Environmental Impacts of Incineration of Hospital Waste

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In many underdeveloped countries, incineration of harmful waste is a general method of hospital waste management.Although it has the advantage of killing microorganisms and decreasing unwanted material by burning them, however, it harms the environment as burning causes the release of harmful toxins in the environment.

Burning of hospital waste generates persistent organic pollutants(pollute air), dioxins, polycyclic aromatic hydrocarbons (PAHs) and much of other harmful compounds which are carcinogenic in nature. Hospital waste incineration is famous for its bad impacts on the environment as it does not completely deteriorate the litter, but it gives out heavy metals as ash. Thirteen of the investigated plants were built between 1994 and 1997 in Poland, in which polychlorinated dibenzodioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) were present as ash bottom due to the burning of waste of the hospitals, and eight of them shown low PCDDs/Fs concentration in stack gases, below 0.1 ng-TEQ/m3n .

Heavy metal ions for example, chromium, lead zinc, mercury, arsenic, and many others and organic compounds e.g., dioxins, benzene, PCBs are precarious, if these are not destroyed properly, they can severely pollute the environment and can consequently cause chronic diseases like acute respiratory syndromes, gastrointestinal abnormalities, and other carcinogenic and death-dealing diseases. Therefore, it is mandatory to disclose some facile and technological approaches to replace existing methods.

In this pursuit, developed countries, i.e., United States, Germany, Netherlands have started other techniques like using autoclave, microwave, and recycling methods instead of incineration to avoid the bad effects of burning on human health and their surrounding environment. However, these sophisticated methods cannot be employed on a commercial scale in underdeveloped countries. Because many hospitals in developing countries have financial issues and they cannot use high-cost methods to dispose of their waste. Autoclaving methods, microwave disinfection, superheated steams are few methods which must be used for the waste management in healthcare centers and hospitals instead of incineration to avoid its deleterious impacts on environment. Steam sterilization (autoclaving) is the most widely used method for sterilization and is considered the most robust and cost-effective method for sterilization of medical devices. The effectiveness of steam sterilization can be measured using biological indicators. Microwave based disinfection system which suits for this purpose, not only ensures complete disinfection of waste but is also a cost-effective, resource efficient and environment friendly method. The efficacy of an on-site superheated water and steam macerating system evaluated for its ability to process infectious and perceived hospital and laboratory waste into municipal waste as a source for fuel or recycling at a lower cost than traditional medical waste handling systems in super heating technique in which waste of hospital is soaked with water at the temperature of 275 degree.

Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) are released in air as a result of hospital waste burning in incinerators. For last two decades, incinerations are being studied with much concern and they have attracted the attention of scientists Clinical solid waste is a major issue in developing countries and its management is very much important to avoid diseases caused by environmental pollution. The study was done at a hospital in Ghana with a capacity of 2000 beds. The average waste was 0·5 and 2·0 kg/bed/day which produced 0.33 million tons of clinical litter every week. The hospital uses an in-built drier that dries waste very fast and a chamber that burns the whole waste in a minimum time of 3 hours. In Nigeria, medical waste gets no special attention and care which it must get, these wastes are still mixed with household wastes and then disposed of .

In hospital we found non-hazardous as well as hazardous waste 75-90 % generated waste is hazardous, 10-25% of hospital waste is hazardous. Non-hazardous waste consists of food scarps, peels of fruits, paper material etc. It is also called as non-risk waste . Hazardous waste contains sharp waste (hypodermic needles etc), Chemical waste (reagents, solvents etc), Pathological waste (human organs, tissues etc), and Infectious waste (e.g., blood and body fluids) .

There are different sources of health care and therapeutic wastes like dispensary, outpatient departments, dialyzes center, blood banks, ICU, etc. Health care waste (therapeutic wastes)  is a by-product of health care that includes sharps, non-sharp blood contaminated items, blood, body parts and tissues, chemicals, pharmaceuticals and radioactive materials. Laboratory and other researching departments are also sources of therapeutic wastes . Treatment and dumping of therapeutic waste decrease danger and threats, fitness threats which are caused by emission of hazardous contaminants into our surrounding environment by these treating or disposing processes.

There are some objectives of incineration 1: To manage the hospital waste effectively and efficiently 2: To estimate the total emission of the gases, particulate matters dioxins, other metal ions in accordance with the waste to be burnt 3: To calculate the standard of atmospheric discharge 4: To precisely define the methods of management of health care centers wastes. However,it is quite evident that it is not an environmentally friendly method but to have an immediate solution to the problem it is preferred mostly.

There are some ways to dispose of medical waste given below:

1: Landfills make clean water dirty if they are not constructed in the proper manners. Risks may increase if these are not designed properly and safely.

2: Incineration has been practiced in the whole world in different countries, but it is an improper technique and unfit and inappropriate as it releases or ejects harmful pollutants in the air and make the environment unpleasant and causes many diseases when a person breath in harmful polluted air and it also releases ashes. Incinerated materials have chlorine which can produce and emits dioxins and furans, which are fatal carcinogens and cause very bad health effects even death. Heavy materials like metal ions (lead, mercury, cadmium etc ) are likely used to disperse toxic metals in the surrounding areas to cause bad health of humans. Dioxins and furans are harmful. Those materials having chlorine, or the metal ions should never be burnt in an incinerator .

Occupational health and safety mostly related to caretaker and laundry workers, doorkeepers, nurses, emergency therapeutic personnel, and decline workers so they must provide with good safety measures. Injuries caused from sharps instruments and exposure to dangerous chemical litter which is also cause health deterioration to employees in those organization which producing bio-therapeutic waste. Proper management of litter and debris can solve problems.

There are some disadvantages of Incineration: 1: One of the main disadvantages of the incineration process is that it emits harmful and disease-causing pollutants directly or indirectly 2: A huge amount of dioxin and furan quantity in the atmosphere are detected after this process 3: This treatment is inappropriate for therapeutic litter.There are some alternatives of incineration which are safe and appropriate methods used by developed countries for the management of therapeutic waste materials are:

Autoclaving: Autoclaving is a process of low heat in which steam is produced and brought directly into contact and blended with waste in an appropriate and controlled manner and for maximum duration to sterilize the therapeutic waste. The system must be in horizontal type because autoclave horizontal is low cost options for general sterilization ideal tool for Laboratories, Hospitals, Nursing Homes, and Agricultural R&D labs etc, Pharmaceutical, Food & Beverage Industries and Institutions. Autoclave designed carefully for the analysis of medical debris for safety and easiness. Pre-vacuum system must be used and preferred in place of gravity system for better and positive outcomes.  It must have tamper-proof control panel with efficient display and recording devices for critical parameters such as time, temperature, pressure, date, and batch number etc.

The heating effects of electromagnetic radiations causes microbes to become inactive; this will show a spectrum of frequencies between 300 and 300,000 MHz Microwave heating is the phenomenon of an inter-molecular heating. The waste material is heated very much in the existence of steam.This process is similar to autoclaving method the difference is that the waste is putted indirectly to heat by giving steam in the outer site. During the process, the litter is continuously collapsed in a compartment like chamber.

In conclusion we can say Incineration is the phenomenon of burning waste in a chamber at a very high temperature. This process has many drawbacks like it is not eco-friendly, as it releases harmful and dangerous matter like PM, POPs, dioxins, benzene, etc. in the air when it is burnt. Underdeveloped countries uses this method to get rid of waste and to disinfect waste so germs or bacteria in it cannot harm human health. However, to avoid environmental issues, some alternative methods such as autoclaving, microwaving, super-heating techniques must be used. Human protection and well-being is of much importance so, that techniques should be used which are not harmful to human beings. Those techniques must be avoided which cause adverse effect on environment and on humans.

Authors: Mahmoona Ashraf, Muneeb Hameed

Mahmoona Ashraf is a student of environmental science at University of Punjab

Muneed Hameed is a student of environmental science at Bahauddin Zakariya University.

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