RISK ASSESSMENT OF HOSPITAL WASTE INCINERATION SUBMITTED BY: MOHIT KUMAR(2013CEV2189) MANGI LAL (2013CEV2187)

Introduction Hospital is a place of almighty, a place to serve the patient. Since beginning, the hospitals are known for the treatment of sick persons but we are unaware about the adverse effects of the garbage and filth generated by them on human body and environment.

WHAT IS A MEDICAL WASTE? Definition of Medical Waste In this course, medical waste includes all infectious waste, hazardous (including low-level radioactive wastes), and any other wastes that are generated from all types of health care institutions, including hospitals, clinics, doctor’s (including dental and veterinary) offices and medical laboratories. Definition of Medical Waste In this course, medical waste includes all infectious waste, hazardous (including low-level radioactive wastes), and any other wastes that are generated from all types of health care institutions, including hospitals, clinics, doctor’s (including dental and veterinary) offices and medical laboratories.

Human anatomical waste Plastic Yellow Table 1. Type of container and colour code for collection of bio-medical waste Category Waste class Type of container Colour 1. Human anatomical waste Plastic Yellow 2. Animal waste -do- 3. Microbiology and Biotechnology waste Yellow/Red 4. Waste sharp Plastic bag puncture Blue/White Translucent proof containers 5. Discarded medicines and Cytotoxic Plastic bags Black Waste 6. Solid (biomedical waste) 7. Solid (plastic) 8. Incineration waste 9. Chemical waste (solid) Source: http://isebindia.com/95_99/99-07-2.html

INCINERATION Newly Regulated Emissions from Medical Waste Incineration: Particulate Matter Carbon Monoxide Dioxin Sulfur Dioxide Hydrogen Chloride Nitrogen Oxides Cadmium Lead Mercury Incineration, complete combustion by exposure of the waste to intense heat, has been used for several years to treat and destroy medical wastes. Stringent, new federal regulations under the Clean Air Act (40 CFR Part 60, Subparts Ec & Ce), however, may result in the decommissioning of these units to avoid the high costs of compliance. The new EPA regulations restrict the following emissions from incinerators: Particulate Matter Carbon Monoxide Dioxin Sulfur Dioxide Hydrogen Chloride Nitrogen Oxides Cadmium Lead Mercury It is believed that 85-90% of all current incinerators will NOT meet the new requirements.

Typical Process Flow Diagram Waste Storage Pre-processing/blending Pollution Control Incineration Flue Gas Ash Stabilization Effluent Landfill POTW

RISKS FROM WASTE INCINERATION Risks to human Risks to the environment, for instance hospital incineration impact upon flora and fauna Risks to aesthetics. Combinations of the previous three.

Table :-2 Case Study of UK ,Hospital incinerator problems Level of risk Very High Moderate Not serious Do not know missing Total General health 29.9% 13.8% 4.2% 22.8 100% Eye irritation 24% 19.2% 18% 7% 31.7% Tension 20.4% 21.6% 5.4% 38.9% Respiratory symptoms 33.5% 24.6% Skin irritation 27.5% 16.2% 3.6%

Table:-3 Hospital incinerator problems (Kirkby) Level of risk Very serious Moderate serious Slight serious Not serious Do not know Missing Data Environmental pollution 71.9 4.2 1.8 18.0 Animals 50.3 4.8 3.6 6.0 30.5 Crops 51.5 6.6 26.9 Children 61.1 9.6 3.0 2.4 20.4 pregnant women 59.9 9.0 7.2 2.4 18.6

Infectious liquid waste   Infectious liquid waste Waste Generators (Hospitals, Nursing home, Clinics) Status Septic tanks Solid Solid waste open drains Collected in open Collection bins without * Overflowing (technical + nontechnical) disinfection drains * No segregation * Poor sanitary * No labeling of bins conditions Sorting (segregation) * No colour coding of bins * Sorting of used disposables without disinfection Recycling (at source) Used plastic and glass Intravenous Bowles infections sets, sharps, syringes and sold to third party Transportation * Manually transported Recycling of * No safety precaution clinical waste by rag picker * Disposal on road or Municipal bins Onsite disposal open pits * No fencing to keep rag pickers away * Health impact Municipal dump yard Open burning Recycling of disposal clinical waste by rag pickers/ unsafe disposal/ unaesthetic conditions/ odour/ nuisance/ ground water pollution *(Source: Saurabh & Ram , 2006)