PESHAWAR:
Even with clear rules which state hospital waste must be incinerated within 24 hours of its collection, incinerators at two major hospitals in Khyber-Pakhtunkhwa (K-P) are out of order and the waste is dumped outside the hospitals.

According to data collected by the Environmental Protection Agency (EPA), 15 to 20 tons of hospital waste is generated daily in the provincial capital alone. Almost half of the total waste is recycled while the rest is collected by the Peshawar Development Authority (PDA).

LRH

“To be honest, we have one incinerator which is not in proper working condition and hardly disposes a quarter of the total waste generated,” said an official at Lady Reading Hospital while requesting anonymity. “But we have a new incinerator which will soon be functional.”

The official, who did not know the exact figure of the waste generated, said LRH has been among the well-equipped hospitals across the country. It has over 5,000 people (at least 3,000 in outpatient and 2,000 in accident and emergency departments) from across the province on a daily basis.

“The incinerator under process has some issues as a few of its parts are yet to be obtained,” said the official. “It also needs sufficient gas—another major problem—but we are in contact with Sui Northern Gas Pipeline Limited (SNGPL).”

The LRH official added the supply of gas to the hospital is not enough for sterilisation. He said the hospital administration is in contact with SNGPL authorities and the issue will soon be resolved.

HMC

Hayatabad Medical Complex (HMC) Chief Executive Dr Mumtaz Marwat said the incinerator at HMC is out of order but it does burn some waste. “The leftover is collected by the PDA and the hospital administration has approved Rs0.4million for a new incinerator, which will soon be installed.”

Khyber Teaching Hospital (KTH) Chief Executive Dr Inayat Shah Roghani said the incinerator at KTH was working properly and recycles over 200 kilogrammes of waste per hour.

“Along with the solid waste generated by KTH, we also recycle waste that comes from a few private hospitals in University Town,” said Roghani.

The EPA has already sent a written notice to the health directorate, asking it to properly dispose of medical waste as mentioned under Hospital Waste Management Rules 2005. These say the responsibility of waste management lies solely with the institute that generated it.

What happens next

Even if the incinerators at these hospitals are repaired, the problem of unattended dump is likely to persist. This is mostly because of the small private health centres which lack the basic knowledge and dispose of their waste as ‘municipal waste’. The ever-increasing number of such centres is directly proportional to the waste generated, making it a threat for the environment as at times the waste is just left in a pile or buried to groundwater.

ADJUMANI.
The incinerator at Adjumani Hospital, which was built four years ago, has burst due to overheating.

For the past four months, support staff at the hospital have been dumping medical waste within the enclosure of the incinerator instead of burning it.

The hospital administrator, Mr Michael Ojja, told Daily Monitor on Wednesday that the incinerator broke down due to continuous burning of accumulated waste from the hospital.

“The waste has increased due to the overwhelming number of admissions and people visiting the outpatient department. But we need to find solutions to protect the staff and environment,” Ojja said.

The hospital medical superintendent, Dr Dominic Drametu, said they had asked the government for construction of a new incinerator.

He said the incinerator was too small to dispose of the hospital’s voluminous medical waste.

Patients admitted to the general ward next to the incinerator expressed fear of infections arising from poor disposal of hazardous medical waste.

According to the 2013-2014 annual health sector performance report, Adjumani Hospital registers 11,731 in-patients, 83,953 outpatients and 1,695 deliveries.

Scientific facts
Incineration of heavy metals or materials with high metal content (in particular lead, mercury and cadmium) releases toxic metals to the environment and the burnt medical waste contains micro-organisms that are potentially harmful to human beings, according to WHO.

The combustion, or burning, of solid waste proceeds through a series of stages. Water is first driven from the unburned waste by heat produced from material burning nearby or from an auxiliary burner. As the waste heats up, carbon and other substances are released and converted into burnable gases. This is referred to as gasification. These gases are then able to mix with oxygen. If the temperature inside the burn chamber is high enough and maintained for a long enough period of time, the hot gases are completely converted into water vapour and carbon dioxide, which is then released into the air. If the temperature inside the burn chamber is not high enough and the burn time is too short, complete conversion of the burnable gases does not occur and visible smoke is released into the air.  Another result of burning at low temperatures is the creation of pollutants that were not originally present in the waste. This process is known as de novo synthesis. Dioxins, furans and other complex chemical pollutants can be formed through this process.

Ash produced from combustion takes the form of either fly ash or bottom ash.  Fly ash is the fine particles carried away in the form of smoke while bottom ash is the course non-combustible and unburned material that remains after the burn is complete. The type and amount of pollutants in the fly and bottom ash depend upon what waste is burned and completeness of the combustion process.

The completeness of combustion is determined by all of the following factors:

Temperature

The temperature generated is a function of the heating value of the waste and auxiliary fuel, incinerator or burn unit design, air supply and combustion control.  Complete combustion requires high temperatures. Generally, temperatures that exceed 650oC with a holding time of 1-2 seconds will cause complete combustion of most food and other common household waste.  Segregation of waste is required when using methods that don’t routinely achieve these temperatures. Dual chamber incinerators, which are designed to burn complex mixtures of waste, hazardous waste and biomedical waste, must provide a temperature higher than 1000oC and a holding time of at least one second to ensure complete combustion and minimize dioxin and furan emissions.  When these high temperatures and holding times are achieved, waste will be completely burned and ash, smoke and pollutant concentrations will be minimized.

Because exhaust gas temperatures vary from ambient to greater than 1000°C each time a batch waste incinerator is used, optional air pollution control systems with evaporative cooling towers and scrubbers are seldom recommended. However, it may be necessary to employ these systems with large continuous feed incinerators if additional cleaning of exhaust gas is required by regulatory authorities.

Holding Time

Complete combustion takes time.  Holding time, otherwise known as retention or residence time, is the length of time available to ensure the complete mixing of air and fuel, and thus the complete burning of waste. Low temperatures, low heating values of the waste and reduced turbulence require that the holding time be increased to complete the combustion process.

Turbulence

The turbulent mixing of burnable gases with sufficient oxygen is needed to promote good contact between the burning waste and incoming air. This will help in achieving the high temperatures at which waste can be completely burned. The amount of mixing is influenced by the shape and size of the burn chamber and how the air is injected. Passive under-fire ventilation achieved during open burning does not result in sufficient turbulence for the burning of a wide variety of waste.  Also, it is important not to overfill the burn chamber as airflow may be blocked and the amount of turbulence further reduced.  The more advanced incineration designs provide effective turbulence through the forced introduction of air directly into hot zones.

Composition of the Waste

The heating value, wetness and chemical properties of the waste affect the combustion process and the pollutants that are contained in the resulting smoke and ash. The higher the burn temperature, holding time and turbulence that are achieved, the less effect the composition of the waste has on completeness of the burn.

The burning and incineration method used is a major factor in determining what type of waste can be safely and effectively disposed of. The methods commonly used in Nunavut include open burning on the ground, unmodified burn barrels and various mechanical incineration systems.  Other useful methods include the use of burn boxes and modified burn barrels. Each method is discussed separately in the following sections.

2.1.1    Open Burning

Open burning means the burning of waste where limited or no control of the combustion process can be exercised by the operator. This method includes burning solid waste directly on the open ground or in burn boxes or burn barrels and often does not achieve the temperatures or holding time needed for complete combustion of the waste to occur.  This results in the formation of potentially hazardous pollutants and ash, which are likely to impact nearby land and water. Food waste that is not completely burned through open burning can also be a powerful attractant for animals.

The various open burning methods can also present a risk of uncontrolled vegetation and tundra fires through the release of hot sparks or embers. The level of fire risk depends upon the type of open burning used, its location, the skill of the operator and the environmental conditions that exist at the time (i.e. dryness of the surrounding vegetation, wind).

The open burning of solid waste remains a common practice in Nunavut.  It is the policy of the Department of Environment to eliminate or minimize open burning of mixed solid waste to the extent practicable and to encourage more acceptable methods of disposal and incineration.

Open Burning on the Ground

Open burning on the ground involves burning solid waste that has been piled directly on the surface of the ground or placed in a small open pit. Many large and small communities and camp operators in Nunavut continue to practice open burning on the ground as a
means of reducing the

volume of solid waste that must ultimately be disposed of. In general,

Figure 1 – Open Burning on the Ground
Photo courtesy of Aboriginal Affairs and Northern Development Canada

open burning on the ground results in the incomplete combustion of waste and the release of various
harmful pollutants to the air, can cause vegetation or tundra fires through the uncontrolled release of hot sparks and embers, and is actively discouraged by the Nunavut Department of Environment as a method for disposing of unsegregated or mixed solid waste.

Burn Boxes

There are two basic types of burn boxes. The enclosed burn box is constructed using heavy sheets of steel or other metal while the open burn box is constructed using expanded metal grating. The latter type is commonly referred to as a burn cage. These devices are not commercially-available in Nunavut, but can be constructed using locally available materials. For example, the enclosed metal burn box shown in Figure 2 is made from a dump truck bed and steel plating.

Photo courtesy of Alaska Department of Environmental Conservation

Burn boxes are considered a modification of open burning. Combustion air is provided passively using a natural draft making electricity unnecessary. Burn boxes are single chambered units.  Waste is raised off the bottom of the box by placing it on grates inside the unit. Unburned bottom ash falls through the grate during burning making removal easier once a sufficient amount has accumulated. Combustion air in enclosed burn boxes is typically provided by cutting holes near the bottom of the box allowing for better mixing with the burning waste.

Open burn boxes, or burn cages, are an improvement over enclosed burn boxes as the waste is exposed to natural drafts through the metal grating on all surfaces including the bottom. This enables air to better mix with burning waste and promotes more efficient combustion throughout the burning period.
Both types of burn boxes are
constructed with hinged tops to enable easier loading and cleaning.

Unlike open burning on the ground, burn boxes help to contain the burning waste within a specific location reducing the risk of fire spreading to other disposal areas or surrounding tundra, while still enabling moderate amounts of solid waste to be burned.

Burn Barrels

There are two basic types of burn barrels – the unmodified burn barrel and modified burn barrel.

Figure 3 – Open Metal Burn Box
Photo courtesy of Alaska Department of Environmental Conservation

The unmodified burn barrel is normally a 45 gallon, or 205 litre, metal fuel or oil drum with the top removed. These devices typically operate at a low temperature resulting in incomplete combustion of the waste and production of large volumes of smoke and fly ash.

A modified burn barrel is a 45 gallon metal fuel or oil drum that has been affixed with devices or features which result in higher burn temperatures, better mixing of the air and a longer holding time. These modifications include a ‘metal mesh basket’ insert or grate designed to suspend the burning waste.
Evenly spaced vents or holes cut above the bottom of the barrel supply combustion air. These features provide for enhanced passive under-fire ventilation and promote better contact between the waste being burned and incoming air. The basket insert is topped with a hinged lid and a chimney port for attachment of an exhaust pipe or stack. The lid helps to increase heat retention and holding time inside the barrel while also allowing for easier loading and mixing of the  waste. The removable mesh basket enables access to the unburned bottom ash.

Modified burn barrels can be built using commonly available materials. They can either be pre-built locally or transported to the site for assembly. Detailed construction plans are provided in Appendix 2.

Although modified burn barrels are designed to create an advantage over open burning on the ground, burn boxes and unmodified burn barrels through achieving higher burn temperatures and increased turbulence and holding time, incomplete combustion of waste and the release of  pollutants to the atmosphere are still likely. In fact, emissions testing by Environment Canada on a modified burn barrel in April 2011 suggest that these devices do not provide any improvement over open burning on the ground in terms of

Figure 4 – Modified Burn Barrel

emissions quality, particularly if wet food waste is added to the waste mixture. Other common  problems include easily overfilling the unit and loading waste that should not be burned (refer to section 3.2).  Wet or frozen masses of waste are particularly difficult to burn and the resulting partly burned food waste may still attract animals. The proper operation of modified burn barrels is critical to achieving the most efficient burn possible. Basic operating instructions are provided in section 4.1.

Burn barrels are capable of burning only small volumes of solid waste. Like burn boxes, they reduce the risk of fire spreading to vegetation and tundra by containing the burning waste to a specific location.

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The permit that allows the Radford Army Ammunitions Plant to burn hazardous waste from firearms outdoors is up for renewal. Community activists see an opportunity to address environmental and health concerns about the open burning – and state regulators see a chance to explore new technology to solve an old problem.
Just a handful of people turned at the Blacksburg Public Library on a recent afternoon for a meeting of the Environmental Patriots of the New River Valley.

“Is there anything we could post to get more people involved? Yes, petitions, a letter campaign… When the EPA was pushed to the wall in Louisiana, they said ‘Uncle.’ So, we want you Senator Kaine and you Senator Warner to do just what Senator Vitter did in Louisiana and write to the EPA and ask them, ‘How is this not a violation of the clean air act?'”

Devawn Oberlender is looking to take a pager from the book of a far away town, where citizen protestors succeeded in stopping outdoor burning explosives of arms and weapons waste at the Louisiana Army Ammunition Plant.

“The opportunity that we have right now only comes up very ten years, because the permit is good for ten years, so what we need to replicate is what they did in north western Louisiana at Camp Minden.

There they formed a “Stop the Burn” movement that ultimately brought together elected officials, state and local regulators and the army for a plan to give up open burning and use a modern indoor incinerator to dispose of the toxic materials. Now, with the open burning permit at the Radford Arsenal up for renewal, the Virginia Department of Environmental Quality is exploring that idea for the first time. William Hayden is spokesman for DEQ in Virginia.

“We have not reached any conclusions yet but that is something that would be looked at as we move forward. We have asked the Arsenal to come up with alternatives to open burning and we do expect to have some options that go beyond the idea of just burning it the open.”

Brian Salvatore is a professor of Organic chemistry at Louisiana State University who argued for using contained incineration.

“This is what we fought for here at camp Minden. And yes it added another 15million dollars and almost doubled the cost of the contract but this was something that, the EPA was willing to go to bat for us for. So I’m glad that the people in the EPA and in the state worked together here and they worked with the Army as well to find the additional money. And we’re quite satisfied here that this alternative — which, in the beginning of this we didn’t know all the details of what these modern incinerators can do. We’re quite confident here that this is going to do the job and the amount of material that’s going to be released total will be on the order of tens of grams as opposed to tons of these emissions.”

A spokesman for the Environmental Protection Agency’s Region 3, which includes Virginia, said it could not comment on the possibility of incinerators like that being adopted at the Radford site, but a spokesperson for BAE Systems, the contractor in charge of the arsenal, confirmed it is “looking for viable alternatives to its current methods of waste disposal.”

The department of Environmental Quality has asked BAE to conduct an environmental impact study on its current open burning practice. William Hayden says it’s the first time DEQ has asked for one.

“Because we’re getting in to an issue that has generated a lot of public interest in the Radford area we knew that the more information we had, the better. People from the public have been asking for us information; they’ve been asking Radford (the arsenal) for information.”

And one of them is Oberlender who says, “We’ve been burning waste out there, open burning it since 1941. You know, it’s not going away.”

And neither are the environmental patriots of the new river valley. Taking another page from the story of Camp Minden Louisiana’s successful effort to get its outdoor burning moved indoors. They’re scheduling meetings with state and federal officials to keep the pressure on. The first is this Friday with U.S. Representative Morgan Griffith who sits on the Committee on Energy and Commerce, which has oversight of the EPA. The group is looking to make a national issue out of one that has for so long been so local and one of the few places where open burning of hazardous waste from explosives is still allowed.

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HAI PHONG (VNS) — A seminar to evaluate a medical waste incinerator project built with Japanese technology was held this morning in the northern city of Hai Phong.

The project has been operational since January. The initial test results, collected by the Hai Phong Urban Environment One Member Limited Company, indicated that the incinerator meets all Vietnamese environmental protection standards.

The incinerator has been designed with the latest Japanese technology to process medical waste and harmful industrial waste.

The project is part of the co-operation programme between the Ministry of Natural Resources and Environment and the Japan International Co-operation Agency. — VNS

by: http://en.baomoi.com/Info/Medical-waste-incinerator-completes-trial-phase/6/496772.epi