Incinerators and Hospital Waste Management System – A Simple Guide

Definition:

Incinerator is an apparatus/furnace used for burning waste material, such as biological refuse, industrial waste includes solid, liquid gaseous waste.

Purpose:

Incinerators are used to safely dispose of solid, liquid, and gaseous wastes that result from manufacturing processes, waste of hospitals, clinics, industries, etc., Incineration is an environmentally and technically superior method of waste disposal entertaining reliability, safety and efficiency. The main purpose of incineration is to reduce the volume of the solid waste, there’s a possibility of energy recovery during the process by adding a boiler. The operation of incineration various by municipal solid-waste, hazardous-waste, and medical-waste incineration facilities.

Background:

Pakistan and other developing countries face an urgent need for affordable, safe, and appropriate solutions for treating infectious waste. Without treatment by heat, steam, or chemicals, used needles and syringes (i.e., “sharps”) can cause infection and injury. Untreated safety boxes filled with used sharps pile up outside health facilities, allowing easy access by curious children or animals. Managing infectious medical waste in developing countries has become an increasingly complex issue due to the fact that Global standards for acceptable performance of Health Care Waste Management (HCWM) do not exist. The World Health Organization (WHO) advocates for a relative risk approach to waste treatment— that is, weighing the health risks from environmental exposures against the risks posed by accidental infection from poorly managed infectious waste (particularly sharps). WHO has indicated that until the infrastructure and resources are available, there is a need for immediate 2 improved solutions for waste treatment that are appropriate for low-resource settings. WHO also recognizes the need to identify feasible and cost-effective approaches that minimize environmental damage. However, the higher cost of these technologies, lack of durable designs, and the lack of reliable electrical supplies in many developing countries has prevented these technologies from being widely used.

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Incineration Process

This is the thermal treatment of waste disposal because of its utilization of intense high temperatures are used to burn material to the point of combustion.

Step 1: Sort

The first step of preparing your waste for incineration should be to sort through the waste. Pick out any high value recyclable items for resale. This could be large pieces of glass or metal that can be re-used elsewhere. Whilst looking for items of value, it is also important that you search for any dangerous items and remove them from the waste. An example of a dangerous material would be batteries. If a battery is left in the waste and placed into the incinerator, it could potentially explode causing damage to your machine and staff. The battery would also release harmful fumes into the atmosphere when burnt which can cause a serious risk to the environment and human health.

Step 2: Shred

Shredding the waste before incineration is an important part of preparation. Shredding is a technique used in the disposal process of paper waste, agricultural waste, household waste and industrial waste. Shredding the material is essentially breaking the material down into smaller pieces. Reducing the size of the waste allows you to burn more waste in one batch which can save money on the running costs of an incinerator.

Step 3: Dry

An additional step when preparing your waste for incineration is drying. The drying process involves reducing the moisture content of the waste as much as possible. If the waste collection has a high humidity it will take a long time to completely burn the waste as the heat will be used to evaporate the moisture first. Reducing moisture content allows faster heating time improves efficiency.

Step 4: Determine batch size

It is important that you determine a batch size suitable for your incinerator. Having a method like this can help you save money on your heating costs. You should not overload your burner as this may cause the waste to burn less. It can also cause damage to your burner if you continue to overfill. While it is important not to overfill your welding machine it is also important not to have too many garbage cans. Using your printer with a small amount of waste is a huge waste of energy and fuel.

Step 5: Pre-heat

Before loading your waste into a fire extinguisher you must first heat it at a temperature of 850?C. Placing debris in a cooling temperature can cause a mixture of harmful particles to form in the river. These particles can cause serious damage to people and the environment, so it is important that you make sure your heater is 850?C before loading any of your waste. The reason the 850?C is given as a temperature is because it is hot enough to kill any of these harmful pollutants before they are released.

Step 6: Load your incinerator

Once you have completed all your pre-preparation steps and your temperature is up to 850?C, it is time to load your waste into a incinerator. Make sure you wear all the necessary safety equipment to avoid the risk of injury during loading. The temperature of the heating elements can reach 1100?C, so it is important that you follow all the guidelines and safety rules when using the incinerator.

Step 7: Let it cool

Once the combustion process is complete, it is important to allow the burner to cool down and ashes. The temperatures inside the incinerator are very hot so it is possible that the outside of the incinerator will also be very hot. It is important that the ash is also cooled when it comes to removing the ashes (de-ashing). Removing the ashes while still hot can cause the ashes to burn and ignite. To comply with health and safety regulations, make sure both the incinerator and ash is cool before handling.

Step 8: De-ashing

Once your incinerator and ash have cooled to a comfortable temperature, you can easily remove the ash system ready for the next batch. Some of brands cinerators models also have an automatic ash removal system that minimizes user contact with the heating system. This removes the risk of any burns from high temperatures or irritation of fly ash.

Step 9: Spot Check

Once your incinerator has been wiped (de-ashed) and completely cooled, you should check (run a spot check) the area in incinerator. Areas for inspection are burners, chamber and fuel lines. By making sure everything works properly, you can ensure good quality burns and help prevent any problems in the future. This will save you time and money by preventing any problems from developing.

Step 10: Re-Load

After you have checked your incinerator to make sure everything is working, you are ready to repeat the steps again to reload the next pile (next-batch) of waste.

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General Classification of Environmental Waste

1. Liquid waste

Liquid waste refers to all grease, oil, sludge’s, wash water, waste detergents and dirty water that have been thrown away. They are hazardous and poisonous to our environment and are found in industries as well as households. Wastewater, as it is often called, is any waste that exists in liquid form.

How is liquid waste removed?

The three methods we can remove liquid wastes from wherever they’re located include;

1. Containment: This involves storing liquid waste in barrels or tanks so that they can be removed from our surroundings. Containing liquid waste prevents it from being dumped in our environment.
2. Treatment: All liquid wastes do not need to be thrown away. You can treat and reuse them. For example, organic waste is composted and used to produce fertilizers in various stations in the UK.
3. Disposal: If no treatment can be done on liquid waste, then it should be disposed of.

2. Solid Waste

Solid waste is any garbage, sludge, and refuse found in industrial and commercial locations. The five major types of solid rubbish are;

Glass and Ceramics: Numerous companies readily recycle ceramics and glass. The catch here is that you have to dispose of them correctly.

Plastic waste: Plastic waste is any container, jar, bottle, and bag that is found in companies and houses. Plastics are non-biodegradable, and most of them cannot be recycled. Do not mix plastic rubbish with regular waste. Instead, sort them out before throwing them away.

Paper rubbish: This refers to all newspapers, packaging materials, cardboards, and other paper products. Paper is recyclable.

Metals and Tins: You can easily find tins and metals in homes because food containers and household materials are made from them. Most metals are recyclable, so take them to a scrap yard or recycling depot after use. You should get a skip hire and use it to transport your solid waste.

3. Organic Waste

Organic waste refers to rotten meat, garden and food waste. This type of rubbish is commonly found in homes. With time, they decompose and turn into manure by the action of microorganisms on them. But be careful; you should not dispose of them anywhere you like.

When decomposing, organic waste produces methane, so, it must not be thrown away with regular waste. Instead, get a green bin and dispose of this type of waste properly.

4. Recyclable Waste

All discarded items like metals, furniture, organic waste that can be recycled fall under this category. Not all items are recyclable, so you have to be careful when putting things into the recycle bin. If you are not sure whether an item is recyclable or not, then check the item’s packaging.

5. Hazardous Waste

Hazardous waste includes flammable, corrosive, toxic and reactive materials. In a nutshell, they are wastes that pose a significant or potential threat to our environment.

Ways of Disposing Hazardous Waste

The four ways of disposing of hazardous waste are;

1.??????Recycling: A few hazardous wastes can be recycled to form other products. For example, circuit boards and lead-acid batteries can bind to other pollutants and later used as pavement fillings. Chemical levels are reduced when hazardous wastes are converted to new products.

2.??????Incineration and Destruction: Another way of disposing of hazardous waste is to destroy or incinerate them. Incineration reduces the amount of hazardous waste and can also generate energy for use in the process.

3.??????Pyrolysis: Pyrolysis, in a very high-temperature arc under inert conditions, is an excellent way to dispose of hazardous waste. This process is used to avoid the dangers of combustion and is preferable when dealing with PCBs, organic waste and pesticides.

4.??????Disposing in a landfill: A landfill is a disposal facility where rubbish is placed in. Land treatment facilities are not landfills.

Classification of Medical Waste by World Health Organization

The WHO has issued its own guidelines on the different types of medical waste, which include:

1. Infectious Waste?–?Anything that’s infectious or contaminated
2. Sharps?–?Waste like needles, scalpels, broken glass and razors
3. Pathological Waste?–?Human or animal tissue, body parts, blood and fluids
4. Pharmaceutical Waste?–?Unused and expired drug or medicines, like creams, pills, antibiotics
5. Genotoxic Waste?–?Cytotoxic drugs and other?hazardous toxic waste, that’s carcinogenic, mutagenic or teratogenic.
6. Radioactive Waste?–?Any waste containing potentially radioactive materials
7. Chemical Waste?–?Liquid waste, typically from machines, batteries and disinfectants
8. General/Other Waste?–?All other, non-hazardous waste.

Classification of Medical Waste by Color Coding

The sterilization and removal methods are also highly dependent on the kind of medical waste you need to get rid of. Color coding basically exists to allow you to easily distinguish the different types of medical waste by sorting them into different categories, each pertaining into a different color.

Need of doing medical waste color coding?

Color coding is not just for the comfort purpose but it works on the very basic principle, “waste doesn’t all go to the same place”. It is essential to differentiate the waste into different types in order to be safely processed. This is essential step of segregation which is used to reduce the, quantity of medical waste that needs special treatment, prevent the reuse of sharps and other waste for illegal purposes, and provides more opportunities of recycling. The mentioned above categories of Medical Waste, the color coding is divided into 4 different colors,

1.????Yellow

-?Pathological waste.

-?Soiled (infectious) waste (like disposable garments contaminated with body fluids, bandages, etc.).

-?Medical Chemical waste.

-?Clinical lab waste.

-?Pharmaceutical waste (discarded/expired medicines).

2.????Red

-?Contaminated waste (Anatomical waste like body parts, blood bags etc.,).

3.????White

-?Sharp waste or translucent.

4.????Blue

-?Medical glassware waste (like metallic body implants). This category maybe not be very common and may not exist in literature.

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Maintaining Operator Safety

Protecting your safety should be a number one priority when operating an incinerator. PPE kits can save lives and prevent serious injury. Your requirements may vary depending on what environment you’re working in and the waste you handle, but there are essential pieces of PPE that every waste handler and incinerator operator should wear. These are:

- Incinerator operative PPE equipment. This includes a safety visor, heat resistant apron and protective sleeves, and heat proof gloves.

- Safety visor or face mask – this will help to protect the eyes and mouth.

- Heavy duty/ heat resistant gloves – to protect the hands from any sharp objects and extreme temperatures.

- Apron or overalls – this will prevent any damage to clothing from spills and parts of the waste.

- Heavy duty boots – to protect your feet from heavy waste and any sharp objects that may become separated when handling the waste.

Reason of wearing PPE?

Personal Protective Equipment can prevent injury and other forms of harm to workers. When handling and incinerating hazardous waste, workers need to be protected from disease and germs, which can easily be inhaled or spread through direct contact. Covering the mouth by using face masks and wearing fully body protective clothing can help to prevent this.

Medical waste can also contain sharp objects, body fluids and chemicals. Heavy duty gloves and full body aprons can be used to prevent cross contamination, scratches and punctures from sharps. Sorting the waste before incineration allows less handling time by the operators, preventing risk of disease, infection and injury. This can be done by using the color coding system for medical waste.

Although most modern incinerator machines feature numerous built in safety measures, workers are still required to manually load waste and operate the incinerator itself. The extreme high temperatures pose a huge threat to anyone involved, so PPE kits are essential for operators. Flame retardant clothing including overalls, gloves, arm guards and jackets are essential pieces of PPE. This equipment will protect against the intense temperatures of the incinerator. A full safety visor is also required to protect the face from the heat and any potential sparks and simmering ash.

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Environmental Baseline Conditions

In order to assess and evaluate the impacts and related mitigation measures, in the project area, existing conditions of physical, biological and the socio-economic environment were studied as under:

Physical Environment:

The physical environment including the topography, climate followed by geology and soil of all the respective proposed project sites at each hospital.

Air Quality:

The ambient air quality monitoring has to be conducted for 24 hours at the side of construction. The parameters monitored were: SO2, NO, NO2, CO, O3, Pb, SPM, PM 2.5 and PM10.

Noise and Vibration:

The sound pressure levels (dB) were frequency weighted on A-curve (dB (A)) and time weighted (dB (A) Leq) on an hourly basis, considering the project site and location. Standard of SEQS (Sindh Environmental Quality Standards) was followed for comparison, i.e. 65 dB (A) for daytime and 55 dB (A) for night time.

Ecological Environment

Flora: Considering the side of the project, if sites are located in the urbanized heart of the respective cities, the floral species are fewer in number and mostly anthropogenic. However, in some cases, scattered vegetation which includes different trees species of medium height was observed in the project area and its surroundings.

Fauna: Considering the site, the number of mammals, birds and reptiles needs to be recorded form the project sites during visits. The vertebrate fauna should be documented just to make sure that no specie should be titles as endangered and do not serve as protected.

Protected Areas/National Sanctuaries

In different countries including Pakistan, there are several areas of land devoted to the preservation of biodiversity through the dedication of national parks and wildlife sanctuaries. There are no protected areas near any of the proposed incinerator project sites.

Socio-Economic and Cultural Environment

The project site should be inspected and surveyed, where incinerators will be installed, and socioeconomic and cultural environment has been delineated. The socio-economic survey involved all possible members of the community, hospital staff members, municipal committee members, followed by doctors and staff of the adjoining public and private hospitals and clinics located in the near vicinity of the selected hospitals.

Public Consultation

Public Consultation for the project, “Provision of Incinerators (Procurement, Installation, Commissioning & Operations) in Different Hospitals of Sindh or any other part of the world”, needs to be held with the adjoining communities and stakeholders for all the selected hospitals. Generally, the communities were not aware of the need of the incinerator, but they were informed about it during the consultation process, and the negative and positive impacts were communicated to them.

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