Global techno-economic analysis of MBR for hospital wastewater treatment

This study comprehensively examines and characterizes global membrane bioreactor (MBR) practices for hospital wastewater treatment, focusing on development trends, technical performance (pollutant removal and carbon emissions), and economic costs, including both capital expenditures (CAPEX) for civil engineering and equipment procurement, and operational expenditures (OPEX) for electricity, membrane replacement, labor, and chemical costs, as well as system footprint. The results show that MBR has been widely used for hospital wastewater treatment for over two decades, with global applications and scales significantly increasing, especially after the COVID-19 pandemic. A notable shift in membrane types has occurred, with hollow fiber membranes dominating before 2010 and flat inorganic membranes gaining prominence after 2020. MBR not only effectively removes conventional pollutants but also greatly reduces pathogens, ARBs and ARGs before disinfection, thus alleviating the subsequent disinfection burden. In addition, MBR is a crucial step in the process of completely removing emerging contaminants (ECs) that pose significant environmental and health risks. The CAPEX of MBR has decreased at the technical level in recent years. MBR requires only 62 % and 21 % of footprint for conventional activated sludge (CAS) and biofilm-based processes, respectively. MBR's land-saving advantage offsets the CAPEX gap with CAS in high land-cost areas. From before 2010 to after 2020, membrane costs saw the largest reduction in OPEX, dropping by 71 %, while electricity consumption saw a 10.71 % reduction, now comparable to biofilm-based processes. Currently, MBR's OPEX (0.158 USD/m3) is only slightly higher than that of biological contact oxidation (0.138 USD/m3). MBR also minimizes sludge production, reducing both treatment costs and associated disposal risks. MBR exhibit minimal concerns of excessive carbon emissions, with a carbon emission intensity (1.11 kg CO2eq·m−3), only slightly higher than biofilm-based processes (0.92 kg CO2eq·m−3). This study demonstrates that MBR is the valuable and practical solution for hospital wastewater treatment, as well as a preferred choice for upgrading existing facilities. [Display omitted] •MBR practices for hospital wastewater (HWW) treatment were analyzed in 206 cases.•More than 30 % of MBR installations and capacity were added during COVID-19.•Membrane types shifted from hollow fiber to flat inorganic in MBRs for HWW post-2020.•Membrane