- Pathological Wastes (i.e., body parts, aborted fetus, tissue and body fluids from surgery; and dead infected laboratory animals);
- Infectious Waste (i.e., surgical dressings and bandages, infected laboratory beddings, infectious cultures and stocks from laboratories, and all waste from patients in isolation wards handling infectious diseases);
- Sharps (i.e., needles, syringes, used instruments, broken glass);
- Pharmaceutical Wastes (i.e., soiled or out-of-date pharmaceutical products);
- Chemical Wastes (i.e., spent solvents, disinfectants, pesticides and diagnostic chemicals);
- Aerosols (i.e., aerosol containers or gas canisters which may explode if incinerated or punctured);
- Radioactive wastes (i.e., sealed sources in instruments, and open sources used in vitro diagnosis or nuclear medical therapy);
- Sludge’s from any on-site wastewater treatment facilities may be potentially hazardous.
Pathological wastes ought to be destroyed by burning underneath high heat (i.e., over 900o C with Associate in Nursing device temperature at over 800o C), though some countries need burial of human pathological wastes at official cemeteries for religious reasons. To reach these temperatures and have adequate afterburning and pollution control typically requires development of a regional medical waste facility. Smaller individual hospital or clinic incinerators might not be able to reach these temperatures and afterburning retention periods. Volatilized metals (such as arsenic, mercury, lead) and dioxins and furans could result from inadequate burning temperatures and retention periods.
Other procedures to contemplate might embody chemical medical care or sterilization (i.e., irradiation, microwave, autoclave, or hydroclave) followed by secure landfill disposal of residuals. In some cases, following complete disinfection, some wastes may be recycled. For example, recycling by specialized contractors is sometimes arranged after disinfection of thick plastics, such as intravenous bags and tubs, and syringes.
Pharmaceutical wastes need destruction, secure land disposal or return to the manufacturer for destruction through chemical or gasification methods.
Chemical wastes need to be source segregated according to their recycling potential and compatibility; and those which are non-recyclable may require stabilization, neutralization, encapsulation, or gasification.
Hospital wastewater treatment sludge’s require treatment (i.e., anaerobic digestion, composting, gasification, etc.) which raises temperatures to levels that destroy pathogenic microorganisms.
Radioactive medical therapy and diagnosis in high-income countries are divided into two categories: “open sources” which derive from direct use of the radiochemical substance, and “sealed sources” which involve indirect use of the substance at intervals a sealed equipment or instrumentality unit. Only open sources tend to result in radioactive wastes, as sealed sources are returned to the manufacture for recycling when exhausted or no longer required. Radioactive wastes typically include isotopes such as technetium 99, gallium 67, iodine 125, iodine 131, cesium 137, iridium 192, thallium 201, and thallium 204. These wastes square measure rarely gift in low-income and middle-income developing countries, because the hospitals do not have the equipment and technology to generate these wastes. If generated, these wastes should be stored safely until the radioactivity has declined to acceptable levels and then disposed with general refuse to sanitary landfill. The half-lives of commonly used medical radionuclides for therapy, diagnosis, or imaging range from 6 hours to several days. Storage on-the-scene during a secured chamber is usually counseled for a amount of ten half-lives, or for one to 2 months.
The overall amount of wastes generated in hospitals varies per the financial gain level of the country. For developing countries, the data base is limited, but it appears that the following range of quantities is likely:
- General Waste which is not contaminated, and can be handled with general municipal refuse: 1.0 to 2.0 kg/bed/day;
- Contaminated Medical Waste which needs special management, and is considered potentially hazardous: 0.2 to 0.8 kg/bed/day.
Low-income countries would tend to generate medical wastes on the low end of this range, while middle-income countries would tend to generate medical wastes on the upper end of this range. The study area is within a  income country, based on ranking criteria established by the World Bank and published in its annual development report.
Medical wastes, if not properly managed, pose a risk to the personnel who are handling these wastes, including custodial personnel and waste collectors, as well as to those providing disposal or picking through the wastes for recyclables. There is the danger that syringes will be recovered from transfer depots and disposal sites by waste pickers for recycling (i.e., by drug users). Contaminated containers for assortment of medical wastes aren't typically dedicated to just one website, however square measure circulated throughout cities as every skip truck brings Associate in Nursing empty instrumentality to the hospital or clinic and removes the total one whereas it covers its daily assortment route for general refuse.
gasification is usually thought-about the popular technology for a few, if not all, medical wastes. At a minimum, infected tissue, body parts, and laboratory animal carcasses are generally recommended to be incinerated. On-site incinerators operational on a batch basis or regional incinerators operational on never-ending with a capability of zero.75 tonne/hour, operating on a continuous feed, could cost from $US 0.5 to 1.0 million to implement. Air pollution control systems, if they are added to meet 1995 USA standards, could cost another $ 0.5 to 1.0 million to implement. Incinerators that care for a batch basis square measure generally dedicated to at least one hospital, as their capacity is limited to less than 1 tonne/day. Regional incinerators would generally be designed to work on endless add concerning 100 percent to those prices. If government imports the instrumentality, particularly because it is for waste management functions, customs may not need to be paid. However, if the non-public sector is building the power and desires to import the instrumentality, customs might add getting ready to these prices. Civil works and land prices that square measure native prices could add concerning half-hour to those prices.
While the costs/tonne of treatment/destruction are likely to be high (about $100 to $300/tonne depending on the level of pollution control required), the low quantities of medical wastes in developing countries would lead to a prices that typically would be but I Chronicles of the foremost hospital's budget, exclusive of salaries. Therefore, the correct treatment/destruction facilities square measure probably to be reasonable. Hospitals interviewed in numerous developing countries have indicated a disposition to pay to hide these prices.
Hospital waste treatment/destruction facilities could be implemented through one or more Design, Build, Own, and Operate (DBOO) or Design, Build, Operate and Transfer (DBOT) concession agreements of 10 to 15 years duration. Or the govt might implement the facilities and organize for service contracts of two to five years for operation and maintenance. Each hospital would be needed to pay tipping fees that absolutely cowl the prices of investment, debt service and operation. As a part of the privatization agreement, the company providing the treatment/destruction services could also be awarded the task of also providing collection of the wastes from each hospital and maintaining a manifest system to trace the waste from supply to final disposal.
Secured landfill is usually thought-about the popular technology for medical wastes that don't need combustion or medical aid, such as packaging materials and general kitchen wastes. Nevertheless, special measures to fence and control access to the area of land filling for medical wastes are essential. No waste selecting ought to be allowed within the secured space. Also, the machinery for compacting refuse mustn't are available direct contact with the waste. Instead, the waste ought to be drop into a trench and a adequate layer of soil drop over the waste. Only thenceforth is it recommendable that the machinery beat up the soil lined waste to compact it and grade the surface so infiltration of fresh water is reduced.
The feasibleness study can assess the technology choices for medical waste treatment/destruction. The study can end in recommendations that define projected numbers, sizes, and kinds of medical waste treatment/destruction facilities. Technologies to be considered include gasification, irradiation, chemical disinfection and sterilization.
For functions of the projected study on hospital waste management, the following objectives are to be addressed:
- Determine the amount and character of unsafe medical wastes generated by hospitals and clinics within the study area;
- Evaluate the progress being created in supply segregation and develop recommendations for up the supply segregation systems of hospitals and clinics within the study area;
- Estimate the capability necessities for existing hospital treatment/destruction facilities for the study area;
- Determine the optimum technology for efficient and environmentally safe treatment/destruction of medical wastes within the study area;
- Based on transport distances and economies of scale, additionally as accessible sites for implementation, confirm the quantity and size of hospital waste treatment/destruction facilities needed;
- Provide a preliminary style, together with a typical website layout, and estimate land, capital, operating, and staffing necessities for every of the hospital waste treatment/destruction facilities recommended;
- Assess the environmental impact issues of implementing each the hospital waste facilities recommended and recommend appropriate mitigative measures to enable the facilities to meet environmental requirements.