Motivated by the detection of 131I in river sediment in routine long-term surveillance samples, a systematic short-term study of the wastewater treatment chain was planned and conducted. Inflow, effluent and primary sludge were collected on a daily basis during two weeks at a regional wastewater treatment plant. Samples were investigated by gamma spectroscopy. Four medically used isotopes could be identified (131I and 99mTc regularly, 153Sm and 123I sporadically). The concentration levels coincide well with literature data for 131I, and with our own long-term data for 131I and 99mTc for the same plant. Cosmogenic 7Be activity in primary sludge correlated well with rainfall intensity. Surface sediment was sampled at low tide at both shores of the river, up- and downstream of the plant. 131I was identified in all samples, with a sharp maximum (about 100 Bq kg-1 d.m.) at the discharge point of the plant and lower levels elsewhere, decreasing monotonically in downstream direction. 7Be and 137Cs showed the same behaviour, but no peak at the discharge point. Predictions from simple equilibrium models for the transport and sedimentation of 131I show good agreement with the experimental data and suggest that the wastewater treatment plant is the main source for this isotope. © 2009 Elsevier Ltd. All rights reserved.