Adsorption Technologies for the Removal of Cytostatics in Water: A Review

One of the most common treatments for cancer disease requires the administration of cytostatics, which are very effective drugs in the elimination of cancerous cells, but are toxic for healthy tissues. After being administered to patients, they are excreted and frequently reach natural water bodies, due to their poor degradation in wastewater treatment plants (WWTPs), posing a global threat to the environment and human health. The study of proper treatment approaches for the effective removal of these hazardous drugs in WWTPs is thus a topic of concern and of utmost importance to ensure environmental integrity, resilience and sustainability. The aim of this work is to perform a comprehensive review of the application of adsorption-based processes for the treatment of aqueous matrices contaminated with cytostatics, which has never been addressed before. A detailed discussion on the operating conditions, type and concentrations of sorbents used, toxicity of the effluents and other relevant parameters is presented. This paper aims to help identify the most promising sorbents and conditions, the current knowledge gaps, and future challenges/perspectives on adsorption technologies (isolated or coupled with other processes) to tackle the problem of cytostatic fingerprints in water courses. Additionally, information concerning the implementation of these technologies from an environmental and economic (life cycle assessment) perspective is given.