With the burgeoning population and increasing awareness of healthcare, hospitals and other health care institutions have proliferated all over the world. Aided considerably by the ever increasing use of disposables and demand for a variety of services, these have, unfortunately, also become a source for generation of bio-medical waste.

 

It was only till a decade or two back that hospital wastes were found washing onto public beaches and uncovered in dumps. Until very recently, some disposables like syringes and catheters found their way into secondary markets to be used by unsuspecting medical personnel and patients.

 

The public was becoming increasingly alarmed by the presence of communicable diseases in our society and is increasingly concerned with the spread of these diseases. It is not quite clear that this is not set free in hospital waste accumulations.

 

Many hospitals have incinerators, which were installed a decade or two ago, when minimal standards only existed for the design and operation of this equipment. They were and are operated by people untrained in their efficient operations and maintenance. Poor design, poor maintenance and poor operation result in poor performance. Many of these units operate as bad neighbors, discharging soot, smoke and odour that public opposition to this technology becomes understandable. The problem is: the public wants effective disposal of hospital wastes but they do not want to have to hear, see or smell the mechanism for its removal and destruction.

 

Right at this moment, many countries in Europe and North America have installed incinerator equipment of the latest design with considerably advanced Air Pollution Control Equipment and Continuous emission monitoring devices, that it has become practically impossible to see or smell the operation in the neighborhood.

 

Before we discuss the technology and process, let us look at the waste stream.

 

“Bio-medical waste” is a term coming into common usage to replace what had been referred to as “pathological” or “infectious” or “clinical” wastes and includes additional related waste streams. The following table illustrates and classifies the full gamut of these wastes along with the recommend methods for their disposal.

 

 

Disposable plastics have been replacing glass and clothing in, what appears at first look to be, a means of cutting costs. They

represent a greater cost in their disposal however, especially those containing chlorine. The plastic content of the hospital waste stream has grown from 10% to 30% in the last decade.

 

It is rare to find an incinerator designated for medical waste destruction to be fired solely on this type of waste. Generally, particularly in hospitals, installation of an incinerator encourages the disposal of other wastes in the unit. Besides the cost savings this represents in not having to cart this trash away, there is the potential for heat recovery. For example, hospitals generally require steam throughout the year for laundry, sterilizers, autoclaves and kitchens. As more waste is fired, more heat is produced and more heat is produced and more steam is generated.

 

Waste generation rates vary from one hospital to another, a function of the number of hospital beds, the number of intensive care beds and the presence of other specialty facilities. 

 

In general bio-medical waste incinerators tend to be smaller, smaller than those used for the disposal of general waste and trash in common incineration disposal sites. 

 

 

Regulatory:

 

Regulations have addressed these larger municipal solid waste incinerators. Smaller units such as 2000 kg/day to 10000 kg/ day bio-medical waste incinerators have generally not been subject to rigorous regulatory attention in the past. The only restriction on their operation in many parts of some countries is that they do not create a public nuisance.

 

That has meant that no odours are to be generated and that the opacity is to be low, i.e., no greater than Ringleman No. 1 for more than, for instance five minutes per hour. Incinerators have been designed to this standard, which is virtually no standard at all. As public attention is starting to focus on hazardous, dangerous and toxic wastes, the regulatory attitude towards clinical waste incinerators is starting to change. Although regulation is not wide spread throughout the world, more and more countries are moving towards a regulatory attitude for medical waste incineration. In some countries for example these waste are classified as hazardous; in others they are regulated as a unique waste stream with its own set of regulations: and in some countries there is still no regulation of medical waste per Se.

 

Hazardous wastes typically generated by in hospital laboratories.