Medical Waste Treatment and Disposal Methods Used by Hospitals in Oregon,Washington, and Idaho

ABSTRACT

This study investigated medical waste practices used by hospitals in Oregon, Washington, and Idaho, which includes the majority of hospitals in the U.S. Environmental Protection Agency's (EPA) Region 10. During the fall of 1993, 225 hospitals were surveyed with a response rate of 72.5%. The results reported here focus on infectious waste segregation practices, medical waste treatment and disposal practices, and the operating status of hospital incinerators in these three states. Hospitals were provided a definition of medical waste in the survey, but were queried about how they define infectious waste. The results implied that there was no consensus about which agency or organization's definition of infectious waste should be used in their waste management programs. Confusion around the definition of infectious waste may also have contributed to the finding that almost half of the hospitals are not segregating infectious waste from other medical waste. The most frequently used practice of treating and disposing of medical waste was the use of private haulers that transport medical waste to treatment facilities (61.5%). The next most frequently reported techniques were pouring into municipal sewage (46.6%), depositing in landfills (41.6%), and autoclaving (32.3%). Other methods adopted by hospitals included Electro-Thermal-Deac-tivation (ETD), hydropulping, microwaving, and grinding before pouring into the municipal sewer. Hospitals were asked to identify all methods they used in the treatment and disposal of medical waste. Percentages, therefore, add up to greater than 100% because the majority chose more than one method. Hospitals in Oregon and Washington used microwaving and ETD methods to treat medical waste, while those in Idaho did not. No hospitals in any of the states reported using irradiation as a treatment technique. Most hospitals in Oregon and Washington no longer operate their incinerators due to more stringent regulations regarding air pollution emissions. Hospitals in Idaho, however, were still operating incinerators in the absence of state regulations specific to these types of facilities.     

Small mammal populations at hazardous waste disposal sites near Houston, Texas, USA

Small mammals were trapped, tagged and recaptured in 0.45 ha plots at six hazardous industrial waste disposal sites to determine if populations, body mass and age structures were different from paired control site plots. Low numbers of six species of small mammals were captured on industrial waste sites or control sites. Only populations of hispid cotton rats at industrial waste sites and control sites were large enough for comparisons. Overall population numbers, age structure, and body mass of adult male and female cotton rats were similar at industrial waste sites and control sites. Populations of small mammals (particularly hispid cotton rats) may not suffice as indicators of environments with hazardous industrial waste contamination.     

Morphological, biochemical, and histopathological indices and contaminant burdens of cotton rats (Sigmodon hispidus) at three hazardous waste sites near Houston, Texas, USA

Male cotton rats (Sigmodon hispidus) were studied at three industrial waste sites near Houston, Texas, to determine whether various morphological, biochemical, and histopathological indices provided evidence of contaminant exposure and toxic insult. Only modest changes were detected in cotton rats residing at waste sites compared with reference sites. No single parameter was consistently altered, except hepatic cytochrome P-450 concentration which was lower ( [Formula: see text] ) at two waste sites, and tended to be lower ( [Formula: see text] ) at a third waste site. Elevated petroleum hydrocarbon concentrations were detected in rats at one waste site, but contaminant burdens of rats from the other sites were unremarkable. Unlike rats captured in summer, those trapped in winter exhibited hepatocellular hypertrophy and up to a 65% increase in liver: body weight ratio, cytochrome P-450 concentration, and activities of aniline hydroxylase, aryl hydrocarbon hydroxylase, and glutathione S-transferase. Although genotoxicity has been previously documented in cotton rats residing at two of the waste sites, biomarkers in the present study provided little evidence of exposure and damage.     

Characterization of municipal waste in Kampala,Uganda

In Kampala, Uganda, about 28,000 tons of waste is collected and delivered to a landfill every month. Kampala Capital City Authority (KCCA) records show that this represents approximately 40% of the waste generated in the city. The remaining uncollected waste is normally dumped in unauthorized sites, causing health and environmental problems. However, the organic fraction of domestic waste can provide an opportunity to improve livelihoods and incomes through fertilizer and energy production. This study characterized the municipal waste generated in Kampala and delivered to Kiteezi landfill between July 2011 and June 2012, that is, covering the dry and wet months. On each sampling day, waste was randomly selected from five trucks, sorted and weighed into different physical fractions. Samples of the organic waste from each truck were analyzed for total solids, major nutrients, and energy content. During the wet months, the waste consisted of 88.5% organics, 3.8% soft plastics, 2.8% hard plastics, 2.2% paper, 0.9% glass, 0.7% textiles and leather, 0.2% metals, and 1.0% others. During the dry months, the waste consisted of 94.8% organics, 2.4% soft plastics, 1.0% hard plastics, 0.7% papers, 0.3% glass, 0.3% textile and leather, 0.1% metals, and 0.3% others. The organic waste on average had a moisture content of 71.1% and contained 1.89% nitrogen, 0.27% phosphorus, and 1.95% potassium. The waste had an average gross energy content of 17.3 MJ/kg. It was concluded that the organic waste generated can be a suitable source of some plant nutrients that are useful especially in urban agriculture.

Implications:?The result of the waste characterization in Kampala was found to be significantly different from that obtained for other Sub-Saharan African (SSA) cities, showing that studies assuming average values for the waste fractions are likely to result in erroneous results. Furthermore, no reduction in organic fraction of the waste was noticed when compared with a study done two decades ago in spite of greatly improved economic status of Kampala city, a finding that is not in agreement with several other similar studies done for other SSA cities.     

Hazardous wastes and economic risk reduction: case study, Poland

A concise summary balance of industrial and hazardous waste is given, reflecting the situation in Poland. Nearly 130 million tonnes of waste were generated annually in the past in more than 1300 larger industrial plants. Approximately 1800 million tonnes of industrial waste is already stockpiled. The amount of hazardous waste generated per year was 0.3 and 1.0 million tonnes of the first and second class of toxicity, respectively. Seventeen existing on-site incinerators cannot treat the whole amount of solid and hazardous waste generated. Therefore, landfilling is still the most widely used method of waste disposal. Decontamination of the abandoned areas left by the Soviet Army, and reclamation of some hundreds of storage sites filled with outdated pesticides are now added to the national plan of waste management. Its implementation, including introduction of the best available and best managed technologies of hazardous waste treatment and disposal, will take at least 20 to 30 years.     

Recovery,Recycle and Reuse

An overview is provided of hazardous waste recovery, recycle and reuse. The quantities and types of hazardous waste that are generated in the United States are identified. Hazardous wastes are classified according to their economic potential for recovery. Energy and material recovery from organic liquids and metal recovery from sludges have the highest potential for economical recovery. Specific examples are provided of recovery from these types of wastes. A variety of financial and regulatory strategies can be used to encourage recovery from waste streams that do not have a potential for economical recovery. These range from restrictions on burial to the establishment of waste exchanges.     

Present State,of Industrial Waste Management in Japan

Systematic management for industrial waste in Japan has been carried out based on the Waste Disposal and Public Cleansing Law which was enacted in 1970. The law and its ordinances designate 19 kinds of waste materials discharged from business activities as industrial waste and prescribe the generator's responsibility, requirements for treatment contractors, standards for consignment, specific personnel, etc. from the view of proper management. And they also, prescribe disposal standards, structure, and maintenance standards for treatment facilities, including final disposal sites, from the view of proper treatment and disposal. The Standard for Verification provides criteria to categorize as hazardous or nonhazardous industrial waste which is subjected to treatment and disposal in conformity with each standard. The fundamental policies to cope with industrial waste focus on reduction of generation, promotion of recycling, establishment of a comprehensive information management system and participation of the public which can contribute well to prevent environmental pollution caused by inappropriate management of industrial waste.     

Short-term responses of Oryzias latipes (Pisces: Adrianichthyidae) and Macrobrachium nipponense (Crustacea: Palaemonidae) to municipal and pharmaceutical waste water in Beijing, China: survival, behaviour, biochemical biomarkers

Whole effluent toxicity was assessed for the fish Oryzias latipes and the prawn Macrobrachium nipponense for 18 h in a dilution series (0-66%) of the inflow and effluent of a municipal waste water treatment plant as well as waste water from a teramycin producing pharmaceutical industry, before, during and after a pilot laboratory purification process. The waste waters caused acute toxicity as measured by inhibition of light emission in the luminiscent bacterium Vibrio qingaiensis sp. nov. (Q67). EROD and aryl hydrocarbon hydroxylase activity in in vitro carp liver-cells showed a dose-dependent toxic response to the municipal waste water. Behavioural responses and time-to-death of fish and prawn, recorded online with the "Multispecies Freshwater Biomonitor" proved to be concentration- and time-dependent sensitive toxicity indicators in both types of waste water. Behaviour changed stepwise from normal activity to (increased or decreased) activity to more time spent on ventilation and finally to increased morbidity at higher concentration and time of exposure. The municipal waste water treatment plant managed to reduce toxicity to bacteria (Q67), prawn and fish. The pharmaceutical waste water treatment process still has to be improved, in order to reduce toxicity for fish and prawn.     

Mercury Measurement and Its Control: What We Know,Have Learned,and Need to Further Investigate

Disposal of mercury waste has always provided unique challenges due to its high degree of complexity and volatility. This study evaluated the feasibility of using waste LF slag to form a cementitious matrix capable of providing an effective stabilization/solidification solution for the treatment of mercury wastes. The new matrix was synthesized and simulated through a combination of alkali activation and autoclaving process and doped with mercury nitrate at increasing dosage while monitoring the final form of the mercury and its effects on the mineral stability and structure of the new matrix. Compressive strength of up to 20 N/mm² was achievable for the original matrix. Promising results were obtained in terms of reduced leachability of the mercury when compared to ordinary Portland cement systems at low doping concentration of around 0.5% by weight. A series of precipitation reactions was found to be the main cause responsible for this successful stabilization, especially the metal sulfide precipitation that occurred with the sulfur present in the original waste LF slag.

Implications: Using waste to treat waste as a concept is a new approach that not only solves waste disposal problems but also minimizes the toxicity and the potential hazard of leaching of heavy metals. This study evaluated the feasibility of using waste ladle furnace slag generated from steel-making industries to form a cementitious matrix capable of providing an effective stabilization/solidification solution for the treatment of mercury-containing wastes. Promising results were obtained, and it clearly showed this approach is feasible, which could be a one-stone-kills-two-birds solution for mercury stabilization as well as an industrial waste disposal problem.     

Municipal anaerobic digesters for codigestion, energy recovery, and greenhouse gas reductions.

Codigestion of five wastes and municipal wastewater sludge was evaluated using full-scale testing. Synergistic, antagonistic, and neutral outcomes were observed depending on codigestate identity and concentration, highlighting the value of careful blending. Yeast waste resulted in notable synergism, increasing biogas production by over 50%, whereas aircraft deicing waste resulted in antagonism at high loadings and neutral outcomes at lower loadings. Restaurant waste codigestion resulted in neutral outcomes. The synergisim with yeast codigestates may have resulted from trace nutrients (i.e., iron, nickel, and cobalt) in the wastes that increased microbiological activity. Antagonist outcomes with deicing waste may have been the result of organic overload or inhibitory deicer constituents. Codigestion of wastes at the feed rates investigated was estimated to produce 0.50 ML/d of methane having an energy equivalent of 17 500 MJ/d. This was estimated to reduce net carbon dioxide emissions by 560 tonnes/y.     

ESPR subject area 5 ‘Environmental Microbiology, (Bio)Technologies, Health Issues’

Goal, Scope and Background  Aquaculture activities are well known to be the major contributor to the increasing level of organic waste and toxic compounds in the aquaculture industry. Along with the development of intensive aquaculture in China, concerns are evoked about the possible effects of everincreasing aquaculture waste both on productivity inside the aquaculture system and on the ambient aquatic ecosystem. Therefore, it is apparent that appropriate waste treatment processes are needed for sustaining aquaculture development. This review aims at identifying the current status of aquaculture and aquaculture waste production in China. Main Features  China is the world’s largest fishery nation in terms of total seafood production volume, a position it has maintained continuously since 1990. Freshwater aquaculture is a major part of the Chinese fishery industry. Marine aquaculture in China consists of both land-based and offshore aquaculture, with the latter mostly operated in shallow seas, mud flats and protected bays. The environmental impacts of aquaculture are also striking. Results  Case studies on pollution hot spots caused by aquaculture have been introduced. The quality and quantity of waste from aquaculture depends mainly on culture system characteristics and the choice of species, but also on feed quality and management. Wastewater without treatment, if continuously discharged into the aquatic environment, could result in remarkable elevation of the total organic matter contents and cause considerable economy lost. Waste treatments can be mainly classified into three categories: physical, chemical and biological methods. Discussion  The environmental impacts of different aquaculture species are not the same. New waste treatments are introduced as references for the potential development of the waste treatment system in China. The most appropriate waste treatment system for each site should be selected according to the sites’ conditions and financial status as well as by weighing the advantages and disadvantages of each system. Strategies and perspectives for sustainable aquaculture development are proposed, with the emphasis on environmental protection. Conclusions  Negative effects of waste from aquaculture to aquatic environment are increasingly recognized, though they were just a small proportion to land-based pollutants. Properly planned use of aquaculture waste alleviates water pollution problems and not only conserves valuable water resources but also takes advantage of the nutrients contained in effluent. It is highly demanding to develop sustainable aquaculture which keeps stocking density and pollution loadings under environmental capacity. Recommendations and Perspectives  The traditional procedures for aquaculture waste treatment, mainly based on physical and chemical means, should be overcome by more site-specific approaches, taking into account the characteristics and resistibility of the aquatic environment. Further research needs to improve or optimize the current methods of wastewater treatment and reuse. Proposed new treatment technology should evaluate their feasibility at a larger scale for practical application. ESS-Submission Editor: Dr. Ding Wang (wangd@ihb.ac.cn)     

Relationship of Particulate Control,SO2 Removal,and Waste Management

Results with the EPRI 2.5 MW(e) Integrated Environmental Control Pilot Plant (IECPP) indicate the interrelationship of particulate penetration, SO₂ scrubber operation, waste production, and waste properties. Tests compared a fabric filter/wet scrubber and ESP/wet scrubber, the latter operated to simulate 1979 New Source Performance Standards (NSPS), 1971 NSPS, and pre-NSPS ESP units. Tests were conducted with low-sulfur coal producing a flue gas concentration of400ppm; flue gas spiking could be used to increase SO₂ to 2000 ppm. Scrubber waste was dewatered in a thickener and vacuum belt filter (to 55 percent solids content), and mixed with fly ash. The pilot SO₂ scrubber—when preceded by an ESP and forced to operate in zero-discharge—captured less SO₂ than when preceded by a fabric filter. Also, scrubber operation with the ESP produced a greater quantity of waste with difficult handling characteristics, as compared to operation with the fabric filter. These difficulties occurred with particulate penetration above 0.10 lb/MBtu, which could reduce reagent utilization to 80percent. These results are attributable to inhibited limestone dissolution due to accumulation of an aluminum/fluoride compound. For both lowsulfur and simulated high-sulfur test conditions, allowing wastewater discharge to purge aluminum/fluoride content restored performance to design levels. Particulate control efficiency also affected solid waste physical properties. The fabric filter/wet scrubber produced the lowest solid waste permeability (10^?8 cm/s). ESP operation at 1979 NSPS and pre-1971 NSPS ESPs increased solid waste permeability to 10^?7 and 10^?6 cm/s, respectively. These results are meaningful for SO₂ scrubbers both for new plants and for retrofit to units with pre-NSPS ESPs, and could become significant with the increasing trend to restricted water discharge.     

Emissions of PCDD/F from uncontrolled, domestic waste burning

Emissions of polychlorinated dibenzodioxin and dibenzofuran (PCDD/F) result from inefficiencies of combustion processes, most typically waste combustion. Uncontrolled combustion, such as occurs during so-called "backyard burning" of domestic waste, may therefore produce optimal conditions for formation and emission of PCDD/F. However, few assessments of PCDD/F emissions are available from these sources. This work describes the first known comprehensive assessment of PCDD/F emissions from uncontrolled, domestic waste burning. Emissions were copious, but highly variable, ranging over several orders of magnitude. The potential for emissions appears to be related primarily to combustion parameters and concentrations of various gas-phase species, the latter which may be affected by changes in waste composition, waste orientation, and/or combustion conditions.     

Hazardous waste disposal in Germany: a case study of the site in Billigheim, Baden-Wurttemberg

The disposal of hazardous waste is a very critical issue. It is associated with many risks. Efforts are made to minimise these by consistent legislation and by proper treatment of the waste. The goal of a hazardous waste disposal site, as described in this paper, is to ensure that hazardous waste is treated and disposed of in a way that does not harm human beings or the environment. To assure this it is necessary to observe the handling of the hazardous waste from its producer up to the disposal site, and to identify possible inherent risks.     

Health disorders among Egyptian municipal solid waste workers and assessment of their knowledge,attitude, and practice towards the hazardous exposure

Environmental Science and Pollution Research - Solid waste workers are exposed to variety of injuries and diseases at work. To study health disorders among workers in the waste management field and...     

A copula-based chance-constrained waste management planning method: An application to the city of Regina,Saskatchewan, Canada

This study proposes a copula-based chance-constrained waste management planning (CCWMP) method. The method can effectively reflect the interactions between random parameters of the waste management planning systems, and thus can help analyze the influences of their interactions on the entire systems. In particular, a joint distribution function is established using preestimated marginal distributions of random variables and an optimal copula selected from widely used Gaussian, Student’s t, Clayton, Frank, Gumbel, and Ali-Mikhail-Haq copulas. Then a set of joint probabilistic constraints in the chance-constrained programming problems is converted into individual probabilistic constraints using the joint distribution function. Further, this method is applied to residential solid waste management in the city of Regina in Canada for demonstrating its applicability. Nine scenarios based on different joint and marginal probability levels are considered within a multiperiod and multizone context to effectively reflect dynamic, uncertain, and interactive characteristics of the solid waste management systems in the city. The results provide many decision alternatives under these scenarios, including cost-effective and environmentally friendly decision schemes. Moreover, the results indicate that even though the effect of the joint probability levels on the system costs is more significant than that of the marginal probability levels, the effect of marginal probability levels is notable, and there exists a trade-off between the total system cost and the constraint-violation risk. Therefore, the results obtained from the present study would be useful to support the city’s long-term solid waste management planning and formulate local policies and regulation concerning the city’s waste generation and management.Implications: The CCWMP method not only can solve chance-constrained problems with unknown probability distributions of random variables in the right-hand sides of constraints, but also can effectively reflect the interactions between the random parameters and thus help analyze the influences of their interactions on the entire systems. The results obtained through applying this method to the city of Regina in Canada can provide many decision alternatives under different joint probability levels and marginal probability levels, and would be useful to support the city’s long-term solid waste management planning.     

Planning,Designing, Operating,and Regulating a Geologic Sequestration Repository as an Underground Landfill—A Review

ABSTRACT

Geologic sequestration appears to be a technically feasible method of storing carbon dioxide in underground aquifers in order to lower greenhouse gas emissions into the atmosphere. The overall feasibility of geologic sequestration is still in question and as such, has been the focus of intense research over the past decade. Researchers have looked to the oil/gas industry and water well industry for lessons learned and technical knowledge, however, a better industry to emulate may well be the waste industry. Viewing geologic sequestration repositories as underground landfills has a great many benefits. First, there is a plethora of existing research and investigations that are directly analogous to geologic sequestration projects. Second, the regulatory framework is rather mature and can be easily adapted to serve geologic sequestration. This paper conducts an extensive literature search of the environmental, waste, and geologic sequestration literature to ascertain planning, design, and operational methodologies, lessons learned, and concepts that are directly useful for geologic sequestration to improve the technical and regulatory framework. Lastly, the paper uses a hypothetical underground landfill geologic sequestration site (ULGSS) in Florida, USA to discuss some of the findings and implications from the literature. It is concluded that there are a number of literature findings from the waste and environmental arena that should be adapted for geologic sequestration.

IMPLICATIONS Geologic sequestration is a promising solution for greenhouse gas control. This work supports that notion but suggests further improvements to the technical and regulatory framework based upon an extensive review of the waste management and environmental literature. The improvements include suggestions in the areas of permitting, site selection, operations, cost accounting, and special waste handling. Some of these improvements are discussed using a hypothetical project site in Florida, USA.     

Perfluorooctane surfactants in waste waters, the major source of river pollution

Perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) are persistent and widely distributed in the environment. Recently, the discharge of municipal waste water has been shown to be an important route of such perfluoroalkyl surfactants into the aquatic environment. The aim of this study was to assess the mass flow of PFOA and PFOS from typical waste water treatment plants (WWTPs) into surface waters. Samples were collected at different stages of treatment of four WWTPs in Northern Bavaria, Germany, and from the rivers receiving the treated waste waters (WW). The outflow of PFOA from the WWTPs to the rivers was 20-fold higher than the inflow to the plants; about a tenth was removed with the sludge. For PFOS, the increase from inlet to outlet was about 3-fold; almost half of it was retained in the sludge. Both surfactants were released into river water from the WWTP of a medium-sized city with domestic, industrial and commercial waste waters; in domestic waste waters the surfactants were found at much lower levels.     

Municipal solid waste management planning for Xiamen City,China: a stochastic fractional inventory-theory-based approach

In this study, a stochastic fractional inventory-theory-based waste management planning (SFIWP) model was developed and applied for supporting long-term planning of the municipal solid waste (MSW) management in Xiamen City, the special economic zone of Fujian Province, China. In the SFIWP model, the techniques of inventory model, stochastic linear fractional programming, and mixed-integer linear programming were integrated in a framework. Issues of waste inventory in MSW management system were solved, and the system efficiency was maximized through considering maximum net-diverted wastes under various constraint-violation risks. Decision alternatives for waste allocation and capacity expansion were also provided for MSW management planning in Xiamen. The obtained results showed that about 4.24 × 10⁶ t of waste would be diverted from landfills when p _i is 0.01, which accounted for 93% of waste in Xiamen City, and the waste diversion per unit of cost would be 26.327 × 10³ t per $10⁶. The capacities of MSW management facilities including incinerators, composting facility, and landfills would be expanded due to increasing waste generation rate.