Quantitative assessment of medical waste generation in the capital city of Bangladesh

There is a concern that mismanagement of medical waste in developing countries may be a significant risk factor for disease transmission. Quantitative estimation of medical waste generation is needed to estimate the potential risk and as a basis for any waste management plan. Dhaka City, the capital of Bangladesh, is an example of a major city in a developing country where there has been no rigorous estimation of medical waste generation based upon a thorough scientific study. These estimates were obtained by stringent weighing of waste in a carefully chosen, representative, sample of HCEs, including non-residential diagnostic centres. This study used a statistically designed sampling of waste generation in a broad range of Health Care Establishments (HCEs) to indicate that the amount of waste produced in Dhaka can be estimated to be 37 ± 5 ton per day. The proportion of this waste that would be classified as hazardous waste by World Health Organisation (WHO) guidelines was found to be approximately 21%. The amount of waste, and the proportion of hazardous waste, was found to vary significantly with the size and type of HCE.     

Medical waste generation in selected clinical facilities in Taiwan

This study investigated the type and amount of medical waste generated from small clinical facilities in Taiwan. We sampled 200 small medical establishments, with few or no patient beds, to survey the wastes generated and disposed. The surveyed medical facilities consisted of four groups including private clinics, medical laboratories, blood centers and public clinics. Private clinics providing surgical, dental, obstetrical, and dialysis services were included in this survey because they may generate higher amounts of infectious waste than other specialties. The overall mean general waste production rate was 3.97 kg/bed/day (or 0.075 kg/patient/day) at all the surveyed facilities, higher than that obtained from larger hospitals in Taiwan, which ranged from 2.41 to 3.26 kg/bed/day. The highest amount of infectious wastes generated among the four groups of facilities were from blood centers (3.14 kg/bed/day), followed by private clinics, medical laboratories and public clinics (1.91, 1.07, and 0.053 kg/bed/day, respectively). The overall average was 2.08 kg/bed/day. This study suggests that the waste generated at small medical facilities ranged widely.     

Semi-continuous anaerobic co-digestion of orange peel waste and residual glycerol derived from biodiesel manufacturing

The manufacturing of orange juice generates high volumes of orange peel waste which should not be deposited in landfill according to current recommendations. Furthermore, glycerol is a compound co-generated in biodiesel manufacturing, but the volume generated is higher than the current demand for pure glycerol. The anaerobic co-digestion of orange peel waste with residual glycerol could reduce the inhibitory effect of some compounds and provide a correct nutrient balance. Under mesophilic temperature and semi-continuous conditions, a mixture of orange peel waste-residual glycerol of 1:1 (in COD) operated favorably for organic loads up to 2.10 g VS/L. At higher organic loads, the accumulation of volatile fatty acids (VFA) and a decrease in the pH caused process destabilization. The methane yield coefficient was quite constant, with a mean value of 330 ± 51 mL_STP/g VS_added, while the organic loading rate (OLR) reached a mean value of 1.91 ± 0.37 kg VS/m³ d (17.59 ± 2.78 kg mixture/m³ d) and the hydraulic retention time (HRT) varied in a range of 8.5–30.0 d.     

Finished leather waste chromium acid extraction and anaerobic biodegradation of the products

Due to the amounts of chromium in the leachate resulting from leather leaching tests, chromium sulfate tanned leather wastes are very often considered hazardous wastes. To overcome this problem, one option could be recovering the chromium and, consequently, lowering its content in the leather scrap. With this objective, chromium leather scrap was leached with sulfuric acid solutions at low temperature also aiming at maximizing chromium removal with minimum attack of the leather matrix. The effects of leather scrap dimension, sulfuric acid and sodium sulfate concentration in the solutions, as well as extraction time and temperature on chromium recovery were studied, and, additionally, organic matrix degradation was evaluated. The best conditions found for chromium recovery were leather scrap conditioning using 25 mL of concentrated H₂SO₄/L solution at 293 or 313 K during 3 or 6 days. Under such conditions, 30–60 ± 5% of chromium was recovered and as low as 3–6 ± 1% of the leather total organic carbon (TOC) was dissolved. Using such treatment, the leather scrap area and volume are reduced and the residue is a more brittle material showing enhanced anaerobic biodegradability. Although good recovery results were achieved, due to the fact that the amount of chromium in eluate exceeded the threshold value this waste was still hazardous. Thus, it needs to be methodically washed in order to remove all the chromium de-linked from collagen.     

Measurement of carbon storage in landfills from the biogenic carbon content of excavated waste samples

Landfills are an anaerobic ecosystem and represent the major disposal alternative for municipal solid waste (MSW) in the U.S. While some fraction of the biogenic carbon, primarily cellulose (Cel) and hemicellulose (H), is converted to carbon dioxide and methane, lignin (L) is essentially recalcitrant. The biogenic carbon that is not mineralized is stored within the landfill. This carbon storage represents a significant component of a landfill carbon balance. The fraction of biogenic carbon that is not reactive in the landfill environment and therefore stored was derived for samples of excavated waste by measurement of the total organic carbon, its biogenic fraction, and the remaining methane potential. The average biogenic carbon content of the excavated samples was 64.6 ± 18.0% (average ± standard deviation), while the average carbon storage factor was 0.09 ± 0.06 g biogenic-C stored per g dry sample or 0.66 ± 0.16 g biogenic-C stored per g biogenic C_.     

Valorisation of used cooking oil sludge by codigestion with swine manure

The addition of lipid wastes to the digestion of swine manure was studied as a means of increasing biogas production. Lipid waste was obtained from a biodiesel plant where used cooking oil is the feedstock. Digestion of this co-substrate was proposed as a way of valorising residual streams from the process of biodiesel production and to integrate the digestion process into the biorefinery concept.Batch digestion tests were performed at different co-digesting proportions obtaining as a result an increase in biogas production with the increase in the amount of co-substrate added to the mixture. Semi-continuous digestion was studied at a 7% (w/w) mass fraction of total solids. Co-digestion was successful at a hydraulic retention time (HRT) of 50 d but a decrease to 30 d resulted in a decrease in specific gas production and accumulation of volatile and long chain fatty acids. The CH₄ yield obtained was 326 ± 46 l/kg VS_feed at an HRT of 50 d, while this value was reduced to 274 ± 43 l/kg VS_feed when evaluated at an HRT of 30 d. However these values were higher than the one obtained under batch conditions (266 ± 40 l/kg VS_feed), thus indicating the need of acclimation to the co-substrate. Despite of operating at low organic loading rate (OLR), measurements from respirometry assays of digestate samples (at an HRT of 50 d) suggested that the effluent could not be directly applied to the soil as fertiliser and might have a negative effect over soil or crops.     

Experimental co-digestion of corn stalk and vermicompost to improve biogas production

Anaerobic co-digestion of corn stalk and vermicompost (VC) as well as mono-digestion of corn stalk were investigated. Batch mono-digestion experiments were performed at 35 ± 1 °C and initial total solid loading (TSL) ranged from 1.2% to 6.0%. Batch co-digestion experiments were performed at 35 ± 1 °C and initial TSL of 6% with VC proportions ranged from 20% to 80% of total solid (TS). For mono-digestion of corn stalk, a maximum methane yield of 217.60 ± 13.87 mL/g TS_added was obtained at initial TSL of 4.8%, and acidification was found at initial TSL of 6.0% with the lowest pH value of 5.10 on day 4. Co-digestion improved the methane yields by 4.42–58.61% via enhancing volatile fatty acids (VFAs) concentration and pH value compared with mono-digestion of corn stalk. The maximum biogas yield of 410.30 ± 11.01 mL/g TS_added and methane yield of 259.35 ± 13.85 mL/g TS_added were obtained for 40% VC addition. Structure analysis by X-ray diffractometry (XRD) showed that the lowest crystallinity of 35.04 of digested corn stalk was obtained from co-digestion with 40% VC, which decreased 29.4% compared to 49.6 obtained from un-treated corn stalk. It is concluded that co-digestion with VC is beneficial for improving biodigestibility and methane yield from corn stalk.     

Improved biogas production from rice straw by co-digestion with kitchen waste and pig manure

In order to investigate the effect of feedstock ratios in biogas production, anaerobic co-digestions of rice straw with kitchen waste and pig manure were carried out. A series of single-stage batch mesophilic (37 ± 1 °C) anaerobic digestions were performed at a substrate concentration of 54 g/L based on volatile solids (VS). The results showed that the optimal ratio of kitchen waste, pig manure, and rice straw was 0.4:1.6:1, for which the C/N ratio was 21.7. The methane content was 45.9–70.0% and rate of VS reduction was 55.8%. The biogas yield of 674.4 L/kg VS was higher than that of the digestion of rice straw or pig manure alone by 71.67% and 10.41%, respectively. Inhibition of biogas production by volatile fatty acids (VFA) occurred when the addition of kitchen waste was greater than 26%. The VFA analysis showed that, in the reactors that successfully produced biogas, the dominant intermediate metabolites were propionate and acetate, while they were lactic acid, acetate, and propionate in the others.     

The effects of different mixing intensities during anaerobic digestion of the organic fraction of municipal solid waste

Mixing inside an anaerobic digester is often continuous and is not actively controlled. The selected mixing regime can however affect both gas production and the energy efficiency of the biogas plant. This study aims to evaluate these effects and compare three different mixing regimes, 150 RPM and 25 RPM continuous mixing and minimally intermittent mixing for both digestion of fresh substrate and post-digestion of the organic fraction of municipal solid waste. The results show that a lower mixing intensity leads to a higher biogas production rate and higher total biogas production in both cases. 25 RPM continuous mixing and minimally intermittent mixing resulted in similar biogas production after process stabilization, while 150 RPM continuous mixing resulted in lower production throughout the experiment. The lower gas production at 150 RPM could not be explained by the inhibition of volatile fatty acids. Cumulative biogas production until day 31 was 295 ± 2.9, 317 ± 1.9 and 304 ± 2.8 N ml/g VS added during digestion of fresh feed and 113 ± 1.3, 134 ± 1.1 and 130 ± 2.3 N ml/g VS added during post digestion for the 150 RPM, 25 RPM and minimally mixed intensities respectively. As well as increasing gas production, optimal mixing can improve the energy efficiency of the anaerobic digestion process.     

Anaerobic digestion and co-digestion of slaughterhouse waste (SHW): Influence of heat and pressure pre-treatment in biogas yield

Mesophilic anaerobic digestion (34 ± 1 °C) of pre-treated (for 20 min at 133 °C, >3 bar) slaughterhouse waste and its co-digestion with the organic fraction of municipal solid waste (OFMSW) have been assessed. Semi-continuously-fed digesters worked with a hydraulic retention time (HRT) of 36 d and organic loading rates (OLR) of 1.2 and 2.6 kg VS_feed/m³ d for digestion and co-digestion, respectively, with a previous acclimatization period in all cases. It was not possible to carry out an efficient treatment of hygienized waste, even less so when OFMSW was added as co-substrate. These digesters presented volatile fatty acids (VFA), long chain fatty acids (LCFA) and fats accumulation, leading to instability and inhibition of the degradation process. The aim of applying a heat and pressure pre-treatment to promote splitting of complex lipids and nitrogen-rich waste into simpler and more biodegradable constituents and to enhance biogas production was not successful. These results indicate that the temperature and the high pressure of the pre-treatment applied favoured the formation of compounds that are refractory to anaerobic digestion.The pre-treated slaughterhouse wastes and the final products of these systems were analyzed by FTIR and TGA. These tools verified the existence of complex nitrogen-containing polymers in the final effluents, confirming the formation of refractory compounds during pre-treatment.     

The operation of cost-effective on-site process for the bio-treatment of mixed municipal solid waste in rural areas

The application of on-site waste treatment significantly reduces the need for expensive waste collection and transportation in rural areas; hence, it is considered of fundamental importance in developing countries. In this study, the effects of in-field operation of two types of mini-scale on-site solid waste treatment facilities on de-centralized communities, one using mesophilic two-phase anaerobic digestion combined with composting (TPAD, 50 kg/d) and another using decentralized composting (DC, 0.6–2 t/d), were investigated. Source-separated collection was applied to provide organic waste for combined process, in which the amount of waste showed significant seasonal variation. The highest collection amount was 0.18 kg/capital day and 0.6 kg/household day. Both sites showed good performance after operating for more than 6 months, with peak waste reduction rates of 53.5% in TPAD process and 63.2% in DC process. Additionally, the windrow temperature exceeded 55 °C for >5 days, indicating that the composting products from both facilities were safe. These results were supported by 4 days aerobic static respiration rate tests. The emissions were low enough to avoid any impact on nearby communities (distance <100 m). Partial energy could be recovered by the combined process but with complicated operation. Hence, the choice of process must be considered in case separately.     

Anaerobic digestion of autoclaved and untreated food waste

Anaerobic digestion of autoclaved (160 °C, 6.2 bar) and untreated source segregated food waste (FW) was compared over 473 days in semi-continuously fed mesophilic reactors with trace elements supplementation, at organic loading rates (OLRs) of 2, 3, 4 and 6 kg volatile solids (VS)/m³ d. Methane yields at all OLR were 5–10% higher for untreated FW (maximum 0.483 ± 0.013 m³ CH₄/kg VS at 3 kg VS/m³ d) than autoclaved FW (maximum 0.439 ± 0.020 m³ CH₄/kg VS at 4 kg VS/m³ d). The residual methane potential of both digestates at all OLRs was less than 0.110 m³ CH₄/kg VS, indicating efficient methanation in all cases. Use of acclimated inoculum allowed very rapid increases in OLR. Reactors fed on autoclaved FW showed lower ammonium and hydrogen sulphide concentrations, probably due to reduced protein hydrolysis as a result of formation of Maillard compounds. In the current study this reduced biodegradability appears to outweigh any benefit due to thermal hydrolysis of ligno-cellulosic components.     

Stabilization of heavy metals in MSWI fly ash using silica fume

The objective of this work was to investigate the feasibility and effectiveness of silica fume on stabilizing heavy metals in municipal solid waste incineration (MSWI) fly ash. In addition to compressive strength measurements, hydrated pastes were characterized by X-ray diffraction (XRD), thermal-analyses (DTA/TG), and MAS NMR (²⁷Al and ²⁹Si) techniques. It was found that silica fume additions could effectively reduce the leaching of toxic heavy metals. At the addition of 20% silica fume, leaching concentrations for Cu, Pb and Zn of the hydrated paste cured for 7 days decreased from 0.32 mg/L to 0.05 mg/L, 40.99 mg/L to 4.40 mg/L, and 6.96 mg/L to 0.21 mg/L compared with the MSWI fly ash. After curing for 135 days, Cd and Pb in the leachates were not detected, while Cu and Zn concentrations decreased to 0.02 mg/L and 0.03 mg/L. The speciation of Pb and Cd by the modified version of the European Community Bureau of Reference (BCR) extractions showed that these metals converted into more stable state in hydrated pastes of MSWI fly ash in the presence of silica fume. Although exchangeable and weak-acid soluble fractions of Cu and Zn increased with hydration time, silica fume addition of 10% can satisfy the requirement of detoxification for heavy metals investigated in terms of the identification standard of hazardous waste of China.     

Co-digestion of sewage sludge with glycerol to boost biogas production

The feasibility of adding crude glycerol from the biodiesel industry to the anaerobic digesters treating sewage sludge in wastewater treatment plants was studied in both batch and continuous experiments at 35 °C. Glycerol addition can boost biogas yields, if it does not exceed a limiting 1% (v/v) concentration in the feed. Any further increase of glycerol causes a high imbalance in the anaerobic digestion process. The reactor treating the sewage sludge produced 1106 ± 36 ml CH₄/d before the addition of glycerol and 2353 ± 94 ml CH₄/d after the addition of glycerol (1% v/v in the feed). The extra glycerol-COD added to the feed did not have a negative effect on reactor performance, but seemed to increase the active biomass (volatile solids) concentration in the system. Batch kinetic experiments showed that the maximum specific utilization rate (μ_max) and the saturation constant (K_S) of glycerol were 0.149 ± 0.015 h^?1 and 0.276 ± 0.095 g/l, respectively. Comparing the estimated values with the kinetics constants for propionate reported in the literature, it can be concluded that glycerol uptake is not the rate-limiting step during the process.     

Medical waste management in China: A case study of Nanjing

Medical waste management is of great importance due to its infectious and hazardous nature that can cause undesirable effects on humans and the environment. The objective of this study was to analyze and evaluate the present status of medical waste management in the light of medical waste control regulations in Nanjing. A comprehensive inspection survey was conducted for 15 hospitals, 3 disposal companies and 200 patients. Field visits and a questionnaire survey method were implemented to collect information regarding different medical waste management aspects, including medical waste generation, segregation and collection, storage, training and education, transportation, disposal, and public awareness.The results indicated that the medical waste generation rate ranges from 0.5 to 0.8 kg/bed day with a weighted average of 0.68 kg/bed day. The segregated collection of various types of medical waste has been conducted in 73% of the hospitals, but 20% of the hospitals still use unqualified staff for medical waste collection, and 93.3% of the hospitals have temporary storage areas. Additionally, 93.3% of the hospitals have provided training for staff; however, only 20% of the hospitals have ongoing training and education. It was found that the centralized disposal system has been constructed based on incineration technology, and the disposal cost of medical waste is about 580 US$/ton. The results also suggested that there is not sufficient public understanding of medical waste management, and 77% of respondents think medical waste management is an important factor in selecting hospital services.The problematic areas of medical waste management in Nanjing are addressed by proposing some recommendations that will ensure that potential health and environmental risks of medical waste are minimized.     

Anaerobic co-digestion of food waste and landfill leachate in single-phase batch reactors

In order to investigate the effect of raw leachate on anaerobic digestion of food waste, co-digestions of food waste with raw leachate were carried out. A series of single-phase batch mesophilic (35 ± 1 °C) anaerobic digestions were performed at a food waste concentration of 41.8 g VS/L. The results showed that inhibition of biogas production by volatile fatty acids (VFA) occurred without raw leachate addition. A certain amount of raw leachate in the reactors effectively relieved acidic inhibition caused by VFA accumulation, and the system maintained stable with methane yield of 369–466 mL/g VS. Total ammonia nitrogen introduced into the digestion systems with initial 2000–3000 mgNH₄–N/L not only replenished nitrogen for bacterial growth, but also formed a buffer system with VFA to maintain a delicate biochemical balance between the acidogenic and methanogenic microorganisms. UV spectroscopy and fluorescence excitation–emission matrix spectroscopy data showed that food waste was completely degraded.We concluded that using raw leachate for supplement water addition and pH modifier on anaerobic digestion of food waste was effective. An appropriate fraction of leachate could stimulate methanogenic activity and enhance biogas production.     

Effect of temperature on VFA’s and biogas production in anaerobic solubilization of food waste

The effectiveness of methane fermentation treatment used in food waste processing is currently limited by solubilization and acidogenesis. In efforts to improve the treatment process, this study examined the effects of temperature on solubilization and acidogenesis. The solubilization rate of food waste, which was based on suspended solid removal, was 47.5%, 62.2%, 70.0%, 72.7%, 56.1% and 45.9% at 15 °C, 25 °C, 35 °C, 45 °C, 55 °C and 65 °C, respectively. Solubilization rate was accelerated from the middle to late experimental periods under mesophilic (35 °C and 45 °C) conditions. In contrast, overall solubilization rate was significantly lower under thermophilic (55 °C and 65 °C) conditions than under mesophilic conditions, although solubilization occurred rapidly in the early experimental period. The production of biogas was high under mesophilic conditions of 35 °C and 45 °C, at 64.7 and 62.7 mL/g-VS, respectively, while it was scarce under thermophilic conditions. Solubilization of food waste was accelerated under both mesophilic and thermophilic conditions; however, solubilization rate was observed to be particularly high under mesophilic conditions, and a shortening of the hydraulic retention time is expected under thermophilic conditions.     

Batchwise mesophilic anaerobic co-digestion of secondary sludge from pulp and paper industry and municipal sewage sludge

Residues from forest-industry wastewater-treatment systems are treated as waste at many pulp and paper mills. These organic substances have previously been shown to have potential for production of large quantities of biogas. There is concern, however, that the process would require expensive equipment because of the slow degradation of these substances. Pure non-fibrous sludge from forest industry showed lower specific methane production during mesophilic digestion for 19 days, 53 ± 26 Nml/g of volatile solids as compared to municipal sewage sludge, 84 ± 24 Nml/g of volatile solids. This paper explores the possibility of using anaerobic co-digestion with municipal sewage sludge to enhance the potential of methane production from secondary sludge from a pulp and paper mill. It was seen in a batch anaerobic-digestion operation of 19 days that the specific methane production remained largely the same for municipal sewage sludge when up to 50% of the volatile solids were replaced with forest-industry secondary sludge. It was also shown that the solid residue from anaerobic digestion of the forest-industry sludge should be of suitable quality to use for improving soil quality on lands that are not used for food production.     

Assessing generated quantities of infectious medical wastes: A case study for a health region administration in Central Macedonia,Greece

In the present study, the quantities of infectious medical wastes, generated from 12 public hospitals supervised by the 2nd Health Region Administration of Central Macedonia, Northern Greece, were calculated at a very disaggregated level for the first time and were compared to other reported characterization studies. Data was recorded by using an appropriately designed questionnaire, which was completed for each day of one week, in every department, clinic, unit or laboratory of each one of the 12 aforementioned hospitals. Afterwards, average generation indexes were determined in relation to certain important organizational and functional factors, such as the number of beds, bed coverage, the different hospital sections and wards, and the type of hospital. The way that sources of infectious wastes, generated from hospitals, vary by ward and department, was also illustrated and the most important sources were identified. Generated infectious hospital wastes vary from 0.26 to 0.89 kg/bed/day or 0.51 to 1.22 kg/patient/day, excluding the three specialised hospitals of the Health Region. The total amount of medical waste generated from the 2nd Health Region (only public hospitals) was estimated to be 691 tonnes/yr or 0.73 kg/cap/yr.     

Separation of polycarbonate and acrylonitrile–butadiene–styrene waste plastics by froth flotation combined with ammonia pretreatment

The objective of this research is flotation separation of polycarbonate (PC) and acrylonitrile–butadiene–styrene (ABS) waste plastics combined with ammonia pretreatment. The PC and ABS plastics show similar hydrophobicity, and ammonia treatment changes selectively floatability of PC plastic while ABS is insensitive to ammonia treatment. The contact angle measurement indicates the dropping of flotation recovery of PC is ascribed to a decline of contact angle. X-ray photoelectron spectroscopy demonstrates reactions occur on PC surface, which makes PC surface more hydrophilic. Separation of PC and ABS waste plastics was conducted based on the flotation behavior of single plastic. At different temperatures, PC and ABS mixtures were separated efficiently through froth flotation with ammonia pretreatment for different time (13 min at 23 °C, 18 min at 18 °C and 30 min at 23 °C). For both PC and ABS, the purity and recovery is more than 95.31% and 95.35%, respectively; the purity of PC and ABS is up to 99.72% and 99.23%, respectively. PC and ABS mixtures with different particle sizes were separated effectively, implying that ammonia treatment possesses superior applicability.