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The purpose of this paper is to cover some aspects about the disposal and regulatory standard around the world toward hospital effluent discharge, its managements and treatment technologies that are adopted and best suitable nowadays.

Due to large and variety of antibiotics available in the market nowadays it is difficult to control its use, thereby risking the whole ecosystem and its components. The regulation pattern is variable depending upon the various factors in different countries. The permissible limit of these emerging pollutants found in sewage as compared to in hospital effluent streams having active pharmaceutical ingredients is very narrow and is a debatable issue.

The disparity in the available legislation for hospital waste management in different countries makes it difficult to compare pro’s and con’s of methods adopted. Strict laws need to be framed for hospital wastewater management and its treatment, as it contains harmful compounds in higher concentrations resulting in development of resistant genes. The guideline applicable nowadays makes it clear that, specific management guidelines with respect to HWW, but also indicate certain characteristics that can be represented to specify their nature and indicator.

Determination of effluent characteristic for each specialized treatment need to be analyzed for meeting the framed regulatory standards. Up-gradation of existing treatment facilities, adopting new technologies and improving operation, maintained is a viable option. As there are no specific treatment schemes available hence combination and optimization of treatment methods may solve the problem to certain extent.

There is some flexibility also there so that law framework can be modified accordingly. For any health facilities direct discharges into natural water bodies it effluent need to follow national discharge standards. These are quite strict as compared to indirect standards and generally not meet by such facilities. This is quite logical because they are not being monitored or treated by municipal systems.

The law indicates that hospital needed to collect and treat effluent according to the treatment standards. But on other hand the law was made making it consideration about the HWW collection in water bodies.

The best way of management as described, is to treat HWW onsite-dividing into primary, secondary and tertiary. The document also provides details about sludge disposal, possible reuse, including the application of new and innovative treatment technologies for HWW. It also provides guidance for minimum approach for HWW management because developing countries patients do not have proper sanitation facilities.