging pathogens and antibiotic resistance” – Results of the interdisciplinary topic “Microbiological risks assessment concepts”) the reduction of antibiotic resistant bacteria In the joint research projects TransRisk ISO 11731: Wasserbeschaffenheit – Zählung von Legionellen (ISO/DIS 11731:2015); Deutsche und Englische was investigated. The analyses showed a and AGRO, the antibiotic resistance genes Fassung prEN ISO 11731:2015, Beuth Verlag, Berlin. significant reduction of the total bacterial under analysis were found in the surface ISO/TS 12869: PD ISO/TS 12869:2012-12-31, Wasserbeschaffenheit – Nachweis und Quantifizierung von load, but the share of resistant isolates in waters examined and quantified in the total Legionella und/oder Legionella pneumophila durch Konzentration und genische Verstärkung mittels the surviving population in the effluent of the population with the help of molecular-bio- Polymerase-Kettenreaktion (RT-PCR), Beuth Verlag, Berlin. ozonation step was in some cases higher. logical methods. The highest concentrations Kaiser, E.; Prasse, C.; Wagner, M.; Bröder, K.; Ternes, T. A. (2014): Transformation of oxcarbazepine and This result gives a first indication about a were measured in bacteria populations from human metabolites of carbamazepine and oxcarbazepine in wastewater treatment and sand filters. Environ. series of antibiotic resistant bacteria that surface waters used as receiving waters for Sci. Technol. 2014, 48 (17), 10208–10216. survive ozonation treatment. However, it is local wastewater treatment plants. But re- Marx, C.; Kühn, V. (2014): Emissionsdynamik urbaner Antibiotikaeinträge unter Verwendung von Verschreibungs- not possible to make a general statement sistant genes, although in smaller amounts, und Felddaten. Prävention und Gesundheitsförderung 9, 198-205 DOI: 10.1007/s11553-014-0453-2. (Emission dynamics of urban antibiotic input considering prescription and field data. Prevention and health for the behavior of all clinically relevant an- were also detected in surface waters with- promotion) tibiotic resistant bacteria. No further signifi- out direct influent from wastewater treat- Rossmann, J.; Schubert, S.; Gurke, R.; Oertel, R.; Kirch, W. (2014): Simultaneous determination of most cant reduction of antibiotic resistant bacte- ment plants. prescribed antibiotics in multiple urban wastewaters by SPE-LC-MS/MS. Journal of Chromatograpy B 969, ria could be found after passing the filters 162–170 DOI: 10.1016/j.jchromb.2014.08.008. downstream of the ozonation step. In the framework of SchussenAktivplus it Schlüsener, M.P.; Kunkel, U.; Ternes, T.A. (2015): Quaternary Triphenylphosphonium Compounds: A New Class was demonstrated that the resistance level of Environmental Pollutants, Environ. Sci. Technol. 49, 14282–14291. did not change while passing through con- Schubert, S.; Käseberg, T.; Benisch, J.; Knoth, H.; Oertel, R.; Fauler, J. (2015): Bestimmung häufig verschrie- structed wetlands and rain water overflow bener Antibiotika in verschiedenen Stadien und Medien im urbanen Abwassersystem mittels USE und SPE sowie LC-MS/MS. Mitt Umweltchem Ökotox GDCh, 21.Jahrg. 2015 Nr.1, ISSN 1618-3258 basins. In a column assay on bank filtration www.gdch.de/fileadmin/downloads/Netzwerk_und_Strukturen/Fachgruppen/Umweltchemie_OEkotoxikologie/ conducted in the framework of the PRiMaT mblatt/2015/b1h115.pdf. joint research project, the reduction of re- (Determination of frequently prescribed antibiotics in various statuses and media in the urban wastewater sistant bacteria during soil passage was system using USE and SPE as well as LC-MS/MS.) demonstrated. Under TransRisk, high bac- Timpel, P.; Gurke, R.; Marx, C.; Knoth, H.; Fauler J. (2016). Antibiotikaeintrag in das urbane Abwasser – Eine sekundärdatenbasierte Analyse zur Eintragsabschätzung am Beispiel der Stadt Dresden (Release of antibiotics teria loads and abundances of hygienically into urban wastewater: A secondary-data based analysis for the input assessment using the city of Dresden as relevant bacteria and resistance genes in an example). Bundesgesundheitsblatt 59:274–283. doi: 10.1007/s00103-015-2288-1. surface waters were measured, especially after strong rains.

Fig. 2.8: Fluorescence micrograph of a bacteria population (© T. Schwartz, Karlsruhe Institute of Technology (KIT))

22 23 3 Risk characterization und risk assessment: drinking water, wastewater, ground and surface water

3 Risk characterization und risk assessment: commissioning of a commercial-scale ac- as a mixture based on their eco-toxicolog- drinking water, wastewater, ground and surface tivated powder unit in a wastewater treat- ical effect proved to be a viable method. water ment plant in the Lake Constance catchment area. The health condition of the Key message 6: Effects of anthropogen- aquatic organisms can be plausibly corre- ic micropollutants on humans and the en- Authors: Dr. Tamara Grummt, Prof. Dr. Rita Triebskorn, Prof. Dr. Martin Exner, Prof. Dr. Thomas Schwartz, lated to the extension of the wastewater vironment could not be evidenced in the Dr. Lars Jurzik, Dr. Marion Letzel, Prof. Dr. Tobias Licha, Prof. Dr. Jörg Oehlmann, treatment plant. Berlin water cycle for real concentrations Prof. Dr. Michael Wilhelm during the period of investigation. Key message 5: The system-specific approach of evaluating the substances and Key messages their (unknown) transformation products

Drinking water Microbial contamination Key message 1: The concept of deriving Key message 2: An extension of the Key message 1: Wastewater systems standardized cultivation processes for a health-related indicator values, or HRIVs, HRIV concept by experimental modules have been identified as important sourc- faster and more comprehensive identifica- (German: gesundheitliche Orientierungs allows for a timely collection of data that es for the direct release of opportunistic tion of microbiological hazards in aquatic werte, GOW) supports the implementation increase the scientific basis for deriving the pathogenic bacteria and clinically relevant systems. of the German Drinking Water Ordinance in HRIVs. This represents an essential ele- antibiotic resistances into the aquatic en- those cases where substances are found in ment for effective risk management. vironment. Adequate technical processes Key message 4: New methodological the drinking water that have so far not been must interrupt these dissemination paths. procedures for antibiotic resistances and regulated by a legally binding standard, Key message 3: With the extended HRIV “new emerging pathogens” need to be in- but which require such regulation in view concept the substances are prioritized and Key message 2: To assess the quality of tegrated into the risk characterization. of their relevance for the drinking water further actions regarding the toxicological wastewater treatment plant effluents, addi- quality. With the HRIV concept of deriving assessment are defined. tional quality characteristics are purposeful Key message 5: Despite a reduction health-related indicator values it is possible and necessary: microbiological indicator in the total bacteria count as a result of to recommend measures also without hav- Key message 4: The toxicological safety parameters (resistance genes, pathogens, wastewater treatment, e.g. by ozonation, ing legally binding standards in place. of drinking water can be guaranteed by viruses) as well as the introduction of mon- selective processes for microorganisms HRIV derivation supported by experimental itoring concepts and microbiological reg- can be observed that lead to an accumula- data. ulations. tion of antibiotic resistances and therefore require a specific adaption of the technol- Key message 3: Molecular-biological meth- ogy in place. Wastewater and surface water ods supplement and complement the Key message 1: Toxic substances in Key message 3: All cleaning technol- wastewater can be significantly reduced ogies examined in this context have their by introducing a fourth treatment stage in pros and cons. It must be clarified on a wastewater treatment plants. case-by-case basis which technology is best suited for treating wastewater under Key message 2: Chemical loads and their the site-specific conditions. 3.1 Toxicological and eco- effects on humans and the environment, on negative impact on aquatic organisms can toxicological assessment the other hand, we are depending on phar- effectively be reduced for specific sub- Key message 4: Positive effects on the maceuticals for quality of life improvements. stances, for example by means of ozona- respective aquatic ecosystem were ob- The risk management of anthropogenic mi- That is why it must be discussed how con- tion and/or adsorption on activated carbon. served already within one year after the cropollutants operates in a field of conflicting crete risks can be reliably assessed. interests. On one hand, we have unwanted

24 25 RiSKWa-Handbook of good practice 3 Risk characterization und risk assessment: drinking water, wastewater, ground and surface water

For the characterization and assessment they collect endpoint-specific effects of both (I) laboratory and in-situ tests (biotests) Human toxicological contaminations and of micropollutant risks in the environment chemicals in environmental samples with which determine the toxicity of chemicals their assessment (groundwater, surface water, wastewater, complex, so far unknown contaminations. and complex environmental samples by soil, air) it is essential to know the adverse Such effect-based tests could be part of means of mostly standardized processes Anthropogenic micropollutants are relevant effects caused by these substances and the an integrated evaluation system for mixed via apical, population-relevant endpoints for the drinking water and thus potentially threshold values that trigger such effects. toxicity studies that can be included in the (e.g. mortality, development, growth, re- also for human health on the grounds of Effect-based tests offer the advantage that assessment. Effect data are obtained from production) and (II) biomarker studies to their properties (including polarity, persis- evidence reactions in exposed organisms tence and mobility). Where such substanc- in the field. es are analytically detected in the drinking Tab. 3.1: Modes of action examined in the RiSKWa joint research projects water, they need to be assessed with regard Mode of action In the framework of RiSKWa, biotests with to the applicable German Drinking Water both apical endpoints and biomarkers were Ordinance, Articles 4 and 6 (Axiom of Con- used as effect-based methods for assess- cern and Minimization Imperative). To this Tab. 3.1: Betrachtete Wirkmechanismen in den RiSKWa-Verbundprojekten ing micropollutants in the water cycle, in effect, the health-relevant indicator value or particular in the joint research projects HRIV is used. The HRIV is a health-related RISK-IDENT, SchussenAktivplus, TOX- precautionary value for substances that can BOX and TransRisk. Individual, effect-relat- only be analyzed to some extent or not at ASKURIS PRiMaT RISK-IDENT RiskAGuA SAUBER+ SchussenAktiv plus TOX-BOX TransRisk ed aspects were also examined in the con- all in terms of their toxicity for humans. This Toxic effects text of the joint research projects ASKURIS, (non-assessibility) is a criterion that applies PRiMaT, RiskAGuA and SAUBER+. In the almost consistently in the case of anthropo- Genotoxicity o o o o o o o projects TOX-BOX and PRiMaT, the main genic micropollutants. Neurotoxicity o o o focus was on assessing drinking water-relevant substances and their elimination, while Under the joint research project TOX-BOX, Dioxin-like toxicity/Biotransformation o o o the other joint research projects focused on in-vitro testing strategies to determine the Cytotoxicity, tissue integrity, inflammation o o o o the effect-based monitoring of micropollut- modes of action relevant for humans (ge ant elimination by various wastewater treat- notoxicity, neurotoxicity, endocrine effects) Proteotoxicity o ment technologies. The individual methods are being developed to derive the HRIV. To are described in detail in the RiSKWa com- assess the relevance for humans, metabo- Phytotoxicity o o o pendium “(Öko)toxikologische Bewertungs lism-competent cell lines are used that have Developmental toxicity o o o methoden“ [(eco)toxicological assessment proven to be highly specific regarding the methods]. Table 3.1 provides a summary of human metabolism. That way, data gaps Reproductive toxicity o o o o o the effects analyzed by the abovementioned can be filled and the toxicological safety en- Growth o o o o o o RiSKWa projects. hanced. This in turn will ensure that risks are not over- or underestimated – an important Ecosystem integrity o In the context of the joint research projects aspect with a view to the overall objective PriMaT, RiskAGuA RISK-IDENT, SAU of the joint research project: a scientifically Unspecific toxicity, mortality o o o o BER+, SchussenAktivplus, TOX-BOX and based risk management. Hormone-like effects TransRisk the toxic properties of drinking water, wastewater, surface water, and Since the HRIV level (as a function of the Estrogenicity o o o aquatic sediments were examined using a data available in a range from 0.1 to 3 µg/l) Anti-estrogenicity o o o series of biotests and biomarkers. In this determines the corresponding risk manage- context, various modes of action of sub- ment actions to be taken, a methodological Androgenicity o o stance contaminations were examined (cf. toolbox for collecting the toxicological data Tab. 3.1). needs to be bindingly established. To this Anti-androgenicity o o

26 27 RiSKWa-Handbook of good practice 3 Risk characterization und risk assessment: drinking water, wastewater, ground and surface water

effect, general guidelines in the form of de- some cases, also an increase in the toxic- Depending on the planned application, an impact of the parameters under analysis cision trees are defined. ity of the wastewater was to be expected in-vitro and in-vivo bioassays (laborato- (e.g. biomass, growth and reproduction) is when applying these new technologies - as ry tests) offer specific advantages. In-vivo attributable to the elimination of toxic sub- A detailed description of the toolbox and a result of the formation of (possibly as yet tests are performed using intact organisms stances and/or formation of potentially toxic the test reports is provided in the guidance unknown) transformation products, for ex- that represent aquatic communities and ex- transformation products or to other proper- document “Hazard-based risk management ample. In this context, especially tests that hibit a higher ecological relevance as com- ties of the effluent (e.g. nutrient concentra- of anthropogenic micropollutants in drinking map genotoxic effects were important since pared to in-vitro tests. While acute tests are tion). water”. The HRIVs derived are published by transformation products frequently exhibit usually not sufficiently sensitive to be able to the German Federal Environmental Agency radical characteristics and may interact with asses effects in environmental samples for The benefits of in-vitro tests for identifying (Umweltbundesamt, UBA) under the link the genetic material of organisms. typical contamination levels, chronic tests and assessing the effects on environmen- “http://www.umweltbundesamt.de/sites/ are particularly well suited for mapping eco- tal samples in general and on wastewater default/files/medien/374/dokumente/liste_ Besides standardized biotests such as the logically relevant effects of substances also samples in particular are that such tests are der_nach_gow_bewerteten_stoffe_2.pdf“). daphnia or luminescent bacteria test which in complex cocktails in surface waters, sed- specifically sensitive for a given mode of ac- are suited as screening methods for high iments and in wastewater samples. tion and that they are easy and inexpensive The endpoint-related test strategy for deriv- toxicity levels and can therefore at best de- to use and thus suited for routine monitoring the HRIVs comprises the following in-vitro tect incidents in European water bodies, On the other hand, however, chronic tests ing, on the one hand, while the ecological testing procedures: also a wide range of modern, sensitive and are time-intensive and therefore better suit- relevance of the findings is limited because to some extent also selective and specific ed for research purposes than for routine only the potential and not the effect on in- • Genotoxicity is analyzed using the ames, in-vitro and in-vivo studies were conducted monitoring and only in exceptional cases tact organisms are measured, on the other. umu and micronucleus test. in the framework of RiSKWa. They allowed allow studying specific toxicity modes of ac- Moreover, the high specificity of the in-vitro for an investigation of the biological poten- tion. Although this constraint can be offset tests reduces the possibilities for detecting • Neurotoxicity is tested by measuring ne- tials and effects in their numerous facets by parallel tests with biomarkers in addition transformation products, for example, and crosis, apoptosis and oxidative stress in ranging from the molecule to the ecosys- to the apical endpoints, it contributes to fur- extensive test batteries are needed to map liver and nerve cells. tem. ther increasing the effort required for testing a sufficient number of relevant modes of ac- and evaluating the test results. It has there- tion. • With the neurite outgrowth assay, neu- fore proven to be effective to use not only ron-specific effects are demonstrated. in-vivo tests with intact organisms, but also In the framework of the joint research project in-vitro assays, like for example in the con- TransRisk, a modular concept for the com- Table 3.1 illustrates the manifestation of text of the joint research projects Schus- parative assessment of enhanced waste- neurites. The toolbox for detecting endo- senAktivplus and TransRisk. water treatment processes that considers crine effects consists of hormone-specific chemico-analytical, eco-toxicological and reporter gene assays and the H295R assay. Another aspect emerged for example when microbiological parameters was developed. analyzing the enhanced wastewater treat- For the eco-toxicological assessment, pri- Eco-toxicological contaminations and ment technology in a wastewater treatment marily standardized in-vitro test procedures their assessment pilot plant under the joint research project were considered for which either a DIN/ISO TransRisk, was that some of the selected standard or a standard operating procedure In the joint research projects ASKURIS, test species in the chronic in-vivo tests re- (SOP) is available. In this context, the fol- PRiMaT, RiskAGuA, SAUBER+, Schus- acted not only to contaminants in the strict lowing eco-toxicologically relevant activity senAktivplus, Sichere Ruhr and Trans- sense, but also showed sensitive reactions groups were analyzed: Risk, effects-based tests were used to to nutrients (nitrogen compounds, phos- characterize the efficiency of different treat- phorous), increased salt concentrations and • Endocrine activities: identification of ment technologies and their combination filterable suspended matter. These reac- the agonistic (receptor-activating) and Fig. 3.1: Neurite differentiation of the cell culture with view to reducing potential toxic and tions can hide the effects of micropollutants antagonistic (receptor-inhibiting) potential SH-SY5Y to asses neurotoxicity hormonal effects in the wastewater. Anoth- (© E. Dölling, Federal Environmental so that, without additional in-vitro tests, it regarding the estrogen receptor α (ER α) er objective was to determine whether, in Agency (UBA), Dessau) cannot be unequivocally clarified whether and the androgen receptor (AR) using

28 29 RiSKWa-Handbook of good practice 3 Risk characterization und risk assessment: drinking water, wastewater, ground and surface water

recombinant yeast reporter gene assays • Further activities can be considered as treatment plant was investigated and com- different modes of action (dioxin-like, gen- (YES, YAS, YAES, YAAS). Methodical required, like for example dioxin-like (in pared using a set of different biomarkers as otoxic, (anti-)estrogen toxicity) and the ef- alternatives include proliferation assays TransRisk measured with the help of the diagnostic tools. This allowed characterizing fects in organisms either exposed in nature (e.g. e-screen) or reporter gene assays Yeast Dioxin Screen as a recombinant the general health condition of organisms, or sampled from there, determined with the on the basis of cell lines (e.g. ER-Calux, yeast reporter gene assay), neurotoxic on the one hand, but in addition also provid- help of biomarkers (cf. Fig. 3.2). In addition, AR-Calux). (e.g. inhibition of the acetylcholinesterase) ed information on specific pollution factors it was possible to correlate certain adverse and/or phytotoxic effects (e.g. inhibition (e.g. genotoxic, dioxin-like or estrogen-like effects in fish and invertebrate animals as • Mutagenic/genotoxic activities are of photosystem II). substances), on the other. In parallel to the well as their reduction after extension of the identified using the Ames fluctuation test biomarker studies, in biota trace substance wastewater treatment plant with the pres- (as per ISO 11350). In addition or as me- In the joint research project SchussenAk- analyses were performed. ence of micropollutants or their further elimi- thodical alternatives, other genotoxicity tivplus the effects of the large-scale exten- nation in the additional treatment step. assays (e.g. umu test, Comet assay, mi- sion of a wastewater treatment plant with Already 15 months after addition of the PAC cronucleus test) can be used. powdered activated carbon on an eco- filter it was possible to plausibly correlate Table 3.2 summarizes the results obtained system of the connected receiving water improvements in the health condition of in the individual RiSKWa joint research pro- • Cytotoxic activities are detected with was investigated. Besides the wastewater aquatic organisms to the extension of the jects regarding the effects of micropollut- the help of mammal (e.g. GH3) or other samples also the surface water and the wastewater treatment plant. This was the ants and their elimination. vertebrate cell lines (e.g. RTL-W1) or with sediments were examined for toxic and hor- case for both, fish and invertebrate aquatic the help of bioluminescence inhibition in monal potentials. Moreover, the health con- organisms. Under this joint research project the case of luminescent bacteria. dition of fish and fish food organisms before it was possible to develop plausible relation- and after the extension of the wastewater ships between the results of in-vitro tests for

Fourth treatment stage in WWTPs

Tab. 3.2: Summary of the results achieved by way of assays in the framework of RiSKWa

Joint research Results achieved Reduction of project micropollutants and microbes PRiMaT A practicable, lab-scale test method was developed that purposefully combines enrichment process and assay. The ozonation of selected trace materials did not produce any evidence about the formation of genotoxic transformation products. Reduction of toxic and hormonal RiskAGuA The eco-toxicological potential decreases as a result of the fermenta- effects potentials tion process. RISK-IDENT Anthropogenic micropollutants are not completely biodegraded in bi- Reduction of adverse effects in fish ological wastewater treatment. Standardized assays (algae growth in- and invertebrates hibition test, Ames fluctuation test and 21d daphnia test) showed that both the residual concentrations and also the transformation products that form in the process of wastewater treatment can be eco-toxicologically relevant. Also in the case of a non-toxic wastewater at the Fig. 3.2: Plausible correlations between the reduction of micropollutants by means of a fourth treat inlet, transformation products may form that are harmful for aquatic ment stage in wastewater treatment plants and an improved health of the ecosystem that organisms. could be indexed by means of biotests. (© University Tübingen)

30 31 RiSKWa-Handbook of good practice 3 Risk characterization und risk assessment: drinking water, wastewater, ground and surface water

Joint research Results achieved 3.2 Microbiological assessment TransRisk project This chapter in many aspects refers to the • Even after conventional treatment, hospi- SAUBER+ Untreated raw sewage from two medical facilities, except for an inhibition of bacterial luminescence, did not show any further indications RiSKWa status paper “Bewertungskonzepte tal and municipal wastewaters contribute of a measurable biological disruption. In both cases, this bacteriot- der Mikrobiologie mit den Schwerpunkten to the release of facultative pathogenic mi- oxic effect found in the raw sewage could be completely eliminated neue Krankheitserreger und Antibiotika- croorganisms into the aquatic environment. by treatment in a membrane bioreactor. No further toxicity (genotox- resistenzen“ [Microbiological assessment icity, growth inhibition, luminescence inhibition) could be found in the concepts with a focus on emerging patho • Clinically relevant determinants of antibi- downstream treatment stages using granular activated carbon and/ gens and antibiotic resistances] which con- otic resistance were in some cases found or ozone. tains the results of the interdisciplinary topic more frequently in the analyzed wastewa- By contrast, a clear rise in the toxicity (bacteria toxicity and genotox- “Bewertungskonzepte der Mikrobiologie“ ters and/or sewage treatment plant efflu-

icity) was found after treating one of the wastewaters with UV+H2O2. [Microbiological assessment concepts] [Ex- ents than in the carrier organisms (indica- This toxicity was attributed to the remaining H2O2 and was not found ner & Schwartz, 2015]. tion of horizontal gene transfer). in further test series. SchussenAktivplus A reduction of the toxic and hormonal potential in the wastewater Ultimately, the microbiological assessments • Advanced treatment (so-called fourth by more than 80% was achieved using powdered activated carbon, are derived from the conclusions of the treatment stage) at wastewater treatment ozone with and without granular activated carbon and a constructed RiSKWa joint research projects listed in the plants involving technologies such as wetland. following. ozonation leads to a further reduction in Positive effects of a commercial-scale powdered activated carbon filter the concentration of bacteria and faculta- on the health of fish and fish food organisms were evidenced. Sichere Ruhr tive pathogenic microorganisms, but not Plausible correlations exist between the results of chemical analyses, to their full elimination. in-vitro tests and biomarker studies. • First-time quantitative risk assessment The relevance of answers at lower biological levels (molecules, cells) (QMRA) for those bathing in the river • Bacteria resistant to antibiotics in the for ecosystem parameters (macrozoobenthos community) was evi- Ruhr: Enteroviral infection risk most rel- wastewater in some cases turned out to denced. evant. be more resistant to oxidative processes TOX-BOX A guideline for defining in-vitro test strategies to assess the hazard and survived the ozone treatment. potential for the relevant endpoints genotoxicity and neurotoxicity as • Successful involvement of the public: well as endocrine effects was developed and health-oriented indicator high level of interest – understanding – • Surface waters impacted by the intake of values were derived. commitment regarding bathing condi- effluents and even groundwater showed tions from the media and the public. concentrations of facultative pathogenic TransRisk A sample treatment method for the in-vitro testing of water samples was defined. microorganisms and determinants for • Technical measures for improved hygiene resistance to antibiotics in relation to the The examination of endocrine potentials in the influent and effluent of assessed: mixed water – wastewater total population. sewage treatment plants in the Donauried region produced an elimina- treatment plant – agriculture are the ap- tion of estrogenic and androgenic activities by ≥ 75% and of anti-estrogenic activities by ≤ 60% as compared to the influent. Anti-estrogenic proaches for improving quality. SchussenAktivplus activities were detected in some groundwater samples. Toxic and hormonal potentials in the wastewater were reduced by • The guide “Flussbaden” [bathing in rivers] • A wastewater treatment plant with add- means of ozone with and without downstream filter systems. A strong describes the legal framework, moni- ed ozonation step resulted in a further increase in mutagenic and genotoxic effects could not be reduced with toring, early warning system, hygiene reduction in the absolute concentration a downstream biofilter, but by way of a downstream granular activated improvement, costs to enable bathing, of facultative pathogenic microorganisms carbon (GAC) filtration. communication. and bacteria resistant to antibiotics in the A modular concept for the evaluation of advanced wastewater treat- sewage treatment plant effluent. ment processes on the basis of chemico-analytical, eco-toxicological • Bathing in German rivers: “Interessenge- and microbiological parameters was developed. meinschaft Baden” [Special interest group • During the passage across the filter the bathing] starts a trial in the river Ruhr. tests sometimes showed an increase in

32 33 RiSKWa-Handbook of good practice 3 Risk characterization und risk assessment: drinking water, wastewater, ground and surface water

the share of antibiotic resistant E. coli, en- AGRO • By contrast, the detection of Legionella In practice, culture-based methods are terococci and staphylococci isolates. pneumophila in the drinking water by way frequently used for detecting hygienical- • Frequent detection of resistance genes in of molecular biological methods (qPCR ly relevant bacteria. On one hand, this is • The passage across the constructed wet- the water of a karstic spring as well as in as per ISO/TS 12869) – unlike in the case mainly due to historical reasons since mo- land resulted in a reduction of the E. coli, the surface waters of the catchment area. of Legionella spp. – is well suited for a lecular biology and non-cultivation analytical enterococci and staphylococci ultimately quick, preliminary risk assessment based methods are still relatively new, on the other released into the receiving water. • Relevant antibiotic resistance genes on an alternative action value yet to be hand the relevant regulation guidelines (e.g. could be identified in the karstic spring specified until the results determined by Drinking Water Ordinance, Bathing Water water under analysis: sul1, sul2, dfrA1, culture analyses are available. Directive etc.) are based on culture analysis. ermB. • A “conversion factor” of genomic units More recent results have shown, however, • Strong rains resulted in a significant in- (GU) and colony-forming units (CFU) can- that also non-cultivable bacteria may be crease in the number of antibiotic resist- not be defined. present in aquatic samples which are not ance genes and their gene copies meas- necessarily dead but in a VBNC (VBNC – ured in the spring water. • The results of the qPCR are not legally viable but not cultivable) condition. robust and so far not suited as a replace- PRiMaT ment for the culture analyses required by The use of cultivation-independent mo- the law. lecular-biological methods is purposeful • Validation of the PCR method success- because (I) the results are mostly much fully conducted by way of comparative SAUBER+ faster and (II) the number of undetected, Fig. 3.3: Microbiological assessment concepts measurements in different laboratories. non-cultivable but yet present bacteria can facilitate evidencing the effectiveness • The concentrations of resistant bacte- be measured. This is necessary to allow for of constructed wetlands, for example (© M. Scheurer, TZW, Karlsruhe) • Reduction of resistance genes and virus- ria and the resistance gene spectrum in a differentiation regarding the hygienic as- es in a column test on bank filtration. the wastewater of the healthcare facilities sessment. ANTI-Resist from which samples were taken did not • Examination and validation of new op- differ much from each other and there is One method for assessing the concentra- • The abundance of E. coli was reduced by tions (Luminex and EMA/PMA) to evi- also very little difference between them tions of viruses, parasites and bacteria is the sewage treatment plant, but the share dence human pathogenic viruses in water and the substance concentrations and the quantitative microbial risk assessment of antibiotic resistant E. coli did not drop as an alternative to cell cultures. genes found in municipal wastewater. (QMRA). To allow a comparison of results during the passage across the sewage at the international level and across disci- treatment plant. • The examination of new methods for evi- • Besides tetracycline resistance genes plines, the DALY (disability-adjusted life dencing human pathogenic viruses is es- also extended-spectrum beta lactama- years) approach could be used as a basis. • The number of multiple resistances in E. sential for future analyses of surface water se-coding sequences (ESBL, MBL) were coli was not significantly reduced by the and effluents in regard to their viral load. ubiquitously detected while methicillin-re- The aquatic environment doubtless plays an sewage treatment plant. Despite the resistant or vancomycin-resistant bacteria important role for the persistence and de- duction, multi-resistant E. coli were still RiMaTH were only found in single instances. velopment of antibiotic resistances. In this released into the downstream water body. context, in particular the horizontal gene • The detection of Legionella spp. in the • Analyses of the municipal wastewater transfer as a method of transmitting viru- • Independently of E. coli, the operating drinking water by means of molecular system upstream and downstream of a lence factors has to be mentioned (Fig. 3.4). dynamics showed a seasonal pattern at biological methods (qPCR as per ISO/TS nursing home by way of high-throughput This refers in particular to the evolution of the wastewater treatment plant inlet and 12869) is not suited for a risk assessment sequencing confirmed the results of cul- new, clinically-relevant antibiotic resistanc- effluent including the abundances of anti- as it does not allow for conclusions to be ture tests. However, an evaluation of the es in the environment without knowledge biotic resistance genes. drawn regarding the presence of patho- small differences is difficult given the state about the exact development processes. gens. of the art of analytical methodology.

34 35 RiSKWa-Handbook of good practice 3 Risk characterization und risk assessment: drinking water, wastewater, ground and surface water

Data confirm that the origins of clinically rel- tals or fattening farms) could be purpose- projects of the funding measure [Jekel et al., pH values, sartans are neither sorptive nor evant resistance genes can also be found in fully treated with adequate techniques to 2015]. volatile. Since the elimination of sartans the environment and not only in the clinical minimize the bacterial loads and thus the therefore occurs mainly by biodegradation, field. These findings show the correlation proliferation risk of antibiotic resistances. It For a more targeted assessment of mobility this varying degree of degradation is prob- between evolution and spread of antibiotic should be noted that it is presently not pos- and persistence in karstic aquifers, marking ably caused by different functional groups resistances in hospitals and urban environ- sible to describe the actual situation regard- tests using typical wastewater-borne mi- within the molecule. It is for example known ments. However, no comprehensive data ing the spread of clinically relevant antibiotic cropollutants (acesulfame K, caffeine, ibu- that the biotransformation of amides is fast for the environmental field are available that resistances in the environment. profen, sodium cyclamate, acetaminophen, [Helbling et al., 2010]. Consistent with the would allow for the assessment of an ex- atenolol, carbamazepine) were for the first elimination values measured, valsartan and isting risk posed by antibiotic resistances. Some essential parameters for the assess- time conducted in the framework of the joint irbesartan, both with an amide function, are Although regulations such as the EU Water ment concepts are: (I) total bacteria count, research project AGRO. Retardation factors degraded faster than candesartan and olm- Framework Directive [EC Water Framework (II) detection methods (culture-based and/or and degradation rates in the karstic aquifers esartan which do not have an amide group. Directive (2000/60/EC)] demand a good bi- DNA/RNA-based), (III) frequency of hygieni- were measured to assess the mobility and The low sorptive retention and/or the high ological and chemical status of water bod- cally relevant microorganisms, (IV) frequency stability. For none of the substances under mobility of sartans is also evidenced by the ies in regard to specific environmental qual- of clinically-relevant resistance determinants analysis a significant retardation could be occurrence of the less easily biodegradable ity standards, pathogens and also specific including mobile genetic elements, (V) de- found. However, it showed that atenolol, sartans candesartan and olmesartan in the antibiotic resistant bacteria and/or antibiotic tection of multiple resistances, (VI) effect of caffeine, ibuprofen and acetaminophen are bank filtrate (cf. Chapter 2.1). resistant genes are presently not mentioned the treatment technologies (reduction po- easily degradable in the hydrogeological in national and international regulations – tentials), etc. system of the aquifer. Cyclamate was not they should, however, be integrated into degraded during the test period. While the the respective regulations. This is also men- Generally, applicable limit values must be caffeine metabolites under analysis could tioned by the WHO. defined which – similar to the chemical pa- not be found in the spring water, detection rameters – will permit to identify a risk po- of the atenolol biotransformation product To this effect, critical areas (e.g. strongly tential when exceeded, and result in actions. atenolol acid provided evidence of an in-situ contaminated partial effluents from hospi- biotransformation.

3.3 Mobility and persistence In the framework of the joint research project RISK-IDENT, the mobility and persis- free DNA In addition to the toxic assessment of sub- tence of selected substances in laborato- Phage infection Dead cells stances also an evaluation regarding their ry-scale wastewater treatment plants and mobility and persistence in the water cycle aquifer columns were examined. Among is needed. Mobile compounds (anions with other substances, the analyses focused on Transduction log D < 2.5 and uncharged compounds the antihypertensive drug group of sartans. with log Kow < 2.5) which are at the same So far, little is known about this substance Transformation time also persistent (half-life period >100 d), group although prescription levels have ris- can overcome the barriers in the multi-bar- en sharply in recent years and sartans have Conjugation rier system (cf. Chapter 5) and thus make at the same time also been prioritized on their way into the drinking water. Among the grounds of their as yet unknown eco- other substances, gabapentin was detect- toxicological effect [Bergmann et al., 2011]. ed in the drinking water in the framework It was striking that the elimination of five Resistance genes of the joint research project ASKURIS and structurally related sartans (valsartan, can- Plasmid valsartan acid in the framework of the joint desartan, eprosartan, irbesartan and ol- Fig. 3.4: Mechanisms of horizontal gene transfer research project . To better assess mesartan) in wastewater treatment varied in the aquatic environment AGRO (© T. Schwartz, Karlsruhe Institute of the functionality of barriers, the indicator strongly between 8% (olmesartan) and 97% Technology (KIT)) concept was developed for all joint research (valsartan) [Bayer et al., 2014]. At ambient

36 37 RiSKWa-Handbook of good practice

3.4 Bibliography 4 Technologies for reducing organic Bergmann, A.; Fohrmann, R.; Weber, F.-A. (2011): Zusammenstellung von Monitoringdaten zu Umweltkonzen- trationen von Arzneimitteln (Compilation of environmental monitoring data of pharmaceuticals), Umweltbundes- micropollutants and pathogens in amt (Federal Environment Agency). aquatic environments Bayer, A.; Asner, R.; Schüssler, W.; Kopf, W.; Weiss, K.; Sengl, M.; Letzel, M. (2014): Behavior of sartans (antihypertensive drugs) in wastewater treatment plants, their occurrence and risk for the aquatic environment. Environmental science and pollution research international 21(18), 10830-10839. Authors: Prof. Dr. Martin Jekel, Dr. Laurence Palmowski, Prof. Dr. Johannes Pinnekamp EG-Wasserrahmenrichtlinie (2000). Richtlinie 2000/60/EG des Europäischen Parlamentes und des Rates vom 23. Oktober 2000 zur Schaffung eines Ordnungsrahmens für Maßnahmen der Gemeinschaft im Bereich der Wasserpolitik. http://eur-lex.europa.eu/legal-content/DE/TXT/?uri=OJ:L:2000:327:TOC. Exner, M.; Schwartz, T. (Eds) (2015): RiSKWa-Statuspapier „Bewertungskonzepte der Mikrobiologie mit den Schwerpunkten neue Krankheitserreger und Antibiotikaresistenzen“ – Ergebnisse des Querschnittsthemas „Bewertungskonzepte der Mikrobiologie“, DECHEMA, Frankfurt am Main. www.bmbf.riskwa.de/de/downloads/ RISKWA_Statuspapier_Mikrobiologie_2015_10_30.pdf. Key messages (RiSKWa status paper “Microbiological assessment concepts with a focus on emerging pathogens and antibi otic resistances” – Results of the interdisciplinary topic “Microbiological assessment concepts”) Helbling, D.E.; Hollender, J.; Kohler, H.-P.E.; Fenner, K. (2010): Structure-Based Interpretation of Biotransfor- Key message 1: Multi-barrier systems in the specific conditions of each location. mation Pathways of Amide-Contaning Compounds in Sludge-Seeded Bioreactors. Environ Sci Technol 44, drinking water treatment offer a high level Combinations of different technologies 6628-6635. of protection from pathogens. may yield benefits, like for example the ISO 11350: ISO 11350:2012-05, Water quality – Determination of the genotoxicity of water and wastewater – elimination of transformation products from Salmonella/microsome fluctuation test (Ames fluctuation test), Beuth Verlag, Berlin. Key message 2: Retrofitting storm water ozonation by means of activated carbon ISO/TS 12869: PD ISO/TS 12869:2012-12-31, Water quality – Detection and quantification of Legionella spp. retention basins and wastewater systems adsorption. and/or Legionella pneumophila by concentration and genic amplification by polymerase chain reaction (RT- represents an essential measure in the PCR), Beuth Verlag, Berlin. catchment area to achieve a sustainable Key message 6: Electrochemical oxida- Jekel, M.; Dott, W.; Bergmann, A.; Dünnbier, U.; Gnirß, R.; Haist-Gulde, B.; Hamscher, G.; Letzel, M.; Licha, T.; Lyko, S.; Miehe, U.; Sacher, F.; Scheurer, M.; Schmidt, C.K.; Reemtsma, T.; Ruhl, A.S. (2015): Selection of or- protection of drinking water resources. tion with boron-doped diamond electrodes ganic process and source indicator substances for the anthropogenically influenced water cycle. Chemosphere has established itself as a novel technology 125: 155–167. Key message 3: Many organic trace sub- for reducing trace substances which can- stances, (antibiotic resistant) bacteria and not be satisfactorily eliminated by means of eco-toxicological effects can be effectively the standard technologies such as ozona- removed from the wastewater with the tion and activated carbon adsorption. available technologies of ozonation and/ or adsorption on activated carbon – with Key message 7: Most of the pharmaceu- additional costs and effects on the environ- tical residues, (antibiotic resistant) patho- ment. gens and toxic substances can be eliminated from the effluents of healthcare facilities Key message 4: The elimination per- on-site using a variety of technologies. formance of the individual technologies is dependent on the substances and the Key message 8: The processes taking ozone and/or activated carbon dosage. place in a biogas plant significantly reduce However, no single technology is capable the formation of resistant bacteria and re- of completely removing all contaminants at sistant genes in wastewaters from intensive reasonable effort and cost. livestock farming and lead to a reduction of the risks for humans and animals. Heavy Key message 5: Which technology is metals (e.g. copper, zinc), by contrast, are best suited for a given site has to be clari- not separated during manure fermentation fied on a case-by-case basis according to in biogas plants.

38 39 RiSKWa-Handbook of good practice 4 Technologies for reducing organic micropollutants and pathogens in aquatic environments

4.1 Introduction water and wastewater [DWA, 2015]. In the The processes of ozonation and activat- (fabric filters, membranes, etc.). When used framework of the RiSKWa joint research ed carbon adsorption are widely used in in wastewater treatment, the PAC is added With the use of different processes or pro- projects, a variety of these processes was commercial-scale drinking water treatment during or after mechanical-biological clean- cess combinations it is possible to eliminate applied and developed or optimized (cf. and are also increasingly used in advanced ing. In the latter case, the loaded “excess micropollutants and pathogens found in raw Tab. 4.1). wastewater treatment. This reflects in the carbon” can be sent to the aeration tank frequency of the variants examined in the and removed from the system together with joint research projects. Over and beyond the excess sludge. Tab. 4.1: Overview on the technologies for the elimination of micropollutants and pathogens examined in these technologies, some of the projects the context of the RiSKWa joint research projects broken down by fields of application. also examined further processes to assess For the elimination of a broad range of or- their adequacy for the elimination of micro- ganic micropollutants in the contact pro- pollutants and pathogens. The individual cess, PAC doses of 10 to 20 g/m³, hydraulic processes are introduced in the following retention times in the contact reactor of 30 before their use in drinking water treatment minutes and PAC retention times in the ad- and wastewater treatment is discussed in a sorption stage (consisting of contact tank, second step. sedimentation and sludge recycling to the contact reactor) of 6 to 9 days have proven 4.2 Technologies for the elimina- to be optimal (inter alia [Metzger, 2010]). tion of organic micropollutants ASKURIS SAUBER+ RISK-IDENT SchussenAktiv plus Ruhr Sichere TransRisk RiskAGuA PRiMaT and pathogens1 Processes based on granular activated carbon PAC Adsorption Granular activated carbon (GAC) is used as Adsorption GAC bed material in filters through which the wa- Polymer-derived carbon Activated carbon is used for the elimina- ter to be treated is passing in up- or down- Oxidation Ozonation tion of organic micropollutants either in the flow mode (cf. Fig. 4.1). Activated carbon form of powdered activated carbon which is filters can be operated in parallel and in se- UV stirred into the wastewater or in the form of ries. The filter can be designed as a closed

UV + H2O2 granular activated carbon in fixed bed filters. or open structure whereby closed pressure filters can achieve higher filtration velocities. Radiation and AOP O3 + H2O2 Processes based on powdered activated In wastewater treatment, GAC filtration is H O 2 2 carbon arranged downstream of the mechanical-bi- electro-chem. processes Powdered activated carbon (PAC) is dosed ological cleaning step. Membrane bioreactor into the water as a concentrated slurry. In the so-called contact process, PAC is The usual filtration velocities and empty Biofilter mixed with the water to be treated in a sep- bed contact times range between 5 and Multi-layer filter arate, in some cases cascaded, tank (con- 10 m/h and 10 to 30 min, respectively (cf. (Membrane) Filtration Slow sand filter tact tank), and then separated. Separation [Sontheimer et al., 1985; Metcalf and Eddy Pressure-driven membrane can be achieved by means of sedimentation Inc., 2004; Worch, 2012]). processes with the help of flocculants and flocculation aids. In this case, sedimentation is followed In the activated carbon bed, a sub- Electrodialysis by a downstream filtration step with a sand stance-specific concentration and loading Constructed wetland Special processes filter also in order to remove very fine PAC profile develops for the specific water com- for the treatment Lamella clarifier particles. As an alternative to sedimentation position and selected process parameters. of storm water Performic acid other separation processes may be used The location of these profiles in the filter

Drinking water treatment Wastewater treatment Treatment of agricultural waste 1 Modified excerpt from [Pinnekamp et al., 2015]

40 41 RiSKWa-Handbook of good practice 4 Technologies for reducing organic micropollutants and pathogens in aquatic environments

changes over time. The substance-specif- duced to a minimum, for example by means Ozone is an unstable gas and must there- lamps with a wave length of 220-280 nm), ic elimination performance of the activated of pre-filtration. In addition to the adsorptive fore be generated on-site from ambient air an effective reduction of bacteria, viruses carbon filter decreases successively as a effect biodegradation processes also take or stored oxygen. The resulting ozone-con- and parasites is achieved by photolytically function of the water volume treated and place in activated carbon filters [Sontheimer taining gas flow is then mixed with the wa- destroying the DNA [Metcalf & Eddy Inc., the amount of adsorbate (organic micropol- et al., 1985]. ter in a contact reactor (cf. Fig. 4.2). When 2004]. lutants) contained therein. Once the separa- used in wastewater treatment, an ozonation performance is no longer sufficient, the Oxidation by means of ozone tion unit is usually installed downstream of With the help of UV radiation, some or- GAC has to be replaced. Unlike powdered the secondary clarification of a mechani- ganic micropollutants (e.g. Diclofenac) are activated carbon, GAC can be thermally re- Ozone is a very strong oxidant and there- cal-biological treatment stage. A sufficient also photolytically degraded. Vacuum UV activated and then re-used, however with fore has the power to chemically oxidize the reaction time must be ensured by way of lamps (wave length <200nm) are used for some losses in the range of up to 10%. substances contained in the raw water or the hydraulic retention time inside the reac- the non-selective elimination of organic sub- wastewater. In this context, a distinction is tor. Given the toxic effect of ozone at high stances in water. In this process, hydroxyl Depending on the solids content in the filter made between the selective, direct reaction concentrations, adequate safety measures radicals form out of water molecules. These influent and biological fouling, activated car- and the unspecific, indirect reaction via the must be taken (e.g. exhaust air treatment to radicals – as already mentioned in the sec- bon filters must be periodically backwashed formation of hydroxyl radicals. Besides its eliminate residual ozone). tion dealing with the ozone oxidation – ex- to remove the separated solids. For an un- oxidative effect ozone is also used for dis- hibit a high oxidation potential and non-se- disturbed formation of the concentration infection and discoloration of water [von The specific ozone dose normally used for lectively oxidize organic micropollutants. profile the backwash frequency must be re- Gunten and von Sonntag, 2012]. eliminating micropollutants is based on an However, the energy demand of such UV

ozone consumption of 0.6-0.8 mg O3/mg radiation is very high.

DOC (range from 0.3 to 1.2 mg O3/mg DOC (cf. [ARGE, 2014])). With this ozone dose, Advanced oxidation processes the substances contained in the raw wa- Advanced oxidation processes (AOPs) re- ter or wastewater are not fully mineralized fer to a series of processes for the chemical but transformed into new substances. The treatment of mainly organic and, in select cas- transformation products that form in the es, also inorganic substances in wastewater ozonation process are usually more easily treatment or in water treatment by oxidation biodegradable than the original micropollut- with hydroxyl radicals. The common trait of ants. However, the environmental behavior all AOPs is the formation of hydroxyl radicals and toxicity of the transformation products from an oxidizing agent (ozone, hydrogen per- have not yet been fully investigated. That is oxide, oxygen or water molecules) with an ad- why a biologically active downstream treat- ditional energy input (UV radiation or electroly- ment, such as a sand filter, is recommended sis) or catalysts (titanium dioxide, polyaniline or [Abegglen & Siegrist, 2012]. iron(II) ions). Once formed, the diffusion-controlled reaction of the hydroxyl radicals with Radiation and advanced oxidation oxidizable substances is normally very fast processes and unspecific. In this process, organic molecules are fragmented very quickly and may be UV radiation partially mineralized. This however, requires a In drinking water treatment, UV radiation is very high dosage of oxidants. Many of these most frequently used for disinfection and in- AOP variants have so far not made it to the stalled downstream of the mechanical, bio- commercial scale, partially because of the rel- logical and/or chemical process steps. This atively high energy demand. Abb. 4.1: Examination of the adsorptive behavior Fig. 4.2: Pilot plant for ozonation within the joint is also the case in some wastewater treat- on granular activated carbon within the research project SAUBER+ joint research project SchussenAktivplus (© ISA, RWTH Aachen) ment plants. If the radiation time and the UV (© SchussenAktivplus) lamps are correctly designed (low pressure

42 43 RiSKWa-Handbook of good practice 4 Technologies for reducing organic micropollutants and pathogens in aquatic environments

Filtration and membrane filtration lar radiation, UV radiation, biodegradation, ated to encourage liquid flow through the Lamella clarifiers adsorption) that eliminate not only the par- membrane (cf. Fig. 4.3). Depending on the The efficiency of a sedimentation-based With a filtration or membrane filtration step ticulate trace substances contained in the size of the retained particles or molecules a separation of solids from combined sewer it is possible to separate particulates and, wastewater, but also dissolved compounds. distinction is made between microfiltration, overflows can be enhanced by reducing the with certain process variants, also dissolved ultrafiltration, nanofiltration and reverse os- flow rate to values in the range of≤ 10 m/h. substances from the aqueous phase. If both oxygen and nutrients are added to mosis. The pressure required rises as the Alternatively, lamella clarifiers can be in- the filter in sufficient amounts, a biofilm may pore size of the membrane decreases. stalled as an addition to existing structures Sand filters and biofilters form on the filter material. This biofilm can or as a new, stand-alone unit where the ef- In some wastewater treatment plants a contribute to water purification by means of Given their pore size, microfiltration mem- fective settling area is increased by means sand filtration step is used for polishing biological degradation processes. The use branes (pore diameter: 0.1-5 µm) can cap- of the lamella. This causes a drop in the flow mechanically, biologically and chemically of activated carbon as a filter material in- ture bacteria. Ultrafiltration membranes rate at the lamella to values in the range of treated wastewater. Where sufficient space stead of inert materials (such as silica sand (0.006-0.2 µm) can additionally remove vi- 3-5 m/h (corresponding to a tank flow rate is available, mainly for drinking water pro- or expanded clay) can improve the elimina- ruses while organic micropollutants usually of ≤ 30m/h), thus allowing for a good solids duction, the filtration is not designed as a tion of organic substances contained in the pass these membranes due to their small separation [Dohmann et al., 2003]. conventional rapid sand filter with filtration water by a combination of adsorption and molecule size. Solids accumulating on the rates of 5-15 m/h, but in the form of a filter biodegradation processes. membrane reduce the pore size over time Constructed wetlands with much lower filtration rates in the range so that finer particles can also be separated. Another option for reducing the solids con- of 0.1-0.2 m/h. Membrane filtration Nanofiltration membranes (0.001-0.01 µm) tent is to treat combined sewer overflows The most frequently used membranes for are able to separate nearly all pharmaceu- in constructed wetlands. In these struc- In the supernatant water and in the filter water treatment are pressure-driven mem- ticals. In the case of reverse osmosis, only tures, the combined sewer overflows pass body processes are taking place (e.g. so- branes where a pressure differential is cre- water, small ions and molecules pass the a plant-covered filter which separates and membrane by solution-diffusion transport degrades the substances contained in the mechanism. influent. The effluent of the constructed wetland is then largely solids-free. In the case of electrodialysis, an electrical field is applied as a driving force for the sep- By creating a biocenosis in the filter, addi- aration of electrically charged molecules. Its tional sorption capacities are obtained. This efficiency with regard to charged organic allows for the adsorption of substances micropollutants is rather low as compared such as oxygen-consuming compounds, to simple salts. This was demonstrated by the especially ammonia, and for their biological results of the joint research project PRiMaT. oxidation during the dry phase until the next rainfall. The concentration of pathogens is Special processes for the treatment of reduced to low values [Waldhoff, 2008]. storm water Some micropollutants can be retained and in part biodegraded. Sufficient data are yet Storm water treatment mostly consists of not available to assess the processes at separating particulate substances to reduce work for the respective groups of substances aquatic pollution. With regard to micropol- [Tondera et al., 2013]. lutants, an improved solids retention during the treatment of combined sewer overflows Performic acid can enhance the separation of particulate Performic acid can be used for the disin- micropollutants. To this effect, lamella clarifi- fection of water and wastewater. The acid ers and constructed wetlands can be used. oxidative effect destroys the cell walls and Fig. 4.3: Ultrafiltration membranes for the treatment of surface water the DNA of pathogens. The literature rec- (© DECHEMA, Frankfurt am Main) ommends concentrations of 5-6 mg/l and

44 45 RiSKWa-Handbook of good practice 4 Technologies for reducing organic micropollutants and pathogens in aquatic environments

reaction times of 5 to 45 minutes [Gehr et Raw water quality impairment of all surface ters. Solids separation processes and dis- example the complexing agent EDTA or the al., 2009; Maya et al., 2012]. waters, of many groundwaters impacted infection are used for the separation and/or pharmaceutical drug primidone, cannot be by surface waters (bank filtrates, artificial inactivation of the pathogens. This means removed during this filtration step and could 4.3 Technologies for the reclama- recharge) and of groundwaters affected by that, in each case, at least two barriers are therefore even be used as internal tracer tion and treatment of drinking anthropogenic influences has been a known created in addition to raw water protection substances. Extensive research on under- water – micropollutants and fact for a long time. In view of the deficits and distribution. ground passage demonstrated an impor- pathogens in water pollution control in the years since tant impact of redox potentials (from aerobic about 1970 it was already necessary to in- Much more common is the indirect utiliza- to anoxic to anaerobic) on the degradation A safe drinking water supply is based on clude additional treatment processes such tion of surface waters via bank filtration (on performance. The findings show that some the choice of high-quality and high-volume as ozone and activated carbon to remove rivers such as the Rhine, Elbe, Spree and substances can only be biotransformed water sources. According to the basic prin- micropollutants (such as organic halogen Havel, cf. Fig. 4.4) or artificial groundwater aerobically while others can only be trans- ciples laid out in the standard DIN 2000 [DIN compounds, AOX) that could be detected treatment with and without upstream or formed anaerobically. An intentional crea- 2000], groundwater from sufficient depths already at that time. It was possible to man- downstream treatment steps. tion of redox zones is only possible in the in well-protected aquifers without anthropo- age the hygienic risks with the help of treat- case of groundwater recharge, while bank genic pollution is best suited as raw water ment and disinfection technologies. As a One essential step is the well-known and filtration is more frequently aerobic in river and usually only requires simple treatment consequence, modern drinking water treat- sustainable purification by underground waters with a good water quality and almost processes (iron and manganese removal, ment can rely on a long lasting experience passage with its multiple effects on the sub- always anaerobic in bank filtration of lakes. removal of carbon dioxide) without disinfec- and extensive results, specifically for ozone stances contained in the water (particles, The detailed list of micropollutants that can tion stage. In regions where these prereq- and activated carbon (in particular for fixed organic matter, pathogens). However, it be degraded in the underground is shown uisites cannot be met, frequently additional bed adsorbers with GAC). was also found that some polar and highly in the guide on micropollutants [Jekel et al., treatment stages including disinfection are persistent organic micropollutants, like for 2013]. The separation of pathogens during needed. Since the quality of the raw water used usually determines the choice and combination Hygienically safe drinking water, as based of treatment processes, in the following the on the WHO Water Safety Plan (and/or the main raw water types will be presented as a Technical Safety Management (TSM) estab- basis to describe the typical treatment pro- lished by the German Technical and Scien- cesses with a focus on organic micropollut- tific Association for Gas and Water, DVGW) ants and pathogens. is ensured by the multi-barrier principle (see also Section 5) involving the elements of Surface waters protection of the raw water source, a sometimes multi-stage treatment and a qualita- Germany has only a few plants for the direct tively safe drinking water distribution. The treatment of river water, e.g. on the Danube German Drinking Water Ordinance [Trink- or on the river Warnow. The treatment se- wasserverordnung, 2015] in its latest ver- quence consists of a solids separation step sion dated 18 November 2015 specifies the with flocculation and sedimentation followed microbiological and chemical parameters by a rapid filtration step, an ozonation unit for the drinking water quality required at the upstream or downstream of the rapid filter, consumer’s faucet. They are complement- a GAC filtration unit (adsorptive and/or bio- ed by the health-related indicator values logical as BAC) and a chemical disinfection (HRIVs) recommended by the German Fed- step using chorine or chlorine dioxide. The eral Environmental Agency (Umweltbundes- elimination of micropollutants is achieved amt) for non-regulated micropollutants that mainly via transformation reactions in the allow for a safe, life-long consumption of the ozonation unit and via adsorption (including drinking water [Umweltbundesamt, 2015]. biodegradation) in the activated carbon fil- Fig.. 4.4: Bank filtration on the Rhine (© Rheinenergie AG, Cologne)

46 47 RiSKWa-Handbook of good practice 4 Technologies for reducing organic micropollutants and pathogens in aquatic environments

underground passage is normally very good treatment processes (ozone, activated wastewater treatment in municipal waste- highly reactive hydroxyl radicals. The op- to complete. Here the 50-days rule is often carbon) has significantly contributed to water plants (the so-called fourth treatment eration showed that this novel, energy-ef- applied which means that a retention time ensuring a safe drinking water quality in stage) downstream of the final sedimenta- ficient process is easy to handle and that of 50 days in a porous aquifer reliably sep- Germany. Many experiences from this field tion (cf. Fig. 4.5), treatment of mixed waters the eco-toxicological effect of the biologi- arates the microorganisms so that a subse- can therefore be transferred to ozonation or from discharge structures and the separate cally pretreated wastewater can be reduced quent disinfection is not needed. the use of activated carbon for wastewater treatment at point sources (cf. Tab. 4.2). to values below the detection limit. Further treatment, but with significant differences The project results obtained for these fields research is still required regarding the mini- Stagnant waters (lakes and reservoirs) regarding the concentration in organic sub- of application are presented in the following mization of inorganic byproducts that form, stances (background level of organic sub- (see also [RiSKWa, 2015]). like for example chlorate and perchlorate. Drinking water reclamation from very well stances in the form of DOC or COD as well Potential is found in particular regarding the protected lakes and reservoirs mainly relies as micropollutants). Advanced wastewater treatment in degradation of micropollutants that cannot on a solids separation by means of floccula- municipal wastewater plants be satisfactorily eliminated with usual tech- tion and rapid filtration as well as a disinfec- 4.4 Application of emission nologies such as ozonation and activated tion step (with UV light or others). Organic reduction technologies in In the joint research project ASKURIS it was carbon adsorption. A preliminary estimate micropollutants of anthropogenic origins wastewater treatment possible to reduce micropollutant concen- of the process costs (plant depreciation, can be found in catchment areas with pollu- trations in the effluent of a municipal waste- process consumables and energy costs) tion from wastewater systems or agriculture The input of anthropogenic micropollutants water plant by means of both, an ozona- produced values of 0.08 to 0.2 €/m3 for the or where eutrophication temporarily leads and pathogens into water bodies via the tion step and the use of activated carbon corresponding elimination of micropollutants. to pollution from algae (odor and taste, al- wastewater is widely documented and, in (PAC and/or GAC). None of the processes gae toxins). In this case the treatment steps addition to being a hazard for the aquatic showed negative effects of the treatment ozonation and activated carbon (sometimes habitat, may also affect the quality of the in terms of genotoxicity. For the ozonation added as PAC upstream of rapid filters) drinking water from bank filtrate, for example. step, a specific ozone dose of 0.7 mg/mg- are again used, similar to direct river water DOC proved to be sufficient for an advanced treatment. The reasons for applying a technology or a removal of many micropollutants detected. combination of technologies in wastewater The bromate concentration remained be- Contaminated groundwater treatment may be: low the limit value for drinking water of 10 µg/l. The examination of biological process- The large number of contaminated ground- • Compliance with expected legal require- es introduced downstream of an ozonation water bodies (contaminated by pesticides ments step to eliminate transformation products and their metabolites, by volatile chlorinat- has shown that only in exceptional cases ed hydrocarbons, by aliphatic and aromatic • Precautionary measure to protect drink- an additional elimination of micropollutants compounds from mineral oils, abandoned ing water sources takes place in these downstream biological military sites, contaminated soils and soil steps. In the process, the concentration of additives) led to substantial treatment costs • Reduction of eco-toxicological effects in N-Nitrosodimethylamine (NDMA) could be and efforts which frequently involve aeration the water body and/or reduced to values below the limit for drink- to remove volatile compounds and activating water of 10 ng/l. The addition of PAC is ed carbon filtration. In the case of severe • Reduction of hygienic contamination in also well suited for eliminating various mi- contamination and of substances that can- the water body. cropollutants, but these are different from not be removed with a technically reason- those eliminated in the ozonation step. The able effort, the water shall not be used for The technologies for the elimination of PAC dosage should be proportional to the drinking water as it is no longer possible to pathogens, micropollutants and toxic sub- DOC whereby PAC/DOC ratios of ca. 1.5 to assure the water quality. stances in the wastewater examined or 2 mg/mg have been found to be adequate. applied in the context of the RiSKWa joint Fig. 4.5: Final sedimentation tank in a conven- In conclusion, it can be said that the ear- research projects can be broken down A diamond electrode was used in the joint tional waste water treatment plant ly integration of advanced drinking water into three fields of application: advanced research project RISK-IDENT to generate (© ISA, RWTH Aachen)

48 49 RiSKWa-Handbook of good practice 4 Technologies for reducing organic micropollutants and pathogens in aquatic environments

Tab. 4.2: Overview on the examined fields of application in wastewater treatment In view of the bacteria and virus input into (including the respective scope of investigation) the water bodies found in the context of Mixed water the joint research project Sichere Ruhr it is Joint research Advanced municipal Separate treatment treatment in municipal advisable to treat the effluents from storm projects wastewater treatment at point sources wastewater plant water retention basins to reduce water pol- ASKURIS lution after rainfall. Depending on the tech- RiskAGuA nical options and space available, retention soil filters, lamella clarifies, disinfection with RISK-IDENT UV light or performic acid may be used. SAUBER+ Sichere Ruhr On-site treatment of wastewater SchussenAktivplus at point sources TransRisk The option of separately treating the efflu- Elimination of pathogens Elimination of organic micropollutants ents of healthcare facilities was examined Elimination of toxic, eco-toxic and/or hormonal potentials under the joint research project SAUBER+. It was possible to demonstrate that phar- Fig. 4.6: PAC dosing at the Langwiese waste- maceutical residues, (antibiotic resistant) Under the joint research project Sichere ination of hormonal and toxic potentials, water treatment plant under the joint pathogens and toxic substances contained Ruhr, which focused on reducing microbio- also a stand-alone PAC dosage as well as a research project SchussenAktivplus in the effluents of healthcare facilities can logical pollution, wastewater plant effluents stand-alone GAC filtration proved to be very (© SchussenAktivplus) be largely eliminated on-site by means of could be effectively sanitized by means of effective. various technologies. However, no single both UV light and ozonation. did not produce any effect in terms of elim- technology is able to eliminate all contam- The results of the joint research project inating micropollutants and the transforma- inants to values below the detection limits In the framework of the joint research pro- TransRisk show that transformation prod- tion products under analysis. In-vitro tests at reasonable cost and effort. Furthermore, ject SchussenAktivplus an efficient elim- ucts form during the ozonation of biologi- showed a decreasing estrogen-like activity it showed that an on-site treatment of efflu- ination of micropollutants was observed cally treated wastewater. In addition to vari- and an increasing anti-estrogen-like activity ents from healthcare facilities is purposeful for all process variants under examination, ous micropollutants also two transformation at higher ozone concentrations. In-vivo tests only in isolated cases. Healthcare facilities whereby the performance depended on products were found (Tramadol-N-oxide produced no signs of toxicity after the treat- may be significant point sources for indi- the respective chemical-physical substance and COFA). The transformation products ment steps. The total bacteria count was vidual pharmaceuticals, but generally they characteristics. The corrosion inhibitor generated in the ozonation step could not reduced by ozonation while the percentage are not. For the healthcare facilities exam- 1H-Benzotriazol, for example, could be be eliminated in the downstream biofilters. antibiotic resistant bacteria went up. ined, no increased input of pharmaceutical eliminated more efficiently with activated With a downstream activated carbon filter, residues, toxic substances and antibiotic carbon than with ozone. For the degrada- by contrast, it was possible to separate Mixed water treatment in municipal resistant bacteria or genes as compared to tion of carbamazepine, by contrast, ozona- one of the transformation products identi- wastewater plants households could be found. Deviations in tion proved to be more effective than acti- fied (Tramadol-N-oxide). Also the micropo- other healthcare facilities may occur so that vated carbon adsorption. Consequently, a llutants remaining after the ozonation step In the joint research project SchussenAk- case-by-case examinations with targeted combination of both processes represents could be further eliminated by means of the tivplus the retention soil filter, unlike the analyses are required. To this effect, it is rec- the most efficient treatment for the analyzed activated carbon filters. In addition, with the lamella clarifier, produced good results re- ommended to use the emission check de- compounds. The concentration of antibiotic combination of ozonation and activated car- garding the separation of micropollutants, veloped in the context of the joint research resistant bacteria could be reduced by all bon filtration, it was possible to permanently bacteria as well as hormone and toxic po- project SAUBER+. processes under analysis, with the most reduce the (filtered) COD below the limit val- tentials. The elimination efficiency was com- suitable technologies being the combina- ue of 20 mg/l as per the German Waste- parable to that of a biological treatment step Manure treatment by fermentation in biogas tion of ozonation and sand filter as well as water Levy Act. A return of ozone-treated in wastewater treatment plants. plants was examined in the framework of ozonation and GAC filtration. For the elim- wastewater to the biological treatment step the joint research project RiskAGuA. With

50 51 RiSKWa-Handbook of good practice 4 Technologies for reducing organic micropollutants and pathogens in aquatic environments

this treatment, a reduction of cultivable and ausgewählten Technologien zur Elimination Jekel, M.; Dott, W.; Bergmann, A.; Dünnbier, U.; Gnirß, R.; Haist-Gulde, B.; Hamscher, G.; Letzel, M.; Licha, T.; Lyko, S.; Miehe, U.; Sacher, F.; Scheurer, M.; Schmidt, C.K.; Reemtsma, T.; Ruhl, A.S. (2013): RiSKWa-Leitfaden known pathogenic bacteria as well as a re- von Spurenstoffen und Krankheitserregern „Polare organische Spurenstoffe als Indikatoren im anthropogen beeinflussten Wasserkreislauf“, Ergebnisse des duction of resistant genes could be achieved aus Abwasser“ (cf. [Pinnekamp et al., 2015]) Querschnittsthemas „Indikatorsubstanzen“. DECHEMA, Frankfurt am Main. without leading to an accumulation of resist- (Terms and definitions for selected tech www.bmbf.riskwa.de/_media/RISKWA_Leitfaden_Indikatorsubstanzen.pdf. (RiSKWa guide “Polar organic micropollutants as indicators in an anthropogenically influenced water cycle”) ant microorganisms. Treatment in a loop re- nologies to eliminate microorganisms and actor with pressurized membranes resulted pathogens in wastewaters) can be broken Maya, C.; Chávez, A.; Lucario, E ; Hernández, E.; Jiménez, B. (2012): Resistance of a wide spectrum of microorganisms to diverse disinfection systems to produce safe reuse water. Disinfection of Water, Wastewater and in a reduction of the antibiotics concentra- down into the following categories: Biosolids Conference, Nov. 2012, Mexico. tions in the fermentation residues and ma- Metcalf und Eddy Inc. (2004): Wastewater Engineering - Treatment and Reuse, McGraw-Hill, New York. nure while multi-resistant pathogens could • Criteria regarding economic efficiency Metzger, S. (2010): Einsatz von Pulveraktivkohle zur weitergehenden Reinigung von kommunalem Abwasser. be eliminated to some extent. Dissertation der TU Berlin, Oldenbourg Industrieverlag. • Criteria regarding effort/technology/ (Use of powdered activated carbon for the advanced treatment of municipal wastewater) 4.5 Conclusion operations Pinnekamp, J.; Letzel, M.; Palmowski, L. (2015): Begriffe und Definitionen zu ausgewählten Technologien zur Elimination von Spurenstoffen und Krankheitserregern aus Abwasser. Leitfaden im Querschnittsthema The choice of the adequate treatment pro- • Criteria regarding ecology and lifecycle „Abwassertechnik“ der BMBF Fördermaßnahme RiSKWa. www.bmbf.riskwa.de/de/downloads/RISKWA_Leitfaden_Abwassertechnik.pdf. cess for a specific application depends on assessment (Terms and definitions for selected technologies to eliminate microorganisms and pathogens in wastewaters) a number of factors and can be made with RiSKWa – Wissenschaftliches Begleitvorhaben der BMBF-Fördermaßnahme „Risikomanagement von the help of assessment criteria that can be • Criteria regarding resource and energy neuen Schadstoffen und Krankheitserregern im Wasserkreislauf“ (2015): Präsentationen im Rahmen der weighted with respect to the defined ob- consumption Abschlussveranstaltung, Berlin, 10./11. Februar 2015, www.bmbf.riskwa.de/de/1372.php (letzter Zugriff am jective for each location. The assessment 3.7.2015). (Accompanying project of the BMBF funding measure “Risk management of emerging pollutants and pathogens in the water cycle”) criteria which are presented in more detail • Criteria regarding operational aspects in the guide “Begriffe und Definitionen zu Sontheimer, H.; Frick, B.R.; Fettig, J.; Hörner, G.; Hubele, C.; Zimmer, G. (1985): Adsorptionsverfahren zur Wasserreinigung, Karlsruhe. (Adsorption technologies for water treatment) Tondera, K.; Koenen, S.; Pinnekamp, J. (2013): Survey monitoring results on the reduction of micropollutants, bacteria, bacteriophages and TSS in retention soil filters. Water Science and Technology, 68 (5), 1004-1012. Trinkwasserverordnung (2015): Verordnung über die Qualität von Wasser für den menschlichen Gebrauch (Trinkwasserverordnung - TrinkwV 2001), Neufassung vom 18.11.2015. (Drinking Water Ordinance: Ordinance on the quality of water for human consumption) 4.6 Bibliography Umweltbundesamt (2015): Liste der nach GOW bewerteten Stoffe, Fassung vom März 2015. Abegglen, C.; Siegrist, H. (2012): Mikroverunreinigungen aus kommunalem Abwasser. Verfahren zur weiter (List of substances assessed according to HRIV) gehenden Elimination auf Kläranlagen. Bericht vom Bundesamt für Umwelt, Bern. www.umweltbundesamt.de/sites/default/files/medien/374/dokumente/liste_der_nach_gow_bewerteten_stoffe_0.pdf. (Micropollutants in municipal wastewater. Processes for an advanced elimination in wastewater treatment Von Gunten, U.; von Sonntag, C. (2012): Chemistry of Ozone in Water and Wastewater Treatment: From Basic plants) Principles to Applications. IWA Publishing. ARGE (2014): Elimination von Arzneimittelrückständen in kommunalen Kläranlagen. Schlussbericht Phase II der Waldhoff, A. (2008): Hygienisierung von Mischwasser in Retentionsbodenfiltern (RBF). Dissertation, „Arbeitsgemeinschaft Spurenstoffe NRW, Teilprojekt 6“ (Arge), gerichtet an das das Ministerium für Klimaschutz, https://kluedo.ub.uni-kl.de/frontdoor/index/index/docId/1825, Kassel. Umwelt, Landwirtschaft, Natur- und Verbraucherschutz des Landes Nordrhein-Westfalen (MKULNV). (Sanitization of mixed water in retention soil filters) (Elimination of pharmaceutical drug residues in municipal wastewater treatment plants) Worch, E. (2012): Adsorption technology in water treatment – fundamentals, processes and modeling. DIN 2000 (2000): Zentrale Trinkwasserverordnung: Leitsätze für Anforderungen an Trinkwasser – Planung, Bau, De Gruyter, Berlin. Betrieb und Instandhaltung der Versorgungsanlagen; Technische Regel des DVGW. (Central drinking water ordinance: guidelines for drinking water requirements – planning, construction, operation and maintenance of utility plants) Dohmann, M.; Buer, T.; Stepkes, H.; Krisam, J.; Arndt, D. (2003): Einsatz von Lamellenabscheidern in Mischwasserbehandlungsanlagen. Schlussbericht zu dem vom BMBF geförderten Forschungs- und Entwick- lungsvorhaben, Institut für Siedlungswasserwirtschaft der RWTH Aachen. (Use of lamella separators in mixed water treatment plants) DWA (2015): DWA-Themenband „Möglichkeiten der Elimination von anthropogenen Spurenstoffen auf Kläranlagen“. (Options for the elimination of anthropogenic micropollutants in wastewater treatment plants) Gehr, R.; Chen, D.; Moreau, M. (2009): Performic Acid (PFA): Tests on an Advanced Primary Effluent Show Promising Disinfection Performance. Water Science and Technology 59 (1), 89-96.

52 53 RiSKWa-Handbook of good practice 5 Management concepts for dealing with micropollutants and pathogens in the water cycle

5 Management concepts for dealing with Wastewater micropollutants and pathogens in the water cycle Key message 1: The introduction of an as, for effluents from healthcare facilities, advanced fourth treatment stage in waste- a separate treatment is only reasonable in water treatment plants and the upgrading exceptional cases. Authors: Dr. Wolf Merkel, Prof. Dr. Traugott Scheytt of mixed water treatment improve the ecological water quality and represent effective Key message 3: The extension of select- protective measures for water bodies with ed wastewater treatment plants and tar- a high fraction of wastewater. geted measures for mixed water treatment involve a moderate financial burden for the Key messages Key message 2: Polluted wastewaters individual citizen. from agriculture should be treated where-

Water pollution control

Key message 1: The reduction of pollut- cals are efficient measures for the protec- 5.1 Introduction The multi-barrier concept is another exam- ant release from agriculture, households tion of water bodies. ple for a risk management approach that and industry, the avoidance of unneces- Micropollutants and pathogens represent a recognizes that an individual barrier may fail sary use of pharmaceuticals in human and Key message 2: Pollution control pays off: hazard for the water cycle. Risks emanating in its function to ensure safe drinking water veterinary medicine as well as the develop- German rivers can be suited for temporary from them must be controlled adequately. and therefore requires redundant measures. ment of environmentally safe pharmaceuti- use as bathing waters. The process applied to ensure an adequate The multi-barrier concept also forms a part risk control is referred to as risk manage- of the risk management approach used Drinking water ment. According to DIN EN 15975, a har- for the Water Safety Plans of the WHO or monized and systematically process-orient- serves as a basis for the applicable DVGW Key message 1: The German Drinking ities applying multiple technical barriers ed risk management allows to analyze and (German Technical Association for Gas and Water Ordinance is effectively protecting effectively removes pathogens and micro- compare risks. Water) regulations for safe drinking water. the population. This is supported by the pollutants. concept of deriving toxicologically based In this chapter on “Risk Management” the The main management approaches for “health-related indicator values” for today Key message 4: The Water Safety Plan focus will be on presenting the manage- assessing chemical substances and path- unknown substances in the water cycle approach goes beyond the scope of re- ment concepts used by the joint research ogens in the water cycle within the project that have (so far) not been regulated by a sponsibility of the water utility and covers projects under the RiSKWa funding meas- approaches under the RiSKWa funding legally binding standard. not only technical, but also organizational ure for the handling of micropollutants and measure are presented. These approaches measures: consideration of the different pathogens in the water cycle. The technical are partly based on each other and there- Key message 2: The systematic deter- barrier effects of karst and porous aquifers, processes are described in Chapter 4; the fore not free from methodological overlaps mination, assessment and control of mi- monitoring concepts, protective measures holistic approach of risk management. – one example is the multi-barrier concept crobiological and chemical hazards at the in catchment areas, preventive measures which is an important element of the Water national and international level follows the for protection against extreme weather Existing risk management concepts origi- Safety Plan. To obtain the broadest possi- WHO Water Safety Plan approach for safe conditions and a responsible operation of nate from various fields of application and ble overview on the RiSKWa contributions, drinking water. domestic installations, for example, are key differ in terms of their manifestations and le- methodological uncertainties were in some elements of a proactive risk management gally binding effects. The risk management cases accepted. Key message 3: The tried and tested as proposed by the multi-barrier concept. of the European Bathing Water Directive, for treatment concept of German water util- example, involves much more than just two hygienic limit values and covers the complete risk environment of a bathing area.

54 55 RiSKWa-Handbook of good practice 5 Management concepts for dealing with micropollutants and pathogens in the water cycle

Multi-barrier concept the overall system – no single barrier must health guidance values also below the HRIV on cost-efficiency criteria [EU Water Frame- be neglected at the expense of another one. are derived [Umweltbundesamt, 2003]. work Directive (2000/60/EC)]. Improving the raw water quality and/or With these steps, the necessary structural protecting the water quality is achieved by quality is ensured. Quantitative Microbial Risk EU Bathing Water Directive (2006) and/or means of a bundle of not only technical, Assessment (QMRA) NRW Bathing Water Decree (2007) but also organizational and staffing meas- Water Safety Plan ures in the process chain from the raw This is a method for determining the risks The Bathing Water Decree of North water source to the water treatment plant In the World Health Organisation’s guide- caused by microbiological hazards due to Rhine-Westphalia (NRW) requires manda- all the way through to the consumer’s tap. lines for drinking water quality [WHO, 2005] different exposure routes. Quantitative mi- tory measurements of indicator bacteria in The multi-barrier concept for ensuring safe the application of a systematic and preven- crobiological risk assessment involves the bathing waters. The limit value for Escheri drinking water supplies involves the protective management approach designed spe- application of risk assessment principles to chia coli is of 1,800 colony-forming units per tion of the catchment area as a first barri- cifically for the water supply is recommend- estimate the consequences of a potential or 100 milliliters (cfu/100ml). For intestinal en- er, the state-of-the-art sourcing, treatment, ed - the Water Safety Plan concept (WSP actual exposure to different concentrations terococci, the limit value is of 700 cfu/100ml. storage and transport of the drinking water concept). It aims at a customized analysis, of microorganisms. The QMRA has four If these values are exceeded during one as a second barrier and the professional do- assessment and control of risks within a stages: hazard identification, exposure as- measurement, a follow-up measurement mestic water installation as a third barrier. supply system by controlling the process- sessment, dose-response assessment and within four days is necessary. If the results of This approach is referred to as “multi-barri- es in the catchment area as well as those risk characterization. this follow-up measurement again exceed er concept”. Since many decades it is one used for sourcing, treatment, storage and the limit value, a bathing prohibition will be of the pillars to provide save drinking water distribution. The WSP concept has, inter DALY enacted [EU Bathing Water Directive, 2006] supply in Germany (cf. Fig. 5.1). The con- alia, been integrated in the DVGW technical and/or [NRW Bathing Water Decree, 2007]. cept is based on avoiding the causes for rules as Guideline W 1001 [DVGW W 1001]. DALY is the acronym for disability-adjusted pollution: exclusion or avoidance of quality life years or disease-adjusted life years (lost). impairments takes precedence over cor- Health-related Indicator Value (HRIV) With this concept, the burden of various dis- rections at a later point that require a lot of concept for the assessment of micro- eases for society can be determined. Also effort to be implemented and may in some pollutants the efficiency of prevention and treatment is cases only be of limited effectiveness. It to become measurable. DALY allows quan- must be noted that each barrier constitutes To assess substances in the drinking wa- tifying not only the mortality, but also the im- an important element for the functioning of ter for which an assessable data basis of pairment of a normal, disease-free life due their toxicological effects on humans is not to an illness, and expressing it as a meas- available or incomplete and whose potential ured value. In this process, the years of life presence in the drinking water is not regu- lost due to premature mortality are com- lated by a limit value but only by the require- bined with the years lost due to disability or ments of Sec. 6(1) of the German Drinking disease. The latter is also calculated as the Water Ordinance [TrinkwV 2001], the Drink- life years lost multiplied by a weight factor ing Water Commission recommends using that reflects the severity of the disability or a pragmatic, health-related threshold value disease. in the amount of HRIV = 0.1 μg/l as a first assessment basis. Depending on the sig- Cost-efficient action programs as per nificance of the toxic end point for human Art. 11 EU-EWFD health as well as on the density of the corresponding database it is possible to derive The European Water Framework Directive hygienically tolerable lifetime limit values (EWFD) requires the implementation of ac- above the HRIV. For substances without tion programs to achieve the specified qual- Fig. 5.1: Bank filtration on the Rhine (Düsseldorf) Abb. 5.2: Semi-natural water bodies – the mission – natural barrier for safe drinking water effect threshold (genotoxic substances), ity targets for water bodies by the year 2009 statement of the European Water (© TZW, Karlsruhe) health-wise acceptable, i.e. risk-based (cf. Fig. 5.2). The selection is to be based Framework Directive (© H. Feldwisch)

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5.2 Development and implemen- water from the storm water retention basin Tab. 5.1: Contributions to management concepts from the RiSKWa joint research projects tation of management to remove micropollutants, bacteria, sub- concepts within RiSKWa stances with toxic and hormone potentials RiSKWa joint Existing management Contributions and results were examined, also with a view to the mul- research project concept from RiSKWa The multi-barrier concept is substantiated ti-barrier concept. Various wastewater treat- by the findings from several RiSKWa joint ment technologies were evaluated in three AGRO Multi-barrier concept Quantification of the influencing research projects whereby especially the wastewater treatment plants regarding their factors for the catchment area contributions from AGRO, ASKURIS and capacity to eliminate micropollutants and and development of measures for SchussenAktivplus should be mentioned. microorganisms. The aptitude of granular reduction and avoidance as preventive measures to protect the In AGRO, the raw water from a karstic or powdered activated carbon was exam- drinking water catchment area spring with a very well characterized catch- ined and granular activated carbon was ment area was examined for pathogens also tested in combination with an ozona- ASKURIS Multi-barrier concept Analysis and assessment of and micropollutants using a large variety of tion step. In addition, also the efficiency of a technical measures for raw water methods. The results were correlated to the retention soil filter and a lamella clarifier for treatment as a technical barrier land use, input and aquifers by means of removing micropollutants and bacteria from Microbial Source Tracking and using the mi- mixed water (storm water retention basins) Water Safety Plan Implementation of a Water Safety cropollutant indicator approach to be able was investigated. Plan for a water utility according to make a prediction on the effects of man- to WHO and DVGW W 1001 agement measures. The work performed Balances were calculated for the catchment under AGRO focused on the analysis of area of the river Schussen and cost-ben- PRiMaT Water Safety Plan Database-assisted risk analysis the catchment area as a basis for measures efit assessments were elaborated. With a aimed at reducing and avoiding emissions. view to the cost-efficient action programs SchussenAktivplus Multi-barrier concept Assessment of new technologies With the methods used, the occurrence of required by the EU Water Framework Di- and/or their combination for the micropollutants and pathogens at different rective the options for the separation of mi- treatment of wastewater and climatic conditions (base runoff, extreme cropollutants a) by extension of the waste- mixed water from storm water groundwater recharge/heavy rainfall, flood- water treatment plants in the catchment retention basins to simultaneously ing) could be clearly linked to individual area of the river Schussen and b) by means remove micropollutants, bacteria events in the catchment area. The techni- of retention soil filters as a treatment step as well as toxic and hormone cal measures implemented on the storm downstream of storm water retention ba- potentials water retention basin, the limited agricultur- sins were evaluated. The resulting additional al use and the changes and adaptation of costs were valued in relation to the elimina- Cost-efficient action Cost-benefit concept for the land uses in the catchment area resulted in tion potential for the catchment area. programs pursuant to catchment area of the River clearly reduced concentrations in the base Art. 11 EU-EWFD Schussen runoff and in the event of strong rainfall. The Also in the joint research project ASKURIS methods developed can be transferred to the barrier “wastewater treatment” was ex- Sichere Ruhr EU Bathing Water Directive Risk assessment on pathogens in watercourses (bacteria, viruses, other catchment areas and provide a better amined with regard to the efficiency of differ- parasites, schistosomes) understanding of the processes as a basis ent activated carbon qualities (PAC, GAC) as for technical measures and management well as the effect of ozonation in combina- QMRA, Risk analysis on the risk of dis- decisions. tion with other treatment processes. Results DALY concept of the WHO ease, valuation of the health im- showed that some micropollutants (e.g. sul- pairment using the DALY concept In the joint research project SchussenAk- famethoxazole, X-ray contrast media) gen- tivplus the use of activated carbon (PAC, erally show a poor adsorption on activated TOX-BOX HRIV concept for the Guideline for a harmonized testing GAC), the combination of GAC and ozona- carbon. In addition to the substance prop- assessment of strategy tion, the retention soil filter and the lamella erties also a high sorption competition due micropollutants clarifier for treating wastewater and mixed to large concentrations of dissolved organic

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carbon was found. In particular, low molec- The European Bathing Water Directive is used in the framework of the joint research ways of action. Project activities focused on ular weight organic substances inhibited based on a risk management approach project Sichere Ruhr was to extend this risk the following: (I) characterization of the expo- sorption on activated carbon as demon- encompassing the catchment area and approach also to watercourses that exhibit sure and identification of individual substanc- strated by LC-OCD analysis. Low molecular the surroundings of a bathing area. The stronger quality fluctuations. A comprehen- es relevant for the drinking water; (II) verifi- weight organic substances are substances resulting risk profile is quite informative for sive range of pathogens (bacteria, viruses, cation of the findings through concentration with a molecular mass of up to 800 g/mol. a stagnant water body so that the hygienic parasites, bird schistosomes) was exam- of water samples; (III) prioritization, devel- They may involve short-chain aliphates, but protection approach of the Bathing Water ined. Results showed that, in the case of opment and definition of endpoint-related also simple aromatic compounds such as Directive specifying concentration limits for strongly fluctuating concentrations, the indi- testing strategies including derivation of as- benzene. The removal of micropollutants by the two indicator bacteria E. coli and intes- cator bacteria can only map the concentra- sessment criteria; (IV) structuring of the hier- means of ozone had positive side effects on tinal enterococci is sufficient. The method tions of other pathogens to a limited extent. archical testing strategy for the assessment both, chemical oxygen demand (reduction) Using the method of Quantitative Microbial and weighting of toxicity data within the over- and wastewater disinfection. Ozone treat- Risk Assessment (QMRA), the actual dis- all process of HRIV derivation. From these ment resulted in the inactivation of bacteria ease risks for swimmers were assessed and results, risk-based and HRIV-based options and viruses. related to other life risks by means of the for action were derived and summarized in a DALY method. In the framework of Sichere guideline for the risk-based management of Irrespective of the foregoing the Water Safe- Ruhr, the comprehensive risk assessment anthropogenic micropollutants. ty Plan as specified by the WHO and DVGW and derivation of DALYs was for the first W 1001 was applied to one wastewater time also used for assessing bathing wa- 5.3 Development of measures treatment plant. In a first step, a risk assess- ters. This approach can be transferred to for avoiding/reducing risks ment including probability of occurrence other river basins. and extent of the damage caused by the re- In the majority of the RiSKWa joint research spective risk was performed, followed by an projects, measures for avoiding or reducing evaluation of the findings according to the risks from pollutants and pathogens in the HRIV concept and an extended monitoring. water cycle were developed. These are list- These measures also included the examina- ed as an overview in Table 5.2 page 63. tion of alternative treatment processes. The list is subdivided into “planning/organ- Under PRiMaT, a database-assisted sys- izational measures” and “technical meas- tem for the risk analysis of water catchment ures” and indicates the level of realization. In areas was created to support this step in this context, realization can be broken down the framework of a Water Safety Plan ap- into the following levels: proach. Based on information about land use, this database shows risks that can be • Conceptualization: under the joint re- related to micropollutants and pathogens. Fig. 5.4: Risk management for anthropogenic search project, a risk management ap- micropollutants in the water cycle The database currently provides information (© DECHEMA) proach was conceptualized as a model on the mobility and persistence of 1,100 case for the study focus. This usually in- individual substances for a substance reg- To support and expand the HRIV approach, volves developing the individual modules ister. This information can be used by the the goal of the TOX-BOX project was to de- and providing an extensive description. water utility company, for example to derive velop a harmonized testing strategy for an its monitoring concept for the catchment exposure-related and risk-based manage- • Pilot project: in cooperation with the area. In the framework of RiSKWa, the da- ment of anthropogenic micropollutants. To partners of the joint research project, the tabase-assisted risk analysis was tested in this effect, generic guidelines in the form of risk management approach was tested in Fig. 5.3: Technical barriers in drinking water the catchment area of a water works using decision trees were defined. Where poten- a pilot plant and the experiences made treatment: pilot rapid filter at the OWA groundwater and a surface water reservoir. in Berlin-Tegel, joint research project tial risks and cases requiring regulation are were used for further optimization, and ASKURIS found, this also includes defining possible documented.

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• Guideline: the experiences made in the over time led to a 90% reduction in the con- Tab. 5.2: Measures from the RiSKWa joint research projects for avoiding/reducing risks context of the joint research project can centrations. be transferred to other users and are RiSKWa joint Measures in the context of risk management concepts research project made available for further applications in Another example was the prohibition by the the form of a guideline. authorities of a planned agricultural use of Planning/organizational measures land for the free-range husbandry of poultry. AGRO Use of micropollutants as indicators and pathogens (Microbial • Implementation: in the context of the Information materials and the presentation Source Tracking) to forecast the input under different scenarios joint research project the risk manage- of the results to the local authorities and the (incl. base runoff, heavy rainfall) as a basis for countermeasures ment approach has already been imple- population to initiate a dialog were able to (e.g. limitation of land use for agriculture) (K, U) mented in at least one application or spe- demonstrate a clear spatial and temporal SAUBER+ Emission check for environmental officers at medical facilities cifically scheduled for implementation in relationship between the use of substanc- Controlled drug disposal (K, L) the follow-up of the joint research project. es and their appearance in the Gallusquelle. Curriculum for an eco-friendly training of medical doctors (K, P) This was in some cases attributable to sin- The measures relating to planning/organiza- gular, directly identifiable actions and result- Sichere Ruhr Operational management for riverside bathing areas (L, U) tion shown in Table 5.2 will be briefly pre- ed in mutually agreed prompt actions aimed Reduction of diffuse pollution from agriculture (K) sented in the following. For the technical at avoiding such input (for the significance Technical measures (see Chapter 4) measures, please refer to the detailed de- of risk communication, cf. Chapter 6). Final- scription provided in Chapter 4. ly, based on the analyses, it was possible to AGRO Extension of storm water retention basin and modification of the discharge (already implemented, the effects on the raw water were show that single climatic events (heavy rain- examined to verify the measure) (U) Under the AGRO joint research project the fall, snow melt) lead to a significantly strong- effects of risk-minimizing measures in the er pollution of the water with pathogens ASKURIS Activated carbon adsorption and ozonation as technical meas- catchment area on the raw water quality at and chemical substances than the extreme ures (P, L) the karst spring could be precisely meas- flooding of May/June 2013. With these re- PRiMaT Treatment processes (oxidation, electrodialysis, adsorption) for ured and evaluated using the newly de- sults, it was possible to communicate that the removal of micropollutants (K, P) veloped indicator approach and microbial there is no reason to fear that flooding caus- RISK-IDENT Reduction of micropollutants by means of AOP - Advanced source tracking methods. The soil mois- es health risks due to a deteriorated water Oxidation Processes – in wastewater treatment (K, P) ture model with a high spatial resolution quality. SAUBER+ Advanced wastewater treatment (MBR, ozonation, activated of groundwater recharge using soil char- carbon filtration, UV and H O ) (K, P) acteristics, together with the groundwater To ensure the successful management of 2 2 residence time model on groundwater flow, recreational bathing on a river bank, the joint Sichere Ruhr Reduction of pathogens in the effluent of wastewater treatment plants and storm water retention basins by ozone, UV light, created the basis for predicting the occur- research project Sichere Ruhr developed a performic acid (K, P) rence of pathogens and micropollutants at risk management approach for bathing wa- the spring Gallusquelle. With these findings ters that is about to be implemented in the Early warning system for the identification of microbiological it was possible to forecast the effects of the context of the founding of the “Interessen- bathing site contaminations (K, U) planning and organizational measures and gemeinschaft Baden in der Ruhr” (English: SchussenAktivplus Activated carbon, activated carbon plus ozonation, use of reten- of the technical measures. special interest group bathing in the Ruhr) tion soil filters and lamella clarifiers (P) on 12 June 2015. The sometimes strongly Assessment of the effects1 of the commercial-scale extension of The example used was the significant re- fluctuating water quality, which can time and the Langwiese (Ravensburg) wastewater treatment plant with a duction of the contamination with patho- again lead to bathing prohibitions, requires a PAC stage on the fish and fish nutritional microorganisms in the gens and wastewater-borne micropollut- continuous management of the bathing ar- river Schussen (U) ants (caffeine) thanks to a capacity increase eas and often also immediate action. Such TransRisk Advanced wastewater cleaning (MBR, ozonation, biofiltration, and operational changes to the storm water action includes a continuous risk communi- activated carbon filtration (K, P) retention basin (cf. Fig. 5.5). The exten- cation with the following elements: contin- (Realization stage: K = Conceptualization, P = Pilot, L = Guideline, U = Implementation planned) sion of the storm water retention basins by uous maintenance of data on the bathing 1 Strictly speaking, this is not a “technical measure”. From the viewpoint of risk management, it represents a final verification of the around 10% and the controlled discharge areas, information about the hygienic water technical measure.

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quality available at all times as well as warn- bitions. The realization concept developed Within the joint research project SAUBER+, the local environment). Should the results ing messages about bathing prohibitions taking the example of the river Ruhr was an emission check protocol was developed show that the situation has to be classified and their revocation via different media at drafted as a guideline for other river basins for medical facilities, to offer on a voluntary as potentially relevant, a more precise as- short notice. The organization and perfor- and metropolitan areas. an opportunity to assess their own situa- sessment of the emission situation should mance of hygienic monitoring must be ar- tion and, with a view to the precautionary be performed in a second step. After the ranged in a close cooperation between the The strategies and measures for reducing principle, take measures that help reducing evaluation of the emission situation it must responsible health authority and the opera- pharmaceuticals emissions from health- emissions into the aquatic environment. As be verified in a third step whether improve- tors of the bathing area. Other elements of care institutions in the joint research project a first step, assessing the relevance of the ment measures need to be implemented. If the risk management are the identification SAUBER+ are based on the precautionary targeted institution as an “emitter” based on this proves to be the case it is recommend- and regulation of conflicting uses for water principle. To this effect, information about a selected criteria is recommended (in pared to develop and implement an emission sports, nature conservation and drinking controlled and water-conserving disposal ticular the interaction of the institution with management with actions suited for the water protection (cf. Fig. 5.6). of pharmaceuticals was compiled in an in- the related wastewater treatment plant and specific institution. formation flyer to close the information gap To reduce diffuse emissions in surface wa- for nursing staff, pharmacists and patients. ters, organizational measures such as the This information flyer is to reach the intend- prolonged storage of farm manure and ed target groups via adequate multipliers. broader riparian strips to reduce the sus- Moreover, a curriculum for an eco-friendly ceptibility to erosion were conceptualized. training including certificate was developed For their implementation, voluntary agree- for medical doctors which is to generate a ments with the farmers in the framework of higher awareness of medical professionals the collaborative work would be promising. regarding the environmental impact of med- One example to reduce the input from bird ical care (cf. Chapter 6.6). droppings would be to enact feeding prohi-

Fig. 5.6: Comprehensive actions catalog for the risk man- Fig. 5.5: Overflow of the storm water retention basin (combined sewer system) after heavy rainfall agement of a bathing water (from: Sichere Ruhr (© C. Stange, TZW: DVGW-Water Technology Center, Karlsruhe) [Schoenemann & Jardin, 2015])

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5.4 Bibliography 6 Communication and educational measures DIN EN 15975-2:2013 (2013): Sicherheit der Trinkwasserversorgung - Leitlinien für das Risiko- und Krisenmanagement – Teil 2: Risikomanagement. Beuth Verlag Berlin. (Safe Drinking Water Supply – Guidelines for Risk and Crisis Management – Part 2: Risk Management) DVGW W 1001 (2008): Safe and Secure Drinking Water Supply – risk management under normal operating conditions, DVGW Deutscher Verein des Gas- und Wasserfaches e. V., Bonn, 18 p. EU Bathing Water Directive (2006). Directive 2006/7/EC of the European Parliament and the Council of Authors: Prof. Dr. Britta Renner, Dr. Martina Gamp, Dipl. Biol. Sabine Thaler, PD. Dr. Maik Adomßent, 15 February 2006 concerning the management of bathing water quality and repealing Directive 76/160/EEC. http://eur-lex.europa.eu/legal-content/DE/TXT/PDF/?uri=CELEX:32006L0007&from=EN. Dipl.-Päd. Klaus Amler, Prof. Dr. Nina Baur, Prof. Dr. Franz Bogner, Dipl. Biol. Nikolaus Geiler, Dr. Konrad Götz, Ulrike Krauße, Dr. Wolf Merkel, Prof. Dr. Manuela Niethammer, Dr. Regina Rhodius, EU Water Directive (2000). Directive 2000/60/EC of the European Parliament and of the Council of 23 October Dipl.-Ing. Bea Schmitt, Dipl.-Agr. Jutta Schneider-Rapp, Dipl.-Geoökol. Sebastian Sturm, 2000 establishing a framework for Community action in the field of water policy. http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=OJ:L:2000:327:TOC. Dipl.-Soz.päd. Patrik Timpel, Dr. Thomas Uhlendahl, Dr. Melanie Wenzel NRW Badegewässerverordnung (2007): Verordnung über die Qualität und die Bewirtschaftung der Badegewässer (Badegewässerverordnung). https://recht.nrw.de/lmi/owa/br_text_anzeigen?v_id=10000000000000000584. Key messages (Bathing water regulation (2007): Regulation on the quality and management of bathing waters (Bathing Water Regulation)) Schoenemann, B.; Jardin, N.; (2015): Baden in Fließgewässern. Ein Handlungsleitfaden am Beispiel des Key message 1: For efficacy, it is impor- Key message 4: Substantial knowledge Baldeneysees & der Unteren Ruhr im Rahmen des BMBF-Projekts Sichere Ruhr. Essen. tant to distinguish risk from crisis commu- gaps exist with regard to drinking water www.sichere-ruhr.de/wp-content/uploads/2014/01/sichere_ruhr_handlungsleitfaden_final.pdf nication. Risk communication refers to a and micropollutants. These gaps should be (Bathing in rivers. An action guideline taking the example of the Baldeney lake and the Untere Ruhr in the process of exchanging information among closed at an early stage through increased context of the BMBF project Sichere Ruhr) stakeholders about the magnitude, signifi- educational efforts. TrinkwV 2001: Verordnung über die Qualität von Wasser für den menschlichen Gebrauch, Trinkwasserverord- cance, and control of potential damage. In nung in der Fassung der Bekanntmachung vom 10. März 2016 (BGBl. I S. 459), www.gesetze-im-internet.de/bundesrecht/trinkwv_2001/gesamt.pdf. contrast, crisis communication conveys in- Key message 5: In terms of communi- (Regulation on the quality of water for human consumption, drinking water regulation in the version as formation and (emergency) strategies in the cation and educational measures it is im- published on 10 March 2016) context of acute and unexpected hazards. portant to convey that the efforts made to Umweltbundesamt (2003). Bewertung der Anwesenheit teil- oder nicht bewertbarer Stoffe im Trinkwasser aus reduce pharmaceutical residues in the en- gesundheitlicher Sicht. Bundesgesundheitsbl - Gesundheitsforsch – Gesundheitsschutz, (3) 2003, 249-251. Key message 2: Effective risk communi- vironment primarily relate to precautionary www.umweltbundesamt.de/sites/default/files/medien/374/dokumente/gow-empfehlung_2003_46.pdf. (Assessment of the presence of partially assessable or non-assessable substances in the drinking water from a cation needs to be targeted to the specific measures and not to protection from con- health perspective.) audience and objective. Possible objectives crete hazards. WHO Water Safety Plan (2005). Water Safety Plans – Managing drinking water quality from catchment to are: sharing information, changing risk per- consumer, World Health Organisation. ceptions and beliefs, or changing behaviors. Key message 6: Target group specific www.who.int/water_sanitation_health/dwq/wsp170805.pdf. communication and educational meas- Key message 3: Crisis communication ures can convey the need to implement requires fast, accurate, consistent, and adequate measures to professionals, politi- trustworthy information. This demands cians, and the general population. systematic preparation and evaluation.

6.1 Introduction 1. Sharing information (e.g. with decision- makers, to advise politicians or increase Risk communication refers to a process of the acceptance of a project or decision) exchanging information among stakehold- 2. Changing beliefs and general risk per- ers about the magnitude, significance, and ception control of potential damage. In general, risk communication can pursue three different 3. Changing behaviors goals (cf. Fig. 6.1):

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Within the first goal of risk communication, Since risk communication often provides Finally, risk communication may aim to 6.2 Public relations the information provided is often gener- numerical information about the probability change behaviors. A necessary prerequisite al and unspecific. That is, target audience of a hazard occurring, displaying risk infor- for behavior change is that people feel per- Public relations have played an important and intended effect are not clearly specified mation in a transparent form is utterly im- sonally at risk. From a psychological view, it role in all RiSKWa joint research projects (“just-say-it” method; [Brewer, 2011; Ren- portant to facilitating understanding [Giger- seems inherently plausible that people need as implementing project results depends ner & Gamp, 2014a]). However, if the infor- enzer, et al., 2007; Renner & Gamp, 2014b; to both be aware of an existing health risk on successful communication. Accordingly, mation provided is not selected according Renner et al., 2015]. In addition, risk per- (‘general risk perception’) and feel personally the local population was informed about the to relevance, comprehensibility, and useful- ceptions are based not only on cognitions at risk (‘personal risk perception’) in order to planned measures in order to initiate partic- ness to the recipients (e.g. consumers), it is but also on intuitive, affect-based process- take protective action [Renner et al., 2015; ipation processes, increase acceptance of unlikely to receive attention sufficient to af- es. These feelings of risk are rapid, largely Sheeran, Harris, & Epton, 2013]. However, the planned measures, and inform the pro- fect perceptions and behaviors. Risk com- automatic, and emerged in the course of since people often underestimate personal fessional public about the project contents munication is, therefore, more effective if evolution [Loewenstein et al., 2001; Slovic risk, compared to that of others (‘unrealis- in a timely manner. tailored to the target audience and delivered & Peters, 2006]. Thus, the more a hazard tic optimism or optimistic bias’; see [Renner with a specific focus and objective. is linked to a negative emotion, the more & Schupp, 2011]), optimistic perceptions The RiSKWa joint research projects used risky it is perceived [Slovic & Peters, 2006]. about one’s own risk might undermine be- different forms of public relations. Each re- Regarding the second goal, risk commu- Providing emotional pictures and narratives havior change motivation. Overcoming the search project has its own website; media nication can convey facts (‘information ap- may, thus, be more effective for risk com- optimistic bias is challenging. Risk commu- cooperation, and print information (e.g., fly- peals’) that enable more accurate risk per- munication than simply presenting numer- nication that only provides information and ers) round off the picture (cf. Fig. 6.2). ception [Renner et al., 2015; Slovic, 2000]). ical facts. facts about general risk may make people aware of a risk (“Smoking causes coronary Special issue heart disease”). However, with this type of “Antibiotics and antibiotic resistances message, recipients have to infer the mag- in urban wastewater” Objective: Objective often vague, not clearly defined nitude of their personal risk, leaving consid- Example: Package inserts (Disclaimer; information etc.) erable leeway for a positive view of one’s The special issue “Antibiotika und Antibio- risk. One possibility to reduce this ambiguity tikaresistenzen im urbanen Abwasser” (An Share Presentation of information: Extensive but not targeted to the audience, “the more the better” and interpretation leeway about one’s per- tibiotics and antibiotic resistances in urban information sonal risk status is to inform people about wastewater) was published in the Spring- Consequence: Relevance of the information is not apparent for their health risk through providing person- er magazine “Prävention & Gesundheits- the audience and often unintelligible; information is only partially remembered and may produce reactance alized risk information (e.g. in the context of a health screening). Var- Objective: Knowledge of risks, accurate general risk perception ious studies show that emotional Example: Informed decision, acceptance of risks reactions to such personalized Change of feedback, such as worry, repre- risk perception Presentation of information: Selection according to decision rele- sent an important determinant for (change beliefs) vance: non-persuasive, open and unbiased to specific outcomes behavior change [Brewer, Chap- Target audience understands and remembers risk Consequence: man, Gibbons, Gerrard, McCaul & information Weinstein, 2007; Renner & Gamp, Objective: Behavior change 2014b; Renner & Reuter, 2012]). Example: Vaccination, adequate disposal of pharmaceuticals Change Presentation of information: Selection according to behavioral behavior relevance, persuasive Consequence: Increased personal risk perception (I am affected) and protection motivation Fig. 6.2: Public relations in the framework of SchussenAk- tivplus: open day at the Ravensburg wastewater Fig. 6.1: Three potential goals of risk communication (Brewer, 2011; Renner & Gamp, 2014a) treatment plant

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förderung” (Prevention & Health Promotion) analyses from urban water management Info campaign “What to do with waste State Ministers Ulrike Scharf (Environment (9/2014) (cf. Fig. 6.3). This magazine views and microbiology with a focus on the inter- pharmaceuticals?” and info leaflet and Consumer Protection), Melanie Huml itself as a scientific forum in the fields of pre- action between wastewater treatment plant “Micropollutants“ (Heath) and by the Vice Chairman of the Ba- vention, individual responsibility and innova- practice, urban water management and a varian Pharmacists’ Association (BAV) Josef tive health management. As an educational medically responsible use of antibiotics. Under the joint research project RISK- Kammermeier, and promoted in the media forum, the target group includes medical The special issue is aimed at conveying IDENT, the Bavarian Environment Agency of the BAV association (www.lfu.bayern.de/ professionals, professionals from social knowledge and sensitizing readers for the prepared an information package about the altmedikamente) addressing pharmacies. sciences, economics and natural sciences, relationship between prescribing antibiot- eco-friendly disposal of waste pharmaceu- students, stakeholders from politics, health ics, antibiotic resistance issues and envi- ticals that is mainly intended for display in The publication “Spurenstoffe im Wasser“ insurance companies, healthcare associa- ronmental risks. It describes the current pharmacies. In addition, an information leaf- (Micropollutants in the water) [Bayerisches tions and care providing institutions. state of scientific knowledge regarding the let was developed to sensitize multipliers in Landesamt für Umwelt – Bavarian Envi- development of a risk management system environmental consultancy for the topic of ronment Agency 2016] provides an easily The special issue focuses on results of for preventive health and environmental pro- micropollutants in water bodies. This publi- understandable overview on organic mi- the joint research projects ANTI-Resist as tection. cation is also available to the public via the cropollutants in aquifers and illustrates the well as on expert contributions from other internet. complex risk assessment methods. Prac- RiSKWa joint research projects and external Brochure “Im Klartext – Schadstoff- tical advice encourages users to reduce research groups. The medical and pharma- spuren im Wasserkreislauf” 2 The information package “Wohin mit alten the discharge of micropollutants into the cological perspectives are combined with (In plain language – Micropollutants in Medikamenten?“ (What to do with waste water bodies also in their own daily lives. the water cycle) pharmaceuticals?) consists of a flyer, a This publication forms part of the series pocket-size info folding card and a post- UmweltWissen (Environmental Knowledge) In the context of the joint research project er. In a Q&A format, these three elements which deals with environmental protection TransRisk, the Institut für Sozial-Ökologis- provide information at different levels of in everyday life3. che Forschung GMBH, ISOE (Institute for detail about the most frequently asked Social-Ecological Research) conducted a questions regarding the disposal of waste Information flyer on the correct media content analysis. The conclusion of pharmaceuticals. The information package disposal of pharmaceuticals4 this analysis was that a future communica- was presented by the two Bavarian tion strategy on anthropogenic micropollut- Under the joint research pro-

nie in den a usguss ants in the water cycle should aim at con- oder die ject SchussenAktivplus, ToileTTe ! veying sound procedural knowledge. Based besides germs and other mi-

veranTWor Tungsvoll handeln Wir alle können dazu beitragen, unsere Gewässer arzneiMiTT on these results, the German Association for zu schützen. el richTig enT cropollutants also pharmaceu- sorgen Geben Sie nicht aufgebrauchte Tabletten, Kap a Salben, Säfte und Tropfen oder abgelaufe rzneiMiTTel nüT Vermeiden Sie überflüssige Arzneimittel. Über seln, zen fen Sie den Bes mittel niemals in die T Arzneimittel sind für viele Menschen unentbehrlich. prü ne Arz nei geWässer schüT tand Ihrer Hausapotheke, bevor Diese Arzneimittel gehörenoilette in den oder Rest den Ausguss. Wir verbrauchen heute mehr Medikamente als jemals zen Water, Wastewater and Waste (DWA) pub- Sie neue Medikamente kaufen. Lassen Sie sich beim ticals were examined. That is zuvor. Viele Wirkstoffe können inzwischen, wenn auch Kauf über die richtige Packungsgröße beraten. müll. In nahezu allen K in sehr geringen Mengen, in unseren Bächen, ommunen wird der Restmüll heu Helfen Sie mit, damit weniger Arzneimittel in das te verbrannt. Damit werden Arzneimittelreste sicher Die Wirkstoffe werden teilweise nach der An Flüssen und Seen nachgewiesen werden. Dies dung mit dem häuslichen Abwasser in die Klär gilt vor al Abwasser gelangen. Fischen nach Testorganismen Sauerstoff messenentsorgt. Falls Sie unsicher sind, fragen Sie Ihre wen lem für häufigMündung v der Schussen Testanlage mit Aktivkohle lished a new “Im Klartext” (In plain language) lagen gespült. Dies läss abbaubare Wirk erwendete oder schwer why the “correct disposal of kommunale Abfallberatung. an stoffe. in Eriskirch meiden – unnötige Belastungent sich in der unserer Regel Gewässernicht ver Tiere und Pflanzen unTer BeoBDieach richtigeTung Entsorgung von Arzneimitteln ist ein durch die falsche Entsorgung nicht gebrauchter Arz In unseren Gewässern BMBlebenf- forschungnicht nur Fische, in Baden-Wür TTeMBerg nie in sondern auc Für aussagekräftige Ergebnisse sorgenwichtiger vielfältige Beitrag, um die Belastung von Ge den ausguss neimittel dagegen schon. h Muscheln,Das Krebse, vom SchneckenBundesministerium und für Bildung und brochure informing interested citizens about mit Arzneimittelwirkstoffen und deren Ab ande re Organismen, die eine ökologi pharmaceuticals” was chosen Untersuchungsmethoden mit lebenden Organis men wässern oder die For schung geförderte und vom Ministe rium für Um dukten zu verringern. Denn trotz der zahlreichen, gut ausgebauten Klär gemein schaft bilden. Einige Wasser sche Lebens und Zellkulturen. baupr oToileTTe welt, Klima und Energiewirt schaft ! anlagen können Arzneimittelrückstände nicht restlos gieren sehr empfindlich aufBaden GewässerWürttemberglebe we sen untersrea tützte Pro Als Testorganismen dienen Fische, Flohkrebse, aus dem Abwasser entfernt werden und gelangen so jekt SchussenbelasAktiv tungen.plus unter sucht die micropollutants in the water cycle. Using Schnecken, Würmer und Wasserlinsen. Die Unter in unsere Gewässer. Manche Stoffe können auchEffekte bei dervon Trink rund 150 Spurenstoffen as the leading subject for pub- gewinnung nur schwer entfernt werden. suchungen finden im Labor, in Freilandlabors mit im Einzugsgebietwasser der Schussen. Die Aquarien undnie inan den Gewässern selbst statt. ser Boden seezufluss ist mit seinem Auch wenn die Konzentrationen so niedrig sind, den ausguss dicht besiedelten und indus trialisierten Einzugs dass sie für den Menschen nach derzeitigem Wis plain language, the brochure explains how Ziel ist, oderaufzuzeigen, die wie sich die verbesserte Was nie in gebiet stark belastet. lic relations. By correctly dis- ToileTT den a senss serq ualität nache Ausbau der Kläranlagen auf die usguss tand unschädlich sind, wollen wir grundsätz oder die lich kei Lebens gemeinsc ! haft im Fluss auswirkt. ne naturfremden StoffeZu imden Trinkwasser. Spurenstoffen zählen neben Haushalts ToileTTe chemikalien, Bioziden und anderen Subs tanzen Die zahlreichen Forschungsergebnisse münden ! auch Rück stände von Arznei mittelwirk stoffen. pharmaceuticals and chemicals of daily use iMPressuM posing their pharmaceuticals, dann in ein praxisnahes Modell für das Einzugs ge Herausgeber: Ministerium für Umwelt, Klima und Energiewirtschaft biet der Schussen, das den Gewässer schutz voran BadenWürttemberg. In Zusammenarbeit mit dem BMBFForschungsprojekt Drei Jahre lang untersuchen Wissenschaftler/innen, treiben soll. welche und wie viele Spurenstoffe sowie Keime SchussenAktivplus. Arzneimittel 1. Auflage, Juli 2013 über das Abwasser in die Schussen und die Argen enter the aquifer via the wastewater and Mehr Informationen über das bundesweit bedeut gelan gen, und wie diese Gesamtbelastung auf Fische individuals can easily make an Gestaltung & Grafiken: VIVA IDEA, www.vivaidea.de richtig entsorgen – same Forsc hungspr ojekt finden Sie unter Bilder: Wasser – juland/Fotolia.com. Cremetube – ruzlizgi/Fotolia.com. und Gewässerorganismen wirkt. www.schussenaktivplus.de oder www.riskwa.de. A. Greiner, J. SchneiderRapp, ABDA, P. Rey, R. Triebskorn Gewässer schützen Erforsc ht werden auch die Auswirkungen der neu which damage they can cause. In addition en zu sätzlichen Rei nigungs stu fen in den Klär anla important contribution to en- gen Langwiese (Ravensburg), Merklingen und Eris kirch am Bodensee und in zwei Regenwasser be to technical measures the brochure also handlungs anla gen. suring that less pharmaceuti- shows what individuals can do to avoid the cal ingredients are discharged Fig. 6.3: Special publication on the release of pollutants into the environment. Fig. 6.4: Information flyer of the joint research project Schussen into our water bodies. That is RiSKWa results1 Aktivplus about the correct disposal of pharmaceuticals why the clear message “Waste

3 The publication is available at: www.lfu.bayern.de/umweltwissen 1 The special publication is available at: http://link.springer.com/journal/11553/9/3/page/1 4 This information flyer can be ordered from the following source: email: [email protected], 2 The information brochure can be obtained from the following source: email: [email protected], Internet: www.dwa.de. Internet: http://schussenaktivplus.de/sites/default/files/Arzneimittel Wasserschutz 8 S. web2.pdf

70 71 RiSKWa-Handbook of good practice 6 Communication and educational measures

pharmaceuticals do not belong into the sink ify in advance which routes are to be taken to trucks, recycling yards, or pharmacies (sys- 6.3 Risk communication/ or toilet” was at the heart of the campaign. In address the target groups. tematic assessment by Ökonsult, Stuttgart). risk perception cooperation with the Ministry of the Environ- Providing a map illustrating the current ment of Baden-Wurttemberg, a new flyer in The flyer “Arzneimittel verantwortungsvoll methods of disposal enables a risk com- Risk experts across various disciplines and German language was developed. This flyer entsorgen” (Responsible disposal of phar munication that not only tells people not to domains (e.g., health, finance, engineering) is available in a six-page basic variant for the maceuticals) of the joint research project discharge pharmaceuticals into the toilet or commonly define risk as a combination of whole of Baden-Wurttemberg and in an eight- SAUBER+5 was designed in a similar way. sink but also provides specific instructions the likelihood of an occurrence of a hazard- page variant (plus 2 pages on Schussen on how to appropriately dispose of pharma- ous event or exposure and the severity of Aktivplus, cf. Fig. 6.4) in the area examined in Map of Germany (‘Deutschlandkarte’) ceuticals where they reside. Effectively, this injury or disease (e.g., lung cancer) caused the context of the project. The flyer was pre- for pharmaceutical disposal map concentrates multiple existing recom- by it. Accordingly, ‘risk’ encompasses two sented to the public by Minister of the Envi- mendations for the disposal of pharmaceu- core elements: (a) the chance or probabil- ronment Franz Untersteller and promoted via An Internet-based, interactive map of Ger- ticals in Germany (by citizens, healthcare ity of adverse health outcomes and (b) the the Association of Towns and Municipalities. many was developed to easily and com- entities, public authorities, the industry, and severity of the expected adverse outcomes. Moreover, the project partners mailed around prehensibly display how to dispose of academia) on one website (cf. Fig. 6.5). Risk is thus described as being proportional 20,000 copies of the project-related flyer to- pharmaceuticals across Germany (concep- gether with the notification of wastewater fees tualization University of Konstanz): www. to users in Ravensburg and four other munici- arzneimittelentsorgung.de. Specifically, the palities in the area. Another 2,000 copies were map presents current recommendations on Acute hazards Potential hazards distributed by other project partners. It would how to dispose of pharmaceuticals at the have been desirable if more pharmacies had level of districts and municipalities. Possible • Unexpected event • Event has not yet occurred agreed to display the flyer. In conclusion, it is methods of disposal in Germany are, for ex- • Requires immediate reactions Characteristics • Requires long term reactions essential for successful public relations to clar- ample, domestic waste, hazardous waste • High stress level • Low stress level

• Reactive • Preventive (prospective) • High stress level • Low stress level • Acute hazard: distinct intense emotions (fear) • No acute hazard: little emotion • High public interest • No/little public interest • High relevance for oneself/ • No direct relevance for oneself/ one‘s family Reactions one‘s family • Increased and focused attention • Low attention level • High motivation • Low motivation level • Intuitive response and heuristic • Rational response and systematic information processing information processing • Routines, habitual behavior • New behavior/discontinued behaviors

• Crisis communication as part of crisis • Risk communication as part of risk management that conveys information management and control that contains about acute hazards and measures for information about probability of occur- damage containment Communication rence and extent and significance of potential damage • Clear communication objective • Communication objectives are commonly diffuse (knowledge, change of perceptions Fig. 6.5: Online map of Germany informing on how to dispose of pharmaceuticals: and attitudes, change in behavior) www.arzneimittelentsorgung.de

5 The information flyer is available at: http://sauberplus.de/index.php/downloads Fig. 6.6: Acute crises versus potential risks (Renner & Gamp, 2014a)

72 73 RiSKWa-Handbook of good practice 6 Communication and educational measures

to both the probability and severity of the Guideline on strategic risk 4. Not all consumers are the same. De- 1. Holistic risk communication event (risk = probability x severity of the communication pending on the target group, different event occurring), implying that greater event communication routes and arguments 2. Central organization of communication likelihood and loss result in a greater overall In the framework of the joint research pro- must be offered. risk [Renner & Schupp, 2011; Slovic, 2000]. ject ASKURIS a so-called institutional field 3. Appeal to common sense and How we respond to risks largely depends was recast. Recasting was based on the 5. The consumer is not always the right responsibility of the individual on the present hazard and our risk percep- questions of whether and how the Berlin target group for risk communication. In tions, i.e. how we think and feel about the drinking water could be contaminated by expert discussions, risk communication 4. Conveying sound practical knowledge risks we face. Different hazards differ across anthropogenic micropollutants and multi-re- is frequently associated with consumer and concrete behavioral instructions a wide range of characteristics [Centers sistant germs and how this could be avoid- communication. However, consumers of Disease Control and Prevention, 2012; ed. The recast institutional field included often have no influence on the change in 5. Fact-based and neutral communication Fischhoff, Brewer & Downs, 2011]. Of par- stakeholders involved in water supply and water quality. ticular importance regarding the perception wastewater production (consumers, indus- 6. Communication of the nature-oriented and communication of hazardous events is trial production, healthcare sector, agricul- 6. Overcoming communication barriers in aspects of river bathing their time of onset. According to the point in ture as well as water supply and disposal expert discussions. Changes in the in- time when the damage occurs, hazardous entities) as well as stakeholders who are stitutional field frequently fail because 7. Trustworthiness of the sender events can be divided into risks and crises. materially involved in the social construc- the expert discourse is often fragmented This distinction is relevant for the hazard’s tion of risk (media, science, politics and civil into numerous sub-discourses. Prefera- 8. Sensitizing the audience for water as an characteristics as well as the responses to society stakeholders). On the basis of this bly, problems are dealt with that relate to asset worth protecting and communication of the hazard (cf. Fig. 6.6) analysis, the following statements for risk a specific phase in the production pro- communication were derived: cess. Challenges that cover the entire 9. Realistic communication of target Most often, the hazard represents a poten- production chain tend to remain unad- achievement. tial risk which needs to be avoided. Accord- 1. Consumer knowledge and media knowl dressed. ingly, risk communication serves as an ele- edge. Overall, media reports about the Another analysis of the media discourse ment of risk management and risk control. situation are rather unspecific and ab- Risk communication and action showed that, although bathing in rivers and It provides information about the probability stract. Different media address different guideline for safe bathing the risks involved are very present in the of the damage occurring in the future as target groups. Overall, consumers know media, the risks are not communicated with well as the scope and significance of the very little about water. In the context of the joint research project a sufficient level of detail. damage. Since risk communication refers Sichere Ruhr, a risk communication con- to a potential damage that might occur 2. Consumers have great confidence in the cept for bathing in natural water bodies was The results of the analyses were processed in the future, i.e. a prospective event, one institutions (politics and water utilities). developed. On a detailed website (www. to a concept entitled “Risikokommunika- important challenge is to raise adequate Consumers act on the assumption that sichere-ruhr.de), information about the top- tion zum Baden in natürlichen Gewässern” public knowledge and interest. In addition, recommendations are well-founded and ics Ruhr and water protection was made (Risk communication on bathing in natural risk communication may aim to motivate expect the institutions to solve water-re- accessible to a broad public to create an waters) and an action guideline “Umsetzu- preventive actions and behaviors by reveal- lated problems and provide suggestions understanding for the risks and challenges ngsszenario zum Baden in der Ruhr“ (Imple ing positive and negative consequences of and recommendations. of bathing in the river Ruhr. In addition, three mentation scenario for bathing in the Ruhr) favorable and unfavorable behaviors. Thus, workshops were organized to share knowl- [Schoenemann & Jardin, 2015] (cf. Chapter as risk communication aims at conveying 3. Proposals fit for everyday use. Water is edge and develop an implementation con- 5.2). The participation process was taken information and knowledge about a nega- considered to be very safe. Risk com- cept for bathing in the river Ruhr. In an anal- up by the Interessengemeinschaft Baden tive event which might occur in the future, munication aimed at changing behaviors ysis of the media discourse, nine success in der Ruhr (or IG Baden in der Ruhr, for it often receives only low or moderate emo- is successful especially in those cases factors for risk communication about “bath- short) as a civil society initiative founded tional response. where concrete proposals are given that ing in natural water bodies” were identified: on 12 June 2015 with participation of the can be easily integrated into everyday City of Essen. IG Baden in der Ruhr plans life. to create several bathing areas on banks of the Ruhr and use the action guideline, the

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communication concept and the website to water bodies. The survey further showed icance and quality of information based on uninvolved experts and practicing com- this effect. that incorrect disposal of pharmaceuticals simple decision-making rules and peripheral munication methods) contributes to the problem of pharmaceu- environmental cues. Moreover, the motiva- For an overview on hygienic, engineering tical micropollutants in the water cycle. The tion to take action is high in crisis situations, 7. Delivery (by trained spokespersons, and organizational issues involved with interviewees were asked whether they would and people perform readily available, habit- trustworthy people, and institutions) regular bathing operations in rivers, please be willing to forego taking pain killers when in ual behaviors as a form of protection. refer to the special issue “Safe Ruhr” of the pain and use alternative offers instead to help An important step in the message mapping International Journal of Hygiene and Envi- curb the release of pain killers into the wa- How can crisis communication succeed? process is to identify and classify common, ronmental Health [Kistemann & Flemming, ter cycle. Their willingness to use alternative Vincent Covello described a “message and often complex, anticipated concerns 2016]. medication depends, among other factors, mapping” method to prepare effective cri- into categories (e.g., health trust, safety). on whether this relates to strong pain (little sis communication in seven steps. The EPA In addition, it is important to prepare the Representative survey on the disposal willingness) or weak pain (higher willingness). applied this method taking the example of a relevant “key messages” that, in case of of waste pharmaceuticals A detailed report about the survey results is hypothetical crisis scenario involving drink- crisis, will be communicated to the public. shown in the magazine “KA Korrespondenz ing water pollution by pesticides [U.S. EPA, Extensive guidelines describe the practical One aspect of the joint research project Abwasser” [Götz et al., 2014]. 2007b, 2012; Wood et al., 2012]: implementation of the “message mapping”, TransRisk involves the adequate communi- including example case studies. cation routes to communicate the problem 6.4 Crisis communication 1. Identify stakeholders (e.g., medical staff, of micropollutants already to the source of drinking water suppliers, public health In order to communicate rapidly, accurately, pollution, i.e. to the users of pharmaceuti- While risk communication conveys infor- department, (affected) public) and consistently during a crisis, the meth- cals, and to address them in a target-group mation about potential damages that might od is as important as the content [Lofst- specific way. To this effect, it is necessary occur in the future, crisis communication 2. Identify anticipated stakeholder ques- edt, 2003; Renn, 2008; U.S. EPA, 2007a]. to know relates to hazards where an acute damage tions and concerns (e.g., “What can you Therefore, it is imperative to systematically or ‘crisis’ has already occurred (see e.g. tell us about the water contamination?”, implement, practice and apply Standard • what level of knowledge exists among the [Centers of Disease Control and Preven- “How many people may have been af- Operation Procedures (SOPs) and a clear population tion, 2012; Hyer & Covello, 2005]). Unlike fected?” “How are you going to clean the communication process. In crisis situations, a potential hazard (risk), an acute hazard system?”) the public’s trust in the involved and com- • which behaviors exist with regard to the (crisis) represents an unexpected threat municating institutions is crucial for crisis disposal of pharmaceuticals that requires an immediate response that 3. Identify frequent concerns (e.g., basis management. This trust, in turn, is not only goes beyond, or varies from, the standard information (who, what, where, when, closely related to the perceived competence • who is considered to be mainly responsi- routines of the actors. Thus, acute hazards why, how?), health concerns, safety, li- of the communicator but also the perceived ble for solving the problem represent a stressor for all stakeholders that ability (who is accountable?), duration, efficiency and fairness of the measures [Lof- evokes significant negative emotions [Glik, decontamination) stedt, 2003; Renn, 2008]. Importantly, the • whether a willingness exists to address 2007]. Because acute hazards are accom- perceived trustworthiness and competence the issue from a practical perspective panied by an increased level of attention 4. Develop key messages (e.g., “We are of the communicator is not only inferred and a high demand for information, fast, testing water quality throughout the sys- from the “facts” communicated. Fast and • which target groups can be addressed. accurate, and trustworthy crisis communi- tem.”) intuitive judgments based on behavioral cation is of the highest importance [Centers (e.g. listening, empathy) and non-verbal, A representative survey for Germany con- for Disease Control and Prevention, 2012; 5. Develop supporting information (e.g., “We peripheral cues (e.g. eye contact, facial ex- ducted by the ISOE showed that nearly half Hyer & Covello, 2005]. During a crisis, infor- are taking samples at various locations.”, pressions, gestures) are similarly important. of the interviewees had never heard about mation is mostly processed “intuitively” and “[Insert laboratory name] is testing those Accordingly, practicing communication sce- the problem of pharmaceutical residues in heuristically. Unlike systematic information samples.”, “The results of these tests will narios is key to an effective preparation of the water cycle. In addition, this representa- processing, which involves carefully con- determine our next steps.”) crisis communication (see also [Hyer & Cov- tive survey of 2,000 interviewees also found sidering and weighing the consequences of ello, 2005]). The preparation and training of that little is known about the causes for the an action, heuristic processing is automatic 6. Testing and training (using standardized crisis communication is even more valuable release of the active substances into the and fast: People evaluate the overall signif- protocols and information validation by if it considers the different phases of a crisis

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pathogens from nursing homes, retirement Pre-Crisis Initial Maintenance Resolution Evaluation 6.5 Consultations homes, medical centers and hospitals into • Be prepared. • Acknowledge the • Help the public • Improve appropriate • Evaluate communi To successfully implement the measures the water cycle. Representatives from or- event with empathy. more accurately public response cation plan derived from the RiSKWa projects it is nec- ganizations and institutions form industry, • Foster alliances. understand its own in future similar performance. • Explain and inform risks. emergencies through essary that they address the needs of the academia, society and the health care • Develop consensus the public, in simplest education. • Document lessons recipients and that users and decision-mak- sector were involved given the fact that, in recommendations. forms, about the risk. • Provide background learned. and encompassing Honestly examine ers accept them. Early interactions with cit- a transdisciplinary dialog, not only the de- • Test messages. • • Establish agency information to those problems and • Determine specific izens and stakeholders help identify these mands but also the practical knowledge and spokesperson actions to improve who need it. mishaps, and then needs and facilitate the measures’ accept- of relevant stakeholders contribute to the credibility. reinforce what worked crisis systems or • Gain understanding in the recovery and the crisis plan. ance. In consultations, the public may either success of the joint research project. To- • Provide emergency and support for response efforts. be informed about the objectives and ben- gether, they developed results and actions. courses of action, response and including how and recovery plans. • Persuade the public efits of a planned measure. In addition, the In some cases, the stakeholders can di- where to get more to support public public may be involved even earlier in order rectly contribute to their implementation. information. • Listen to stakeholder policy and resource to integrate their ideas and collaboratively First and foremost, the integration of dif- and audience allocation to the • Commit to stake feedback, and correct problem. develop solutions. ferent stakeholders at such an early stage holders and the misinformation. was aimed at driving the development of public to continue • Promote the activities communication. • Explain emergency and capabilities Public survey practice-oriented, viable strategies. At the recommendations. of the agency, same time, the stakeholders acted as mul- including reinforcing • Empower risk/benefit its corporate identity, A representative public survey conducted tipliers in their respective organizations. decision-making. both internally and under the joint research project Sichere externally. Ruhr about bathing in the river Ruhr among During the three-year term of the project more than 1,000 households in Essen and stakeholder workshops (6) were held at Fig. 6.7: Crisis communication cycle (according to: Crisis and Emergency Risk Communication (CERC) neighboring cities showed that designat- regular intervals. The workshops involved Lifecycle, Centers for Disease Control and Prevention, 2012, p. 9) ed bathing areas with basic infrastructure moderated discussions where the knowl- (42%) are preferred over dedicated swim- edge and interests of the participants were as well as the corresponding requirements utilities are well advised to build up a good ming baths in rivers with lifeguards and assessed by methods such as the value for communication and actions (cf. Fig. 6.7). reputation through good public relations other infrastructures (31%) and free bathing tree analysis, group Delphi, participatory already during “normal times”. The more at river banks (22%). Around 55% of the in- scenario development, and impact assess- Guideline for risk and crisis trust a utility company gains also among terviewees would be willing to participate in ment. The information and opinions for- communication6 critical citizens, local media and politicians, financing measures aimed at improving the warded by the stakeholders contributed to the smaller the risks of “going down” in the water quality of the river Ruhr. In this con- the development of new action concepts. Also in the field of drinking water supply we event of a real or perceived contamination. text, the direct use of the Ruhr and its lakes see an increasingly discriminating customer It shows that, with regard to microbial con- as bathing waters is the most frequently Through this active participation, new attitude, especially when it comes to mi- taminations, also the communication crises mentioned reason for their willingness to knowledge was generated on both sides, crobial and chemical contaminations of the between water utilities and health authori- pay. Furthermore, the legacy for future gen- i.e. researchers and stakeholders from the drinking water. In such events, they expect ties are increasingly escalating. In the frame- erations and the option value, i.e. the possi- field, which proved to be essential for the a professional crisis management. This in- work of the joint research projects PRiMaT, bility to also use the Ruhr as a bathing water further development of solutions proposals cludes a communication that responds to a practice-oriented guideline for risk and were mentioned. in their research subject. the customers’ fears and concerns and pro- crisis communication in drinking water sup- vides comprehensible explanations of the ply was developed on the basis of, inter alia, Stakeholder workshops 6.6 Education causes and the remedial action taken to ad- three workshops with representatives from dress contamination. To ensure effective cri- water utilities and health authorities. The joint research project SAUBER+ un- Education can also be used as an effec- sis communication in an ‘emergency’, water der the lead of RWTH Aachen university’s tive, innovative communication measure. Institute of Environmental Engineering ex- Innovation stems from the fact that edu- 6 This guideline can be downloaded from: www.primat.tv/download/PRiMaT Leitfaden_zur_Risiko_und_Krisencommunication.pdf amined the release of pharmaceuticals and cational measures may be developed and

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implemented as projects evolve rather than In addition, an e-learning tool for students es. Learners should be able to handle this into the vocational training and professional simply being applied after the introduction was developed in the context of the joint multidimensionality to fully participate in the qualification curricula as quickly as possible. of a new scientific and/or technical devel- research project TransRisk (http://de.dwa. social discourse. Taking the example of mi- In particular, the new findings on the charac- opment. In RiSKWa, scientists from different de/forschung-und-innovation.html). In at to- cropollutants and pathogens in the water terization of micropollutants, their pathways fields, such as education and psychology, tal of 100 PowerPoint slides, the students cycle, a school project for the lower and into the water cycle and the technologies cooperated with experts working in the field were familiarized with the following topics: upper classes of secondary education was available to minimize their concentrations in in order to conceptualize and implement conceptualized and tested by the Technical the wastewater treatment plant are relevant various measures. These measures cover • Anthropogenic micropollutants University Dresden in the framework of the topics for the professional education. a broad spectrum, including conceptual joint research project TransRisk. The aim suggestions for the adjustment of curric- • Transformation products and their forma- of this project is to promote the students’ In the field of vocational training, the “Ver- ula, learning materials and platforms, and tion (biotransformation, abiotic formation competence to assess scientific problems ordnung über die Berufsausbildung in um- courses and trainings to the relevant profes- of transformation products) of daily life. welttechnischen Berufen” (Regulation on sional groups. Additionally, both teachers vocational training in environmental pro and learners act as multipliers of the new • Chemical analyses (target/non-target anal- In role plays, the students participating in fessions) and the “Rahmenlehrplan für den projects and measures. yses) the school project develop an expert opin- Ausbildungsberuf Fachkraft für Abwas- ion on anthropogenic micropollutants in the sertechnik” (Framework curriculum for the E-learning modules • Biological testing processes water cycle and offer a recommendation for profession of wastewater technician) are action regarding the introduction of a fourth sufficiently adaptable to also integrate new The joint research project PRiMaT devel- • Eco-toxicological evaluation of micropol- treatment stage in the municipal wastewa- content into the existing learning fields. oped a portal for teachers/learners (http:// lutants and transformation products ter treatment plant. While familiarizing them- When looking at the ecological material www.bayceer.uni-bayreuth.de/primat/). In selves with the subject, the learners discuss cycles and at hygienic aspects in the field a modern way, this webpage (designed by • Toxicological relevance of transformation intensively about the different discharge of wastewater technology, for example, it the University of Bayreuth) provides qualified products and In silico-toxicology (com- paths of the micropollutants into the water is possible to also focus on new findings information for the general public comple- puter-aided processes to assess the tox- cycle and about possibilities to minimize about micropollutants and pathogens. New mented by different functionalities: an up- icity of micropollutants) these emissions. With the help of experi- technologies in wastewater treatment can load/download function, for example, offers ments that recreate models of the proposed in addition also be presented directly after the possibility to upload teaching sugges- • Elimination of micropollutants and trans- advanced wastewater cleaning processes, the conventional treatment processes. The tions/materials into the portal also for ex- formation products in wastewater treat- the learners can understand the modes of number of hours of the individual learning ternal users. This function is only available ment action of these new technologies and eval- fields has to be adjusted accordingly. upon registration on the website to monitor uate their benefits. The learners assess all which content is loaded onto the portal. A • Indicator substances for the evaluation of findings taking into account ecological, eco- In the context of their professional training to comment function makes it possible to ask technical measures nomic and social aspects, and summarize become a wastewater manager, the partic- questions or to evaluate and discuss teach- them in an expert opinion. ipants will look extensively into wastewater ing suggestions. The teaching suggestions • Assessment of wastewater treatment and environmental engineering processes. from the University of Bayreuth were up- technologies with regard to microbiologi- Suggestions for the curricula Here, too, it would be possible to integrate loaded onto the portal and are freely avail- cal pollution wastewater technician, wastewater research findings about extended wastewa- able for registered users. An analysis of the manager ter treatment processes. portal user data attests to the willingness • Statutory regulations and interest in using the portal. Overall, the The introduction of new technical process- Training for healthcare professionals “traffic” on the website suggests that third School project es in wastewater treatment also results in parties became users of the portal. Summa- new demands being placed on the experts Following a survey among medical doctors rizing, it can be said that the portal is already Countless situations in daily life and on working in environmental engineering. The and nursing care professionals regarding showing first successes after its completion the job require decisions that need to be results of the joint research projects Trans- their knowledge about pharmaceutical res- and given its short history, and represents based on a differentiated consideration of Risk were analyzed from a didactic per- idues in the water cycle and how they han- a modern and purposeful information tool. different positions and solution approach- spective to integrate the research findings dle them, tailor-made training courses for

80 81 RiSKWa-Handbook of good practice 6 Communication and educational measures

these two groups of professionals were de- For nursing care professionals and with a Fischhoff, B.; Brewer, N.; Downs, J. (2011): Communicating risks and benefits: An evidence-based user’s guide. Washington, DC: Food and Drug Administration. veloped and tested under the joint research view to their target-group specific require- Gigerenzer, G.; Gaissmaier, W.; Kurz-Milcke, E.; Schwartz, L. M.; Woloshin, S. (2007): Helping Doctors and project SAUBER+. ments (participation in Certified Nursing Ed- Patients Make Sense of Health Statistics. Psychological Science in the Public Interest, 8(2), 53–96. ucation (CNE) in voluntary), attempts were Glik, D. C. (2007): Risk communication for public health emergencies. Annual Review of Public Health, 28, 33–54. For medical doctors, the (timely and situ- made to make the subject accessible for as Götz, K.; Birzle-Harder, B.; Sunderer, G. (2014): Ergebnisse einer Repräsentativbefragung zu Medikamenten- ationally) adaptable training concept “An- many potential addressees as possible. To rückständen im Wasserkreislauf und zur Medikamentenentsorgung. KA Korrespondenz Abwasser, Abfall, Nr. tibiotikaresistenzen und pharmazeutische this effect, a review paper entitled “Gefähr 12, 61. Jg., 1102–1105. Wirkstoffe im Wasserkreislauf. Risikochar- liche Rückstände im Klinikabwasser?” (Haz (Results of a representative survey on pharmaceuticals residues in the water cycle and on pharmaceuticals disposal) akterisierung und ärztliche Handlungsop- ardous residues in hospital effluents?) was Hyer, R. N.; Covello, V. T. (2005): Effective media communication during public health emergencies: 7 tionen” (Antibiotic resistances and active launched in the publication CNE.magazin A WHO handbook. World Health Organization. pharmaceutical ingredients in the water currently used by some 460 hospitals to Kistemann T.; Flemming H.C. (Eds.) (2016): Special issue “Safe Ruhr”, Int. J. Hyg. Env. Health, 219(7), 627-708. cycle. Risk characterization and options qualify their employees in the field of health Loewenstein, G. F.; Weber, E. U.; Hsee, C. K.; Welch, N. (2001): Risk as feelings. Psychological Bulletin, 127(2), for action for physicians) was developed. and nursing care. Moreover, members of 267–286. The aim is to create greater risk awareness the project consortium regularly published Lofstedt, R. (2003): Risk communication: Pitfalls and promises. European Review, 11(03), 417–435. among physicians and show how this im- contributions in the employee magazine of Renn, O. (2008): Risk governance: Coping with uncertainty in a complex world. London: Earthscan. portant target group can contribute to re- the Ortenau Clinic Centre, OKplus, there- Renner, B.; Gamp, M. (2014a): Krisen- und Risikokommunikation. Prävention und Gesundheitsförderung, 9(3), ducing aquifer pollution with active pharma- by reaching around 5,000 employees and 230–238. [Crisis and risk communication. Prevention and health promotion] ceutical ingredients and pathogens through informing them about the project as well Renner, B.; Gamp, M. (2014b): Psychologische Grundlagen der Gesundheitskommunikation. In K. Hurrelmann their (changed) work and behavioral routines. as their individual possibilities for action E. Baumann (Eds.), Handbuch Gesundheitskommunikation (pp. 64–80). Bern: Huber. (Psychological principles of health communication) (for further reading see [Adomßent 2015a, Renner, B.; Gamp, M.; Schmälzle, R.; Schupp, H. T. (2015): Health risk perception. In J. Wright (Ed.), International 2015b]). encyclopedia of the social and behavioral sciences (2. Ed, pp. 702–709): Oxford, England: Elsevier. Renner, B.; Reuter, T. (2012): Predicting vaccination using numerical and affective risk perceptions: The case of A/H1N1 influenza. Vaccine, 30(49), 7019–26. Renner, B.; Schupp, H. (2011): The perception of health risks. In H. S. Friedman (Ed.), Oxford handbook of health psychology (pp. 637–665). New York: Oxford University Press. Schoenemann, B.; Jardin, N.; (2015): Baden in Fließgewässern. Ein Handlungsleitfaden am Beispiel des 6.7 Bibliography Baldeneysees der Unteren Ruhr im Rahmen des BMBF-Projekts Sichere Ruhr. Essen. www.sichere-ruhr.de/wp-content/uploads/2014/01/sichere_ruhr_handlungsleitfaden_final.pdf. Adomßent, M. (2015a): What do doctors and nursing staff know about pharmaceutical residues in the water (Bathing in rivers. An action guide taking the example of the Baldeney lake of Untere Ruhr in the framework of cycle and how do they handle them? International Journal of Chemical and Environmental Engineering, 6 (3), the BMBF project Sichere Ruhr) 142-149. Sheeran, P.; Harris, P. R.; Epton, T. (2013): Does heightening risk appraisals change people’s intentions and Adomßent, M. (2015b): “Taking the pulse” of doctors and nurses to reduce pharmaceutical residues in the behavior? A meta-analysis of experimental studies. Psychological Bulletin, 140(2), 511–543. water cycle. A ground-breaking survey and its educational implications. WIT Transactions on The Built Slovic, P. E. (2000): The perception of risk. London: Earthscan Publications. Environment, 168, 167-178, doi: 10.2495/SD150151 Slovic, P. E.; Peters, E. (2006): Risk perception and affect. Current Directions in Psychological Science, 15(6), Bayerisches Landesamt für Umwelt (2016): UmweltWissen: Schadstoffe, Spurenstoffe im Wasser, 13 S., 322–325. Augsburg, http://www.lfu.bayern.de/umweltwissen/doc/uw_125_micropollutants.pdf U.S. EPA (2007a): Effective risk and crisis communication during water security emergencies (Hazardous substances, micropollutants in the water) (EPA/600/R-07/027). Washington, DC: United States Environmental Protection Agency. Brewer, N. (2011): Goals. In B. Fischhoff, N. Brewer, J. Downs (Eds.), Communicating Risks and Benefits: An U.S. EPA (2007): Risk Communication in Action: The tools of message mapping (EPA/625/R-06/012). Evidence-Based User’s Guide (pp. 3–10). Washington, DC: Food and Drug Administration Washington, DC: United States Environmental Protection Agency. Brewer, N. T.; Chapman, G. B.; Gibbons, F. X.; Gerrard, M.; McCaul, K. D.; Weinstein, N. D. (2007): Me- U.S. EPA (2012): Need to know: Anticipating the public’s questions during a water emergency ta-analysis of the relationship between risk perception and health behavior: The example of vaccination. Health (EPA/600/R-12/020). Washington, DC: United States Environmental Protection Agency. Psychology, 26(2), 136–45 Wood, M. D.; Bostrom, A.; Bridges, T.; Linkov, I. (2012): Cognitive mapping tools: Review and risk manage- Centers for Disease Control and Prevention (Ed.). (2012): Crisis and emergency risk communication. Retrieved ment needs. Risk Analysis, 32(8), 1333–48. from http://emergency.cdc.gov/cerc/resources/pdf/cerc_2012edition.pdf

7 This article is available at: www.thieme.de/statics/bilder/thieme/final/de/bilder/tw_pflege/022-023_CNEm_2014_05_ Sauber_plus.pdf

82 83 Annex Annex

Chapter authors (in alphabetical order) 4 Technologies for reducing organic micropollutants and pathogens in aquatic environments Responsible authors: 1 Introduction Prof. Dr. Martin Jekel, TU Berlin Responsible authors: Dr. Laurence Palmowski, RWTH Aachen Dr. Thomas Track, DECHEMA e.V., Frankfurt am Main Prof. Dr. Johannes Pinnekamp, RWTH Aachen email: [email protected] email: [email protected] Additional authors: email: [email protected] Friederike Bleckmann, Project Management Agency Karlsruhe, Water Technology and 5 Management concepts for dealing with micropollutants and pathogens Waste Management (PTKA-WTE), Karlsruhe Institute of Technology (KIT) in the water cycle Dr. Verena Höckele, Project Management Agency Karlsruhe, Water Technology and Waste Management (PTKA-WTE), Karlsruhe Institute of Technology (KIT) Responsible authors: Dr. Wolf Merkel, IWW Water Centre, Mühlheim a.d. Ruhr 2 Occurrence of micropollutants, pathogens and antibiotic resistances PD Dr. Traugott Scheytt, TU Berlin in the water cycle email: [email protected] Responsible authors: email: [email protected] Dr. Marion Letzel, Bavarian Environment Agency, Wielenbach 6 Communication and educational measures Dr. Frank Sacher, TZW: DVGW Water Technology Center, Karlsruhe Prof. Dr. Thomas Ternes, German Federal Institute of Hydrology, Koblenz Responsible authors: email: [email protected] Dr. Martina Gamp, University Konstanz email: [email protected] Prof. Dr. Britta Renner, University Konstanz email: [email protected] Sabine Thaler, DWA e.V., Hennef email: [email protected] Additional authors: email: [email protected] Prof. Dr. Martin Exner, University Bonn email: [email protected] Prof. Dr. Thomas Schwartz, Karlsruhe Institute of Technology (KIT) Additional authors: 3 Risk characterization und risk assessment: drinking water, wastewater, PD. Dr. Maik Adomßent, Leuphana University Lüneburg ground and surface water Klaus Amler, Ökonsult GbR, Stuttgart Responsible authors: Prof. Dr. Nina Baur, TU Berlin Dr. Tamara Grummt, Federal Environmental Agency (UBA), Bad Elster Prof. Dr. Franz Bogner, University Bayreuth Prof. Dr. Rita Triebskorn, Eberhard-Karls-University, Tübingen Nikolaus Geiler, regioWASSER e.V., Freiburg email: [email protected] Dr. Konrad Götz, ISOE, Frankfurt email: [email protected] Ulrike Krauße, TU Dresden Dr. Wolf Merkel, IWW Water Centre, Mühlheim a.d. Ruhr Additional authors: Prof. Dr. Manuela Niethammer, TU Dresden Prof. Dr. Martin Exner, University Bonn Dr. Regina Rhodius, Albert-Ludwigs-University Freiburg, regioWASSER e.V., Freiburg Dr. Lars Jurzik, Ruhr-University Bochum Bea Schmitt, team ewen, Darmstadt Dr. Marion Letzel, Bavarian Environment Agency, Wielenbach Jutta Schneider-Rapp, Ökonsult GbR, Stuttgart PD Dr. Tobias Licha, Georg-August-University, Göttingen Sebastian Sturm, TZW: DVGW-Water Technology Center, Karlsruhe Prof. Dr. Jörg Oehlmann, Johann Wolfgang Goethe-University, Frankfurt am Main Patrick Timpel, TU Dresden Prof. Dr. Thomas Schwartz, Karlsruhe Institute of Technology (KIT) Dr. Thomas Uhlendahl, regioWASSER e.V., Freiburg Prof. Dr. Michael Wilhelm, Ruhr-University Bochum Dr. Melanie Wenzel, TU Berlin

84 85 RiSKWa-Handbook of good practice Imprint

Editor:

DECHEMA e.V. Theodor-Heuss-Allee 25 60486 Frankfurt am Main

Contact persons for the BMBF funding measure “Risikomanagement von neuen Schadstoffen und Krankheitserregern im Wasserkreislauf“ RiSKWa (Risk Management of Emerging Compounds and Pathogens in the Water Cycle, RiSKWa):

At BMBF: Dr. Christian Alecke Federal Ministry of Education and Research (BMBF) Unit 724 - Resources and Sustainability 53170 Bonn Germany Phone: +49 (0)228 9957-3890 Fax: +49 (0)228 9957-83890 email: [email protected]

At Project Management Agency: Dr. Verena Höckele Project Management Agency Karlsruhe, Karlsruhe Institute of Technology Hermann-von-Helmholtz-Platz 1 76344 Eggenstein-Leopoldshafen Germany Tel.: +49 (0)721 608-24932 Fax: +49 (0)721 608-924932 email: [email protected]

Editor: Scientific support project for the BMBF funding measure “Risk Management of Emerging Compounds and Pathogens in the Water Cycle” (RiSKWa)

Responsible in terms of German press law: Dr. Thomas Track DECHEMA e.V. Phone: +49 (0)69 7564-427 Fax: +49 (0)69 7564-117 email: [email protected]

Sponsored by the Federal Ministry of Education and Research (BMBF) Support code: 02WRS1271

ISBN: 978-3-89746-192-5

The responsibility for the content of this publication rests solely with the authors of the individual articles. This brochure is not intended for commercial sale. Published in March 2017 at the end of the BMBF funding measure RiSKWa

Pictures cover page – top left to right: © Bodenseewasserversorgung; © DECHEMA; bottom left to right : © J. Couillard; © University Tübingen

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