European-wide spatial analysis of sewage treatment plants and the possible benefits to nature of advanced treatment to reduce pharmaceutical emissions

•The potential of upgrading STPs to reduce pharmaceutical emissions is analysed with 3 scenarios.•Total EU emission load can be reduced from 48% to 69% when large STPs are updated with advanced treatment.•Not all pharmaceuticals are well removed in STPs, even by advanced techniques.•Some water bodies and nature areas might not be sufficiently protected in any scenario.•Results can be used to model emissions and prioritize STPs to install advanced treatment. Pharmaceuticals are known to widely occur in the environment and to affect the health of ecosystems. Sewage treatment plants (STPs) are main emission pathways for pharmaceuticals, which are often not sufficiently removed during wastewater treatment. In Europe, STP treatment requirements are specified under the Urban WasteWater Treatment Directive (UWWTD). The introduction of advanced treatment techniques, such as ozonation and activated carbon, under the UWWTD is expected to be an important option to reduce pharmaceutical emissions. In this study, we present a European-wide analysis of STPs reported under the UWWTD, their current treatment level and potential to remove a set of 58 prioritised pharmaceuticals. Three different scenarios were analysed to show 1) UWWTD present effectiveness, 2) the effectiveness at full UWWTD compliance, and 3) the effectiveness when advanced treatment is implemented at STPs with a treatment capacity of >100.000 person equivalents. Based on a literature study, the potential of individual STPs to reduce pharmaceutical emissions ranged from an average of 9% for STPs with primary treatment to 84% for STPs applying advanced treatment. Results of our calculations show that European-wide emission of pharmaceuticals can be reduced with 68% when large STPs are updated with advanced treatment, but spatial differences exist. We argue that adequate attention should also be paid with regards to preventing environmental impacts of STPs with a capacity