Linking microbial diversity and population dynamics to the removal efficiency of pharmaceutically active compounds (PhACs) in an anaerobic/anoxic/aerobic (A2O) system

Native microorganisms for sustainable dye biodegradation in wastewaters from jeans finishing

The textile mill is one of the most water-consuming industries. Wastewater production is very high, and among the main generated pollutants are dyes. In particular, jeans finishing, which is performed all over the world, generates wastewater with indigo dye that has to be eliminated before discharge. This work studies the biological treatment of this type of wastewater using native microorganisms, i.e., without the need for external seed sludge to start-up the process. Two strategies for starting up the biological treatment using laboratory sequencing batch reactors have been compared: the addition of seed sludge from a biological reactor of a wastewater treatment plant and the non-addition of seed sludge, which means that native microorganisms (those in wastewater coming from the industry facilities) are responsible for COD and color degradation. Special attention is paid to biomass shift in both reactors, analyzing both bacterial and fungal populations. Results yielded more than 90% of COD and color removal after 25 days in both reactors. MLSS increased in both reactors during the operation, reaching very similar values (around 1840 mg/L). Rozellomycota was the predominant phylum in the reactors. Concerning bacteria, Planctomycetota abundance increased considerably in both reactors, which shows the important role of these bacteria in the treatment. It can be concluded that the lower bacterial diversity in the native population in comparison with the seeded sludge was shifting to a higher microbial diversity during the process, achieving a similar microbial population in reactors. It implies that it is not necessary to either work with isolated cultures or seeded sludge, which leads to a simpler and more sustainable solution for textile wastewater treatment in areas all over the world.

Biosorption Ability of Pharmaceutically Active Compounds by Anabaena sp. and Chroococcidiopsis thermalis

Drug overuse harms the biosphere, leading to disturbances in ecosystems' functioning. Consequently, more and more actions are being taken to minimise the harmful impact of xenopharmaceuticals on the environment. One of the innovative solutions is using biosorbents-natural materials such as cells or biopolymers-to remove environmental pollutants; however, this focuses mainly on the removal of metal ions and colourants. Therefore, this study investigated the biosorption ability of selected pharmaceuticals-paracetamol, diclofenac, and ibuprofen-by the biomass of the cyanobacteria Anabaena sp. and Chroococcidiopsis thermalis, using the LC-MS/MS technique. The viability of the cyanobacteria was assessed by determining photosynthetic pigments in cells using a UV-VIS spectrophotometer. The results indicate that both tested species can be effective biosorbents for paracetamol and diclofenac. At the same time, the tested compounds did not have a toxic effect on the tested cyanobacterial species and, in some cases, stimulated their cell growth. Furthermore, the Anabaena sp. can effectively biotransform DCF into its dimer.

Microbial indicators of efficient performance in an anaerobic/anoxic/aerobic integrated fixed-film activated sludge (A2O-IFAS) and a two-stage mesophilic anaerobic digestion process

An analysis of the community structure, diversity and population dynamics of Bacteria and Archaea in the suspended and attached biomass fractions of a pilot-scale anaerobic/anoxic/aerobic integrated fixed-film activated sludge (A²O-IFAS) was executed. Along with this, the effluents of the acidogenic (AcD) and methanogenic (MD) digesters of a two-stage mesophilic anaerobic (MAD) system treating the primary sludge (PS) and waste activated sludge (WAS) generated by the A²O-IFAS were also analyzed. Non-metric multidimensional scaling (MDS) and Biota-environment (BIO-ENV) multivariate analyses were performed to link population dynamics of Bacteria and Archaea to operating parameters and removal efficiencies of organic matter and nutrients, in search of microbial indicators associated with optimal performance. In all samples analyzed, Proteobacteria, Bacteroidetes and Chloroflexi were the most abundant phyla, while the hydrogenotrophic methanogens Methanolinea, Methanocorpusculum and Methanobacterium were the predominant archaeal genera. BIO-ENV analysis disclosed strong correlations between the population shifts observed in the suspended and attached bacterial communities of the A²O-IFAS and the removal rates of organic matter, N and P. It is noteworthy that the incorporation of carriers combined with a short sludge retention time (SRT = 4.0 ± 1.0 days) enhanced N removal performance of the A²O by favoring the enrichment of bacterial genera able to denitrify (Bosea, Dechloromonas, Devosia, Hyphomicrobium, Rhodobacter, Rhodoplanes, Rubrivivax, and Sulfuritalea) in the attached biomass fraction. In addition, operation at short SRT enabled the generation of a highly biodegradable WAS, which enhanced the biogas and methane yields in the two-stage MAD. An increase in the relative abundance of Acetobacteroides (uncultured Blvii28 wastewater-sludge group of Rikenellaceae family) correlated positively with the volatile solids removal rate (%VSR), CH₄ recovery rate and %CH₄ in the biogas (r > 0.8), supporting their relevance for an efficient methanogenesis in two-stage systems.

Occurrence of antibiotics in wastewater: Potential ecological risk and removal through anaerobic-aerobic systems

Antibiotics are intensively used to improve public health, prevent diseases and enhance productivity in animal farms. Contrarily, when released, the antibiotics laden wastewater produced from pharmaceutical industries and their application sources poses a potential ecological risk to the environment. This study provides a discussion on the occurrence of various antibiotics in wastewater and their potential ecological risk in the environment. Further, a critical review of anaerobic-aerobic processes based on three major systems (such as constructed wetland, high-rate bioreactor, and integrated treatment technologies) applied for antibiotics removal from wastewater is performed. The review also explores microbial dynamics responsible for antibiotic biodegradation in anaerobic-aerobic systems and its economic feasibility at wider-scale applications. The operational problems and prospective modifications are discussed to define key future research directions. The appropriate selection of treatment processes, sources control, understanding of antibiotic fate, and adopting precise monitoring strategies could eliminate the potential ecological risks of antibiotics. Integrated bio-electrochemical systems exhibit antibiotics removal ≥95% by dominant Geobacter sp. at short HRT ∼4-10 h. Major process factors like organic loading rate, hydraulic loading rate (HRT), and solid retention time significantly affect the system performance. This review will be beneficial to the researchers by providing in-depth understanding of antibiotic pollution and its abatement via anaerobic-aerobic processes to develop sustainable wastewater treatment technology in the future.

Spatial distribution and risk assessment of certain antibiotics in 51 urban wastewater treatment plants in the transition zone between North and South China

The release of antibiotics from WWTPs into the environment has raised increasing concern worldwide. The monitoring of antibiotics in WWTPs throughout a region is crucial for emerging pollutant management. A large-scale survey of the occurrence, distribution, and ecological risk of seven antibiotics in 51 WWTPs was conducted in Shaanxi Province, China. Norfloxacin and ofloxacin had the highest detection concentrations of 474.2 and 656.18 ng L^-1, respectively. Antibiotic residues in effluents were decreased by 5.88-94.16 % after different treatment processes. In particular, A²O or mixed processes performed well in removing target antibiotic compounds simultaneously. The ecological risk posed by antibiotic compounds detected in effluents was calculated using the risk quotient (RQ). Norfloxacin, ofloxacin, tetracycline, and roxithromycin posed different levels of potential ecotoxicological risk (RQ = 0.02-7.59). Based on the sum of the RQ values of individual antibiotic compounds, each investigated WWTP showed potential ecological risk. WWTPs with high risk levels were mainly found in the central region, while those in the southern region exhibited low risk levels, and those in the northern region showed risk levels between medium and high. This comprehensive investigation provides promising results to support the safe use and control of antibiotics in the study area.

Optimization of Microalgae–Bacteria Consortium in the Treatment of Paper Pulp Wastewater

The microalgae–bacteria consortium is a promising and sustainable alternative for industrial wastewater treatment, since it may allow good removal of organic matter and nutrients, as well as the possibility of producing products with added value from the algae biomass. This research investigated the best bacterial and microalgae inoculation ratio for system start-up and evaluation of removing organic matter (as chemical oxygen demand (COD)), ammoniacal nitrogen (NH4+–N), nitrite nitrogen (NO2−–N), nitrate nitrogen (NO3−–N), phosphate phosphorus (PO43−–P) and biomass formation parameters in six photobioreactors with a total volume of 1000 mL. Reactors were operated for 14 days with the following ratios of pulp mill biomass aerobic (BA) and Scenedesmus sp. microalgae (MA): 0:1 (PBR1), 1:0 (PBR2), 1:1 (PBR3), 3:1 (PBR4), 5:1 (PBR5), and 1:3 (PBR6). Results show that COD removal was observed in just two days of operation in PBR4, PBR5, and PBR6, whereas for the other reactors (with a lower rate of initial inoculation) it took five days. The PBR5 and PBR6 performed better in terms of NH4+–N removal, with 86.81% and 77.11%, respectively, which can be attributed to assimilation by microalgae and nitrification by bacteria. PBR6, with the highest concentration of microalgae, had the higher PO43−–P removal (86%), showing the advantage of algae in consortium with bacteria for phosphorus uptake. PBR4 and PBR5, with the highest BA, led to a better biomass production and sedimentability on the second day of operation, with flocculation efficiencies values over 90%. Regarding the formation of extracellular polymeric substances (EPS), protein production was substantially higher in PBR4 and PBR5, with more BA, with average concentrations of 49.90 mg/L and 49.05 mg/L, respectively. The presence of cyanobacteria and Chlorophyceae was identified in all reactors except PBR1 (only MA), which may indicate a good formation and structuring of the microalgae–bacteria consortium. Scanning electron microscopy (SEM) analysis revealed that filamentous microalgae were employed as a foundation for the fixation of bacteria and other algae colonies.

A comprehensive assessment of fungi in urban sewer biofilms: Community structure, environmental factors, and symbiosis patterns

Sewers are important parts of wastewater treatment facilities and the fungal microbial communities therein make large contributions to the biotransformation of wastewater. Therefore, this experiment constructed an experimental sewer system and characterized the fungal microbial communities using ITS high-throughput sequencing technology in combination with network structure analysis and statistical correlation analysis methods. The results demonstrated that the overall diversity of the fungal communities gradually increased as growth phases progressed, but the dominant groups differed significantly among phases. In the early growth phase (RS1) the dominant genera were Apiotrichum and Inocybe, with abundances of 34% and 14%, respectively, while the middle and late growth phases (RS2 and RS3) were dominated by Candida, with a relative abundance of 47%-66%. CCA and correlation analysis showed that the fungal communities diversity from the artificial sewers had significant positive correlations with COD (r² = 0.44, p < 0.05) and NH₄⁺ (r² = 0.64, p < 0.05) and that environmental factors significantly influenced the abundances of Fusarium and Aspergillus. Network analysis revealed differences in the fungal groups representing key nodes during different periods. Candida, Trichosporon, Fusarium, and Aspergillus played important roles in the microbial ecosystem of the simulated sewer systems. This study provides data-supported insight into the bacterial-fungal interaction mechanisms and associated pollutant biodegradation technologies in sewers.

Influence of cosubstrate and hydraulic retention time on the removal of drugs and hygiene products in sanitary sewage in an anaerobic Expanded Granular Sludge Bed reactor

Diclofenac (DCF), ibuprofen (IBU), propranolol (PRO), triclosan (TCS) and linear alkylbenzene sulfonate (LAS) can be recalcitrant in Wastewater Treatment Plants (WWTP). The removal of these compounds was investigated in scale-up (69 L) Expanded Granular Sludge Bed (EGSB) reactor, fed with sanitary sewage from the São Carlos-SP (Brazil) WWTP and 200 mg L^-1 of ethanol. The EGSB was operated in three phases: (I) hydraulic retention time (HRT) of 36±4 h; (II) HRT of 20±2 h and (III) HRT of 20±2 h with ethanol. Phases I and II showed no significant difference in the removal of LAS (63 ± 11-65 ± 12 %), DCF (37 ± 18-35 ± 11 %), IBU (43 ± 18-44 ± 16 %) and PRO (46 ± 25-51 ± 23 %) for 13±2-15 ± 2 mg L^-1, 106 ± 32-462 ± 294 μg L^-1, 166 ± 55-462 ± 213 μg L^-1 and 201 ± 113-250 ± 141 μg L^-1 influent, respectively. Higher TCS removal was obtained in phase I (72 ± 17 % for 127 ± 120 μg L^-1 influent) when compared to phase II (51 ± 13 % for 135 ± 119 μg L^-1 influent). This was due to its greater adsorption (40 %) in the initial phase. Phase III had higher removal of DCF (42 ± 10 % for 107 ± 26 μg L^-1 influent), IBU (50 ± 15 % for 164 ± 47 μg L^-1 influent) and TCS (85 ± 15 % for 185 ± 148 μg L^-1 influent) and lower removal of LAS (35 ± 14 % for 12 ± 3 mg L^-1 influent) and PRO (-142 ± 177 % for 188 ± 88 μg L^-1 influent). Bacteria similar to Syntrophobacter, Smithella, Macellibacteroides, Syntrophus, Blvii28_wastewater-sludge_group and Bacteroides were identified in phase I with relative abundance of 3.1 %-4.7 %. Syntrophobacter was more abundant (15.4 %) in phase II, while in phase III, it was Smithella (12.7 %) and Caldisericum (15.1 %). Regarding the Archaea Domain, Methanosaeta was more abundant in phases I (84 %) and II (67 %), while in phase III it was Methanobacterium (86 %).

Insights into the removal of pharmaceutically active compounds from sewage sludge by two-stage mesophilic anaerobic digestion

The removal efficiencies (REs) of twenty-seven pharmaceutically active compounds (PhACs) (eight analgesic/anti-inflammatories, six antibiotics, four β-blockers, two antihypertensives/diuretics, three lipid regulators and four psychiatric drugs) were evaluated in a pilot-scale two-stage mesophilic anaerobic digestion (MAD) system treating thickened sewage sludge from a pilot-scale A²O™ wastewater treatment plant (WWTP) which was fed with wastewater from the pre-treatment of the full-scale WWTP Murcia Este (Murcia, Spain). The MAD system was long-term operated using two different sets of sludge retention times (SRTs) for the acidogenic (AcD) and methanogenic (MD) digesters (phase I, 2 and 12 days; and phase II, 5 and 24 days, in AcD and MD, respectively). Quantitative PCR (qPCR) and Illumina MiSeq sequencing were used to estimate the absolute abundance of Bacteria, Archaea, and Fungi and investigate the structure, diversity and population dynamics of their communities in the AcD and MD effluents. The extension of the SRT from 12 (phase I) to 24 days (phase II) in the MD was significantly linked with an improved removal of carbamazepine, clarithromycin, codeine, gemfibrozil, ibuprofen, lorazepam, and propranolol. The absolute abundances of total Bacteria and Archaea were higher in the MD regardless of the phase, while the diversity of bacterial and archaeal communities was lower in phase II, in both digesters. Non-metric multidimensional scaling (MDS) plots showed strong negative correlations among phyla Proteobacteria and Firmicutes and between genera Methanosaeta and Methanosarcina throughout the full experimental period. Strong positive correlations were revealed between the relative abundances of Methanospirillum and Methanoculleus and the methanogenesis performance parameters (volatile solids removal, CH₄ recovery rate and %CH₄ in the biogas), which were also related to longer SRT. The REs of several PhACs (naproxen, ketoprofen, ofloxacin, fenofibrate, trimethoprim, and atenolol) correlated positively (r > 0.75) with the relative abundances of specific bacterial and archaeal groups, suggesting their participation in biodegradation/biotransformation pathways.

Novel recyclable acidic hydrophobic deep eutectic solvents for highly efficient extraction of calcium dobesilate in water and urine samples

Deep eutectic solvents (DESs) have been considered to be one of the most promising green alternatives of conventional volatile solvents for liquid-liquid separation. However, acidic hydrophobic DESs have been less studied although they are of great importance for the extraction of compounds which are unstable in alkaline conditions. In this study, a novel family of acidic hydrophobic deep eutectic solvents was designed and prepared from methyl trioctyl ammonium chloride and a series of haloacetic acids. For the first time, the obtained DESs were used for extraction and determination of calcium dobesilate, which is an extensively used medicine for treating vascular diseases, but it can be easily oxidized under alkaline and neutral conditions. The factors influencing extraction process including pH, temperature, extract time, inorganic salts and organic coexistence were systematically investigated. It is found that these DESs exhibited outstanding extraction performance towards calcium dobesilate. The extraction equilibrium time was only 3 min in a wide range of pH (1.2-9.2) at room temperature and the extraction capacity was up to 504 mg/g. The detection limit of calcium dobesilate extracting from water samples was 0.05 μg/L and the limit of quantification was 0.5 μg/L. A variety of inorganic salts with the concentration up to 1.0 mol/L and common coexisting organic compounds, such as glucose and starch, with the concentration more than 1000 times higher than the target analyte had no obvious impact on the extraction efficiency. The relative recovery for real samples ranged from 93.2% to 108.6%. Furthermore, the DESs could be recycled and regenerated through back extraction. After fifteen cycles, the extraction efficiency was still up to 99%. Finally, the extraction and back extraction mechanism was discussed in detail.

Antibiotics in wastewater: From its occurrence to the biological removal by environmentally conscious technologies

In this critical review, we explored the most recent advances about the fate of antibiotics on biological wastewater treatment plants (WWTP). Although the occurrence of these pollutants in wastewater and natural streams has been investigated previously, some recent publications still expose the need to improve the detection strategies and the lack of information about their transformation products. The role of the antibiotic properties and the process operating conditions were also analyzed. The pieces of evidence in the literature associate several molecular properties to the antibiotic removal pathway, like hydrophobicity, chemical structure, and electrostatic interactions. Nonetheless, the influence of operating conditions is still unclear, and solid retention time stands out as a key factor. Additionally, the efficiencies and pathways of antibiotic removals on conventional (activated sludge, membrane bioreactor, anaerobic digestion, and nitrogen removal) and emerging bioprocesses (bioelectrochemical systems, fungi, and enzymes) were assessed, and our concern about potential research gaps was raised. The combination of different bioprocess can efficiently mitigate the impacts generated by these pollutants. Thus, to plan and design a process to remove and mineralize antibiotics from wastewater, all aspects must be addressed, the pollutant and process characteristics and how it is the best way to operate it to reduce the impact of antibiotics in the environment.

Photocatalytic-persulfate- oxidation for diclofenac removal from aqueous solutions: Modeling, optimization and biotoxicity test assessment

In this paper, the influence of several aquatic factors (the nature of catalyst, the initial pH and the initial concentration of the pollutant) on the photocatalytic degradation of diclofenac (DFC), one of the most widely prescribed anti-inflammatory non-steroidal drug, was studied. Also, in order to examine the intensification process, the variation of the photocatalytic DFC degradation in the presence of sodium persulfate (PPS) was analyzed. It was found that, compared to titanium dioxide (TiO₂), the zinc oxide (ZnO) photocatalyst performed exceptionally well, with a 96.13% DFC degradation efficiency after 150 min. The photodegradation of DFC by ZnO catalyst fitted well the Langmuir-Hinshelwood kinetic model. The maximum efficiency is 97.27% for simulated solar-UVA/ZnO/PPS and 77% for simulated solar-UVA/ZnO. In order to determine the optimal conditions leading to the maximization of DFC removal, an artificial neural network (ANN) modeling approach combined with genetic algorithm (GA) was applied. The best ANN determined had a correlation of 0.999 and it was further used in the process optimization where a 99.7% degradation efficiency was identified as the optimum under the following conditions: DFC initial concentration 37,9 mg L^-1, pH 5,88 and PPS initial concentration 500 mg L^-1. The effectiveness of the process and the toxicity of the pharmaceutical pollutants and their by-products were also evaluated and confirmed by the biological tests using liver and kidney of Mus musculus mice.

Effect of mixed petrochemical wastewater with different effluent sources on anaerobic treatment: organic removal behaviors and microbial community

Petrochemical industrial effluent contains industrial wastewater from various manufacturing processes. The mixed treatment of these different petrochemical wastewater effluents may influence the organic removal performance of the anaerobic processes. In this study, three typical petrochemical effluents, including polyester (PE), polyethylene terephthalate, and purified terephthalic acid wastewater, were collected. The effect of the mixed petrochemical wastewater on the organic removal and microbial community structure was investigated in the anaerobic batch assays via spectroscopy and high-throughput sequencing. The organic removal efficiencies were similar (71-85%) in all the batch assays for 90 h acclimation. The mixture of wastewater, especially the addition of PE wastewater, significantly prolonged organic removal process. It was related to the aromatic removal performance and microbial community structure during the mixed wastewater treatment. The microbial community structure in the mixed wastewater batch assay showed high similarity with that in the PE wastewater batch assay. Ignavibacterium, Syntrophus, and Pelotomaculum were crucial to the degradation of aromatic compounds together with Methanosaeta. The mixture of wastewater, especially the addition of PE wastewater, caused the decay of these functional microbes and resulted in the inefficient removal of the aromatic compounds.

Quantification, removal and potential ecological risk of emerging contaminants in different organic loads of swine wastewater treated by integrated biological reactors

This study aims to evaluate the dynamics and their ecological risks for aquatic species of lipid regulator, nervous stimulant, anti-inflammatory and endocrine disrupters in an upflow anaerobic sludge blanket (UASB), submerged aerated biological filters (SABF) and horizontal subsurface flow constructed wetland (HSSF-CW) reactors that treat swine wastewater. Four organic loads of swine wastewater (SW) were used according to changing the chemical oxygen demand. 13 contaminants were quantified, standing out the endocrine disruptors, lipid regulator and anti-inflammatory. In phase III, 8318.4 ng L^-1 of 4-ocylphenol was found at the influent of the UASB reactor and removal from 1877.1 to 13.7 ng L^-1 in the bisphenol A system. With the maximum organic load, there was a reduction among all the treatment units, with concentrations between 1877.1 and 13.7 ng L^-1 of bisphenol A and had naproxen removal of 94.5% and 2,7 ng L^-1 after treating phases II and III. It was found that 24.6% of the contaminants presented a high ecological risk, with maximum values of 27.4 (4-nonylphenol, phase II), 24.6 and 5.9 (17β-estradiol, phase IV and I, respectively), 13.4 (4-ocylphenol, phase III) and 4.4 (estrone, phase IV) in the influent system. The reduction of ecological risk potentials was optimized by SABF and HSSF-CW. The effect oxygen availability and microbiological activities optimized the reduction of ecological risks on zebrafish (Danio rerio) and cnidarian (Hydra attenuata) species, moreover, the reduction of mass flows and ecological risks of the emerging contaminants are associated with the use of biological reactors in series and organic stabilizations.

Activated sludge and other aerobic suspended culture processes

This paper provides an overview of activated sludge related to suspended growth processes for the year 2019. The review encompasses process modeling of activated sludge, microbiology of activated sludge, process kinetics and mechanism, nitrogen and phosphorus control, design, and operation in the activated sludge field. The fate and effect of xenobiotics in activated sludge, including trace organic contaminant and heavy metal xenobiotics, which had influence on the growth of suspended sludge, are covered in this review. Compared to past reviews, many topics show increase in activity in 2019. These include, biokinetics process of aerobic granular sludge formation, pyrolysis kinetic mechanism of granular sludge. These topics are referred to formation and disintegration of granular sludge. Other sections include activated sludge settling model, toxicity resistant microbial community, nitritation-anammox processes for nitrogen removal, and respirometry used in the operation of real wastewater treatment plant are especially highlighted in this review. PRACTITIONER POINTS: Biokinetics process of aerobic granular sludge formation Toxicity resistant microbial community in activated sludge Nitritation-anammox processes for nitrogen removal in activated sludge.

A sustainability anti-infective pharmaceutical wastewater treatment technology: multi-stage vertical variable diameter membrane bioreactor with DO online controlling

The proper choice of dissolved oxygen (DO) is important in aerobic treatment. In this paper, a multi-stage vertical variable diameter membrane bioreactor was developed to treat pharmaceutical wastewater containing 6-APA and ceftriaxone sodium. In the 180 days of operation, the performance of COD, BOD₅, 6-APA, ceftriaxone sodium removal, sludge index, and microbial enzyme activity under different DOs (from 0.5 to 6.0 mg/L) were investigated. The results showed that the optimal range of DO was 1.5-2.1 mg/L, and the highest removal rates of COD and BOD₅ were observed 87.3%±2.4% and 95.3%±1.8%, the corresponding effluent COD and BOD₅ were 189 mg/L and 24 mg/L, respectively. To reduce the energy consumption and ensure stability of DO in the reactor, a control strategy based on an improved differential evolution BP fuzzy neural network was built and found that the performance and cost of the controlled DO were improved effectively than that of uncontrolled DO.

Distribution and Removal of Pharmaceuticals in Liquid and Solid Phases in the Unit Processes of Sewage Treatment Plants

In this study, we analyzed 27 pharmaceuticals in liquid and solid phase samples collected from the unit processes of four different sewage treatment plants (STPs) to evaluate their distribution and behavior of the pharmaceuticals. The examination of the relative distributions of various categories of pharmaceuticals in the influent showed that non-steroidal anti-inflammatory drugs (NSAIDs) were the most dominant. While the relative distribution of antibiotics in the influent was not high (i.e., 3%–5%), it increased to 14%–30% in the effluent. In the four STPs, the mass load of the target pharmaceuticals was reduced by 88%–95% mainly in the biological treatment process, whereas the ratio of pharmaceuticals in waste sludge to those in the influent (w/w) was only 2%. In all the STPs, the removal efficiencies for the stimulant caffeine, NSAIDs (acetaminophen, naproxen, and acetylsalicylic acid), and the antibiotic cefradine were high; they were removed mainly by biological processes. Certain compounds, such as the NSAID ketoprofen, contrast agent iopromide, lipid regulator gemfibrozil, and antibiotic sulfamethoxazole, showed varying removal efficiencies depending on the contribution of biodegradation and sludge sorption. In addition, a quantitative meta-analysis was performed to compare the pharmaceutical removal efficiencies of the biological treatment processes in the four STPs, which were a membrane bioreactor (MBR) process, sequencing batch reactor (SBR) process, anaerobic–anoxic–oxic (A2O) process, and moving-bed biofilm reactor (MBBR) process. Among the biological processes, the removal efficiency was in the order of MBR > SBR > A2O > MBBR. Among the tertiary treatment processes investigated, powdered activated carbon showed the highest removal efficiency of 18%–63% for gemfibrozil, ibuprofen, ketoprofen, atenolol, cimetidine, and trimethoprim.