AUTOCLAVE TECHNOLOGY SELECTION FOR A REGIONAL HEALTHCARE WASTE PROCESSING PLANT IN KWAZULU NATAL...

AUTOCLAVE TECHNOLOGY SELECTION FOR A REGIONAL

HEALTHCARE WASTE PROCESSING PLANT IN

KWAZULU NATAL

Healthcare Waste Management in Africa Today

Ray Lombard

Lombard & Associates

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LOMBARD & ASSOCIATES

Town & Regional Planning Commission Report

EIA & Public Participation Legislative framework General Technical Assessment Bondtech Autoclave

A NEW HEALTH CARE RISK WASTE TREATMENT SYSTEM

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Town & Regional Planning Commission Report

The Town & Regional Planning Commission Report on the Need for Hazardous Waste Disposal Facilities - completed in September 2000

Need for Health Care Risk Waste treatment facilities in KwaZulu Natal formed part of that investigation

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Town & Regional Planning Commission Report Findings – HCR Waste Generation

11 9941 68210 312Total

1 117611 056Empangeni

75918741Newcastle

4 8351 1443 691Durban

347347Jozini

86385778Ulundi

44630416Ladysmith

2 8913202 571Pietermaritzburg

73624712Port Shepstone

TOTAL DAILY GENERATION RATE

STATE-AIDED & PRIVATE FACILITIES

GOVT. FACILITIES

KWAZULU NATAL HEALTH REGION

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Town & Regional Planning Commission Report Findings – HCR Waste Management

The data reported are conservative – no data for veterinary practices and little for private practices

Almost half of the waste is unaccounted for

The waste is either being burned in environmentally unacceptable ovens or illegally dumped

The data reported are conservative – no data for veterinary practices and little for private practices

Almost half of the waste is unaccounted for

The waste is either being burned in environmentally unacceptable ovens or illegally dumped

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EIA process

informs Interested & Affected Parties (I&APs) of proposed development

provides opportunities for I&APs to raise issues, concerns and suggestions

promotes transparency and understanding of the project and its consequences

promotes liaison and communication with I&APs

serves as a data gathering mechanism for the Scoping Study

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Public Participation Process

Facilitated by Icando with Compass Waste Services interacting with I&APs that included:

Depts of Water Affairs & Forestry and Environmental Affairs & Tourism at the national level

Depts of Agriculture & Environmental Affairs and Health in KwaZulu Natal Province

Local government including eThekwini Metro, Pietermaritzburg/ Msunduzi, uThukela, Ugu and Ilembe District Municipalities

Competitors (Sanumed (Pty) Ltd, Waste Services (Pty) Ltd, Clinx)

Client health care institutions (Afrox, Netcare & Provincial hospitals)

Organised labour in health care (Hospersa)

Pharmaceutical Society, NGOs (groundWork, EJNF and WESSA) and interested members of the public

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Legislative Framework

Policy and guidelines

Relevant South African legislation and regulations

International guidelines and codes of practice

Informed by an extensive and comprehensive public participation process involving a wide spectrum of interested and affected parties – including all levels of government, environmental NGOs, user groups, potential competitors and concerned citizens

Policy and guidelines

Relevant South African legislation and regulations

International guidelines and codes of practice

Informed by an extensive and comprehensive public participation process involving a wide spectrum of interested and affected parties – including all levels of government, environmental NGOs, user groups, potential competitors and concerned citizens

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Policy & Regulatory Guidelines

Integrated Pollution and Waste Management

National Waste Management Strategy

Best Practical Environmental Option

Constitution (1996) NEMA (1998) ECA (1989) Health Act (1977) OHSA (1993) A mass of old Statutes Scheduled Trade Permit

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Health Care Risk Waste Treatment

Historically, in the USA incineration was an effective way to deal with HCRW

EPA rulings have greatly increased the cost of incineration

Flue gas scrubbings generate other hazardous wastes apart from dioxins, dibenzofurans and organohalides

Hospitals have begun to close existing incinerators

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General Technical Assessment

WHO Basel Convention SWANA ISWA CIWM in UK Vogel International Health Care without Harm Shristi

Interested & Affected Parties roles

Public Participation Processes

Work Sessions

Decision making Tables designed by stakeholders in the process

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Alternative Technology Selection

Incineration

E-beam

Microwave

Dry heat

Wet Heat

Chemical sterilisation

Autoclaving

Landfill or burial

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Matrix used to eliminate Inappropriate Technology

LANDFILL

CHEMICAL STERILISATION

INCINERATION

ELECTRON BEAM

PLASMA ARC

AUTOCLAVE

MICROWAVE

ECONOMIC IMPLICATIONS

ENVIRONMENTAL & SOCIAL IMPACTS

HEALTH RISKS

PROVEN TECHNOLOGY

INFORMATION AVAILABLE

TECHNOLOGY

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Overall Assessment Matrix

0-10-111LANDFILL

-111-1-1-1TOXIC 400

-4-10-1-1-1MACROburn

-41-2-1-1-1Gencor

-210-1-1-1RD700

-41-2-1-1-1RD500

3TINCINERATOR

3110012500DI

4120011500DI

Rotoclave

1100-11S2000

2110-11S1000

STI ChemclaveAUTOCLAVE

-21-10-1-1HG-A250S

SanitecMICROWAVE

OverallRegulatory Compliance

Economic Implications

Environmental & Social Impact

Occupational Risk

MaintenanceMachineTechnology

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Toxic 400 Dual Chambered Pyrolysis Incinerator

Capacity

Air emissions

Disposal of ash

Growing public pressure

Logistics

Maintenance

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Emission Data

2.642.47Total Metals mg/m3

18210652163120TSP mg/m3

2263413.52825SOx mg/m3

931458.6118NOx mg/m3

0.71.757.326730Cl- mg/m3

120747339CO vpm3

9.59.911.0 -11.51111Oxygen%

4.83.710.0 -14.0 10Stack Exit Velocity m/s

1 139951860779 - 842Stack Temp 0C

Jan 2001March 2000May 1999April 1998GUIDELINEDETERMINAND

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Autoclaves

Objectives:-

To render health care risk waste sterile

To produce unrecognisable sterile waste material

Internationally acceptable specifications

Environmentally acceptable

Cost effective health care risk waste treatment in South Africa

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Autoclaving

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Features of Autoclave Option

Rugged design built for commercial use

Low maintenance Hydraulic door closure Liquid ring vacuum

pump or steam ejector for high vacuum operation

Programmable Logic Control system

Recorders for pressure & temperature

Packaged and modularised for easy installation

Removal of moisture for less weight at time of disposal

Built under ASME Boiler and Pressure Vessel Code, Section VIII, Div1

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How does the autoclave work?

What is the process?

How long does it take for one cycle?

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Cost effective medical waste treatment

75 units operating in USA

Meets US Standards

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Bin Loading

The carts are then rolled on to the lift table. The table lifts the cart up and it is then rolled into the machine

The waste is brought to the machine and loaded into the stainless steel carts

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Bin Loading

Once all of the carts are loaded the door is shut and the hydraulic lock is engaged

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Treatment

After the Autoclave door is closed the following steps are performed by the pre-programmed controller:

Pre-vacuum evacuates air from vessel and expedites steam penetration into infectious waste

Steam is injected and soaks the waste under pressure at temperatures from 141°C to 152°C for 40 minutes

A post vacuum process is used to dry the load and to reduce the associated treatment smell

Pre- and post vacuum air is filtered and all vapour is condensed and discharged to sewer

A green light indicates that the cycle is complete

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Unloading

Bins are unloaded by forklift which empties each cart into a shredder. The autoclave is ready for the next cycle

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Shredder Specifications

Direct Drive

Hex Shaft Design

Automatic Reversing

Low Speed, High Torque

Anti-Jamming Device

Low Noise

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Shredded Waste

After sterilizationAfter sterilization

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GTA factors favouring autoclave option

Lower health impacts on humans and environment than existing incineration methods

Unregulated liquid, solid or gaseous emissions are not produced

Unrecognisable final product a mixture of sterile solid and fibrous matter that is safe to landfill

Treated residue does not require hazardous waste disposal site specification

Kills all human pathogens in health care risk waste

Reduces volume of health care risk waste by 85% when shredded or compacted

Lower health impacts on humans and environment than existing incineration methods

Unregulated liquid, solid or gaseous emissions are not produced

Unrecognisable final product a mixture of sterile solid and fibrous matter that is safe to landfill

Treated residue does not require hazardous waste disposal site specification

Kills all human pathogens in health care risk waste

Reduces volume of health care risk waste by 85% when shredded or compacted

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Recommended mitigation measures

Health care risk waste collection, transportation and associated activities – standard industry controls

Off-loading and associated activities

Processing of streamed HCRW through the autoclave process – as specified controlled by PLC

Validation tests (Bacillus stearothermophilus & B subtilis) as in WHO & Basel Convention Guidelines

Disposal of sterile processed waste material at Class G Landfill (accepted by DWA&F in RSA)

Radioactive and chemically hazardous wastes are proscribed

Health care risk waste collection, transportation and associated activities – standard industry controls

Off-loading and associated activities

Processing of streamed HCRW through the autoclave process – as specified controlled by PLC

Validation tests (Bacillus stearothermophilus & B subtilis) as in WHO & Basel Convention Guidelines

Disposal of sterile processed waste material at Class G Landfill (accepted by DWA&F in RSA)

Radioactive and chemically hazardous wastes are proscribed

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Benefits of autoclave option

No combustion products or ash formed

No dioxins and furans from the combustion of chlorinated aromatics and other chlorine containing materials because operating temperatures do not exceed 160oC (problems at 277oC to 427oC)

No HCl (hydrogen chloride), SOx (sulphur oxides), NOx (nitrogen oxides), CO nor CO2 formed

No combustion products or ash formed

No dioxins and furans from the combustion of chlorinated aromatics and other chlorine containing materials because operating temperatures do not exceed 160oC (problems at 277oC to 427oC)

No HCl (hydrogen chloride), SOx (sulphur oxides), NOx (nitrogen oxides), CO nor CO2 formed

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Other impacts

Air pollutionAir pollution

Noise pollutionNoise pollution

Light pollutionLight pollution

Water pollutionWater pollution

Air pollutionAir pollution

Noise pollutionNoise pollution

Light pollutionLight pollution

Water pollutionWater pollution

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Conclusions

Negative social impacts were related to issues of public health and safety

Effective and transparent communication from the start ensured that representatives from the surrounding industries and residents were well informed

Fears based on misinformation or disinformation eliminated

Based on the information available to the consultants and the outcome of the public participation process, an authorization to implement the project was granted by the authorities

Negative social impacts were related to issues of public health and safety

Effective and transparent communication from the start ensured that representatives from the surrounding industries and residents were well informed

Fears based on misinformation or disinformation eliminated

Based on the information available to the consultants and the outcome of the public participation process, an authorization to implement the project was granted by the authorities

AUTOCLAVE TECHNOLOGY SELECTION FOR A REGIONAL HEALTHCARE WASTE PROCESSING PLANT IN KWAZULU NATAL...

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