Programme on Small Scale Medical Waste Incinerators for Primary Health Care Clinics in South Africa


TABLE OF CONTENTS

  1. OBJECTIVE OF THE PROGRAMME 4
  2. STRUCTURE OF THE PROGRAMME 4
  3. COLLABORATORS INVOLVED IN THE PROGRAMME 4
  4. STAKEHOLDERS INVOLVED IN THE PROGRAMME 4
  5. LABORATORY TRIALS 5
  6. FIELD TRIALS 13

 

 

 

1.     OBJECTIVE OF THE PROGRAMME

 

The objective of the programme is to select technical criteria suitable for tender specification purposes that will enable the South African Department of Health to obtain the services and equipment necessary for the primary health care clinics to carry out small-scale incineration for the disposal of medical waste.

 

2.     STRUCTURE OF THE PROGRAMME

 

The test programme is being carried out in phases, as follows:

Phase 1         A scoping study to decide the responsibility of the different parties and

consensus on the test criteria and boundaries of the laboratory tests. The criteria for accepting an incinerator on trial was approved by all parties involved.

Phase 2         Laboratory tests with a ranking of each incinerator and the selection of the incinerators to be used in the field trials.

Phase 3         Completion of field trials, to assess the effectiveness of each incinerator under field conditions.

Phase 4         Preparation of a tender specification and recommendations to the DoH for the implementation of an ongoing incineration programme.

 

This document provides feedback on phases 2 and 3 of the work.

 

 

 

3.     COLLABORATORS INVOLVED IN THE PROGRAMME

 

SA Collaborative Centre for Cold Chain Management SA National Department of Health

CSIR

Pharmaceutical Society of SA World Health Organisation UNICEF

 

 

 

4.     STAKEHOLDERS INVOLVED IN THE PROGRAMME

 

The following stakeholders participated in the steering committee:

 

  • Dept of Health (National & provincial levels) (DoH)
  • Dept of Occupational Health & Safety (National & provincial levels)
  • Dept of Environmental Affairs & Tourism (National & provincial levels) (DEAT)
  • Dept of Water Affairs & Forestry (National & provincial levels) (DWAF)
  • Dept of Labour (National & provincial levels) (DoL)
  • National Waste Management Strategy Group
  • SA Local Government Association (SALGA)
  • SA National Civics Organisation (SANCO)
  • National Education, Health and Allied Workers Union (NEHAWU)

 

 

  • Democratic Nurses Organisation of SA (DENOSA)
  • Medecins Sans Frontieres
  • SA Association of Community Pharmacists
  • Mamelodi Community Health Committee
  • Pharmaceutical Society of SA
  • CSIR
  • UNICEF
  • WHO
  • SA Federation of Hospital Engineers

 

 

International visitors:

  • Dr Luiz Diaz – WHO Geneva and International Waste Management , USA
  • Mr Joost van den Noortgate – Medecins Sans Frontieres, Belgium

 

 

 

 

5.     LABORATORY TRIALS

 

5.1.   Objective of the laboratory trials

 

  • Rank the performance of submitted units to the following criteria:

y Occupational safety

y Impact on public health from emissions

y The destruction efficiency

y The usability for the available staff

 

  • The panel of experts for the ranking consisted of a:

y Professional nurse; Mrs Dorette Kotze from the SA National Department of Health

y Emission specialist; Dr Dave Rogers from the CSIR

y Combustion Engineer; Mr Brian North from the CSIR

 

5.2.   Incinerators received for evaluation

 

Name used in report Model no. Description Manufacturer
C&S Marketing

incinerator

SafeWaste Model Turbo

2000Vi

Electrically operated fan supplies combustion air

– no auxiliary fuel

C&S Marketing cc.
Molope Gas incinerator Medcin 400 Medical

Waste Incinerator

Gas-fired incinerator Molope Integrated

Waste Management

Molope Auto incinerator Molope Auto Medical

Waste Incinerator

Auto-combust incinerator – uses wood

or coal as additional fuel to facilitate incineration

Molope Integrated

Waste Management

 

Name used in report Model no. Description Manufacturer
PaHuOy

incinerator

Turbo Stove Auto-combust unit,

using no additional fuel or forced air supply

Pa-Hu Oy

 

 

5.3.   Emission testing: laboratory method

 

Sampling of emissions followed the US-EPA Method 5G dilution tunnel method for stove emissions. Adjustments to the design were made to account for flames extending up to 0.5 m above the tip of the incinerator and the drop out of large pieces of ash. Emissions were extracted into a duct for isokinetic sampling of particulate emissions. The sampling arrangement is shown by a schematic in Figure 1. A photograph of the operation over the Molope gas fired incinerator unit is shown in Figure 2.

 

All tests were performed according to specified operating procedures. The instructions provided by the supplier of the equipment were followed in the case of the C&S Marketing Unit. No operating procedures were supplied with the Molope Gas, Molope auto-combustion and PaHuOy units. These procedures were established by the CSIR personnel using their previous experience together with information provided by the supplier.

 

Test facilities were set up at the CSIR and measurements were carried out under an ISO9001 system using standard EPA test procedures or modifications made at the CSIR.

 

 

 

Figure 1. Schematic diagram of the laboratory set-up

 

 

 

 

 

Figure 2:Photograph of air intake sampling hood over Molope gas incinerator

 

 

 

5.4.   RANKING RESULTS OF THE LABORATORY TRIALS

 

Using the criteria listed under section 4.1 above, the incinerators were ranked as followed:

 

  Molope gas-fired

unit

Molope wood-fired

unit

C&S electric

unit

PaHuOy wood-fired

unit

Safety 6.8 4.8 5.5 3.3
Health 5.5 3.5 4.3 2.3
Destruction 9 2 6 1
Usability 2 3 3 5
Average 5.8 3.3 4.7 2.9

 

 

5.5.   EMISSION RESULTS OF THE LABORATORY TRIALS

 

Quantitative measurements were used to rank the units in terms of destruction efficiency and the potential to produce hazardous emissions.

 

Conformance to the South African Department of Environmental Affairs and Tourism’s (DEAT) recommended guidelines on emissions from Large Scale Medical Waste Incinerators is summarized in Table 1. The measurements are listed1 in Table 2.

 

 

 

Table 1: Summary qualitative results

 

Parameter Measured Units Molope

 

Gas-fired

Molope

 

Wood-fired

C&S

 

Electric

PaHuOy

 

Wood-fired

SA DEAT

Guidelines

Stack height m × × × × 3 m above

nearest building

Gas velocity m/s × × × × 10
Residence time s × × × × 2
Minimum combustion

temperature

ºC 4 × × × > 850
Gas combustion

efficiency

% × × × × 99.99
Particulate emissions mg/Nm3 4 × 4 × 180
Cl as HCl mg/Nm3 × 4 4 × < 30
F as HF mg/Nm3 4 4 4 4 < 30
Metals mg/Nm3 4 × × 4 < 0.5 and

< 0.05

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1 Emission concentrations are reported in accordance with the South African reporting requirements, ie, normalized to Normal Temperature (0

oC) and Pressure (101.3 kPa) and corrected to a nominal concentration of

8 % of CO2 on a dry gas basis. If a measurement fell below the detection limit for the method is it either reported as the detection limit or as N.D., ie, not detectable.

 

 

Table 2: Detailed quantitative results

 

 

Parameter Measured *

 

Units

 

Molope gas

 

Molope auto

 

C&S

 

PaHuOy

 

SA Process Guide1

 

Comments

 

Stack height

 

m

 

1.8

 

1.8

 

1.9

 

0.3

 

3 m above nearest building

 

None of these unite has a stack. The height of the exhaust vent is taken as the stack height. If it is above the respiration zone of the operator it provides some protection from exposure to smoke.

 

Gas velocity

 

m/s

 

0.8

 

0.5

 

1.1

 

0.5

 

10

 

Gas velocities vary across the stack for the Molope gas, Molope auto-combustion, and the PaHuOy units.

 

Residence time

 

s

 

0.4

 

0.7

 

0.6

 

0.4

 

2

 

Residence time is taken to be the total combustion time, and the maximum achievable

 

Minimum combustion zone temperature

oC  

800 -900

 

400 – 650

 

600 – 800

 

500 – 700

 

> 850

 

Molope auto-combustion temperatures are expected to be higher as the centre of the combustion zone is not expected to be at the measurement location.

 

CO2 at the stack tip

 

% vol

 

2.64

 

3.75

 

4.9

 

3.25

 

8.0

 

Actual emission concentrations are less than the values reported here, which are normalized to 8 % CO2 and Normal temperature and pressure for reporting purposes. They are lower between 4 to 8 times.

 

Gas

 

%

 

99.91-

 

98.8 -98.4

 

99.69-

 

98.9

 

99.99

 

Most accurate measurement in

Combustion 99.70 99.03 the duct where mixing of exhaust
efficiency gases is complete. Results of two

trials.

 

Particulate emissions entrained in exhaust gas

mg/Nm3  

102

 

197

 

130

 

338

 

180

 

The total emissions are the sum of the both entrained and un- entrained particulates. Emissions are lower than expected for such units and this is attributed to the absence of raking which is the major source of particulate emissions from incinerators without an emission control

system.

 

Particulate fall- out

mg/Nm3  

42

 

105

 

n.d.

 

n.d.

 

 

Large pieces of paper and cardboard ash rained out of the emissions. Totalling 0.8 to 2 g over a +/- 2 minute period.

 

Soot in particulates

 

%

 

42.2

 

58.1

 

48.7

 

84.8

 

 

Correlates directly with gas combustion efficiency

 

1 Emission concentrations are reported in accordance with the South African reporting requirements, ie, Normalized to Normal Temperature (0

oC) and Pressure (101.3 kPa) and corrected to a nominal concentration of

8 % of CO2 on a dry gas basis. If a measurement fell below the detection limit for the method is it either reported as the detection limit or as N.D., ie, not detectable.

 

 

Parameter Measured *

 

Units

 

Molope gas

 

Molope auto

 

C&S

 

PaHuOy

 

SA Process Guide1

 

Comments

 

% ash residual from medical waste

 

%

 

14.8

 

12.9

 

15.6

 

21.7

 

 

Measurement of destruction efficiency of the incinerator. Typical commercial units operate at 85-90 % mass reduction. PaHuOy is lower due to the melting and unburnt plastic.

 

Cl as HCl

mg/Nm3  

46

 

13

 

25

 

35 & 542

 

< 30

 

PaHuOy chloride concentrations varied considerably. This is expected due to the variability of the feed composition.

 

F as HF

mg/Nm3  

< 6

 

< 1

 

<2

 

< 1

 

< 30

 

Fluoride not found in this waste.

 

Arsenic (As)

mg/Nm3  

< 0.2

 

< 0.2

 

< 0.2

 

< 0.2

 

0.5

 

Arsenic is not expected as a solid.

 

Lead (Pb)

mg/Nm3  

< 0.4

 

< 0.4

 

< 0.4

 

< 0.4

 

0.5

 

Lead not expected in waste

 

Cadmium (Cd)

mg/Nm3  

< 0.2

 

< 0.2

 

< 0.2

 

< 0.2

 

0.05

 

Sensitivity of the x-ray method is adequate for ranking. Higher sensitivity not sought for this trial.

 

Chromium (Cr)

mg/Nm3  

< 0.1

 

0.7

 

0.7

 

< 0.1.

 

0.5

 

Chromium relative to iron ranges between 12 and 25% which is consistent with stainless steel needles

 

Manganese (Mn)

mg/Nm3  

< 0.1

 

0.3

 

0.3

 

< 0.1

 

0.5

 

Manganese may be a component in the stainless steel needle.

 

Nickel (Ni)

mg/Nm3  

< 0.1

 

0.3

 

< 0.1

 

< 0.1

 

0.5

 

Nickel may be a component in the needle.

 

Antimony (Sb)

mg/Nm3  

< 0.2

 

< 0.2

 

< 0.2

 

< 0.2

 

0.5

 

Not expected in this waste.

 

Barium (Ba)

mg/Nm3  

< 0.5

 

< 0.5

 

< 0.5

 

< 0.5

 

0.5

 

Lower sensitivity due to presence in the filter material

 

Silver (Ag)

mg/Nm3  

< 0.2

 

< 0.2

 

< 0.2

 

< 0.2

 

0.5

 

Not expected in this waste.

 

Cobalt (Co)

mg/Nm3  

< 0.1

 

< 0.1

 

< 0.1

 

< 0.1

 

0.5

 

Cobalt might be present in stainless steel.

 

Copper (Cu)

mg/Nm3  

< 0.5

 

< 0.5

 

< 0.5

 

< 0.5

 

0.5

 

Lower sensitivity due to copper in the sample blanks. May be background in the analytical equipment.

 

Tin (Sn)

mg/Nm3  

< 0.2

 

< 0.2

 

< 0.2

 

< 0.2

 

0.5

 

Tin not expected in this waste.

 

Vanadium (V)

mg/Nm3  

< 0.1

 

< 0.1

 

0.4

 

< 0.1

 

0.5

 

Vanadium might be present in stainless steel.

 

Thallium (Tl)

mg/Nm3  

< 0.4

 

< 0.4

 

< 0.4

 

< 0.4

 

0.05

 

Not expected in this waste. Sensitivity of the x-ray method is adequate for ranking. Higher sensitivity not sought for this trial.

 

 

 

5.6.   MAIN FINDINGS OF THE LABORATORY TRIALS

 

The main conclusions drawn from the trials are as follows:

 

:::          All four units can be used to render medical waste non-infectious, and to destroy syringes or render needles unsuitable for reuse.

:::                           The largest potential health hazard arises from the emissions of smoke and soot.              (the combustion efficiency of all units lies outside the

regulatory standards). The risk to health can be reduced by training operators to avoid the smoke or by installation of a chimney at the site.

:::          The emissions from small scale incinerators are expected to be lower than those from a wood fire, but higher than a conventional fire-brick-

lined multi-chambered incinerator.

:::          Incomplete combustion, and the substantial formation of smoke at low height rendered the PaHuOy unit unacceptable for field trials. Figure 3

below shows this unit during a trial burn. Molten plastic flowed out of

the incinerator, blocked the primary combustion air feed vents, and burnt outside of the unit.

 

 

 

Figure 3: Photo of PaHuOy incinerator during trial burn

 

 

5.7.   COMPARISON OF THE FIELDS TRIALS WITH THE LABORATORY TRIALS

 

The CSIR performed a quantitative trial in the field for gas combustion efficiency, temperature profiles and mass destruction rate on the Molope Auto wood-fired unit at the Mogale Clinic.

 

The results of this trial are compared to the laboratory trial results below:

 

  • Waste loading: Disposable rubber gloves were observed in addition to needles syringes, glass vials, bandages, dressings, and paper w
  • Temperatures and combustion efficiency: The same performance in gas combustion        efficiency   was    obtained    for    wood    .

Temperatures were higher but for a shorter time and this was

correlated with the type of wood available to the clinic. The fuel was burnt out before the medical waste was destroyed completely and this resulted in lower temperatures, lower combustion efficiency and higher emissions while burning the waste.

  • Emissions: Large amounts of black smoke were observed and this was correlated directly to cooling of the unit as the wood fuel was exhausted

prior to full ignition of the waste.

  • Destruction efficiency: The destruction efficiency was similar to that in the laboratory measurem
  • Usability: The unit is difficult to control as the result of the variability of the quality of wood
  • Acceptability: the smoke was not acceptable to the clinic, the community, or the local

 

It was concluded that:

  • The performance with fuel alone indicates that laboratory trial data can be used to predict emissions in the
  • The Molope Auto unit is too difficult to control for the available staff and fuel at the

 

 

 

5.8.   RECOMMENDATIONS FROM THE LABORATORY TRIALS

 

The following recommendations are made as the result of the laboratory trials:

:::     A comprehensive operating manual must be supplied with each unit.

Adequate training in the operation of the units must be provided, especially focussed on safety issues.

:::     It is recommended that the height of the exhaust vent on all units be

addressed.     In order to facilitate the dispersion of emissions and reduce the exposure risk of the operators.

:::     The suppliers of the incinerators must provide instructions for the safe handling and disposal of ash.

 

 

 

5.9.   RECOMMENDATIONS FROM THE STEERING COMMITTEE

 

 

 

After completion of the laboratory trials, the project steering committee recommended that the Molope Gas and C&S Marketing units be submitted for field testing. The Molope Auto was recommended for field testing on the condition that the manufacturer modified the ash grate so as to prevent the spillage of partially burnt needles and syringes.

 

 

 

6.     FIELD TRIALS

 

6.1.   OBJECTIVE OF THE FIELD TRIALS

 

The objective of the field trials was to obtain information in the field and assess the strengths and weaknesses of each of the incinerators during use at primary health care clinics.

 

A participative decision making process was used for the trials. It was based on expert technical evaluation by the CSIR and the National Department of Health as well as participation in the trials by experienced end users and participating advisors. All decisions were made by the Steering Committee, which consisted of representatives of stakeholders in the clinical and medical waste disposal process. These included representatives from the National, Provincial, and Local Government departments of Health, Safety and the Environment, as well as Professional Associations, Unions, NGOs, UNICEF, the WHO and local community representatives.

 

6.2.   CLINIC SELECTION

 

The Provinces in which the trials were done selected clinics for the field trials. The criteria set by the Steering Committee for the selection of the clinics were the following:

 

  • Location must be rural or under-serviced with

y No medical waste removal

y No existing incineration

y No transport

  • It must be in a high-density population area
  • Acceptable environmental conditions must prevail
  • Community acceptance must be obtained
  • Operator skill level to be used must be at a level of illiteracy

 

The clinics that were selected were as follows:

 

  • Steinkopf Clinic – Northern Cape Province – Gas incinerator

 

 

  • Marydale Clinic – Northern Cape Province – Gas incinerator
  • Mogale Clinic – Gauteng Province             – Auto combustion

incinerator, wood-fired.

  • Chwezi Clinic – KwaZulu-Natal Province – Gas incinerator
  • Ethembeni Clinic- KwaZulu-Natal Province – Auto-combustion electrical

incinerator

 

 

 

 

 

 

MAP OF SOUTH AFRICA INDICATING WHERE THE CLINICS ARE SITUATED

 

 

 

 

 

 

 

 

NORTHERN PROVINCE

 

GAUTENG PROVINCE

 

 

 

 

 

NORTH WEST PROVINCE

MPUMALANGA PROVINCE

 

 

 

 

 

 

FREE STATE PROVINCE

 

 

NORTHERN CAPE PROVINCE

 

 

KWAZULU-NATAL PROVINCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I:/UnitPublic/Valerie/Technet 99/Working papers/Session 3/rogers.doc

 

 

 

EASTERN CAPE PROVINCE

 

 

WESTERN CAPE PROVINCE

 

 

6.3.   COORDINATION OF THE TRIALS

 

The criteria for the ranking of the incinerators in accordance with performance in the field were:

 

  • Safety (occupational and public health)
  • Destruction capability
  • Usability
  • Community acceptability

 

The South African National Department of Health coordinated the field trials.

 

Information regarding the field trials as well as questionnaires were supplied to the coordinators in the participating provinces.

 

The team in the field consisted of the operator, supervisor and inspector (coordinator). The manufacturer of the incinerators did the training of the operators.

 

The questionnaires used during the trials were set so as to obtain information with regard to the criteria set for the ranking of the incinerators in accordance with performance in the field. The questionnaires were received from the clinics at two-weekly intervals.

 

Questions with regard to the criteria were the following:

 

A.  SAFETY (occupational and public health)

 

  • Smoke Emission

y Volume and thickness

y Colour

y Odour

  • Ash Content
  • Are the filled sharps boxes and soiled dressings stored in a locked location while waiting to be incinerated?

 

 

 

B.  DESTRUCTION CAPABILITY

 

  • Destruction Rate

y Complete

y Partial

y Minimal

y Residue content

 

C.  USABILITY (for the available staff)

  • Can the incinerator be used easily?

 

 

  • Is the process of incineration safe?
  • Has training been successful?
  • Is protective clothing such as gloves, goggles, dust masks and safety boots available?

 

D.  COMMUNITY ACCEPTABILITY

 

  • What is the opinion of the following persons on the use of the incinerator?

y Operator

y Nurse

y Head of the clinic

y Local Authority representative

y Community leader

 

During the trials the clinics were visited and the incinerators evaluated by members of the Steering Committee and the CSIR as well as Dr L Diaz from WHO, Mr M Lainejoki from UNICEF and the coordinator from the National Department of Health.

 

6.4.   QUESTIONNAIRE RESULTS

 

6.4.1.      MOGALE CLINIC

 

Type of incinerator at the clinic: Molope Auto-Combustion (Fired with wood)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 4 & 5: Molope Auto wood-fired incinerator during field trials at Mogale clinic

 

 

A.               SAFETY (occupational and public health)

 

  1. The process of incineration with this unit was considered by the operator, supervisor and the inspector as unsafe because there is no protective cage around the During the process the incinerator becomes very hot and this could result in injury to the operator.

 

  1. The smoke emission of this incinerator had a volume and thickness which was heavy and black, with a distinct unpleasant odour, and was considered This could cause a pollution problem.

 

 

 

B.               DESTRUCTION CAPABILITY

 

  1. The needles and vials were not completely destroyed but were rendered unsuitable for re-use.

 

  1. The soft medical waste was completely destroy

 

 

 

C.               USABILITY

 

Difficulty in controlling the operating temperature and avoiding smoke emissions made this incinerator user unfriendly.

 

D.               COMMUNITY ACCEPTABILITY

 

As a result of the heavy, black smoke emission the unit was not acceptable to the community.

 

 

6.4.2.      ETHEMBENI CLINIC:

 

 

Figure 6: C&S Marketing Auto Combust Electrical Incinerator At Ethembeni Clinic

 

 

 

Type Of Incinerator: C&S Auto-Combustion (Uses an electrically actuated fan)

 

 

 

A.               SAFETY (occupational and public health)

 

  1. The operator, supervisor and inspector considered this incinerator easy to operate with no danger to the Removal of the ash from the drum for disposal in a pit is, however, considered difficult, as the drum is heavy. Removal of the incinerator lid before it has been allowed to cool has been identified as a potential danger to the operator.

 

  1. Emission of smoke from this incinerator was not considered ex The volume and thickness was evaluated as moderate with no pollution experienced.

 

 

 

B.               DESTRUCTION CAPABILITY

 

  1. The needles and vials were not completely destroyed but were rendered unsuitable for re-use.
  2. The soft medical waste was completely destroy

 

 

 

C.               USABILITY

 

Considered user friendly by operator, supervisor and inspector.

 

D.               COMMUNITY ACCEPTABILITY

 

The incinerator was accepted by the community and was not considered to be harmful.

 

 

 

6.4.3.      CHWEZI CLINIC, MARYDALE CLINIC AND STEINKOPF CLINIC:

 

Type of incinerator: Molope Gas incinerator

 

Figure 7:       Molope Gas incinerator during field trials at Marydale clinic

 

A.               SAFETY (occupational and public health)

 

  1. The operator, supervisor and inspector considered this incinerator easy to operate with minimal danger to the
  2. Smoke emissions were not excessive and were reported to be minim

 

B.               DESTRUCTION CAPABILITY

 

  1. Sharps not completely destroyed but were rendered unsuitable for re-use.

 

 

  1. Soft medical waste completely destroy

 

C.               USABILITY

 

This incinerator was considered user friendly.

 

 

 

D.               COMMUNITY ACCEPTABILITY

 

 

 

The incinerator was accepted by the community and was not considered to be harmful.

 

 

 

6.5.   RANKING

 

 

INCINERATOR RANKING
Molope Gas 1
C&S Auto-Combustion (Uses electrical fan)  

2

Molope Auto- Combustion (Fired with

wood, coal also an option)

 

3

 

 

 

 

6.6.   OUTCOME OF THE FIELD TRIALS

 

Incinerator Safety Destruction Capability Usability Community Acceptability
Molope Gas Good Good Good Good
C&S Auto- Combustion

(Uses Electricity)

 

Good

 

Good

 

Good

 

Good

Molope Auto-

Combust Incinerator

Un-Acceptable Good Un-Acceptable Un-Acceptable

 


An Unexpected Ebola Infrastructure Problem: Waste


Patients with this debilitating virus produce 440 gallons of medical waste daily, including instruments, gowns, gloves, body fluids, sheets, mattresses and more. That’s a substantial amount of medical waste in any situation, but it’s especially daunting in this case because it needs to be disposed of extremely cautiously, to avoid the risk of spreading infection. What do you do with a problem like Ebola waste? Because you don’t want to toss it in the garbage.

Somewhat surprisingly, says Bausch, the United States actually faces bigger problems when it comes to safely disposing of Ebola waste, which is simply burned in large pits in Africa: “In the United States, of course, we are somewhat beholden to higher tech solutions, which in some ways are a little bit more problematic in terms of treating all that waste, and we need autoclaves or incinerators that can handle that sort of thing. It’s not the actual inactivation that’s particularly difficult; it’s just the process of getting the waste from, of course, the frontline of care and interaction with the patients safely to the place where it can be incinerated or autoclaved.”

The problem in the United States is ironically compounded by the increased access to medical care, and the higher quality of medical services, available. In the United States, patients are treated by medical teams with access to a huge volume of supplies they use for protection, including masks, gowns, booties, and gloves, along with sanitizers and other tools. Moreover, patients receive extensive medical interventions that generate waste like needles, tubing, medical tape, empty IV bags, and more. The very care that has helped most of the handful of Ebola patients in the United States conquer the disease has contributed to the huge amount of waste generated, highlighting a critical hole in U.S. medical infrastructure — while African hospitals may have lacked the supplies and personnel needed to supply aid to Ebola patients, they’re at least prepared to handle the waste.

The CDC just issued guidelines to help clinicians and administrators decide upon how to handle Ebola waste, but The New York Times notes that many facilities don’t have the autoclave, and incinerator, capacity to handle medical waste on this scale. Some states prohibit the burning of medical waste altogether, or have barred incineration of Ebola waste, leading to the transport of waste across state borders to facilities that can handle it, which poses its own risks; with every mile added to transport, there’s a greater risk of spreading disease to previously unexposed communities.

Surprisingly, defenders of burning the waste come from surprising corners. Environmentals like Allen Hershkowitz, National Resources Defense Council senior scientist, point out that: “There’s no pollutant that’s going to come out of a waste incinerator that’s more dangerous than the Ebola virus. When you’re dealing with pathogenic and biological hazards, sometimes the safest thing to do is combustion.”

The argument in defense of incineration can be bolstered by the fact that medical waste companies specialize in high-efficiency incineration with equipment designed to minimize and trap byproducts of combustion, reducing overall pollution considerably. Fears about Ebola, rather than genuine environmental or public health concerns, are driving the decision to push against incineration of ebola waste in many regions, but eventually, the United States is going to have to face facts: The mounting waste that accumulates in facilities where Ebola patients receive treatments needs to be disposed of safely, and promptly.

 

by: http://www.care2.com/causes/an-unexpected-ebola-infrastructure-problem-waste.html


Msw Incinerator


Basic Info.

Export Markets:Global

Additional Info.

Trademark:nanjing clover medical
Origin:Nanjing

Product Description

It is being recently issued an ordinance by the Ministry of Environment to build incineration plants in the metropolitans which generate more than 10.000kg of medical waste per day. And this implementation is going to start in the beginning of the year 2014. 
Our aim is to build a Medical Waste Incineration Plant in one of the metropolitan cities in Turkey. We have been preparing for the tenders which are going to be held soon by the Metropolitan Municipality. 
We would like to cooperate with a supplier/contractor for building an incineration plant. Would you be able to advise if you devise incineration plants, if yes kindly advise in which part of the world you had worked (built incineration plants). 

Could you also please inform us regarding the following issues: 
– Is it possible to reach an incineration temperature of 1.100° C within the systems which you have been devising? (This is one of the standards for the incineration plants according to the regulations in Turkey). 
– Is it possible to generate electricity and how? 
– If it is possible to generate electricity within the system, what would be the kwh amount of electricity per ton of waste incinerated? 
– What is the period for building the plant? How long would it portable medical incinerators, portable pet cremation, portable trash incinerator, posco krakow incineration plant, post-animal incinerator fuel, take for building a plant and would it depend on the plant capacity as for 1.000kg/hr or 2.000kg/hr? 
– What is the water consumption per incinerated ton? And if there is electricity generation within the system, what would be the amount of water consumption per ton for generating 1 kwh of electricity? 
– Do the plants which you devise have gas cleaning and filtering systems? If already included or can be added, would you be able to advise your prices including the gas cleaning and filtering systems? 
– Would there be a change in the prices if electricity generation can be added to the system? If yes, would you please advise your prices according to this? 
We look forward to your cooperation. 
Thank you in advance for your quickest possible response. (Turkey) 

Que valor tiene un incinerador PARA quemar droga. 

– Que consumo de energí A tiene? ? ? 
– Cuanta contaminació N genera a la ATMó Sfera. 

Saludos y quedo atento. (Chile)

Items/Model TS10(PLC) TS20(PLC) TS30(PLC) TS50(PLC) TS100(PLC)
Burn Rate 10 kg/hour 20 kg/hour 30 kg/hour 50 kg/hour 100 kg/hour
Feed Capacity 20kg 40kg 60kg 100kg 200 kg
Control Mode PLC PLC PLC PLC PLC
Combustion Chamber 100L 210L 330L 560L 1200L
Internal Dimensions 50x50x40cm 65x65x50cm 75x75x60cm 100x80x70cm 120x100x100cm
Secondary Chamber 50L 110L 180L 280L 600L
Smoke Filter Chamber Yes Yes Yes Yes Yes
Feed Mode Manual Manual Manual Manual Manual
Voltage 220V 220V 220V 220V 220V
Power 0.5Kw 0.5Kw 0.5Kw 0.7Kw 0.7Kw
Oil Consumption (kg/hour) 5.4–12.6 7.8–16.3 10.2–20 12.1–24 14–28
Gas Consumption (m3/hour) 6.2–11.4 8–15.7 9.8–20 9.9–26.1 10–32.2
Temperature Monitor Yes Yes Yes Yes Yes
Temperature Protection Yes Yes Yes Yes Yes
Oil Tank 100L 100L 100L 100L 200L
Feed Door 30x30cm 45x40cm 55x50cm 70x55cm 80x60cm
Chimney 3Meter 3Meter 5Meter 5Meter 10Meter
Chimney Type Stainless Steel Stainless Steel Stainless Steel Stainless Steel Stainless Steel
1st. Chamber Temperature 800degree–1000degree 800degree–1000degree 800degree–1000degree 800degree–1000degree 800degree–1000degree
2nd. Chamber Temperature 800degree–1000degree 800degree–1000degree 800degree–1000degree 800degree–1000degree 800degree–1000degree
Residency Time 2.0 Sec. 2.0 Sec. 2.0 Sec. 2.0 Sec. 2.0 Sec.
Gross Weight 1500kg 2200kg 3000kg 4500kg 6000kg
External Dimensions 140x90x120cm 160x110x130cm 175x120x140cm 230x130x155cm 260x150x180cm

Pets Crematorium


Basic Info.

Style:Crematorium
Material:Crematorium
Species:Dog
Export Markets:Global

Additional Info.

Trademark:CLOVER
Origin:Nanjing Clover

Product Description

The required circular Medical Waste Incinerator will be quoted in accordance with Technical Specifications provided below: 
1) A self-contained, diesel fuel, medical waste incinerator with a minimum burn rate capacity of 100 kg/day. 

2) A medical waste incinerator shall be specifically designed by the manufacturer to dispose of all Bio-Hazard medical wastes. 

3) At a minimum the unit shall be sized to incinerate 2.0 kg/exam-room/24-hrs when being operated continuously for 12 hours per day, but no less than 100kg/day total. 

4) The Incinerator shall be manually batch fed. 

5) The incinerator fuel tank shall meet the following requirements: 
A) The tank shall be installed above ground and according to all of the large medical waste incinerator, large portable incinerator, large scale animal incinerator, large scale incinerators for medical waste disposal, fuel tank requirements in Section 1015 including secondary containment. 
B) The tank shall be sized to hold a 14 day supply of diesel fuel 

6) Manufacturer has to provide the following capacity calculations and all supporting information for the incinerator: 

– The daily waste stream rate (kg/day or lbs/day) 
Minimum incinerator burn rate capacities 
– Minimum cure time for the refractory to prevent cracking to the refractory 
A complete list of the maintenance parts 
A minimum of 500 lbs of refractory for repairs 
A minimum of 1 gallon of hydraulic oil 

7) The contractor shall provide 3 pricing options: 
Option 1: To Quote only for the Full System 
Option 2: To Quote the price of Full System, and also the Installation 
Option 3: To provide training to appropriate relevant staff according to the 'Operations and Maintenance. (Afghanistan)

Items/Model TS10(PLC) TS20(PLC) TS30(PLC) TS50(PLC) TS100(PLC)
Burn Rate 10 kg/hour 20 kg/hour 30 kg/hour 50 kg/hour 100 kg/hour
Feed Capacity 20kg 40kg 60kg 100kg 200 kg
Control Mode PLC PLC PLC PLC PLC
Combustion Chamber 100L 210L 330L 560L 1200L
Internal Dimensions 50x50x40cm 65x65x50cm 75x75x60cm 100x80x70cm 120x100x100cm
Secondary Chamber 50L 110L 180L 280L 600L
Smoke Filter Chamber Yes Yes Yes Yes Yes
Feed Mode Manual Manual Manual Manual Manual
Voltage 220V 220V 220V 220V 220V
Power 0.5Kw 0.5Kw 0.5Kw 0.7Kw 0.7Kw
Oil Consumption (kg/hour) 5.4–12.6 7.8–16.3 10.2–20 12.1–24 14–28
Gas Consumption (m3/hour) 6.2–11.4 8–15.7 9.8–20 9.9–26.1 10–32.2
Temperature Monitor Yes Yes Yes Yes Yes
Temperature Protection Yes Yes Yes Yes Yes
Oil Tank 100L 100L 100L 100L 200L
Feed Door 30x30cm 45x40cm 55x50cm 70x55cm 80x60cm
Chimney 3Meter 3Meter 5Meter 5Meter 10Meter
Chimney Type Stainless Steel Stainless Steel Stainless Steel Stainless Steel Stainless Steel
1st. Chamber Temperature 800degree–1000degree 800degree–1000degree 800degree–1000degree 800degree–1000degree 800degree–1000degree
2nd. Chamber Temperature 800degree–1000degree 800degree–1000degree 800degree–1000degree 800degree–1000degree 800degree–1000degree
Residency Time 2.0 Sec. 2.0 Sec. 2.0 Sec. 2.0 Sec. 2.0 Sec.
Gross Weight 1500kg 2200kg 3000kg 4500kg 6000kg
External Dimensions 140x90x120cm 160x110x130cm 175x120x140cm 230x130x155cm 260x150x180cm

Incinerator Medical Waste Maximum Capacity


Basic Info.

 

Model NO.:medical waste incinerator manufacturers
Export Markets:Global

Product Description

 

Nanjing Clover Medical Technology Co., Ltd. is a leading waste incinerator manufacturer in China. We are local manufacturer and one of the largest exporter of China. Pyrolytic incinerator equipment technical is main waste treatment all of the world, for Medical Waste, Animal Incineration, Pet cremation and other Solid wste. The capacity from 10kgs/Hr. To 500kgs/Hr., up to 6ton per day. Presently, we supply clover incinerater, clover medical China medical west incinerator, cloverinvinerator, clovermed, incinerator for a hotel, incinerator for animal waste, different series for local customer requirements and design updated incinerator with our leading technology. The updated design feature of our range of incinerators make them one of the most cost effective in the world. 

Key Features: 
* All models with Dual combustion chamber. 
* Stainless Steel chimney/stack, long lifetime. *according to order 
* High temperature, long lifetime of incinerator. 
* Free or minimum installation on site. 
* High burn rate, from 10kgs to 500kgs per hour, up to 6ton per day. 
* PLC Control Plane. *according to order 
* New Design for pet animal cremation business. 
* One year warranty on incinerator and parts in stock. 

Application Scope: 
1. Hospital& clinic: Iatric Waste, Infectious Waste, Dressing, Bio-Waste, Medicine. 
2. Slaughter House &Pet Hospital &Farm: Dead Animal, Bio-Waste. 
3. Community & Sea Port & Station: Municipal Solid Waste, etc. 
4. Laboratories, Remote Locations, Disaster Relief Operations, Animal Cremation

Items/Model YD-10C YD-20C YD-30C YD-50C
Burning Rate (kgs/Hour) 10 kgs/Hr. 20 kgs/Hr. 30 kgs/Hr. 50 kgs/Hr.
Feed Capacity (kgs) 40 kgs 40 kgs 50 kgs 80 kgs
Equipment Weight 1200 kgs 1200 kgs 1800 kgs 2200 kgs
Picture  
Primary Chamber (Liters) 200 200 250 400
Secondary Chamber (Liters) 140 140 140 140
External Dimensions (cm) 170x140x160 170x140x160 170x140x190 180x160x200
Internal Dimensions (cm) 55x55x65 55x55x65 55x55x85 70x70x85
Oil Tank(Liters) 50 100 100 150
Door Opening (cm) 38 x 48 38 x 48 38 x 48 45×55
Chimney (M) 5 5 5 5
Chimney Type Stainless Steel Stainless Steel Stainless Steel Stainless Steel
Secondary Chamber  YES YES YES YES
Mix-Combustion Chamber YES YES YES YES
Smoke Filter Chamber YES YES YES YES
Combustion Fuel Oil/Gas Oil/Gas Oil/Gas Oil/Gas
Residency Time 2.0 Sec. 2.0 Sec. 2.0 Sec. 2.0 Sec.
Temperature Monitoring YES YES YES YES

Kenya: How Toxic and Infectious Medical Waste Is Harming Citizens


A visit to the hospital does not usually reveal what happens at the back. It is here where discarded blood and body tissues and parts from surgeries, pharmaceuticals, medicine bottles — tonnes of hospital waste — go through. In the case of the Kenyatta National Hospital, this could be as much as one tonne a day estimated to be half the medical waste generated in the city. Quite understandably, it is not usually open to the public.

Most of these normally end up in incinerators — the most affordable medical waste disposal method for most hospitals. But a lot of it slips through the system to get us worried.

Incinerating waste at temperatures between 800-1,100 degrees Celsius kills viruses, bacteria and other pathogens but the ash still contains dangerous heavy metals like mercury and cadmium. Best practice dictates that such ash be buried.

But as this writer found out, this is better said than done. Lack of adequate equipment to safely dispose of waste and failure to observe best practices was a common feature in most hospitals visited in this survey.

From releasing dangerous fumes and ash openly to the environment to dumping medical waste together with general waste, the local medical waste management scene still has a long way to go.

Raw medical waste and toxic ash from incinerators ends up in open dumps like Dandora and Eastleigh posing a health risk to thousands of people salvaging plastic and metal for recycling and residents living nearby. Major hospitals like Kenyatta National Hospital which otherwise have good incinerators have run out of grounds to bury toxic ash. Few hospitals have a scrubber system where fumes are filtered to remove potentially toxic gases including dioxins from burning plastic — a common material discarded by hospitals.

A recent report on the global status of waste management ranks Nairobi as one of the worst in waste management. Residents living near Dandora reported a high number of respiratory diseases and were found to have unacceptably high levels of heavy metals like lead in their blood. Dandora dumpsite reeks of heavy metals which can hinder brain development as our independent tests confirmed.

“Most health facilities take ash from their waste to municipal dumpsites directly or through collectors,” says Mary Kinoti, a lecturer on environmental and occupational health at the University of Nairobi.

Walking through the dumpsite opened during the 1970s reveals unlikely materials that end up here. Lying in the pile of an unsightly mix of plastic bags and organic waste, one often finds bloodied gloves, dressing bandages, needles, discarded drugs and a host of other metals tucked away.

From their small quantities, it is easy to conclude that this come from smaller hospitals, clinics and dispensaries not willing to spend on the proper disposal of waste. Level five hospitals, formerly called provincial hospitals like Nakuru, are mostly well equipped with incinerators that can combust pathological waste into water and ashes, says Kinoti.

A peek at the Dandora dumpsite reveals an unsightly mix of plastic, food remains, animal products and all manner of waste the city discards. Every few minutes a truck makes its way through the mountains of garbage the city has accumulated over decades. The steady stream of trucks falls silent at dusk.

But as dark falls, another set, mostly lone trucks hurriedly enter the dumpsite, quickly offload their contents and make their exit, all within a few minutes — well aware of their wrongdoing. A closer look at the dumped material reveals used needles, bloodied bandages, pharmaceuticals and a host of other waste from hospitals. We even found syphilis and HIV test kits.

Early in the morning, a County Government of Nairobi earth mover turns over the waste mixing it with garbage ready to receive the next batch for the day.

Tens of people descend on the site, sorting the garbage with their bare hands. Their interests are different. While some solely focus on milk packets which they wash in a sewage tunnel, others are interested in salvaging metals from the burnings heaps, fuelled by the excessive gas underneath.

Still others are after the food remains which they collect to feed animals — all determined to make a living. A prick from an infected needle and they could end up with serious infections including HIV.

They all seem too aware of the danger, but they have to feed their children, a man, protected only by a pair of gumboots, says.

The National Environmental Management Authority and the County Government of Nairobi did not respond to our enquiries.

Yet the danger of medical waste in the country does not start or end here. Medical facilities try to safely dispose of their waste to various levels of success. A large number incinerate their waste, but lack the prerequisite air pollution control equipment to guard against materials such as sulphur, known collectively as flue materials, getting into the environment.

In such cases, residents living near such facilities are prone to respiratory infections. Dioxins from plastics are known to cause serious respiratory complications and cancer. A study carried out by a Yale University student recently found that high levels of toxic fumes from incinerators rending the air were responsible for respiratory infections among residents living near such facilities.

A recent report detailed the high levels of heavy metals such as lead in vegetables grown and sold in Nairobi. Lead is a dangerous metal that can cause retardation in children. Some farmers in Kinangop were recently in the spotlight for using sewage to grow their crops largely sold in the city.

Incinerators below standard

Dumping of toxic ash is not the sole problem facing the medical waste management scene. The state of equipment is wanting, some dating several decades ago and ill equipped to minimize pollution.

Most public hospital below level five have de Montfort incinerators where temperatures are not controlled and are likely to pollute as they lack scrubber systems. “Unfortunately this type of incinerators are common in district hospitals and health centres,” Kinoti says.

“A wet scrubber is a compartment where the emissions are sprinkled with water to dissolve air pollutants, and what is released to the environment is clean,” Kinoti explains. Workers are also not well protected in mid-level hospitals. Because of the design of the incinerators, medical waste is loaded manually and workers who mostly do not have protective gear are exposed, she says.

A medium size incinerator costs an average of Sh20 million before installation, clearly a high shot for hospitals. Add the high maintenance costs and the fact that these facilities guzzles several thousands of litres of fuel to run per day and you end up with a very high bill.

“But the high cost of incinerators is no excuse for polluting the environment,” says Kinoti. “Hospital waste contains mercury and can produce furans which are very toxic and can cause cancer and acute respiratory diseases,” she says.

Medical facilities which do not have incinerators are required to have contracts with specialised waste disposal companies to handle their waste. For some, this is just an unnecessary hurdle they have to undergo before acquiring a license to operate a hospital. Little is done to comply. A number do not follow through with these requirements posing a huge health risk to the public and the environment.

Hospitals categorize their waste differently for their safe handling during transport, storage, treatment and disposal, says Bernard Runyenje, assistant chief public health officer, Kenyatta National Hospital.

Highly infectious waste are those expected to be containing highly infectious pathogenic organisms such as bacteria and viruses while general waste may consist of office paper. Usually in red packages, infectious waste require special care throughout the process of waste disposal and are supposed to be treated at source. It is not however unusual to find a worker carrying a yellow or red disposal bag without gloves or any other protective gear.

Tissues that decompose quickly such as amputated limbs are disposed of quickly or put under refrigeration. Most of these highly infectious waste — except radioactive waste — should most appropriately end up at the incinerator, Dr Runyenje says. Most African countries use incineration to dispose of medical waste.

According to Dr Runyenje, incineration should be a controlled process and should happen in an enclosure. But he also admits that incinerators in rural areas do not meet these specifications.

A good incinerator should have more than one chamber where waste is burned in the first chamber, so that there is increased temperature in the second chamber and gases can be burned in the third chamber, he says. At the end of the process, most of the waste has been burned to an acceptable level. Clinics and dispensaries often operating in highly populated areas often flout the regulations, openly burning their waste using paraffin and charcoal to avoid the cost of safe disposal. Half burned waste is easy to spot in dumps on roadsides and quite visible in municipal dumpsites.

Incineration however does not get rid of toxic fumes and heavy metals — if anything it can disperse toxic fumes to a wide areas if not done properly. The scrubber system is designed to reduce such pollution but the system is expensive and most hospitals visited do not have it. The gas from the incinerator is passed through fluid to remove any particulate matter — inside a scrubber system. Such gases may include carbon monoxide, carbon dioxide, dioxins and furans which can cause serious diseases such as cancer.

The minimum height of a chimney should be at least 10 feet above the tallest building around to minimise direct exposure to residents. Anything that comes out of the chimney should be dispersed away from nearby buildings.

“Sometimes it is difficult to know what you are emitting to the environment. If you release it directly to human beings, then you expect to have some health issues, whether it is inhalation of carbon monoxide, carbon dioxide, dioxins or furans,” Dr Runyenje says. A high chimney should not however be seen as a replacement for a scrubber system, adds Kinoti. A high chimney only disperses fumes further to residents who may not even be aware of them, she observes.

To many, including waste managers interviewed, ash from incinerators, or any ash for that matter is not harmful — a misplaced notion that could be contributing to its dumping. The truth is that they contain harmful metals like mercury, lead and cadmium as our independent tests confirmed.

Incineration reduces the waste to about 10 per cent of the original volume. But the remaining ash usually contains very high content of heavy metals. How hospitals and waste disposal companies handle this will determine the health of our environment. Such should usually be buried in sanitary landfills to prevent it from leaching to the ground, but this practice appears rare in the country.

Whether through sheer negligence, or lack of space and facilities or reluctance to meet the associated costs, medical waste nevertheless ends up in our environment. When disposed in open ground, heavy metals easily leach to the groundwater or make a direct way to our food chain.

Bottom ash under normal circumstances should be buried, but most health facilities do not have disposal grounds. These burial grounds are not present either at Dandora where officials claimed the ash was taken to be buried.

Some companies are licensed to handle hazardous waste. However, Dr Runyenje however notes that not many handle general medical waste.

A number of incinerators in public hospitals were in a state of disrepair leaving tonnes of toxic waste piling up and posing a danger to the public.

Kenyatta National Hospital has a ground where tonnes of waste are kept awaiting disposal. Two of its three incinerators are awaiting repair causing a backlog estimated at 170 tonnes.

Its newly acquired incinerator from India is the most advanced among the hospitals visited consisting of two chambers for maximum combustion. The wide network of smoke pipes leads to a chamber where the smoke is passed through a fluid to remove fumes and other residue.

The resulting black slime contains some of the dangerous metals. But the design and structure of the holding area does not meet specifications and some of it seeps to the ground, a source tells us. Its aging incinerators dating back to when the hospital was started are awaiting repair.

The incinerator cannot be operated during the day because the nursing school is just metres away.

The location of incinerators in relation to hospitals, offices and other residential is a common problem in many facilities. The one at the Chiromo School of Physical and Biological Sciences for example is not in operation as it sits near an embassy.

One incinerator in Nakuru County is perilously close to the maternity ward, some smoke go directly to patients.

The scenario plays out in many other hospitals around the country who also lack additional air pollution control equipment.

Ash dumped in open ground are an open feature in a number of leading facilities that could potentially poison ground water through leaching.

Ideally, ash from such waste should be buried in landfills, a practice that was long abandoned in the country.

With people living near such facilities, they are inevitably exposed, and risk serious respiratory infections and serious diseases including cancer. The Kenyatta National Hospital incinerators operate at night to minimise exposure to the students at the School of Nursing barely a dozen metres away.

A source told this writer that the soils were so contaminated they will have to be skimmed off and buried. Meanwhile, residents will have to contend with dangerous, possibly carcinogenic, ash emanating from such facilities.

Larger hospitals like Nairobi Women’s Hospital are stepping in to help smaller ones incinerate their waste. “The cost of the incinerator is too high for them to afford,” says Thomas Imboywa, who is in charge of one of these at the Nairobi Women’s Hospital, one of the largest in the region. On a daily basis, he oversees the safe disposal of the days waste.

The incinerator, a huge blue structure sits on about 100 square metres of space slightly off the main building and sports a high chimney, towering above the nearby building.

“Medical waste is ideally incinerated within 24 hours,” says Imboywa. But when a clinic or hospital does not turn in any waste for weeks on end, it raises eyebrows, Imboywa says. He is familiar with many such cases and the hospital is quick to repudiate such contracts as per their policy. Some medical facilities may just secure a contract with them to wade through National Environmental Authority (Nema) regulations but have no intention to safely dispose of their waste, Imboywa observes.

Those who do not have incinerators are required by Nema to have a contract with hospitals like Nairobi Women’s Hospital to dispose their waste. However, not all medical waste ends up in such specialised facilities. Instead, in places like Kibera they are doused with paraffin and burned in the open.

“But in this case, sharps will remain and the waste can still remain infectious because they cannot reach the required temperature,” Imboywa said. In fact the material can remain infectious because they may not reach the required temperatures.

Devolution could make it worse

As more hospitals come up in tandem with the growing population, a rethinking how medical waste is handled will be inevitable. The devolution of resources has seen more clinics and dispensaries put up in previously unreached areas. But the resources are so limited to put up waste disposal facilities such as incinerators.

Besides being expensive, Dr Runyenje agrees that even if these facilities were to put up their own incinerators, there would be more pollution and authorities will have more difficulty supervising them.

“There is need to pool incineration facilities for medical and hazardous waste,” he says. These centres can serve as emission monitoring points for authorities. “It will then be easier to put controls from such a central facility. “At the Technical Working Group, we are looking at how counties can pool their facilities together and have their medical waste incinerated at a central point. It will be very expensive in the long run to have every facility to have its own incinerator that cannot run at full capacity,” he says.

The best waste disposal method is controlled tipping being practiced in most of Europe and North America where it is buried in layers, Dr Runyenje says. “The advantage with this method is that the land can still be used for other activities. It is the only assurance of disposal of any form of waste,” he says.

Kariobangi, which now hosts light industries, used to be a controlled tipping site before open dumping at Dandora. “Counties should be thinking of controlled tipping instead of investing heavily in incinerators,” he says.

General waste can have many recyclable materials but proper segregation which can make this possible is still lacking in the country.

The effectiveness of recycling is determined by the effectiveness of segregation.

The problem, according to Kinoti, is enforcement of the law. While bigger hospitals are trying to properly dispose of their waste, some smaller clinics may be spoiling it, she says. The fact that generators cannot monitor their waste once it is given to waste collectors is also another problem according to her.

“There are many quacks doing waste management mixing household waste with hazardous waste. This can pose a serious health problem,” says Kinoti. Since they empty waste bins from homes, waste collectors can cause serious contamination in households. “Waste collectors who are collecting hazardous waste should be dedicated waste handlers and should not handle other general waste,” Kinoti says.

Effluent from the scrubber system should be taken for treatment to remove heavy metals and other pollutants. But the sewerage system is broken and a lot is discharged on the way. Sewage pipes are sometimes deliberately punctured and effluent used as fertiliser for crops.

“The law on sound medical waste disposal should be enforced, district and healthcare centres should install larger incinerators to handle waste from smaller fee. We should have dedicated healthcare waste managers,” Kinoti says.

 

by: http://allafrica.com/stories/201411111021.html


Incinérateur P déchets médicaux à Atmosphere contrôlé conçu pour À 'incinération des déchets biomédicaux


Incinérateur de déchets médicaux à air contrôlé conçu pour l’incinération des déchets biomédicaux générés dans un centre de traitement du sang. Les déchets à traiter comprennent principalement les biodéchets (c’est-à-dire les fluides corporels), les déchets infectieux et dangereux tels que les seringues, les aiguilles et autres déchets médicaux (c’est-à-dire les caoutchoucs de silicone, les plastiques, les textiles, les papiers, les emballages, etc.)

Spécifications opérationnelles Spécifications physiques
Volume de la chambre de combustion (m3) 8,80 m3
Taux de combustion * jusqu’à 1500 kg par heure
Consommation moyenne de carburant 65 kg par heure ou plus (7 brûleurs diesel)
Température opérationnelle 850 à 1320 ° C
Rétention de gaz dans la chambre secondaire Grande chambre secondaire
Surveillance de la température Oui
Résidus de cendres moyen (%) 3%
Dispositif thermostatique Oui
Réservoir de fumée diesel 1000l
Laveur de gaz Venture
Système d’alimentation hydraulique de bélier
Grand incinérateur à moteur diesel
Spécification minimale requise

Normes