By Mohamed Elfeki, September 2000, Saxion University, the Netherlands THE APPLICATION OF TECHNOLOGY TO TREAT INFECTIOUS WASTE IN EGYPT TITLE By Mohamed Elfeki, September 2000, Saxion University, the Netherlands

PRESENATION CONTENTS INTRODUCTION THE OBJECTIVE MAIN RESEARCH QUESTION TARGET GROUPS PROBLEM DESCRIPTION TREATMENT TECHNOLOGIES INCINERATION MANAGEMENT CONCLUSION RECOMMENDATION QUESTIONS END

Introduction 1- INFECTIOUS WASTE 2- RISKS OF INFECTIOUS WASTE Health Inside hospitals Outside hospials Environment Introduction

The Objective The Objective Evaluation the treatment technologies options for infectious waste, which is produced by hospitals in the Netherlands in order to be able to select the most appropriate techniques that can be applied in Egypt. The Objective

Main Research Question What are the most appropriate techniques to treat infectious waste, which is produced by hospitals in Egypt to be in accordance with the legal international allowable limits of environmental pollution and public healthcare?

Target Groups 1- Egyptian Ministry of State for Environmental Affairs (MSEA) 2- Egyptian Ministry of Health and Population (MOHP) Target Groups

Problem Description Problem Description TONS/YEAR

Treatment Technologies 1- Incineration 2- Steam sterilisation 3- Microwave sterilisation Treatment Technologies

4- Landfills 5- Chemical sterilisation 6- Gas sterilisation 7- Hot air/dry heat sterilisation 8- Electrothermal deactivation 9- Irradiation sterilisation 10- Cobalt-60 gamma rays 11- Ultraviolet 12- Electro beam sterilisation

Typical incineration Plant Support fuel (oil/gas) & air Stack Primary combustion chamber 2ry combustion chamber Boiler/heat exchanger /cooling system Flue gas cleaner Bottom ash (Landfill) Heat and/or hot water (to be utilized) Dry process = Fly ash + Chemicals or Wet process = fly ash + Sludge (Landfill) + Water (Sewer system)

Typical Steam sterilisation plant Steam from gas/oil Size reduction Heat + Pressure treatment Compaction Loading + transport to landfill Water + Wastewater Wastwater Landfilling of treated waste

Typical Microwave plant Water for dry waste Power to feed microwave generator Size reduction Heat + microwave treatment Compaction Loading + transport to landfill Water vapour Wastewater Landfilling of treated waste

Comparison between the most common treatment options

Incinerators 1- Municipal Incinerators 2- Rotary Kiln Incinerators 3- Pyrolytic Incinerators Incinerators

Comparison between the available incinerators

16 Ammonia 25% storage A Hospital waste 1a Gasification incinerator B Air and gas 1b After burner C Process water 02 Slag container D Slag 03 Boiler E Flue gas 04 Steam drum F Steam 05 Ash collecting bag G Boiler feed water 06 Breakwater tank H Fly ash 07 1st scrubber I Sour wash water 08 2nd scrubber J Base water 09 Tank 10% NaOH K Injection of NaOH 10 Adsorbent storage L Injection of adsorbent 11 Bag house M Used adsorbent 12 Main fan N Injection of Na4OH 13 Used adsorbent storage O To the chimney 14 SCR DeNOx reactor 15 Injector NH4OH 16 Ammonia 25% storage

Allowable emission limits and the achieved emissions by ZAVIN Allowable emission limits and the achieved emissions by ZAVIN. All values are expressed in micrograms/m3 (ugm/m3)

Real values could be obtained by dividing the values above by 100 Real values could be obtained by dividing the values above by 100. All values are expressed in ugm/m3 except for dioxins that are in nanogram/m3 (ngm/m3)

Management Management

1- Constructing Treatment Plants in Egypt 2- Managing the Infectious Waste in Egypt - Segregation - Collection / packaging - Storage - Transporation

Conclusions 1- Infectious waste in Egypt is burned openly on-site or burned in sub-standard burners. 2-There are no specific article in the Egyptian law about the emissions released due to infectious waste treatment. 3- Infectious waste management is important for environmental health protection. 4- The pyrolysis/gasification with after-burning and steam boiler is the most appropriate thermal treatment technique of infectious waste for Egypt especially with pathological waste and contaminated sharps because it renders body parts unrecognisable, sharps unusable and destroys Cytostatics completely. 5- The Netherlands has an advanced management and treatment system in the field of infectious waste. This system has proved a very high quality by lowering the emissions limits to a level, which is less than the European limits. 6- Central Treatment Centres (CTC`s) could offer a complete service to hospitals for all kind of hazardous waste. Conclusions

Recommendations 1- (MSEA) has to establish a table containing the allowable emission limits in the case of treating infectious waste. This table must be under the international limits or at least the same. 2- Direct landfilling of untreated infectious waste must be prohibited for public and occupational health as well as aesthetic reasons. 3- Using the management plan of this research as an example to manage infectious waste. 4- The (CTC`s) including Pyrolysis/Gasification could be suitable manner in order to manage infectious waste adequately and economically. In addition this system has no limitations except for the separation of radioactive waste, Hence it can overcome bad separation of the different waste streams. 5- The awareness of hospital staff and personnel about waste separation and packaging in a proper way to minimise the negative impact on the environment and public health. Recommendations

Questions

Thank you End Bedankt Salaam