Engineering Strategies and Sustainable Technologies for Radioactive Medical Wastewater Treatment

The rapid expansion of nuclear medicine in disease diagnosis and radionuclide therapy has led to a sharp increase in the generation of radioactive medical wastewater (RMW). These effluents, characterized by mixed radionuclides, complex chemistries, and biological contaminants, pose significant challenges for radiation protection and environmental sustainability. This review presents a comprehensive analysis of existing and emerging RMW treatment technologies from an engineering and system-design perspective. Conventional processes—chemical precipitation, ion exchange, membrane separation, adsorption, evaporation concentration, and biological treatment—are evaluated in terms of removal efficiency, energy consumption, scalability, and secondary waste management. Recent progress in hybrid process integration, energy recovery, and digital process optimization is discussed, along with the role of electrochemical advanced oxidation, functionalized membranes, and automation. The review emphasizes the importance of multitechnology coupling, intelligent process control, and regulatory harmonization for safe and sustainable management. Future perspectives highlight the need for radiation-resistant materials, low-carbon operation, and closed-loop system design to enable industrial-scale, environmentally responsible treatment of radioactive medical wastewater.