Abstract - Solid waste management (SWM) is a vital issue to reduce, manage, segregate, dispose off properly and it involves more management, skills, and techniques when it is being involved in so many types of infected waste materials. The paper in hand depicts the solid waste management in Thammasat hospital located in Pathumthani Municipality, Thailand. Hospital has the capacity of more than 600 beds and daily about more than 1000 patients visit the hospital. Waste generation rate is 1200 kg per day approximately and the cost of waste collection is more than 3 millions almost annually. Waste disposing is the main problem for the hospital and this study attempted to suggest appropriate technology to resolve this problem. The results showed that two technologies can be selected to dispose the waste i.e. incineration and sanitary landfill.
Keywords - Hospital Waste Management, Hazardous Waste, Appropriate Technology, SHTEFIE Criteria, Sanitary Landfill
INTRODUCTION
Environmental problems are at top priority since last few decades as these are directly vulnerable to human beings, animals, crops and surrounding environment as well. These issues are so vital to discuss and are not ignorable at any cost. Hospitals are the places of health care and if waste will be not disposed off properly then most of the stakeholders may get infected especially employees working in the hospital, patients and surrounding communities also which could cause more troubles than the original ones. Infectious waste can be source of diseases like Hepatitis, AIDS, Typhoid and Boils etc.
Most of the hospitals are places to generate pathological, sharp and non sharp infectious wastes; among those 42.3 percent hospitals generate chemical wastes and major part of the chemical wastes is generated by government hospitals . So, it would be good to mention that 23.1 percent private hospitals and 53.8 percent government hospitals generate radiological waste. Thammasat hospital is the largest hospital in Pathumthani province and it falls under the municipality of Pathumthani also with the capacity of more than 600 beds and daily 1000 patients approximately visit the hospital. Quantity of biomedical waste produced is 1200 kilogram per day approximately and the cost of waste collection is about more than 3 million per year. Before entering into detail of solid/hazardous waste management of hospital, it is necessary to know about the different kind of medical wastes; the hospital waste has classified into different categories.
Biomedical waste needs spatial care and concern to dispose it properly because it cannot mix with household or other kinds of wastes. A separate and fully equipped technology is required to deal hazardous waste; inappropriate technology may lead to different unwanted direct problems not only to humans but environments as well [. The objectives of this case study were to identify the current situations of waste management in Thammasat hospital and to suggest appropriate technology(s) on sustainable basis and cost effective as well to manage the waste efficiently and appropriately. Currently, hospital has no solid/hazardous waste solution on long run and sustainable basis; hospital waste is mixed with bio degradable and recyclable waste without any deliberation to find out its proper solution.
Methodology
This research study is descriptive and involved primary and secondary data collections; site surveys, staff, managing authorities and private company's interviews are also part of this data collection techniques and methods. For the Thammasat hospital hazardous waste management SHTEFIE criteria was used to suggest appropriate technology as long run and cost effective solution. For this purpose SHTEFIE criteria is best suitable method to apply because it covers the seven important factors which are normally dealt to select technology(s) after examining the current situation of the area under consideration. Technology selection is concerned with choosing the best technology from a number of available options.
The criteria for a 'best' technology may differ depending on the specific requirements. Technology selection involves gathering information from various sources about the alternatives, and the evaluation of alternatives against each other or some set of criteria.The best to choose of this method is that, it considers and selects technology which is best suitable according to the local conditions and circumstances. This specific technology selection criteria gives new insight to the decision makers at the local as well as regional level and it depends on the scope and limitations of the work and the purpose behind to do the study. In order to study and go through the waste circle of Thammasat hospital SHTIFIE criteria mostly consider following factors to check sensibly options so that decision must be made on the clear and dire need basis.
Overview of existing situation
Current scenario of the hospital waste management is quite simple and straight in terms of management. As discussed above as well that quantity of biomedical waste produced in the hospital is 1200 kilogram per day approximately and the cost of waste collection is about more than 3 million annually; actually the waste collection contract has been given to two private companies at the same time i.e. Peerapat company and care & clean company of Thailand. Peerapat company is located in Bang-pa-in, Ayutthaya province. Peerapat company deals with the biomedical waste only while care & clean company responsible for all kind of wastes along with cleaning and sweeping of hospital as well. Peerapat workers come to collect the waste from the hospital day after tomorrow in the whole weak and until their arrival waste is stored in the storage house located one kilometer away from the main hospital building. The waste is collected and stored in different bags to separate waste according to the company instructions to the collectors and sweepers. There are three types of bags used for the separation of waste during cleaning i.e. black, red and green bags; further description of bags and waste collections is following:
Black bag is used to collect general waste like food, bottles, cans, glass, plastic etc.
Green bag is used to collect and store the recyclable waste generated within the hospital.
Red bag contains all the biomedical and infected waste such as needles, syringes, blades, used gloves, cotton swabs, drains tubes and also infected patients' clothes etc.
The hospital had its own incineration unit about 2-3 years before installed with the purpose to dispose the waste and by own hospital waste management unit but after the complaints from surrounding areas and keeping in view the environmental degradation issues it was stopped to operate; the plant is still present at its original place but silently.
Results
To focus on the hazardous waste management of the hospital some possible options were considered to select best technology(s); those included incinerator, sanitary landfill, steam autoclaving, chemical treatment, microwave radiation and control dumping etc. These choices were considered keeping in mind the SHTEFIE criteria at the mean time which explains the factors affecting the local, current and salient features and showed clear picture of current scenario. Many constraints were identified and brought on front by this set of criteria using specific factors. Analysis has showed that financial and environmental factors are dominant for the selection of best technology; site surveys, community and hospital concerns helped sufficient to observe the needs and priorities closely. Sanitary landfill (for the general and radioactive types of waste) and incineration (for all types of hazardous waste) are declared best being cost effective and less pollutant.
Incinerator has already been present in the hospital territory and needs little maintenance to be in working condition again but sanitary landfill is big deal as it is labor intensive and need huge investment as well. The sanitary landfill is an isolated area of land, where waste is dumped in excavated trenches and covered daily with a soil cover. The main purpose of landfill is for storage and containment of the waste deposited into it. The landfills for hospital waste are supposed to be divided into two portions, one for putting general waste and the other, biomedical waste. Landfills should be properly secured and properly designed.
So, incineration could be considered best among these two so far. Under ideal conditions, there should be no smoke but only colorless exhaust into the atmosphere. Thus, temperature must be sufficient enough to demolish the waste accurately, support the self-sustaining conditions of combustion and allow the reaction to occur in a reasonably short time. Furthermore, a properly designed incinerator should completely burn waste leaving a minimum of residual in the form of ashes and should be equipped with scrubbers to trap toxic air pollutants emitted. The polythene bags made of chlorinated plastics should not be incinerated. Plastic materials as part of the waste encourage the release of dioxins when incinerating them. This is because plastics contain chlorine by-products such as polyvinyl chlorides (PVCs).
Conclusion
Environment and health are two main concerns of each hospital required to be in flow exactly so that each common may not be affected by these problems. Waste itself is a big host to damage environment and health; especially patients of hospitals are sensitive being there. The study has tried to find the best solution for Thammasat hospital waste and concluded that sanitary landfill and incineration are two best appropriate technologies to adapt. Furthermore, incinerations is declared best being cost effective, less pollutant and most feasible as compared to sanitary landfill which is alone not a sustainable solution of waste management in hospital. Infact, the emissions from the incinerator lead to major health and environmental problems to the surrounding area. These can be mitigated by adapting simple technology. Precipitators are available to catch the dust particles from smoke and gas by adding this tool to the system; it is possible to reduce the dust problem efficiently on sustainable basis. Most of the polluted gases will disappear if the temperature set at more than 1200 degree Celsius. It is necessary to regulate system to the temperature more than 1200 degree Celsius to incinerate the infectious hospital wastes.
References
