A critical review of "Draft manual for infectious waste management".
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An efficient and cost-effective on-site infectious waste management program can be implemented by integrating the decontamination advantages offered by both steam sterilization and incineration. To do so requires the understanding of the interrelationship between the components that comprise the program. The physical and chemical characteristics of the various infectious waste constituents will dictate the mode by which each constituent will be decontaminated. The treatment mode will in turn dictate the packaging and containment necessary to ensure decontamination. An understanding of the operating principles, and design features of each treatment mode will further enhance treatment efficacy.
Medical waste has, with each passing year, become a subject of greater and greater concern for the general public, legislative bodies, and the healthcare industry. Regulations have been passed and governing organizations created to set the problem right. These actions have cost the healthcare industry (and thus the public) exorbitant amounts of money. But is the panic wrongly focused, and is money being spent on the wrong things? This article discusses these issues and makes some eye-opening revelations about the medical waste crisis.
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The California Air Resources Board (ARB) completed a series of source tests of eight operating biomedical waste incinerators (BMWI) under conditions of typical operation. The emissions of certain metals, and chlorinated dioxins and furans in the flue gases of BMWI are relatively high in comparison to emissions from other combustion sources, such as hazardous waste or municipal waste incinerators of modern design. This study reports on an analysis of the status of the existing regulatory framework and the California data base. Clarification of definitional issues at the federal level is needed to effectively treat BMWI management issues. Although few relationships among combustion parameters and emissions were uncovered, patterns of emissions were evident, suggesting commonality and relationships among the waste stream constituents and emissions. Potential implications for future research, operation of BMWI, controls and source reduction and waste segregation strategies are also discussed.
To allow testing of microbial destruction in medical waste incinerators, methods were developed to determine indicator microorganisms (Bacillus Stearothermophilus spores) in incinerator air emissions and residue. The emission trapping train consisted of a water cooled glass probe and impingers containing a neutral phosphate buffer. In field tests, spores were injected directly into the probe, and results showed that approximately 60 percent of the spores were recovered. Spores were analyzed with adequate precision using a microbial membrane filter unit. Lab experiments indicated that spores were stable in neutral pH phosphate buffer for up to 20 days, and heat shocking samples (heating to 80 degrees C for 20 minutes) reduced spore numbers in acidic or basic buffer. Laboratory tests also showed that 60 to 70 percent of spores initially added to ash were recovered up to 22 days after addition of the spores. In addition, lab tests showed that spores can be effectively recovered from residue test pipes spiked with indicator spores.
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For selecting the most efficient treatment method of hospital waste, the composition analysis is generally considered to be the fundamental information. Currently, there are few studies regarding the characteristics of hospital waste. This study evaluated the physical and elemental composition of the hospital waste at the National Taiwan University Hospital (NTUH). The results should help us design an incinerator for the treatment of infectious waste, plastic syringes, pathological waste, and kitchen waste. During the study period, the estimated daily waste generation rate at NTUH was 4,600 kg/day, which consisted of 4,100 kg/day noninfectious refuse, 340 kg/day infectious waste, 70 kg/day kitchen waste, 50 kg/day pathological waste, and 40 kg/day plastic syringes. The NTUH waste consisted of 99.02% combustible wastes and 0.97% noncombustible wastes by mass. The combustible wastes constituted paper (16.17%), textiles (9.77%), cardboard, wood, and leaves (1.12%), food waste (21.51%), and plastics (50.45%). The noncombustible waste included 0.40% metal and 0.57% glass. Furthermore, the analysis indicated that the wastes contained 38% moisture, 4% ashes, and 58% solid with an average heat value of 3,400 kcal/kg. From the elemental analysis, the dominant elements were found to be carbon (34%) and oxygen (15%).
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