Steroid hormones in Ghana’s wastewater: A comprehensive review of levels, occurrence, fate, and control strategies

Steroid hormones are potent endocrine-disrupting compounds (EDCs) that can elicit biological effects in aquatic organisms at nanogram-per-litre concentrations. In Ghana, rapid urbanisation, widespread wastewater reuse, and limited treatment infrastructure heighten concerns about chronic exposure to hormonally active contaminants, yet national evidence remains fragmented. This review synthesises Ghana-specific data on the occurrence, sources, environmental fate, analytical detection, and treatment of steroid hormones in wastewater and wastewater-impacted environments. Reported concentrations of estrone (E1), 17β-estradiol (E2), and 17α-ethinylestradiol (EE2) in Ghanaian waters typically range from 3 to 42 ng/L, exceeding predicted no-effect concentrations for sensitive aquatic species, particularly for EE2 (≤1 ng/L). Key fate processes, including sediment sorption, E2–E1 interconversion, regeneration from conjugated metabolites, and leakage from on-site sanitation systems, indicate that sediments and shallow groundwater may act as long-term secondary reservoirs. Analytical capacity remains limited by restricted access to LC-MS/MS techniques, constraining routine monitoring and risk assessment. Conventional treatment systems show variable hormone removal (≈40–70%), while constructed wetlands (30–80%) and activated-carbon polishing (80–98%) represent feasible mitigation options. This review provides the first nationally focused synthesis of steroid hormone pollution in Ghana and outlines a pragmatic 10–20-year wastewater management roadmap for low- and middle-income countries.