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Municipal wastewater treatment plants (WWTPs) are crucial for maintaining good quality of surface water, limiting environmental pollution. However, during wet-weather events, WWTPs become an important point-source discharge due to the activation of the bypass, which releases a mix of untreated wastewater and stormwater. This work aims to assess how the WWTP discharges (effluent and bypass) impact on the receiving surface water body during dry- and wet-weather, monitoring 78 pollutants (7 conventional pollutants, 19 heavy metals, and 52 micropollutants) in each stream (effluent during dry-weather, effluent and bypass during wet-weather), including the influent in dry-weather for comparison. The occurrence, concentration levels and variability, and environmental risk were addressed, with a specific focus on high-resolution (up to 20-min) sampling of the bypass, based on the expected relevant temporal dynamicity. A wider range of pollutants occurred in the bypass, included undetected compounds in the dry-weather influent. Besides, a greater inter-events variability in bypass concentrations was observed, but smaller intra-event variability, with only some pollutants exhibiting a distinct first-flush effect. To address the challenge of a cost-effective bypass monitoring, we explored the applicability of readily measurable water quality parameters (total suspended solids and electrical conductivity) as proxies for micropollutants. Correlations between these parameters and specific pollutant groups suggest a promising path for further investigation and broader application. The magnitude of the rain event also affected concentration levels, with event volume clearly affecting pollutants dilution. The environmental risk assessment revealed a significantly higher risk associated to bypass discharge compared to the effluent, especially for conventional pollutants, metals, and terbutryn, highlighting the urgency of improved bypass management strategies. Overall, this study highlights the contribution of wet-weather discharges from WWTPs, emphasizing the importance of high-frequency bypass monitoring to capture peak pollutant concentrations and accurately assess the environmental risk., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The reuse of reclaimed wastewater is increasingly recognized as a viable alternative water source for irrigation. Its application, whether direct or indirect, impacts several interconnected compartments, including groundwater, surface water, soil, crops, and humans. Reclaimed wastewater provides essential resources for crops, like water and nutrients. However, it also introduces pathogens, and contaminants of emerging concern (CECs), defined as chemicals that may pose risks to human health and ecosystems but are not yet fully regulated, such as pharmaceuticals and personal care products, among others. Additionally, reclaimed wastewater may contain antibiotic-resistant bacteria (ARBs) and disinfection by-products (DBPs), all of which present potential health and environmental risks. Therefore, regulatory bodies stress the need for preventive risk assessments to ensure safe reuse. This paper critically reviews available models for assessing the impacts of reclaimed wastewater reuse in agriculture. It identifies gaps in current modelling approaches and outlines future research directions. Key areas requiring further investigation include the fate and transfer of CECs, ARBs and DBPs, and the co-occurrence of multiple risks in such interconnected systems, especially in the indirect reuse. To address these gaps, we proposed a simplified approach to integrate three types of risk associated with CECs in indirect reuse, focusing on risks posed by antibiotics and other pharmaceuticals: human health risk, environmental risk and risk from antibiotic resistance development. This approach aids in identifying the most critical endpoints within the One Health approach, supporting (i) CECs prioritization in regulations based on their critical endpoints and (ii) the adoption of CEC-specific mitigation measures., Competing Interests: Declaration of competing interest All authors confirm the absence of any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Water shortages, exacerbated by climate change, are posing a major global challenge, particularly impacting the agricultural sector. A growing interest is raised towards reclaimed wastewater (RWW) as an alternative irrigation source, capable of exploiting also the nutrient content through the fertigation practice. However, a prioritization methodology for selecting the most appropriate wastewater treatment plants (WWTPs) for implementing direct RWW reuse is currently missing. Such prioritization would benefit water utilities, often managing several WWTPs, and policymakers in optimizing economic asset allocation. In this work, a prioritization framework is proposed to evaluate WWTPs' suitability for implementing direct RWW reuse considering both WWTP and surrounding territory characteristics. This procedure consists of four key steps. Firstly, a techno-economic model was developed, in which monthly mass balances on water and nutrients are solved by matching crop requirements, rainfall conditions, and effluent characteristics. Economic suitability was quantified considering economic benefits due to savings in freshwater resource, mineral fertilizers and avoided greenhouse gases emissions, but also losses in crop yield due to RWW salinity content. Secondly, a classification procedure was coded to select representative WWTPs among a set of WWTPs, based on their size, presence of nutrient removal processes, and type of crops in their surroundings. The techno-economic model was then applied to these selected WWTPs. Thirdly, input parameters' relevance in determining WWTP suitability for RWW reuse was ranked. Finally, scenario analyses were conducted to study the influence of rainfall patterns and nutrient treatment removal on the RWW reuse feasibility. The type of crops surrounding the WWTPs and RWW salinity content resulted to be crucial elements in determining WWTPs suitability for RWW reuse implementation. The proposed methodology proved to be an effective support tool for policymakers and water utilities to assess the techno-economic feasibility of direct RWW reuse, generalizing results to several combinations of WWTPs and crops., Competing Interests: Declaration of competing interest The authors declare no competing financial interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The presence of Contaminants of Emerging Concern (CECs) in drinking water is raising concern for potential negative effects on human health. Ozonation and adsorption on activated carbon are the most suitable processes for CECs removal in drinking water treatment plants (DWTPs). This study aims at evaluating the performance of ozonation and adsorption as in-series processes compared to those of the stand-alone processes, focusing on 18 compounds representative of various CECs families. No CECs spike was performed to evaluate the effectiveness of these processes towards CECs at their environmental concentrations. Adsorption isotherms were performed on water samples collected before and after the full-scale ozonation in a DWTP, testing different combinations of ozone and activated carbon doses. Generally, the combination of the two processes was beneficial (83% average removal) compared to adsorption and ozonation alone (71% and 34% average removal respectively). The effect of ozonation on adsorption depends on CECs reactivity with ozone, since ozonation improves the adsorption performance of poorly-oxidizable CECs, but worsens that of well-oxidizable compounds. The removal of organic matter, investigated by absorbance at 254 nm and fluorescence, by ozonation reduces competition for the subsequent CECs removal by adsorption (up to 20% increase of total CECs adsorption). Finally, the removal of both absorbance and fluorescence seems to be a good proxy variables for total CECs adsorption, with different relationships depending on the presence of ozonation. Conversely, it is not effective for ozonation, since the relationship depends on the reactivity of the specific CEC with ozone., Competing Interests: Declaration of competing interest All authors confirm the absence of any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Pulp and paper wastewater (P&P WW) often requires tertiary treatment to remove refractory compounds not eliminated by conventional biological treatment, ensuring compliance with high-quality effluent discharge or reuse standards. This study employs a life cycle assessment (LCA) methodology to compare alternative tertiary treatment technologies for P&P WW and rank them accordingly. The evaluated technologies in the scenarios include inorganic (S1) and organic (S2) coagulation-flocculation, ozonation (O 3 ) (S3), O 3 +granular activated carbon (GAC) (S4), and ultrafiltration (UF)+reverse osmosis (RO) (S5). The analysis focuses on a P&P wastewater treatment plant (WWTP) in Northeastern Italy. The LCA is complemented by an economic analysis considering each technology's capital and operating costs, as well as potential revenues from internal effluent reuse. Results indicate that S4 (O 3 +GAC) outranks all the other scenarios in terms of both environmental performance and economic viability, primarily due to the advantages associated with effluent reuse. S5 (UF+RO), which also involves reuse, is limited by the high energy consumption of UF+RO, resulting in increased environmental impacts and costs. The physicochemical scenario S2 (Chem Or), currently utilized in the WWTP under study, remains the best-performing technology in the absence of effluent reuse. In contrast, S3 (O 3 alone) exhibits the poorest environmental and economic outcomes due to substantial energy requirements for O 3 generation and the inability to reuse the treated effluent directly. Lastly, a sensitivity analysis underscores the strong influence of chemical dosages in S1 and S2 on environmental and economic impacts, which is more significant than the impact of water reuse percentages in S4 and S5. The high electricity cost observed during 2022 negatively affects the energy-intensive scenarios (S3-S5), making coagulation-flocculation (S1-S2) even more convenient., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

The increasing overexploitation and pollution of freshater resources are potential threats for public health, causing cross-contamination among the interconnected environmental compartments (freshwater, soil, crops). In particular, contaminants of emerging concern (CECs) originating from anthropic activities are not completely removed by wastewater treatments plants. This leads to their presence in drinking water (DW) sources, soil and crops intended for human consumption due to discharges of treated wastewater in surface waters and direct wastewater reuse practices. Currently, health risk assessments are limited to single exposure sources without considering the multiple exposure routes to which humans are subjected. For instance, among CECs, bisphenol A (BPA) and nonylphenol (NP), respectively, adversely affect immune and renal systems and have been frequently detected in DW and food, their major exposure sources for humans. Here, an integrated procedure is proposed to quantitatively assess health risk from CECs due to multiple exposure from the consumption of both DW and food, considering the relevant inter-connected environmental compartments. This procedure was applied to BPA and NP to calculate their probabilistic Benchmark Quotient (BQ), showing its potential in quantitatively apportioning the risk between contaminants and exposure sources, and its use as a decision support tool for prioritizing mitigation measures. Our results indicate that, even though the human health risk due to NP is not negligible, the estimated risk due to BPA is significantly higher, and the consumption of food from edible crops determines a higher risk compared to tap water. Hence, BPA is undoubtedly a contaminant to be prioritized, especially through mitigation actions aimed at its prevention and removal from food., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Unfounded concerns regarding fever are increasingly observed among nurses worldwide. However, no study has so far explored the preferred approach towards pediatric fever among nursing students. Therefore, we aimed to investigate the attitude towards pediatric fever among final-year nursing students., Methods: Between February and June 2022, final-year nursing students of 5 Italian university hospitals were asked to answer an online survey on their approach to fever in children. Both quantitative and qualitative methods were utilized. Multiple regression models were employed to explore the existence of moderators on fever conceptions., Results: The survey was filled in by 121 nursing students (response rate 50%). Although most students (98%) do not consider discomfort to treat fever in children, only a minority would administer a second dose of the same antipyretic in nonresponsive cases (5.8%) or would alternate antipyretic drugs (13%). Most students would use physical methods to decrease fever (84%) and do not think that fever has mainly beneficial effects in children (72%). The own know-how adequacy on fever was inversely associated (OR 0.33, 95% CI 0.13-0.81) with the beliefs that high fever might lead to brain damage. No further predictive variable was significantly associated with the concern that fever might be associated with brain damage, the advice of physical methods use, and the assumption that fever has mostly positive effects., Discussion: This study shows for the first time that misconceptions and inappropriate attitudes towards fever in children are common among final-year nursing students. Nursing students could potentially be ideal candidates for improving fever management within clinical practice and amongst caregivers., (© 2023. The Author(s).)

Hyponatremia is a common disorder in childhood. The indirect and the direct potentiometry are currently the most popular techniques employed for sodium assessment, although discrepancies between the two techniques may be > 10 mmol/L. It is known that < 20% of the recently published articles report information about the technique used for sodium analysis, but no data are available on pediatric studies. This study aimed at investigating the laboratory technique employed for sodium measurement in studies conducted in childhood. A systematic literature search in PubMed, Embase, and Web of Science was undertaken to identify articles containing the word "hyponatremia" in the title between 2013 and 2020. Papers with < 10 subjects were excluded. A total of 565 articles were included. Information on the laboratory technique used for sodium analysis was more commonly (p = 0.035) reported in pediatric (n = 15, 28%) than in non-pediatric (n = 81, 16%) reports. The frequency of reports with and without information on the technique for sodium assessment was not different with respect to the study characteristics, the quartile of the journal where the paper was published, the country income setting, and the inclusion of neonates among the 54 pediatric studies.   Conclusion: Most pediatric papers do not report any information on the technique used for sodium analysis. Although international authorities have recommended the implementation of direct potentiometry, a low awareness on this issue is still widespread in pediatric research. What is Known: • Direct potentiometry and indirect potentiometry are currently employed for sodium analysis in blood. • Direct potentiometry is more accurate. What is New: • Less than 30% of pediatric articles provide information on the technique employed for sodium analysis in blood. • Indirect potentiometry is more frequently employed than direct potentiometry in pediatric studies., (© 2022. The Author(s).)

The occurrence and hazard risks of mixtures of Contaminants of Emerging Concern (CECs) in drinking water (DW) lead to serious consideration regarding the possible impacts on public health. Consequently, there is ongoing research, development and empowerment of risk assessment procedures to get more toxicological insight. For instance, alkylphenols and phthalates have been frequently reported to be present both in bottled and tap water, affecting different human endpoints. Currently, deterministic chemical risk assessment (CRA) is used to evaluate the compounds' mixture health risk. However, CRA deals just qualitatively with sources of uncertainty, which may lead to erroneous assessment of risks. Here, a new procedure for quantitative chemical risk assessment of CEC mixtures (QCRA MIX ) is proposed. Its potential is illustrated by a case study where the risks related to the presence of mixtures of alkylphenols or phthalates in tap versus bottled DW are compared. Uncertainties in both exposure and hazard assessment steps of the procedure are included to calculate a probabilistic mixture Benchmark Quotient (BQ MIX ). The QCRA MIX procedure highlighted the non-negligible health risks posed by those compounds in both DW sources based on overall water consumption. In fact, DW consumers' behaviour in 13 different countries, in terms of total DW consumption and fraction of bottled and tap water consumed, were considered to evaluate the influence on health risk. For alkylphenols, the total water consumption was found to be the most relevant factor in increasing the health risk, while for phthalates the risk was found to be mainly influenced by the percentage of bottled water consumed. Hence, the proposed QCRA MIX procedure can be a valuable tool for prioritization of CECs to be included in DW regulations which aim to minimize the overall risk, accounting for actual DW consumption., (Copyright © 2022. Published by Elsevier Ltd.)

Perfluoroalkyl substances (PFAS) persistence in the environment leads to their presence in drinking water, that is of high concern due to their potential human health risk. Adsorption onto activated carbon (AC) has been identified as an effective technique to remove PFAS. Adsorption isotherms and breakthrough curves, determined by rapid small-scale column tests (RSSCTs), were studied for eight PFAS and four granular ACs, characterized by different origins, porosities and numbers of reactivation cycles. Both batch and RSSCT results highlighted the strong interaction of AC and PFAS characteristics in adsorption capacity. The most important factor affecting AC performance is the surface charge: a positively-charged AC showed higher adsorption capacities with greater Freundlich constants (K F ) and later 50% breakthroughs compared to the AC with neutral surface. Among the positively-charged ACs, a microporous AC demonstrated higher adsorption capacities for hydrophilic and marginally hydrophobic PFAS, while the mesoporous AC performed better for more hydrophobic PFAS, possibly due to lower pore blockage by organic matter. These results were confirmed at full-scale through a one-year monitoring campaign, in which samples were collected at the inlets and outlets of GAC systems in 17 drinking water treatment plants spread in a wide urban area, where the four analyzed ACs are used., Competing Interests: Declaration of competing interest All authors confirm the absence of any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Monitoring and management of drinking water distribution networks (DWDNs), including possible leaching from materials in contact with drinking water, have been stressed as crucial to avoid re-contamination of drinking water leading to a potential increase of human health risk. Recent scientific studies and regulations clearly highlighted the leaching of bisphenol A (BPA) from plastic materials used to renovate DWDNs pipelines as one of the major hazardous source, resulting in severe consequences for human health. In this study, lab migration tests were performed on three commercial epoxy resins, designed with the Design of Experiments (DoE) method in order to build a BPA migration model as a function of water chemical stability, evaluated as aggressivity index (AI), and residual chlorine concentration. Tests lasted about 170 days to account for both short and long-term leaching. BPA migration over time was well described by a combination of two 1st-order kinetic models with an initial peak of leaching, a decrease and, then, a second increase due to resins' deterioration. Initial BPA concentration in the contact water and BPA integral migration over time showed inverse proportionality with both chlorine concentration and AI values. However, measurements of free BPA content in epoxy resins proved that this is due to BPA transformation, not to a reduced leaching. The validated BPA migration model was combined with the hydraulic model of the DWDN in an urban area, through EPANET-MSX software. The model allowed to simulate the propagation of BPA in the DWDN, after the execution of a relining intervention, identifying the most vulnerable areas and permitting to customize a site-specific monitoring and intervention plan to minimize the health risk for final consumers., Competing Interests: Declaration of competing interest All authors confirm the absence of any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: To measure patient flow at our Pediatric Emergency Department (PED) during the Italian lockdown, with particular care in terms of otolaryngological (ENT)-related diagnoses., Methods: A retrospective evaluation of electronic charts of children admitted to our PED in the City Center of Milan (Italy) for any disease. The outcome was to compare distribution of diagnoses performed at our PED during 21 February-3 May 2019 (period 1) to 21 February-3 May 2020 (period 2)., Results: A total of 4538 children were evaluated during period 1 compared to 1310 during period 2. A statistically significant overall effect on diagnosis between the study periods was attested ( p -value < 0.001; pseudo R2 = 0.010), ENT-related diagnoses being more frequently documented in period 1 (80.4% vs. 19.5%; p -value < 0.001), as well as those related to middle ear infections (92.8% vs. 7.2%; p -value < 0.001). Non-complicated acute otitis media more frequently occurred in period 1 (92.0% vs. 8.0%; p -value < 0.001); no significant difference in the number of complicated middle ear infections occurred (95.8% vs. 4.2%)., Conclusions: The exceptional circumstances of the Italian lockdown resulted in a significant decrease in patients' attendance to our PED, especially when considering diagnoses related to any ENT disorder, middle ear disease, and non-complicated middle ear infection.

The tests currently used for the identification of SARS-CoV-2 include specimens taken from the upper and lower respiratory tract. Although recommendations from the World Health Organization prioritise the usage of a nasopharyngeal swab (NS), nasopharyngeal aspirates (NPA) are thought to be superior in identifying SARS-CoV-2 in children. To our knowledge, however, no paediatric study has been published on the subject. The aim of this study is to evaluate the diagnostic performances of NS referred to NPA for SARS-CoV-2 in children. We calculated the sensitivity and specificity of the NS referred to the NPA of the whole sample and considered both age and collection period as covariates in different analyses. We collected 300 paired samples. The NS had a specificity of 97.7% and a sensitivity of 58.1%. We found similar results for the group of subjects ≥ 6 years old, while for subjects < 6 years old, the sensitivity was 66.7% and the specificity 97.8%. Considering period as a covariate, the sensitivity and specificity for patients hospitalised in March (31 patients, 52 records) were 70.0% and 97.6%, while for patients involved in the follow-up (16 patients, 57 records), they were 57.2% and 89.7%. The NS has a low sensitivity in detecting SARS-CoV-2 in children when referred to the NPA, whereas its specificity is high. Our results suggest that in children under 6 years of age, NSs should be preferred whenever possible. Though statistically not significant, the sensitivity of the NS rises when performed before the NPA.

The second epicenter of the global COVID-19 epidemic following Wuhan, and the first in the Western world, occurred unexpectedly in the Lombardy region of Italy, whose capital city is Milan. The aggressive nature of the outbreak in the region was dramatic, leading to a 2-month period of lockdown. Within the Policlinico, the historic hospital in the center of Milan, many units were rapidly converted into intensive care units or semi-intensive units for adult patients. During lockdown, the pediatric inpatient units had to face daily reorganization caused by the necessary logistic and structural transformations, thus restricting routine care pathways for chronic patients, while the Pediatric Emergency Unit had to develop a system able to effectively separate the children and caregivers infected with COVID-19 from those who were not affected. These 2 months enhanced resilience among both doctors and nurses, and facilitated the transversal transmission of data aimed at helping colleagues and patients in any way possible, in spite of the restrictive measures limiting the rate of activity in pediatric care. The reorganization of the current phase of decreasing epidemic activity still leaves us with unanswered questions regarding the further possible changes to implement in the event of a potential reoccurrence of epidemic peaks.

The uncertainties on the occurrence, fate and hazard of Contaminants of Emerging Concern (CECs) increasingly challenge drinking water (DW) utilities whether additional measures should be taken to reduce the health risk. This has led to the development and evaluation of risk-based approaches by the scientific community. DW guideline values are commonly derived based on deterministic chemical risk assessment (CRA). Here, we propose a new probabilistic procedure, that is a quantitative chemical risk assessment (QCRA), to assess potential health risk related to the occurrence of CECs in DW. The QCRA includes uncertainties in risk calculation in both exposure and hazard assessments. To quantify the health risk in terms of the benchmark quotient probabilistic distribution, the QCRA estimates the probabilistic distribution of CECs concentration in DW based on their concentration in source water and simulating the breakthrough curves of a granular activated carbon (GAC) treatment process. The model inputs and output uncertainties were evaluated by sensitivity and uncertainty analyses for each step of the risk assessment to identify the most relevant factors affecting risk estimation. Dominant factors resulted to be the concentration of CECs in water sources, GAC isotherm parameters and toxicological data. To stress the potential of this new QCRA approach, several case studies are considered with focus on bisphenol A as an example CEC and various GAC management options. QCRA quantifies the probabilistic risk, providing more insight compared to CRA. QCRA proved to be more effective in supporting the intervention prioritization for treatment optimization to pursue health risk minimization., Competing Interests: Declaration of Competing Interest All authors confirm the absence of any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Variability in presentation of children with coronavirus disease 2019 (COVID-19) is a challenge in emergency departments (EDs) in terms of early recognition, which has an effect on disease control and prevention. We describe a cohort of 170 children with COVID-19 and differences with the published cohorts., Methods: Retrospective chart reviews on children (0-18 years) evaluated in 17 Italian pediatric EDs., Results: In our cohort (median age of 45 months; interquartile range of 4 months-10.7 years), we found a high number of patients <1 year with COVID-19 disease. The exposure happened mainly (59%) outside family clusters; 22% had comorbidities. Children were more frequently asymptomatic (17%) or with mild diseases (63%). Common symptoms were cough (43%) and difficulty feeding (35%). Chest computed tomography, chest radiograph, and point-of-care lung ultrasound were used in 2%, 36%, and 8% of cases, respectively. Forty-three percent of patients were admitted because of their clinical conditions. The minimal use of computed tomography and chest radiograph may have led to a reduced identification of moderate cases, which may have been clinically classified as mild cases., Conclusions: Italian children evaluated in the ED infrequently have notable disease symptoms. For pediatrics, COVID-19 may have rare but serious and life-threatening presentations but, in the majority of cases, represents an organizational burden for the ED. These data should not lower the attention to and preparedness for COVID-19 disease because children may represent a source of viral transmission. A clinically driven classification, instead of a radiologic, could be more valuable in predicting patient needs and better allocating resources., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)

In recent years, the presence of micropollutants in drinking water has become an issue of growing global concern. Due to their low concentrations, monitoring databases are usually rich in censored data (e.g. samples with concentrations reported below the limit of quantification, LOQ) which are typically eliminated or replaced with a value arbitrarily chosen between 0 and LOQ. These conventional methods have some limitations and can lead to erroneous conclusions on: presence of micropollutants in the source water, treatment efficiencies, produced water quality and associated human health risk. In this work, an advanced approach, based on Maximum Likelihood Estimation method for left-censored data (MLE LC ), was applied on monitoring data of 19 contaminants (metals, volatile organic compounds, pesticides and perfluorinated compounds) in 5362 groundwater (GW) and 12,344 drinking water (DW) samples, collected from 2012 to 2017 in 28 drinking water treatment plants in an urbanized area. This study demonstrates the benefits of MLE LC method, especially for high percentages of censored data. Data are used to build statistical distributions which can be effectively used for several applications, such as the time trend evaluation of GW micropollutant concentrations and the estimation of treatment removal efficiency, highlighting the adequacy or the need for an upgrade. Moreover, the MLE LC method has been applied to assess the human health risk associated with micropollutants, indicating the high discrepancy in the estimations obtained with conventional methods, whose results do not follow precautionary or sustainability criteria., Competing Interests: Declaration of competing interest All authors confirm the absence of any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work., (Copyright © 2020 Elsevier Ltd. All rights reserved.)