Model	CA50
Feed Capacity	Average 60 kgs per feed
Burning Rate	Average 70 kgs per hour
Burning Time per Feed	1 hour
Voltage	220V
Power	0.7Kw
Fuel	Diesel oil
Burner	Italy Burner
Feed Mode	Manual
Fuel consumption (Oil)	Average 18 Kgs/Hour
Internal Dimensions	100x80x70cm (Primary Chamber)
External Dimensions	230 x 130 x 155cm (main body)
Waste combustion chamber	560Liters
Post Combustion Chamber	280Liters
Oil Tank Capacity	100 Liters
Door Opening	70 x 50cm
Chimney	5.0M
Gross Weight	4500kgs
Chamber Material	Firebrick ,Refractory Concrete
Max. Heat Value	240,000Kcal/Hr.
Operation Technical Specifications
Solid Chamber temperature	8000C -10000C
Gas Chamber temperature	10000C -12000C
Chamber Anti-Rate	14500C
Residency time	2.0 Sec.
Burning efficiency	＞98%
Waste Lower Calorific Power	3000Kcal

HAI PHONG (VNS)— A medical waste incinerator in Hai Phong built by the Ministry of Natural Resources and Environment (MONRE) and the Japan International Co-operation Agency in Viet Nam (JICA) completed its trial phase on Thursday.
Constructed in January, the US$600,000 incinerator has been operational since March with initial test results collected by the Hai Phong Urban Environment One Member Limited Company (URENCO) indicating that the incinerator satisfied most of the requirements set out in the 2012 Viet Nam Environmental Standards by MONRE.

“The incinerator is going to be of great assistance to the city’s effort to manage and process medical waste,” said Le Ngoc Tru, director of URENCO.

The Hai Phong Department of Health estimated the city’s hospitals created around 7,500 kg of medical waste per day, of which 800kg was solid toxic waste.

The city’s old incinerator built in 2002 is now outdated and not designed to process such a large amount of medical waste.

Tru said the incinerator built with the latest Japanese technology offered more than three times the capacity at 200kg per hour for 50 per cent less fuel consumption compared to the old incinerator.

It is also safer for workers to operate due to its automatic waste handling system that allows workers to process waste from a safe distance.

However, test results from water used for the incinerator did not meet Vietnamese standards and needed to be collected and processed separately in the nearby Trang Cat industrial waste treatment compound.

Air and water from neighbouring areas were also tested and came back with satisfactory results.

Kimura Mitsumasa, director of the Industrial Waste Association from Fukushima, said medical waste had to be labelled and transported using specific vehicles and trained workers.

Phung Chi Sy from VITTEP, a HCM City-based environment institute, said workers should be trained and able to categorise medical waste to maximise the incinerator’s efficiency by creating optimal mixtures of waste for the burning process.

Masuda Chikahio, senior representative of JICA Viet Nam, said the project, funded with Japanese Official Development Assistance, was part of a larger programme to encourage small-to-medium-size Japanese companies to transfer technology to Viet Nam.

At a seminar to evaluate the project’s trial phase on Thursday, representatives from other provinces’ health and environment sectors showed interest in the application of the incinerator. — VNS

by: http://vietnamnews.vn/environment/261890/hai-phong-trials-waste-incinerator.html

Incinerators differ from the simpler methods of open burning as the operator has a higher degree of control over the burning process. The resulting higher temperatures, longer holding times and greater turbulence lead to more complete combustion of the waste. Although a wider range of wastes can be destroyed using high temperature single or dual-chambered incinerators, determined efforts should still be taken to reduce the quantity and type of waste generated and to implement other changes which would result in reductions in air emissions. Refer to section 3 for further information proper waste management practices and a listing of what waste can and cannot be incinerated.

The incinerator manufacturer’s operating instructions must be followed at all times to ensure designed temperature, holding time and turbulence conditions are achieved and to avoid damage to the facility. When operating during winter months, additional care must be taken because cold air introduced into the primary and secondary chambers may make it difficult for normal operating temperatures to be achieved. Operators must be properly trained and qualified to operate the equipment under both normal and emergency conditions. Owners are strongly encouraged to consult system manufacturers or other qualified persons with expertise before purchasing an incinerator. Additional guidance on the selection of incinerator technologies and their operational requirements can be obtained by referring to Environment Canada’s Technical Document for Batch Waste Incineration.

The installation and operation of monitoring and control systems is critical for the proper and safe operation of any incinerator.  The design, installation, certification and operation of continuous emissions monitoring systems (CEMS) should comply with the principles described in Environment Canada’s Protocols and Performance Specifications for Continuous Monitoring of Gaseous Emissions  from Thermal Power Generation. While the document is written for power generation facilities, the principles apply equally well to other types of facilities and continuous emissions monitoring systems. For incinerators operating in Nunavut, key operational parameters must be monitored at all times using on-line instruments capable of continuously measuring the combustion process and stack emissions quality. These instruments should be equipped with visible and audible alarms and be on-line whenever the incinerator is in operation, including ‘start-up’ and ‘cool down’ phases. Table 3 lists the monitoring and control system requirements.

Heathrow Airport has announced plans to move an incinerator away from Stanwell and create a 15 mile ‘green ring’ around the town.

The airport said it altered its plans after residents raised concerns over its plans to relocate its incinerator to the Bedfont Road area.

A Labour county councillor however has said it is like moving pieces around a chess board.

Stanwell and Stanwell Moor councillor Robert Evans said: “I welcome very much the changes and that is due to the pressure put on BAA by me and the Labour party.

“But local resident Andrew McLuskey has done all the hard work.

“But in saying that, we are still battling away to stop expansion happening at Heathrow at all.

“There are still serious reservations and I don’t believe an expansion of the airport is right for the area or the whole country.

“We are talking semantics here – it’s a big expansion in a very cramped area. It’s like moving pieces around a chess board – whatever we don’t like around Stanwell will be just as massive somewhere else.”

Changes to the plans include introducing a 15 mile ‘green corridor’ which will increase the amount of recreational space between the town and a new car park south to the airport – which has also been reduced in size.

A new park and an all-weather sports pitch is being mooted for the area, as well as the potential building of ‘balancing ponds’ to help control the release of floodwater.

Roberto Tambini, chief executive of Spelthorne Borough Council, said: “We are delighted that Heathrow has listened to and acted upon our feedback in creating its updated expansion plans and that the residents of Spelthorne have been offered an improved deal as a result.

“I am sure that we can work together and that Heathrow will continue to listen to Spelthorne residents and demonstrate a flexible approach to future proposals.”

Some of the £16 billion of private money being invested will also be used to support the Environment Agency in developing flood prevention schemes to protect homes and property in the surrounding areas.

The airport has also announced plans to fund a new bypass to replace the existing A3044 at Colnbrook and Poyle to ease congestion issues.

John Holland-Kaye, chief executive of Heathrow said: “The expansion of Heathrow can bring significant benefits for local people as well as the UK economy.

“As well as bringing 50,000 new jobs and 10,000 apprenticeships, we can also improve the environmental landscape around the airport and mitigate some of today’s problems including road congestion and flooding. We continue to improve our plans based on the feedback we receive.”

The Airports Commission is currently assessing the case for expansion of either Heathrow or Gatwick.

Specifications of ovens:

• Installing a readymade concrete base (Precast) with Height 30 cm above the ground and 20 cm below the surface of the earth.
• The dimensions of the base are increased by (2 meters) from the edge of incinerators
• The rest of the accessories in all the trends even allows the worker directly feeding and maintenance work, cleaning and move easily taking into account the tendencies of the base toward the door for drainage of water.
• The floor coating must be high-quality epoxy paint.
• Install anti-rust and heat Umbrella of brick and steel (pyramid shape) of (5) meters height above the ground which installed with the edge of the concrete base by thick galvanized columns
• This umbrella Cover the site furnace and allow bringing the chimney
• The site is surrounded by an iron fence (sheet metal) 3 meters height from the surface of the earth in order to protect the incinerators from dust storms
• The iron fence must have a 5 meters Width gate
• Automatic anti-rust and heat electrical circuit must be provided
• The furnaces are highly efficient, emissions-free, safe, and environmentally friendly and have capacity of not less than 3,000 kg of materials and the rate of burning at least 400 kg / h
• The method of feeding the furnace through a side slot or from the top and the emission of the smoke is completely prevented.
• a furnace Must have two rooms, one of them is the main room of not less than the “5” stoves to the process of burning materials and other secondary room of not less “2” stoves to burn resulting gas from the first process as well as the chimney
• The main component of the body of the furnace is stainless steel box, the thickness of not less than 7 mm with a layer of zinc phosphate plated with aluminium reflector to heat
• the thickness of the door of 150 mm and a hardness of not less than 170 kg / m 3 to be burnt, automatic comprehensive remote system.
• Furnaces must be destructive enough to burn and incinerate the material which mentioned previously
• furnaces must have certificates are supported global enterprises and government competent for environmental protection In the country of origin or the General Presidency of Meteorology and Environment Protection in Saudi Arabia
• The oven can work for 24 hours so as to allow for the burning of materials for a period of not less than 12 consecutive hours and the remainder for cooling and provides full fuel tank with a capacity of 1000 L to turn on the oven.
• Must have an automatic ignition and diesel is used
• a furnace has the ability to withstand extreme temperatures up to “130o c And also, it guarantees continuous operation of which can be utilized for 24 hours with the ability to remove residues during the work of the oven, Insulating layer of calcium must be present in the rooms with Thickness not less than 50 mm and a wall thickness of 100 mm
• Isolation of burning room: the space between the walls must be of the “stainless steel”. In addition, burn room must fill with Thermal insulation material.
• Ensure that the combustion of materials emitted in the secondary room should be at least two seconds period and the room is lined with high-density ceramic fibbers
• Incinerators must contain a system for processing (purification) gasses before emission of the smoke.
• Incinerators must have the capacity of self-cooling after the end of the daily operating period.
• Incinerators must have chimney not less than “4 meters” height from the surface of the oven, also, it must be thermally insulated and non-rust able, and must also be removable, installation and tide default.
• Electrical capacity required “220/ 380-volt “60 hertz
• Incinerators must be fitted with a control panel of the electronic keys to monitor all the necessary indicators of activation keys, as well as start-up and switch off so as to be isolated inside a metal box with the presence of the following:

Alarm Sensor in the event of (crashes “burner” or purification device or heat leakage       or internal connections and wiring)

Monitors for the temperature of the rooms

Aerosols Filter indicators/ monitors

Room temperature sensors

Indicators for furnaces and index overload

Timer for Extinguish the oven automatically depending on the time required.

• All equipment must be highly resistant to external conditions such as high temperature (50oc)
• All doors must have special lock are not allowed non-persons appointed to work.
• Providing fire extinguisher for each site with a capacity of 10 kg at least

 

Sales and marketing manager Paul Niklas said they had more than a hundred orders from global organisations and aid agencies, including the United Nations and the Red Cross.

He also said most of their workforce was dedicated to manufacturing the incinerators.
The larger ones can burn up to 1,000kg of waste an hour, smaller ones up to 400kg per hour.

Mr Niklas said: “We feel very proud of the fact that they have come to us and that we have a product that is part of the solution.

“Because this has to be contained at the source.

“As soon as you start trying to move waste, it can spread further and further.

“Our incinerators burn at 850 degrees Celsius which burns the toxins, then in the second chamber they burn the gases from that at 1,200 degrees so what is coming out of the chimney is clean.

“And our incinerators are mobile, too, so they can be taken to the source.”
Calls for the incinerators started a few months back when the Ebola crisis was just emerging. Since then they have manufactured and sold more than 120 incinerators to be shipped out to West Africa.

“Their engineers usually go out to help with installation but because of the Ebola threat, engineers employed by aid agencies and organisations are being sent to be trained up at the plant in Canning Road Industrial Estate instead.

Mr Niklas added: “They first contacted us when the outbreak began a couple of months ago. But we are geared up for these things, anyway. The last time demand was like this was the Iraq War. We’ve set up a separate plant so when it does happen we can manage it.”

British Army medics were sent to Sierra Leone yesterday as global leaders promised to step up the international community’s efforts to halt the spread of the disease which has so far taken more than 4,000 lives.

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.

 

2. 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.

 

2. 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.

 

2. 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.

 

 

2. 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