This review is based on 59 papers published between 2002 and 2015, referring to about 450 treatment trains providing data regarding sludge concentrations for 169 compounds, specifically 152 pharmaceuticals and 17 personal care products, grouped into 28 different classes. The rationale of the study is to provide data to evaluate the environmental risk posed by the spreading of treated sludge in agriculture. Following discussion of the legislative scenario governing the final disposal of treated sludge in European countries and the USA, the study provides a snapshot of the occurrence of selected compounds in primary, secondary, mixed, digested, conditioned, composted and dried sludge originating in municipal wastewater treatment plants fed mainly with urban wastewater as well as in sludge-amended soil. Not only are measured values reported, but also predicted concentrations based on Kd values are reported. It emerges that in secondary sludge, the highest concentrations were found for fragrances, antiseptics and antibiotics and an attenuation in their concentrations occurs during treatment, in particular anaerobic digestion and composting. An in-depth literature survey of the (measured and predicted) Kd values for the different compounds and treated sludge are reported and an analysis of the influence of pH, redox conditions, sludge type was carried out. The data regarding measured and predicted concentrations of selected compounds in sludge-amended soil is then analyzed. Finally an environmental risk assessment posed by their occurrence in soil in the
case of land application of sludge is examined, and the results obtained by different authors are compared. The most critical compounds found in the sludge-amended soil are estradiol, ciprofloxacin, ofloxacin, tetracycline, caffeine, triclosan and triclocarban. The study concludes with a focus on the main issues that should be further investigated in order to refine the environmental risk assessment.