en عمومى General مقاله اصیل Original Article <div style="text-align: justify;">Introduction: Hospitals generate substantial volumes of highly contaminated wastewater, posing serious environmental and public health concerns. Hospital wastewater (HWW) contains pharmaceutical residues, heavy metals, disinfectants, pathogens, and antibiotic-resistant bacteria, many of which are not completely removed by conventional wastewater treatment plants (WWTPs).<br> Methods: This study evaluated the performance of hospital WWTPs in Tehran, Iran. A total of 128 effluent samples were collected in 2024 from 59 hospital WWTPs affiliated with Iran University of Medical Sciences. Samples were analyzed to assess treatment efficiency using key physicochemical and microbiological parameters, including biochemical oxygen demand (BOD₅), chemical oxygen demand (COD), total suspended solids (TSS), total coliforms, and fecal coliforms, according to standard methods.<br> Results: All hospitals operated wastewater treatment systems; however, 8.33% consistently failed to comply with national effluent discharge standards. Regarding disposal routes, 66.6% of effluents were discharged into municipal sewer systems, 21.6% into infiltration wells, and 11.6% were reused for irrigation.<br> Conclusion: Despite the presence of treatment systems, deficiencies in pollutant removal and improper discharge practices remain concerns. Ensuring full connection of hospital WWTPs to municipal sewer networks would enable further treatment at centralized facilities, reducing environmental and health risks. Strengthened regulatory enforcement and adoption of advanced treatment technologies are essential to improve hospital wastewater management and safeguard public health.</div> Wastewater, Hospitals, Quality, Environmental health, Pollution 1 9 http://ehemj.com/browse.php?a_code=A-10-1-453&slc_lang=en&sid=1 Pezhman Gheitasian pejman844@gmail.com 100319475328460022297 100319475328460022297 No Department of Environmental Health Engineering, Deputy of Health, Iran University of Medical Sciences, Tehran, Iran Farbod Ebadifard Azar f_ebadi@yahoo.com 100319475328460022298 100319475328460022298 No Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran Maryam Meserghani m_eserghany@yahoo.com 100319475328460022299 100319475328460022299 Yes Correspondence to: Department of Environmental Health Engineering, Deputy of Health, Iran University of Medical Sciences, Tehran, Iran Elham Shariatmadari elhamp@yahoo.com 100319475328460022300 0009-0007-7736-1516 No Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran