Fourth treatment stage in the context of "Septic drain field"

Sewage treatment is a type of wastewater treatment which aims to remove contaminants from sewage to produce an effluent that is suitable to discharge to the surrounding environment or an intended reuse application, thereby preventing water pollution from raw sewage discharges. Sewage contains wastewater from households and businesses and possibly pre-treated industrial wastewater. There are a large number of sewage treatment processes to choose from. These can range from decentralized systems (including on-site treatment systems) to large centralized systems involving a network of pipes and pump stations (called sewerage) which convey the sewage to a treatment plant. For cities that have a combined sewer, the sewers will also carry urban runoff (stormwater) to the sewage treatment plant. Sewage treatment often involves two main stages, called primary and secondary treatment, while advanced treatment also incorporates a tertiary treatment stage with polishing processes and nutrient removal. Secondary treatment can reduce organic matter (measured as biological oxygen demand) from sewage,  using aerobic or anaerobic biological processes. A quaternary treatment step (sometimes referred to as advanced treatment) can also be added for the removal of organic micropollutants, such as pharmaceuticals. This has been implemented in full-scale in Sweden.

A large number of sewage treatment technologies have been developed, mostly using biological treatment processes. Design engineers and decision makers need to take into account technical and economical criteria of each alternative when choosing a suitable technology. Often, the main criteria for selection are desired effluent quality, expected construction and operating costs, availability of land, energy requirements and sustainability aspects. In developing countries and in rural areas with low population densities, sewage is often treated by various on-site sanitation systems and not conveyed in sewers. These systems include septic tanks connected to drain fields, on-site sewage systems (OSS), and vermifilter systems. On the other hand, advanced and relatively expensive sewage treatment plants may include tertiary treatment with disinfection and possibly even a fourth treatment stage to remove micropollutants.

The environmental effect of pharmaceuticals and personal care products (PPCPs) is being investigated since at least the 1990s. PPCPs include substances used by individuals for personal health or cosmetic reasons and the products used by agribusiness to boost growth or health of livestock. More than twenty million tons of PPCPs are produced every year. The European Union has declared pharmaceutical residues with the potential of contamination of water and soil to be "priority substances".

PPCPs have been detected in water bodies throughout the world. More research is needed to evaluate the risks of toxicity, persistence, and bioaccumulation, but the current state of research shows that personal care products impact the environment and other species, such as coral reefs and fish. PPCPs encompass environmental persistent pharmaceutical pollutants (EPPPs) and are one type of persistent organic pollutants. They are not removed in conventional sewage treatment plants but require a fourth treatment stage which not many plants have.