Faculty of Medicine Introduction to Community Medicine ... · 1.1 The maximum allowable limit for...
Transcript of Faculty of Medicine Introduction to Community Medicine ... · 1.1 The maximum allowable limit for...
Faculty of Medicine Introduction to Community Medicine Course
(31505201)
Unit 3 Public Health/Environmental Health
Introduction to Water pollution Food Safety
Waste and Health
By
Hatim Jaber MD MPH JBCM PhD
23-10-2017
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Every day in 2016, 15 000 children died before
their fifth birthday, 46% of them – or 7 000 babies – died in the first 28 days of life,
according to a new UN report.
Introduction to Unit 3 Public Health and Environment
4 lectures 1. Introduction to Public Health and Environment-- 16-10-
2017 2. Environment 1- Air pollution—18-10-2017
3. Environment : introduction to Water Quality and water borne diseases Food Safety and food borne diseases Waste and health- Management 23-10-2017 4. Occupational Health -25-10-2017
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Presentation outline
Time
Water Quality, Quantity and Health Water pollution and Sources Water and contaminations
08:15 to 08:25
Water related diseases 08:25 to 08:40
Food Safety and health Food borne Diseases and HACCP
08:40 to 09:00
Waste definition and classification Waste and Health . Solid Waste Management
09:00 to 09:15
Waste Occupational Health Hazards Healthcare/Hospital Waste
09:15 to 09:30
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Water Quality and Health
• The quality of drinking-water is a powerful environmental determinant of health
• Water is essential for life, but it can and does transmit disease in countries in all continents – from the poorest to the wealthiest.
• The most predominant waterborne disease, diarrhoea, has an estimated annual incidence of 4.6 billion episodes and causes 2.2 million deaths every year
• Millions of people are exposed to unsafe levels of chemical contaminants in their drinking-water
• In 2015, 71% of the global population (5.2 billion people) used a safely managed drinking-water service – that is, one located on premises, available when needed, and free from contamination.
• 844 million people lack even a basic drinking-water service, including 159 million people who are dependent on surface water.
• Globally, at least 2 billion people use a drinking water source contaminated with faeces.
• Contaminated drinking water is estimated to cause 502 000 diarrhoeal deaths each year.
• In low- and middle-income countries, 38% of health care facilities lack an improved water source, 19% do not have improved sanitation, and 35% lack water and soap for handwashing.
How much water does an individual use?
In Jordan
Water supply per Capita (2000-2013)
General information of water sources Sources Quality Quantity Accessibility Reliability Cost
Groundwater
Good quality for deep
aquifers; poor to fair
for shallow aquifers
Good with little
variation
Depends on the
best location of
well; pumping
required unless
artesian well
Good,
maintenance on
pump required
regularly, must
not over pump the
aquifer
Moderate if need
to pump
Springs and
Seeps
Good quality;
disinfection
recommended after
installation of spring
protection.
Good with little
variation for
artesian flow
springs; variable
with seasonal
fluctuations likely
for gravity flow
springs.
Storage necessary
for community
water supply;
gravity flow
delivery for easy
community
access.
Good for artesian
flow and gravity
overflow; fair for
gravity
depression; little
maintenance
needed after
installation.
Fairly low cost;
with piped system
costs will rise.
Ponds and
Lakes
Fair to good in large
ponds and lakes; poor
to fair in smaller
water bodies;
treatment generally
necessary.
Good available
quantity; decrease
during dry season.
Very accessible
using intakes;
pumping required
for delivery
system; storage
required.
Fair to good; need
for a good
program of
operation and
maintenance for
pumping and
treatment
systems.
Moderate to high
because of need to
pump and treat
water.
Information of water sources
Streams and
Rivers
Good for mountain
streams; poor for
streams in lowland
regions; treatment
necessary.
Moderate: seasonal
variation likely;
some rivers and
streams will dry up
in dry season.
Generally good;
need intake for
both gravity flow
and piped
delivery.
Maintenance
required for both
type systems;
much higher for
pumped system;
riverside well is a
good reliable
source.
Moderate to high
depending on
method;
treatment and
pumping
expensive.
Rain
Catchments
Fair to poor;
disinfection
necessary
Moderate and
variable; supplies
unavailable during
dry season; storage
necessary.
Good; cisterns
located in yards
of users; fair for
ground
catchments.
Must be rain;
some
maintenance
required.
Low-moderate
for roof
catchments; high
for ground
catchments
Sources Quality Quantity Accessibility Reliability Cost
What’s the Quality of Our Drinking Water? Drinking water is defined as potable water used for domestic purposes, food, industries, and ice manufacturing.
Community asks for information:
Sodium Hardness Mineral content (TDS)
pH
Chlorine
Coliform Bacteria
Contamination
Standard conditions 1 Microbial Parameters 1.1 The maximum allowable limit for the TCC (MPN/100ml)
should be < 1.1 as a result of the Multiple Tube Test and 0 as result of the Membrane Filtration Test
.1.2 The sample should be free from a) Thermo tolerant coli form bacteria, and b) Enteric viruses and germs 2 Biological Parameters: Drinking water should be free from a) Any
pathogenic protozoa b) Any pathogenic nematode eggs c) Any free living pathogens,
and d) Fungus .3 Physical Characteristics The physical characteristics of water should
be as follows: a) Taste: Acceptable for the majority of people b) Odor: Acceptable
for the majority of people c) Color: The maximum allowable limit is 10 units –15 units d) Turbidity: The maximum allowable limits is 1 – 5 NTU
.4 Chemical Characteristics Where chlorine is used to disinfect the drinking water, the maximum allowable limit
for free chlorine supplied to the consumer is 0.2-1mg/l after 15 minutes from disinfection and 15 minutes before arriving to the consumer.
Parameters Related to Water Taste read as indicated in the following table. Note that the lower range level is obligatory for private wells.
Primary drinking water standards criteria
• Microorganisms - Giardia lamblia; Virus; Legionella;Turbidity
• Disinfection Byproducts- bromate, chlorite, trihomethanes; haloacetic acids
• Disinfectants- chloramines, chlorine and chlorine dioxides
• Inorganic Chemicals – Arsenic, barium, fluoride, copper, lead,
• Organic Chemicals – Benzine; Carbon tetrachloride; Dichloromethane
• Radionuclides – Uranium; Alpha particles; Beta particles and photon emitters
Secondary - Drinking water standards
Contaminant Secondary Standard
Aluminum 0.05 to 0.2 mg/L
Chloride 250 mg/L
Color 15 (color units)
Copper 1.0 mg/L
Corrosivity noncorrosive
Fluoride 2.0 mg/L
Foaming Agents 0.5 mg/L
Iron 0.3 mg/L
Manganese 0.05 mg/L
Odor 3 threshold odor number
pH 6.5-8.5
Silver 0.10 mg/L
Sulfate 250 mg/L
Total Dissolved Solids 500 mg/L
Zinc 5 mg/L
Community actions to improve WQ
Source of pollution What the communities can do
Agricultural: from
both agriculture
practices and
livestock rearing.
o Managing pastures to maintain vegetative cover and
stable soils
o Employing conservation farming technique
o Minimizing stock access to streams and damage to
stream banks
Storm water:
Generated by
rainfall storms
o Actively controlling erosion problems Constructing
farm dams to encourage water plant growth so that
they act as filters for run-off
Sewer o Maintaining and operating on-site household
wastewater systems (septic tanks and aerated
wastewater treatment units) to prevent nutrients
getting into streams or groundwater
Industrial o regulating industrial activities, as well as controlling
diffuse sources, to prevent water pollution
o Protecting local wetlands for their role in filtering
sediment and nutrients and providing a diversity of
wildlife habitat
o Reusing effluent where possible
Methods for purification
• Simplest is boiling
• Filtration
• Chlorination
• Ozone
• UV treatment
• Water guard (Sodium hypo chlorite)
• Distillation
Filters
• Sand filters for large communities
• Gravity filters for small communities
• Domestic household filters
• Filter cartridges ( for many types of ions)
• Activated carbon or charcoal filters
• Fluoride filters – CDN as a leader
• Reverse osmosis – More advanced
The working principles of some specific filters
1. Ozone filters – Through oxidation process, all organic, inorganic and biological substances are destroyed
2. Steam distillation – Natural methods which is able to remove Biological Entities, Heavy Metals, Organic Chemicals, Inorganic Chemicals & Radioactive Material
3. Carbon filters (Charcoal) – A good media for a wide range of contaminant like chlorine, pesticides, herbicides and inorganic materials
4. Far Infrared Light (FIR) - Very suitable for toxin removal
5. Ultraviolet Light – Very cheap to use – Deactivates the DNA of bacteria, virus and other pathogens
6. The ceramic water filters – Very cheap and affordable- removes dirt, microbes, virus and bacteria
7. CDN Fluoride filters- Single and combined
“These two filters are cheap and wananchi friendly”
Sand filters
UV filters
Ceramic water filters
CDN Single and combined Fluoride filters
Water pollution and Water related diseases
Pollutants Found in Runoff Sediment
Soil particles transported from their source
Biochemical Oxygen Demand (BOD) ● Oxygen depleting material Leaves Organic material
Toxics ● Pesticides Herbicides Fungicides Insecticides
● Metals (naturally occurring in soil, automotive emissions/ tires) Lead Zinc Mercury
● Petroleum Hydrocarbons (automotive exhaust and fuel/oil)
Debris Litter and illegal dumping
Nutrients ● Various types of materials that become dissolved and suspended in water (commonly found in fertilizer and plant material): Nitrogen (N)
Phosphorus (P)
Bacteria/ Pathogens
Originating from:
● Pets
● Waterfowl
● Failing septic systems
Thermal Stress Heated runoff, removal of streamside vegetation
Major Water Pollutants and Their Sources
Common Diseases Transmitted to Humans through Contaminated Drinking Water
What Can You Do? Water Pollution, Ways to Help Reduce Water Pollution
Diseases Related to Water
Water-borne
Diseases
Water-washed Diseases
Water-based Diseases
Water-related Diseases
Water-borne Diseases
Diseases caused by ingestion of water contaminated by human or animal excrement, which contain pathogenic microorganisms
Include cholera, typhoid, amoebic and bacillary dysentery and other diarrheal diseases
In addition, water-borne disease can be caused by the pollution of water with chemicals that have an adverse
effect on health
• Arsenic
• Flouride
• Nitrates from fertilizers
• Carcinogenic pesticides (DDT)
• Lead (from pipes)
• Heavy Metals
Water-washed Diseases
Diseases caused by poor personal hygiene and skin and eye contact with
contaminated water
These include scabies, trachoma, typhus, and other flea, lice and tick-borne diseases.
Water-based Diseases
Diseases caused by parasites found in intermediate organisms living in
contaminated water
Includes Schistosomiasis
and Dracunculiasis
Water-related Diseases
Water-related diseases are caused by insect vectors, especially mosquitoes, that breed
or feed near contaminated water.
They are not typically associated with lack of access to clean drinking water or sanitation services
Include dengue, filariasis, malaria, onchocerciasis, trypanosomiasis and
yellow fever
Other Water-borne diseases
• Bathing
• Swimming
• Other recreational activities that have water contact
• Agriculture
• Aquaculture
The Problem • ~80% of infectious diseases
• > 5 million people die each year
• > 2 million die from water-related diarrhea alone
• Most of those dying are small children
Other Consequences
• Lost work days
• Missed educational opportunities
• Official and unofficial healthcare costs
• Draining of family resources
Food Safety and health
Food security and safety
• Food security: availability of the right quality and quantity of food to supply the recommended daily nutrients to maintain good health and prevent malnutrition.
• Food safety: reflection of food sanitation and is related to safeguarding from the immediate or late health hazards resulting from biological, chemical , or physical contamination of food ( production, transport, distribution, processing, and subsequent use are properly handled )
What is Food Safety?
Food Safety is making a food safe to eat and free of disease causing agents such as:
• Too many infectious agents
• Toxic chemicals
• Foreign objects
What is Food Quality?
Food Quality is making a food desirable to eat with regards to good taste, color, and texture; bad food quality can be judged by:
• Bad color
• Wrong texture
• Smells bad
• Temperature
• Adulteration, contamination of food is major cause of ill health.
• The GIT is the usually portal of entry for many infectious and parasitic organisms.
• Food stuff readily become contaminated through human, insects and other intermediaries.
• Control of the cleanliness and composition of food is clearly important but it is more complex and difficult than ensuring a safe water supply
Food preservation:
Dehydration ( Drying ) Osmotic inhibition Heating to kill micro organisms Oxidation (eg. Use of sulphur dioxide ) Toxic inhibition (eg. smoking ). Low temperature inactivation (freezing ) Vacuum -packing
What are the Types of Food Hazards?
• Biological: bacteria, viruses, parasites
• Chemical: heavy metals, natural toxins, sanitizers, pesticides, antibiotics
• Physical: bone, rocks, metal
Biological Hazards in Food
Biological = Living Organisms
In Meat and Poultry:
• Salmonella bacteria (poultry and eggs)
• Trichinella spiralis parasite (pork)
On Fruits and Vegetables:
• E. coli bacteria (apple juice)
• Cyclospora parasite (raspberries)
• Hepatitis A virus (strawberries)
Chemical Hazards in Food
Chemical hazard: a toxic substance that is produced naturally added intentionally or un-intentionally
• Naturally-occurring:
– Natural toxins (aflatoxins, marine toxins)
• Added intentionally:
– Antibiotics, preservatives
• Added non-intentionally:
– Cleaning agents, Pesticide Residues
Physical Hazards in Food
Physical hazard: a hard foreign object that can cause illness or injury
• Inherent to the food or ingredient
– Bone fragment, feathers
• Contaminant during processing
– Stones, rocks, dirt, fingernails
Food borne Diseases
What are the foodborne illness risk factors
Food from unsafe source
Inadequate cooking
Improper holding temperature
Contaminated equipment
Poor personal hygiene
Microbiological pathogens
Food poisoning
Infective food poisoning Toxic food poisoning
Some bacteria produce toxins ,these toxins cannot be removed or inactivated by cooking. Examples Staphylococcus aureus, Clostridium perfringens
Occurs as a result of eating food contaminated with bacteria itself Examples; Salmonella, Listeria and Escherichia coli.
What is a Foodborne Illness?
Foodborne illnesses are caused by agents that enter the body through the ingestion of food.
• Every person is at risk of foodborne illness.
• May be serious for very young, very old, people with long term illness
• Reaction may occur in a few hours or up to several days after exposure
Symptoms
• Abdominal cramps, headache, vomiting, diarrhea (may be bloody), fever, death
What is the Impact of Foodborne Illness?
• The global incidence of foodborne disease is difficult to estimate • Up to 30% of the population annually
• Diarrhoeal disease is the second leading cause of death in children under five years old. It is both preventable and treatable.
• Each year diarrhoea kills around 525 000 children under five. • A significant proportion of diarrhoeal disease can be prevented
through safe drinking-water and adequate sanitation and hygiene.
• Globally, there are nearly 1.7 billion cases of childhood diarrhoeal disease every year.
• Diarrhoea is a leading cause of malnutrition in children under five years old – Food & Water Contamination – Malnutrition & Death in Infants & Children
Hazard Analysis Critical Control Point
Hazard
Analysis
and Critical
Control
Point (HACCP)
The HACCP It is the system that is required for any food
business or organisation in most countries.
The joint FAO / WHO Codex Alimentarius Commission recommends the HACCP approach to enhance Food Safety in all process of food production.
The goal of HACCP is to prevent and/or minimize risks associated with biological, chemical, and physical hazards to acceptable levels
What are the Steps involved in HACCP?
1. Identify hazards
2. Determine Critical Control Points (CCPs)
3. Determine safety limits for CCPs
4. Monitor CCPs
5. Corrective action
6. Record data
7. Verify that the system is working
Waste and
Health
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Waste Definition : Waste material are unwanted substance because the good part of them has been use or removed WASTE is the by- product
of human activities.
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TYPES OF WASTES
1. Human body wastes: urine and
feces
2. Excess materials and foods: trash
and garbage
3. Vegetation wastes: grass clippings
and tree branches
4. Construction and manufacturing
wastes (including excess heat and
noise).
5. Transportation wastes: carbon monoxide, nitrous oxides, hydrocarbons,
other gaseous pollutants and used motor oil
6. Energy production wastes: mining
wastes, electrical power (combustion
of coal), nuclear power (radioactive) wastes
and weapons production (radioactive) wastes
Types of waste
• Non Hazardous waste: refuse, garbage, sludge, municipal trash.
• Hazardous waste: solvents acid, heavy metals, pesticides, and chemical sludge
• Radioactive: high and low-level radioactive waste
• Mixed waste: Radioactive organic liquids, radio active heavy metals. ” ( Moeller, 2005).
Forms of waste
• Solid= refuse
• Liquid= sewage
• Gaseous
• Radioactive
• Hazardous
• Nonhazardous
Characteristics of wastes
• Corrosive: these are wastes that include acids or bases that are capable of corroding mental containers, e.g. tanks
• Ignitability: this is waste that can create fires under certain condition, e.g. waste oils and solvents
• Reactive: these are unstable in nature, they cause explosions, toxic fumes when heated.
• Toxicity: waste which are harmful or fatal when ingested or absorb.
Waste components
Jordan
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Other Definitions The following definitions are intended to serve as a guide and are not meant to be
arbitrary or precise in scientific sense 1. Food waste( garbage): - Food waste are the animal, fruit or vegetable
residues resulting from handling, preparation, cooking and eating of food.
Often ,decomposition lead to development of offensive odors. 2. Rubbish: - it consist of combustible and non combustible solid waste of
residential and commercial activities, excluding food waste. 3. Ashes and residues: - Materials remaining from the burning of wood, coal, coke
and other combustible waste.
4. Demolition and construction waste: - Demolition waste are waste from razed building and other structures.
5. Special Waste Are street sweepings, litter from municipal containers, dead animals and abandoned vehicles.
• 6.Treatment plant waste: Include solid and semisolid from water, waste water and waste treatment plant or facilities.
7. Agriculture Waste:- Results from diverse agricultural activities such as planting and harvesting of field crops, tree, the production of milk, production of animals for slaughter, animal excreta.
8. Hazardous waste: These are chemical, biological, flammable, explosive or radioactive waste which pose a substantial danger (immediately or over time) to human, animal or plant life . Usually occurs as liquid, but some times as gases or solid.
9. Green house effect: fluochlorocorbens destroy ozone layer which protect the earth from ultraviolet rays.
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Relation of waste with environment
The relationship between environment and improper storage, collection and disposal of waste is quite clear.
Public health authorities have shown that rats, flies, and other disease vector bread in open dumps and as well as in poorly constructed or poorly maintained housings, in food storage facilities.
The US Public health services (USPHs) has publish the result of a study tracing the relation 22 human diseases to improper solid waste management.
Data are also available to show that the illness/accident rate in sanitation workers is several time higher than industrial employees.
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-water such as impact, Ecological
also have been , and air pollutionattributed to improper management of
solid waste. -For example liquid from dumps and poorly engineered
landfills have contaminated surface and ground
water.
- In mining are the liquids leached from waste dumps
may contain toxic element or may contaminate
water supply with unwanted salts of calcium and
magnesium.
What is solid waste
• Solid waste is defined as any garbage, refuse, sludge from waste treatment plant, water supply treatment plant, or air pollution
control facility and other materials, including solid, liquid, semisolid, contained gaseous resulting from industrials, commercials, mining and agricultural operations from community activities ( Moeller, 2005).
Causal of increase in solid waste
• Population growth
• Increase in industrials manufacturing
• Urbanization
• Modernization
Modernization, technological advancement and increase in global population created rising in demand for food and other essentials.
This has resulted to rise in the amount of waste being generated daily by each household.
Impacts of solid waste on health
Chemical poisoning through chemical inhalation
Uncollected waste can
obstruct the storm water runoff resulting in flood
Low birth weight
Cancer
Congenital malformations
Neurological disease
Impacts of solid waste on health
• Nausea and vomiting
• Increase in hospitalization of diabetic residents living near hazard waste sites.
• Mercury toxicity from eating fish with high levels of mercury.
Impacts of solid waste on Environment.
• Waste breaks down in landfills to form methane, a potent greenhouse gas
• Change in climate and destruction of ozone layer due to waste biodegradable
• Littering, due to waste pollutions, illegal dumping, Leaching: is a process by which solid
waste enter soil and ground water and contaminating them.
• U.S. Environment Protection Agency (2009)
Disposal is the final disposition of solid wastes
in such a way as to prevent them from harming the environment or human health.
i. Sanitary landfills are sites or locations judged suitable for the in-ground disposal of solid wastes.
ii. Incineration is the burning or combustion of solid wastes.
iii. Recycling (resource recovery) is the collection and reprocessing of a solid waste "resource" so it can be reused.
iv. Source reduction is the reduction in, or elimination of use of materials that could become solid waste.
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Solid waste Disposal Methods
There is many methods of solid waste disposal the choice dependent upon cost and availability of land and labor
1. Dumping: - dumping in low lying area
2. Controlled tipping: - it differ from ordinary dumping that it is covered with earth at the end of the day.
3. Incineration: - Best for Hospital refuse by burning or where the place is not available.
4. Composting: - refuses and night soil or sludge together its end product is compost (samad) which contain nitrogen
5. Manure pits: - In villages where there is no system of waste collection a hole can be dig and waste in dump in it and everyday it is covered with earth when one is full other hole is dug.
6. Burial : - Suitable for small camps
II- HAZARDOUS WASTES
are those that are dangerous to human
health or to the environment.
Hazardous wastes are solid wastes that can: a. Cause or significantly contribute to an increase in
mortality or an increase in serious irreversible, or
incapacitating, reversible illness.
b. Pose a substantial present or potential hazard to
human health or the environment when improperly
treated, stored, transported, or disposed of, or
otherwise managed.
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Special or Hazardous waste Special waste include those from
hospitals, animal slaughter wastes and industrial waste.
These wastes are better to be described under title “hazardous waste”
Why they are considered hazardous? - Being non – degradable or persistent in nature - Can be biologically magnified. - Can be lethal - Many cause or tend to cause detrimental cumulative effects.
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Methods must be developed for - Storage - Handling - Transport - Recycling and - Disposal of such wastes i.e. management of these waste are highly specialized and controlled.
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Classification of hazardous waste
Hazardous waste are considered in five categories
1. Radioactive
2. Chemical
3. Biological
4. Flammable
5. Explosive waste
(1) Radioactive substances Are those emitting ionizing radiation. Sub substance are hazardous because prolonged exposure to radiation often result in cancer or other genetic disorders. These radioactive substance may remain active for millions of years. Biological half life of U 232 =72 years U 236 = 23,420,000 years Radio active waste management is not responsibility of municipality.
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Symptoms of radiation It can range from Headache, dizziness and vomiting, burning, hair fall to much more serious problems. Because it is genotoxic, it may also effect genetic material.
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(2) Chemicals: - Most of chemical are highly toxic, genotoxic, corrosive, flammable, explosive. They can cause intoxication, burn or injuries. They can be classified into 4 groups. - Synthetic organic - Inorganic metals - Flammables - Explosive
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(3) Biological The ability to infect other living organisms and ability to produce toxins are the most significant characteristics of a hazardous biological waste. Such as - needles - bandages - outdated drugs - malignant tissue during surgery - by products of industries biological conversion process
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(4) Flammables: - These may be in liquid; gaseous or solid forms. Typical example include organic solvent. Oil, plasticizers and organic sludge's. (5) Explosive:- As flammables and have potential hazards in storage and disposal.
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Hazardous waste management
a. Secured landfills are the least expensive method
of hazardous waste disposal when they are: i. Carefully designed and located ii. Monitored for leakage
b. Deep well injection is the pumping of liquid hazardous waste into wells below the aquifer.
c. Incineration of hazardous waste is the controlled combustion of hazardous waste.
d. Hazardous waste recycling is the process of reusing hazardous waste to produce a usable product, a process sometimes accomplished through "waste exchanges" in Europe.
e. Neutralization of hazardous waste is the
process of detoxifying the waste so it is less toxic,
corrosive, or otherwise hazardous.
f. Source reduction is the alteration of manufacturing
processes to reduce or eliminate the generation of
hazardous waste.
3.Hazardous waste cleanup
a. Since the disposal of hazardous waste was
unregulated before 1976, there exist many
hazardous waste sites around the United States.
b. The "Superfund" Law (CERCLA) was passed in
1980 and amended in 1986 to clean up such sites.
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Liquid waste (sewage) disposal
Definition: - “Sewage” is waste water from a community containing solid and liquid excreta derived from houses, street, yard washing and factories.
The term “sludge” is applied to waste water which does not contain human excreta. For example waste water from kitchen and bath rooms.
Composition of sewage
99 % of water Partly organic
1 % of solid
Partly inorganic
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Disease agent present in excreta Liquid waste contain several microorganism
particularly useful and harmful bacteria the organism may reach several millions per cubic
centimeter of liquid waste. Most of bacteria, worms and insect larvae as well
as algae considered useful organism that play on important role in treatment of liquid waste, particularly stabilizing the organic matter, which on anaerobic decomposition cause black coloration.
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A. Virus: - as those causing Poliomyelitis Epidemic viral hepatitis (A) and Viral gastroenteritis (rotavirus)
B. Bacteria:- i. As those causing: - Cholera Enteric fever Typhoid
Paratyphoid Bacillary dysentery, Malta fever, T.B food poisoning: - infective (salmonella F. P) - intoxication – Staphylococcal - Botulism - Cl. Welch
ii. Coliform Bacteria: - especially E.coli which is used as an indicator of water pollution with human waste, as it is present in the G.I. T. of healthy and diseased person
iii. Fungi and yeast: - e.g. C. albicans which cause monilial infection
iv. Parasites:- e.g. a. Cyst of amoebiasis
b. Ova of Ascaris, Ancylostoma, trichuris, hetrophytes, tapeworms, bilharzia. c. The parasite it self e.g. Traphazrites of trachomenas, Ascaris worms, parts of tape worm
Healthcare/ Hospital Waste
Health care waste 1. 80% can be dealt with normal domestic and urban waste management. 2. 15% pathological waste 3. 1% sharp waste 4. 3% Chemical and pharmaceutical waste 5. less than 1% special waste such as radioactive , cytotoxic, or pressurized container , broken thermometer and batteries Total waste per bed range from ½ to 4 kg
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• Hospital waste include all waste arising from healthcare establishments.
Responsibility for Waste Management
• Waste Management Team of the Hospital/ Clinic/ Lab. shall be responsible to ensure proper management of the waste generated in the Hospital/ Clinic/ Lab.
• Preparation and Monitoring of Plan
• • Periodic Review
• • Revision or updating
• • Implementation of WMP
• • Compliance
Waste Segregation • Waste Segregation z Different color coding has to
be assigned to various waste for effective segregation, as:
• i. Black : Non-Risk waste.
• ii. Red: Risk waste with Sharps.
• iii. Blue: Risk Waste without sharps.
• iv. Yellow: Radioactive waste
• v. Green: Chemicals like Mercury & Cadmium
All this segregation should be done by the individual user.
INFECTIOUS WASTE MANAGEMENT
PLANS
Components of an Infectious Waste Management Plan:
1. Designation of the waste that should be managed as infectious
2. Segregation of infectious waste from the noninfectious waste
3. Packaging
4. Storage
5. Treatment
6. Disposal
7. Contingency measures for emergency situations
8. Staff training
Color coding and type of container for disposal of biomedical waste
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Color coding Type of container Waste category
Treatment option
Yellow
Red
Blue/ white translucent
Black
Plastic bag Disinfected container/ plastic bags Plastic bags/puncture proof container Plastic bags
1, 2, 3, 6 3, 6, 7 4, 7 5, 9, 10
incinerator/ deep burial Autoclaving,/ microwaving/ chemical Autoclaving,/ microwaving/ chemical treatment and destruction and shredding
Disposal in secured land fill.
Best Practice Colour Coding
Colour
Description
Infectious Waste Minimum treatment / disposal required is incineration in a suitably licensed or permitted facility.
Infectious Waste Minimum treatment / disposal required is to be ‘rendered safe’ in a suitably licensed or permitted facility.
Cyto-toxic / Cyto-static Waste Minimum treatment / disposal required is incineration in a suitably licensed or permitted facility.
Offensive Waste* Minimum treatment / disposal required is landfill in a suitably licensed or permitted site. This waste should not be compacted in un-licensed/permitted facilities.
Domestic Waste Minimum treatment / disposal required is landfill in a suitably licensed or permitted site.
Sharps
Must be collected at the point of generation, in a leak-proof and puncture-resistant container
Containers must bear the international biohazard symbol and appropriate wording
Containers should never be completely filled, nor filled above the full line indicated on box.
Generator’s
Section
Transporter’s
Section
Treatment
Facility’s
Section
Main Principles of Solid Waste Management
• Reduce
• Reuse
• Re-cycle
We all can save the Earth
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Integrated Solid Waste Management:
•A set of plans to manage solid waste
•Adopted by many governments
•A means of achieving sustainability
Waste treatments
• Incineration:
• Solidification: solid waste are melted or evaporated to produce a sand like residue.
• Heat treatment: Heat applied at moderate temperature, is used in treating volatile solvents.
• Chemical treatment: is the application of chemical treatment in the treatment of corrosive solid.
Waste Disposal • Landfills: waste is placed into or onto the land
in disposal facilities.
• Underground injection wells: waste are injected under pressure into a steel and concrete-encased shafts placed deep in the earth.
• Waste piles: is accumulations of insoluble solid, non flowing hazard waste. Piles serves as temporary or final disposal.
Waste Disposal
• land treatment: is a process in which solid waste, such as sludge from wastes is applied onto or incorporated into the soil surface.
• Waste are disposed in flowing rivers in less developed countries.
Moeller, D. W. (2005). Environmental Health (3rd ed.). Cambridge, MA:Harvard University Press
Groups at risks due to solid waste
The groups at risk from the unscientific waste disposal include:
• Populations in areas where there is no proper waste treatment method.
• Children
• Waste workers
• Populations living close to waste dump
• Animals
SOURCES OF HUMAN EXPOSURES Exposures occurs through
• Ingestion of contaminated water or food
• Contact with disease vectors
• Inhalation
• Dermal
PREVENTIVE MEASURES
• Proper management of solid waste
• Involving public in plans for waste treatment and disposal
• Provide the public accurate, useful information about the whole projects, including the risks and maintain formal communication with public
• Educate people on different ways of handling waste.
PREVENTIVE MEASURES
Waste Minimization is a process of reducing waste produce by individuals, communities and companies, which reduces the impact of chemical wastes on the environment to the greatest extent.
Household level of proper segregation of waste, recycling and reuse.
Process and product substitution e.g. use paper bag instead of plastic bags.
Moeller,2005