Determination of the best appropriate management methods for the health-care wastes in Istanbul

Health-care waste management has been a significant problem in most economically developing countries as it is in Turkey. Most of the time, the main reason for the mismanagement of these wastes is the lack of appropriate legislation and effective control; other reasons are: financial strains and a lack of awareness. Being aware of the significance of the subject, in this paper the management of the health-care wastes in Istanbul, as a Metropolitan City of Turkey, was analyzed to create an integrated health-care waste management system in the city. Within the scope of the study, the existing situation and management practices such as the amount of the health-care wastes generated, segregation procedures, collection, temporary storage and transportation of the wastes within and outside of the institution were examined. Deficiencies, inconsistencies and improper applications were revealed. The existing Turkish Medical Wastes Control Regulation and institutional structure of the health-care waste management body were reviewed. After the evaluation and comparison with the requirements of other national and international organizations, items to be changed/added in the Regulation were identified. At the end of the study, the best management methods for the Istanbul City were determined and started to be applied at the institutions. After this study, the existing Regulation has been changed. The modified Regulation was published in 2005 and implementation has started. It is expected that by the application and implementation of the research outcomes, the management of health-care wastes in Istanbul and then in all over Turkey will be improved. The results obtained can also be used in most economically developing countries where there are similar environmental problems and strict budgets.     

Solid waste management in Macao: practices and challenges

The rapid economic development and population growth in Macao have resulted in a large increase in refuse generated over the past decade. In 2003, the quantity of solid waste generated reached 249,255 tons, corresponding to 1.52 kg/day per capita. This figure has been gradually increasing. Domestic solid waste is the primary source of solid waste generation. The data showed that a considerable amount of the solid waste generated can be recycled and reutilized. Due to Macao's small geographic area and high cost of land, landfilling has the lowest priority for waste disposal. Solid waste incineration has been given a top priority over other waste disposal methods although it is much more expensive. In the last decade, more than 80% of the total waste in Macao was incinerated. However, the incineration capacity of the Macao Incineration Plant is going to reach its saturation earlier than expected. Waste minimization, the establishment of an effective waste collection and disposal fee system, and alternate ways dealing with the limited capacity of waste treatment facilities are regarded to be major challenges in the future.     

Fuzzy multicriteria disposal method and site selection for municipal solid waste

The use of fuzzy multiple criteria analysis (MCA) in solid waste management has the advantage of rendering subjective and implicit decision making more objective and analytical, with its ability to accommodate both quantitative and qualitative data. In this paper a modified fuzzy TOPSIS methodology is proposed for the selection of appropriate disposal method and site for municipal solid waste (MSW). Our method is superior to existing methods since it has capability of representing vague qualitative data and presenting all possible results with different degrees of membership. In the first stage of the proposed methodology, a set of criteria of cost, reliability, feasibility, pollution and emission levels, waste and energy recovery is optimized to determine the best MSW disposal method. Landfilling, composting, conventional incineration, and refuse-derived fuel (RDF) combustion are the alternatives considered. The weights of the selection criteria are determined by fuzzy pairwise comparison matrices of Analytic Hierarchy Process (AHP). It is found that RDF combustion is the best disposal method alternative for Istanbul. In the second stage, the same methodology is used to determine the optimum RDF combustion plant location using adjacent land use, climate, road access and cost as the criteria. The results of this study illustrate the importance of the weights on the various factors in deciding the optimized location, with the best site located in Çatalca. A sensitivity analysis is also conducted to monitor how sensitive our model is to changes in the various criteria weights.     

Medical waste management in Trachea region of Turkey: suggested remedial action.

The main objective of this paper was to analyse the present status of medical waste management in the Trachea region of Turkey and subsequently to draw up a policy regarded with generation, collection, on-site handling, storage, processing, recycling, transportation and safe disposal of medical wastes. This paper also presents the results of study about awareness on how to handle expired drugs. Initially all health-care establishments in Tekirda?, Edirne and Kyrklareli provinces in Trachea region were identified and the amounts of hospital wastes generated by each of them were determined. Current medical waste-management practices, including storage, collection, transportation and disposal, in surveyed establishments were identified. Finally, according to results, remedial measurements for medical waste management in these establishments were suggested. Unfortunately, medical wastes are not given proper attention and these wastes are disposed of together with municipal and industrial solid wastes. The current disposal method is both a public health and environmental hazard. When landfill sites are visited, many scavengers can be seen sorting for recyclable materials, a practice which is dangerous for the scavengers. In addition, it was found that some staff in health-care establishments are unaware of the hazard of medical wastes. It is concluded that a new management system, which consists of segregation, material substitution, minimization, sanitary landfilling and alternative medical waste treatment methods should be carried out. For the best appropriate medical waste management system, health-care establishment employers, managers and especially the members of house- keeping divisions should be involved in medical waste management practice.     

Report: environmental assessment of Darmstadt (Germany) municipal waste incineration plant.

The focus of this study was the emissions from waste incineration plants using Darmstadt (Germany) waste incineration plant as an example. In the study the emissions generated by incineration of the waste were considered using three different approaches. Initially the emissions from the waste incineration plant were assessed as part of the impact of waste management systems on the environment by using a Municipal Solid Waste Management System (MSWMS) assessment tool (also called: LCA-IWM assessment tool). This was followed by a comparison between the optimal waste incineration process and the real situation. Finally a comparison was made between the emissions from the incineration plant and the emissions from a vehicle.     

Assessing recycling versus incineration of key materials in municipal waste: The importance of efficient energy recovery and transport distances

Recycling of materials from municipal solid waste is commonly considered to be superior to any other waste treatment alternative. For the material fractions with a significant energy content this might not be the case if the treatment alternative is a waste-to-energy plant with high energy recovery rates. The environmental impacts from recycling and from incineration of six material fractions in household waste have been compared through life cycle assessment assuming high-performance technologies for material recycling as well as for waste incineration. The results showed that there are environmental benefits when recycling paper, glass, steel and aluminium instead of incinerating it. For cardboard and plastic the results were more unclear, depending on the level of energy recovery at the incineration plant, the system boundaries chosen and which impact category was in focus. Further, the environmental impact potentials from collection, pre-treatment and transport was compared to the environmental benefit from recycling and this showed that with the right means of transport, recyclables can in most cases be transported long distances. However, the results also showed that recycling of some of the material fractions can only contribute marginally in improving the overall waste management system taking into consideration their limited content in average Danish household waste.     

Determination of inorganic and organic priority pollutants in biosolids from meat processing industry

The biosolids (BS) generated in the wastewater treatment process of a meat processing plant were monitored and the priority pollutant content was characterized. The trace metal and organic pollutant content – polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/PCDF) – were determined quantitatively and compared to guideline limits established by the US EPA and EU. PCBs were not detected in the solid samples, while trace metals, PAHs and PCDD/PCDF were detected in concentrations below the limits established by international standards. Toxic equivalent factors were evaluated for the biosolids, and the results proved that these wastes can be safely deposited on land or used in combustion/incineration plants. Since no previous data were found for meat processing waste, comparisons were made using municipal sewage sludge data reported in the literature. Since, this report monitored part of the priority pollutants established by the US EPA for meat and poultry processing wastewater and sludge, the results verified that low pollution loads are generated by the meat processing plant located in the southern part of Brazil. However, the BS generated in the treatment processes are in accordance with the limits established for waste disposal and even for soil fertilizer.     

Management of immunization solid wastes in Kano State, Nigeria

Inadequate management of waste generated from injection activities can have a negative impact on the community and environment. In this paper, a report on immunization wastes management in Kano State (Nigeria) is presented. Eight local governments were selected randomly and surveyed by the author. Solid wastes generated during the Expanded Programme on Immunization were characterised using two different methods: one by weighing the waste and the other by estimating the volume. Empirical data was obtained on immunization waste generation, segregation, storage, collection, transportation, and disposal; and waste management practices were assessed. The study revealed that immunization offices were accommodated in either in local government buildings, primary health centres or community health care centres. All of the stations demonstrated a high priority for segregation of the infectious wastes. It can be deduced from the data obtained that infectious waste ranged from 67.6% to 76.7% with an average of 70.1% by weight, and 36.0% to 46.1% with an average of 40.1% by volume. Non-infectious waste generated ranged from 23.3% to 32.5% with an average of 29.9% by weight and 53.9% to 64.0% with an average of 59.9% by volume. Out of non-infectious waste (NIFW) and infectious waste (IFW), 66.3% and 62.4% by weight were combustible and 33.7% and 37.6% were non-combustible respectively. An assessment of the treatment revealed that open pit burning and burial and small scale incineration were the common methods of disposal for immunization waste, and some immunization centres employed the services of the state or local government owned solid waste disposal board for final collection and disposal of their immunization waste at government approved sites.     

Solid waste management practices in Turkey

As an economically developing country, Turkey has very well operated integrated solid waste management applications structured on modern facilities, besides over 2,000 scattered open dump areas in the country. Integrated waste management applications seem eligible for the metropolitan cities like Istanbul and Izmit (Kocaeli). Attempts have not been encouraging for the scattered regional settlements using central storage sites due to financial shortages and received rejections from nearby settlements. Small-scale compact solid waste management systems with materials recycling and composting can be more suitable alternatives in the small-scale regional settlements. The major constituents of municipal solid waste are organic in nature and approximately a quarter of municipal solid waste is recyclable. Although paper, including cardboard, is the main constituent, the composition of recyclable waste varies strongly by the source or the type of collection point. Solid wastes need primary treatment in order to be suitable for incineration and composting. Turkey needs to give more emphasis on the usage of modern solid waste removal technologies to overcome the overgrowing solid waste disposal problems.     

Biomedical solid waste management in an Indian hospital: a case study

The objectives of this study were: (i) to assess the waste handling and treatment system of hospital bio-medical solid waste and its mandatory compliance with Regulatory Notifications for Bio-medical Waste (Management and Handling) Rules, 1998, under the Environment (Protection Act 1986), Ministry of Environment and Forestry, Govt. of India, at the chosen KLE Society's J. N. Hospital and Medical Research Center, Belgaum, India and (ii) to quantitatively estimate the amount of non-infectious and infectious waste generated in different wards/sections. During the study, it was observed that: (i) the personnel working under the occupier (who has control over the institution to take all steps to ensure biomedical waste is handled without any adverse effects to human health and the environment) were trained to take adequate precautionary measures in handling these bio-hazardous waste materials, (ii) the process of segregation, collection, transport, storage and final disposal of infectious waste was done in compliance with the Standard Procedures, (iii) the final disposal was by incineration in accordance to EPA Rules 1998, (iv) the non-infectious waste was collected separately in different containers and treated as general waste, and (v) on an average about 520 kg of non-infectious and 101 kg of infectious waste is generated per day (about 2.31 kg per day per bed, gross weight comprising both infectious and non-infectious waste). This hospital also extends its facility to the neighboring clinics and hospitals by treating their produced waste for incineration.     

Improvement and modification of the routing system for the health-care waste collection and transportation in Istanbul

Handling of health-care wastes is among the most important environmental problems in Turkey as it is in the whole world. Approximately 25–30 tons of health-care wastes, in addition to the domestic and recyclable wastes, are generated from hospitals, clinics and other small health-care institutions daily on the European and the Asian sides of İstanbul [Kocasoy, G., Topkaya, B., Zeren, B.A., Kılıç, M., et al., 2004. Integrated Health-care Waste Management in İstanbul, Final Report of the LIFE00 TCY/TR/054 Project, Turkish National Committee on Solid Wastes, İstanbul, Turkey; Zeren, B.A., 2004. The Health-care Waste Management of the Hospitals in the European Side of İstanbul, M.S. Thesis, Boğaziçi University, İstanbul, Turkey; Kılıç, M., 2004. Determination of the Health-care Waste Handling and Final Disposal of the Infected Waste of Hospital-Medical Centers in the Anatolian Side of İstanbul. M.S. Thesis, Boğaziçi University, İstanbul, Turkey]. Unfortunately, these wastes are not handled, collected or temporarily stored at the institutions properly according to the published Turkish Medical Waste Control Regulation [Ministry of Environment and Forestry, 2005. Medical Waste Control Regulation. Official Gazette No. 25883, Ankara, Turkey]. Besides the inappropriate handling at the institutions, there is no systematic program for the transportation of the health-care wastes to the final disposal sites. The transportation of these wastes is realized by the vehicles of the municipalities in an uncontrolled, very primitive way. As a consequence, these improperly managed health-care wastes cause many risks to the public health and people who handle them.This study has been conducted to develop a health-care waste collection and transportation system for the city of İstanbul, Turkey. Within the scope of the study, the collection of health-care wastes from the temporary storage rooms of the health-care institutions, transportation of these wastes to the final disposal areas and the cost-benefit analyses of the existing and the proposed optimum transportation routes are investigated and the most feasible routes from the point of view of efficiency and economy have been determined.In order to solve the scheduling and route optimization problem, special software programs called MapInfo and Roadnet were used. For the program, the geocodes of hospital locations, data about the amount of the health-care wastes generated, the loading and unloading process times, and the capacity of the collecting vehicles were taken into account. The new systems developed aim at the daily collection of the health-care wastes from the institutions and their transportation directly to the final disposal area/facility by using the shortest and the most efficient routes to resolve the routing and scheduling problem and to reduce the cost arising from the transportation.     

Centralized incineration treatment of infectious waste for regional hospitals in Taiwan

Taiwan has a high population density. Recently, rapid advances of medical activities have caused an environmental problem in managing the wastes generated by hospitals or clinics. Government regulations, public concern and an increased commitment to a clean environment have also brought more attention to the handling problems of medical waste. A project to plan and manage the first centralized incineration plant for infectious hospital waste has been carried out in Taiwan. This paper summarizes the results of the execution of this project. It addresses the experience gained in siting a regional incinerator, its technical operation to meet local environmental regulations and the management of the regional plant. Public concern against incineration was considered to be the most important criterion to address during establishment of the incinerator, as well as good operational performance. The operational problems encountered most frequently in the regional plant with possible causes and solutions to the problems are summarized in this paper. It was also found that a delivery manifest was useful to manage the delivery of infectious waste.     

Assessment of health-care waste disposal methods using a VIKOR-based fuzzy multi-criteria decision making method

Nowadays selection of the appropriate treatment method in health-care waste (HCW) management has become a challenge task for the municipal authorities especially in developing countries. Assessment of HCW disposal alternatives can be regarded as a complicated multi-criteria decision making (MCDM) problem which requires consideration of multiple alternative solutions and conflicting tangible and intangible criteria. The objective of this paper is to present a new MCDM technique based on fuzzy set theory and VIKOR method for evaluating HCW disposal methods. Linguistic variables are used by decision makers to assess the ratings and weights for the established criteria. The ordered weighted averaging (OWA) operator is utilized to aggregate individual opinions of decision makers into a group assessment. The computational procedure of the proposed framework is illustrated through a case study in Shanghai, one of the largest cities of China. The HCW treatment alternatives considered in this study include “incineration”, “steam sterilization”, “microwave” and “landfill”. The results obtained using the proposed approach are analyzed in a comparative way.     

Integrated assessment of a new Waste-to-Energy facility in Central Greece in the context of regional perspectives

The main aim of this study is the integrated assessment of a proposed Waste-to-Energy facility that could contribute in the Municipal Solid Waste Management system of the Region of Central Greece. In the context of this paper alternative transfer schemes for supplying the candidate facility were assessed considering local conditions and economical criteria. A mixed-integer linear programming model was applied for the determination of optimum locations of Transfer Stations for an efficient supplying chain between the waste producers and the Waste-to-Energy facility. Moreover different Regional Waste Management Scenarios were assessed against multiple criteria, via the Multi Criteria Decision Making method ELECTRE III. The chosen criteria were total cost, Biodegradable Municipal Waste diversion from landfill, energy recovery and Greenhouse Gas emissions and the analysis demonstrated that a Waste Management Scenario based on a Waste-to-Energy plant with an adjacent landfill for disposal of the residues would be the best performing option for the Region, depending however on the priorities of the decision makers. In addition the study demonstrated that efficient planning is necessary and the case of three sanitary landfills operating in parallel with the WtE plant in the study area should be avoided. Moreover alternative cases of energy recovery of the candidate Waste-to-Energy facility were evaluated against the requirements of the new European Commission Directive on waste in order for the facility to be recognized as recovery operation. The latter issue is of high significance and the decision makers in European Union countries should take it into account from now on, in order to plan and implement facilities that recover energy efficiently. Finally a sensitivity check was performed in order to evaluate the effects of increased recycling rate, on the calorific value of treated Municipal Solid Waste and the gate fee of the candidate plant and found that increased recycling efforts would not diminish the potential for incineration with energy recovery from waste and neither would have adverse impacts on the gate fee of the Waste-to-Energy plant. In general, the study highlighted the need for efficient planning in solid waste management, by taking into account multiple criteria and parameters and utilizing relevant tools and methodologies into this context.     

Disposal of solid waste in Istanbul and along the Black Sea coast of Turkey

The increasing amount of solid waste arising from municipalities and other sources and its consequent disposal has been one of the major environmental problems in Turkey. Istanbul is a metropolitan city with a current population of around 14 million, and produces about 9000 ton of solid waste every day. The waste composition for Istanbul has changed markedly from 1981 to 1996 with large decreases in waste density, much of which is related to decreased amounts of ash collected in winter. In recent years, the Istanbul region has implemented a new solid waste management system with transfer stations, sanitary landfills, and methane recovery, which has led to major improvements. In the Black Sea region of Turkey, most of the municipal and industrial solid wastes, mixed with hospital and hazardous wastes, are dumped on the nearest lowlands and river valleys or into the sea. The impact of riverside and seashore dumping of solid wastes adds significantly to problems arising from sewage and industry on the Black Sea coast. Appropriate integrated solid waste management systems are needed here as well; however, they have been more difficult to implement than in Istanbul because of more difficult topography, weaker administrative structures, and the lower incomes of the inhabitants.     

Classification and categorization of treatment methods for ash generated by municipal solid waste incineration: A case for the 2 greater metropolitan regions of greece

The primary goal of managing MSW incineration residues is to avoid any impact on human health or the environment. Incineration residues consist of bottom ash, which is generally considered as rather harmless and fly ash which usually contains compounds which are potentially harmful for public health. Small quantities of ash (both bottom and fly) are produced currently in Greece, mainly from the healthcare waste incineration facility in Attica region. Once incineration plants for MSW (currently under planning) are constructed in Greece, the produced ash quantities will increase highly. Thus, it is necessary to organize, already at this stage, a roadmap towards disposal/recovery methods of these ash quantities expected.Certain methods, related to the treatment of the future generated ash which are more appropriate to be implemented in Greece are highlighted in the present paper. The performed analysis offers a waste management approach, having 2016 as a reference year for two different incineration rates; 30% and 100% of the remaining MSW after recycling process. The results focus on the two greater regions of Greece: Attica and Central Macedonia. The quantity of potential future ash generation ranges from 137 to 459 kt for Attica region and from 62 to 207 kt for central Macedonia region depending on the incineration rate applied. Three alternative scenarios for the treatment of each kind of ash are compiled and analysed. Metal recovery and reuse as an aggregate in concrete construction proved to be the most advantageous -in terms of economy-bottom ash management scenario. Concerning management of the fly ash, chemical treatment with phosphoric solution addition results to be the lowest total treatment cost and is considered as the most profitable solution. The proposed methodology constitutes a safe calculation model for operators of MSW incineration plants regardless of the region or country they are located in.     

The Ümraniye-Hekimbaşi open dump accident

The open dump of Ümraniye-Hekimbaşi was the main solid disposal site of the Asiatic side of Istanbul. At this site, which was in operation since 1976, 1500–2000 tonnes of solid wastes were disposed of daily. No waste compaction was undertaken during placement. The slope formed by the solid wastes was very steep (3 vertical to I horizontal), and recently demolition wastes were disposed of on top of these wastes. On 28 April 1993, an “explosion” took place, followed by the displacement of a large mass of solid wastes which engulfed II houses causing the death of 39 people. This paper investigates the possible reasons for this accident and concludes that it was caused by the initial sliding of the solid wastes, which were not deposited in a stable way, followed by an explosion of the methane generated and retained in the landfill.     

Application of system dynamics modeling for evaluation of different recycling scenarios in Singapore

The influence of socioeconomic factors, such as population and rapid economic growth, and the change of consumption and living patterns make waste management in Singapore, a complex issue. Due to limited land and resources, the solid waste management scheme requires a comprehensive approach. Therefore, system dynamics (SD) modeling was applied to assess alternative strategies for solid waste management by interconnecting landfill capacity and recycling efficiency with reference to the projection on waste generation. Nine different scenarios were investigated to identify the best approach to maintain environmental sustainability without inhibiting the economic growth. Four subsystems (i.e., population, economy, waste recycling, and waste disposal) have been incorporated into the SD model to broaden the effectiveness of the waste management system. Research findings revealed that a high economic pattern and a high recycling rate are recommended to satisfy the requirements for economic growth and environmental sustainability while extending landfill capacity for waste disposal. Even though the balance of expenditure could be increased by the high recycling rate, it meets the need for long-term incineration and landfill planning.     

Management of municipal solid waste in the Three Gorges region

As the fourth phase of the Three Gorges reservoir project commenced in 2008, the rate of water flow in the Yangtze River has obviously decelerated further downstream and water clarity within the storage facility has decreased. Meanwhile, the rate of urbanization in the region is adding to the amount of municipal solid waste (MSW) being generated by every day life. The composition of the waste is becoming more diversified and complicated, thereby presenting an increasing threat to the ecological environment and water resources of the Three Gorges region. This paper is a probe into MSW in terms of its characteristics as well as methods of storage, collection, transportation, recycling, treatment and disposal, the protection of environmental ecosystems. Municipal solid waste management (MSWM) is one of the major environmental problems in the Three Gorges region, and indeed the whole of China. Based on the analysis of the present situation of MSWM and its treatment/disposal, some methods of sorting, recycling, decomposing, incineration and reuse are described, sanitary landfill as the main disposal method in Chongqing city, incineration being the second. Sanitary landfill or dump was also used for MSW treatment in the Three Gorges region, and this paper also provides some suggestions for improving MSWM in the Three Gorges region.     

Municipal waste management in Sicily: practices and challenges

There are numerous problems yet to be solved in waste management and although efforts towards waste recovery and recycling have been made, landfills are still the most common method used in the EU and many other industrialised countries. Thermal disposal, particularly incineration, is a tested and viable alternative. In 2004, only 11% of the annual waste production of Italy was incinerated. Sicily, with over five million inhabitants, is the second largest region in Italy where waste management is now a critical problem. The use of landfills can no longer be considered a satisfactory environmental solution; therefore, new methods have to be chosen and waste-to-energy plants could provide an answer. This paper gives details of municipal solid waste management in Sicily following a new Waste Management Plan. Four waste-to-energy plants will generate electricity through a steam cycle; the feedstock will become the residue after material recovery, which is calculated as 20-40% weight of the collected municipal solid waste.