CAPEGATE GROUP

ENVIRONMENTAL FRIENDLY AND ECONOMICAL

HEALTHCARE WASTE MANAGEMENT PROJECT

By Dr. CEMAL KALDIRIMCI ( www.metan.com.tr )

CAPEGATE
 What
Healthcare Waste Management
Aims at

To protect the PUBLIC and the

ENVIRONMENT from exposure to
DISEASE CAUSING AGENTS or
HARM CAUSED by
HAZARDOUS HEALTHCARE WASTES

CAPEGATE
Implementing waste
management
Why hospital waste management?
•Protection of the human health by reducing the exposure
of patients and the public to harmful goods
•Enhanced community relations by demonstrating a
commitment to environmental protection (positive press
coverage)
•Avoidance of long term liability (Responsibility of the
generator)
•High efficient, low cost waste logistic and disposal
•Increased employee morale, resulting from a healthier and
safer work environment
•Longterm savings of disposal costs
 STEPS OF IMPLEMENTING
STATE OF THE ART
HEALTHCARE WASTE MANAGEMENT
SYSTEM IN HOSPITALS FROM CONSTRUCTION
OF THE HOSPITALS TO FINAL DISPOSAL and
RECYCLING OF THE WASTE
1- MEASURES TAKEN DURING CONSTRUCTION
2- IMPLEMENT OF A PROPER IN-HOUSE
HELTHCARE WASTE MANAGEMENT
PRACTICING
3- EXTERNAL LOGISTICS
4- FINAL DISPOSAL
SOURCES OF MEDICAL WASTE :

The primary sources of Bio-Medical Waste are

• Hospitals
• Diagnostic Centers
• Laboratories
• Blood Banks
• Nursing Homes
• Clinics
• Veterinary Hospitals % clinics
• Pharmacy shops
• Dialysis center
1- MEASURES TO BE TAKEN
DURING CONSTRUCTION OF
HOSPITAL
• Provisions for onsite segregation and
storage of all recyclables as glasses,
pallets, plasterboard, plastic, cardboard, textiles, etc.
• Provisions for internal logistics , storage and interim
storage of hazardous waste streams
• Provisions for hard-core, agricultural waste (green
waste) and general kitchen-like waste ( for instance
composting facilities )
• Provisions for establishing proper infection control
• Provisions for reducing waste generating materials
• Provisions for reducing the environmental impact to
environment
IMPLEMENT OF A PROPER
IN-HOUSE
HEALTHCARE-WASTE
MANAGEMENT PRACTICING
 FOR IMPLEMENTING A PROPER
MEDICAL WASTE MANAGEMENT
PRACTICING ; WHICH CONSISTS
OF ;
• Planning
• Projecting
• Implementing

• The start is AWARANESS

 WASTE STREAMS
GENERATED IN
HOSPITALS

• FROM MEDICAL OPERATIONS

• FROM NON-MEDICAL AND
PARAMEDICAL OPERATIONS
 How Hospital Waste Generated from Medical
Operations is Segregated

Healthcare Waste
(100 %)

Non-Risk Waste Risk Waste

( 80 %) ( 20 %)

Refuse Recycling Medical Waste Chemical Waste Other Waste

( 40 %) ( 40 %) ( 14,5 %) ( 5 %) ( 0,5 %)

• Infectious w. • Photo-Chemicals • Radioactive w.

• Pathological w. • Pharmaceuticals • Cytotoxic ,
•Sharps & Needles •Other Chemical w. mycotoxic,w.
Non-hazardous Medical Waste
Most of it (75-90%) is similar to
domestic waste. This fraction
referred to as healthcare general
waste (HCGW) is made of
paper, plastic packaging, food
preparation, etc. that haven't
been in contact with patients
Infectious Medical Waste
Infectious Medical Waste can be in form of bacterial,
fungal, viral and parasitic organisms and cultured
cells and is medical waste which is capable of
producing an infectious disease.

Medical waste shall be considered capable of

producing an infectious disease if
(1) it has been, or is likely to have been,
contaminated by an organism likely to be
pathogenic to healthy humans,
(2) if such organism is not routinely and freely
available in the community, AND
(3) such organism has a significant probability of
being present in sufficient quantities and with
sufficient virulence to transmit disease
TYPES OF INFECTIOUS WASTE
•Cultures of microorganisms & biologicals
• Human blood and blood products
•Pathological wastes
•All Sharps and needles (even if not
contaminated)
•Contaminated animal carcasses, body
parts, bedding
and related wastes
•Materials (soil, water, or other debris)
which result from the cleanup of a spill of
any infectious medical waste.
•Waste contaminated by or mixed with
infectious medical waste.
 Human Blood & Blood
Products
• All human blood (wet or dried)
• Products from human blood.
Simply; Whatever contacted with blood or human
fluid is considered as
“ potentially infectious waste “
Cultures and stocks of
microorganisms and biologicals
 Sharps
Items that could cause cuts or punctual wounds,
whether or not they are infected. Sharps are
considered as hazardous health care waste.

Sharps include:
•Needles
•Scalpels and other blades
•Knifes and saws
•Infusions sets
•Broken glass
•Nails

METAN
 Pathological waste
Waste, which should be treated in a special way out
of ethical reasons. Pathological waste is normally
not hazardous but needs special attention.

Consists of:
• Tissues
• Organs, Placentas
• Body parts
• Human fetuses
• Animal carcasses
• Blood
• Body fluids
Pathological Waste
• Human pathological wastes - tissues,
organs, body parts, containers of body
fluids
Animal Waste
• Contaminated animal carcasses, body
parts, animal bedding known to have been
exposed to infectious agents during
research
Definition of Hazardous Medical waste
Discarded biologic product, such as blood
or tissues, removed from operating rooms,
morgues, laboratories, or other medical
facilities. The term may also be applied to
bedding, bandages, syringes, and similar
materials that have been used in treating
patients, and body parts used in research
Simply, any waste–regardless of whether it
is potentially infectious–generated as a
result of Patient (man/animal) diagnosis
and treatment.
More simple, anything (can’t be
disinfected) that comes in contact with the
blood or body fluid .
Examples of hazardous wastes from non-medical operations

• Used oil, hydraulic fluid, diesel fuel, or jet fuel;

• Soil contaminated with toxic or hazardous polluhydraulic fluid, diesel
fuel, or jet fuel);
• resins, roofing cement, adhesives, machinery lubricants, and caulk; •
Cleanup materials (such as rags) contaminated with the items listed
above;
• Drums and containers that once contained the items listed above;
• Computer monitors and televisions with cathode ray tubes; • Gypsum
drywall (due to sulfate); • rescent bulbs, broken mercury switches,
batteries, or thermostats); and
• Other items that may have inseparable hazardous constituents. tants
(e.g., soil contaminated with used oil, Waste paints, varnish, solvents,
sealers, thinners, Waste carpeting (due to formaldehyde contents);
Lead-based paint, lead flashing, or lead solder;
• Mercury-containing demolition wastes (e.g., fluorescent bulbs, broken
mercury switches, batteries, or thermostats);
• Other items that may have inseparable hazardous constituents.
CHEMICAL WASTE
MAIN CHEMICAL WASTE
KINDS
BASIC SYMBOLS
CAPEGATE
CAPEGATE
CAPEGATE
CAPEGATE
Pharmaceutical waste
Typical waste coming from the pharmacy, etc. If
pharmaceutical waste depends on the containing
substances. About 90% can be considered as non-
hazardous waste, however a misuse must be provided.

Includes:
•Expired-
•Unused-
•Spilt-
•Contaminated-
•-pharmaceutical products, drugs, vaccines and sera
METAN
 Chemical waste
Consists out of discarded solid, liquid, and gaseous chemicals.
Chemical waste must be considered as hazardous if the substance
has at least one of the following
properties:

• Toxic
• Corrosive (pH <2 or pH >12)
• Flammable
• Reactive (explosive, water –
reactive, shock – sensitive)
• Genotoxic
• Hazardous for health
• Hazardous for the
METAN
environment
 Heavy metal waste
Wastes with a high heavy metal content represent a
subcategory of hazardous chemical waste and are
usually highly toxic.

Includes:
• Broken thermometers
• Blood pressure gauges
• Batteries
• Amalgam
• Etc.

METAN
 Genotoxic waste
Genotoxic drugs are mainly used in the anti-tumour
chemotherapy medicine (cancer treatment) and are
Highly hazardous and are showing following
characteristics:

• Mutagenic
• Teratogenic
•Cytotoxic
•Carcinogenic
Radioactive waste
Radioactive waste is mostly created during research,
investigation and cancer treatment. Most radioactive
waste has a short half-life time. Radioactive waste is as
highly hazardous waste

For example:
•Unused liquids from radiotherapy
or laboratory research
•Contaminated glassware
•Packages of absorbent paper
•Urine or excreta from patients
treated or tested with unsealed radio
nuclides

METAN
NOTICE !!!
If non-hazardous and hazardous waste streams are not
segregated properly and put all together, then;
the entire waste volume becomes hazardous and must
be disposed off properly

In order for these wastes not to pose a threat to human

health and the environment, they have to be properly
identified, segregated and disposed of.

Unfortunately, due to imperfect procedures , the wastes

from the different groups get mixed together.

As a result, they become hazardous wastes which

require costly methods of treatment resulting in
adverse environmental impacts.
 MAIN STEPS OF IN-HOUSE MEDICAL WASTE MANAGEMENT
The management of waste must be consistent from the point of generation
(«cradle») to the point of final disposal («grave»).

The path between these two points can be segmented schematically into eight
steps.

1. Waste minimization
2. HCW generation
3. Segregation and containerization
4. Intermediate storage (in the HCF)
5. Internal transport (in the HCF)
6. Centralized storage (in the HCF)
7. External transport
8. Treatment and final disposal
• Segregation
At the hospital the staff to separate
hazardous waste from domestic waste by
company providing different bag colors.
• Packaging and handling
Proper packing of waste according to it’s
nature (liquid, tissue, sharp object, etc..)
By providing different waste containers
(bags, boxes , etc , …)
 BAD EXAMPLES TO
IN-HOUSE MEDICAL
WASTE MANAGEMENT
 Momentary situation - segregation
If waste is mixed, the entire mixture must be classified as
hazardous waste and the costs will rise up. Momentary, an
efficient segregation system is not implemented.
Problems:
• Large amounts of
hazardous waste
• No segregation
equipment like colour
coded bins and bags are
available
• The waste generator are
missing awarness and
know-ledge
 Momentary situation – segregation II

In some hospitals, some kind of waste are already today

separate collected. However a general system could not be
identified and regulations and guidelines are not existing.

Identified, segregated waste:

• Pathological waste
• Radioactive waste
• Fixing bathes
• Fluorescent lamps
 Momentary situation - packaging
A suitable packing of the waste does not take place. In most
cases, the mixed waste is loose packed and transported.

Problems:
• Risk of accidents during
transportation
• Spreading of germs in the
hospitals
• Difficult to interim store
the waste
• Waste is accessible to
strangers and rodents
METAN
 Momentary situation - collection
The collection of the waste is done by the nurses or the
cleaning personal. Special training and equipment is not
available.
Problems:
• Untrained personal
• No operational
proceedings for spillages,
accidents, etc.
• High unawareness and
combined “easy going”
• Spreading of waste on the
premise ofMETAN
the hospital
 Momentary situation - transportation
In large hospitals, waste chutes for the transportation of
waste are used.
Problems:
• Airborne, infectious diseases can
spread in the hospital
• Feeding and breeding place for insects
• Problematic removal of the waste
 Momentary situation – interim storage

The interim storage places for

waste are not well maintained
and not suitable for this kind of
waste.
Problems:
• Accessible for strangers
and rodents
• Occupational hazards are
existing
• Non regulated cleaning of
the interim storage places
• Spreading of germs from
METAN
the interim storage place
 Momentary situation – external Logistic
The waste from the hospital is collected by normal waste
trucks. Waste from hospital will be mixed with domestic waste
Problems:
• Contamination also of non-
risk waste
• Workers are not trained for
the handling of hazardous waste
• Trucks are not designed for
the transportation of hazardous
waste, risk of spreading of
diseases

METAN
 Momentary situation – Disposal

The hazardous hospital waste is

Dumped like normal household
waste.
Problems:
• High infection risk for the
waste workers and the waste
pickers
• Needles can puncture the
wheels of the trucks
• Hygienic risks for the public
and the environment

METAN
 GOOD
EXAMPLES TO
IN-HOUSE MEDICAL
WASTE MANAGEMENT
Receptacle for highly infectious
waste
 Puncture proof
 Liquid proof
 Irreversible closable
 Autoclavable, without PVC
 UN, local approved
 Easy to handle
 Coded
 Labelling of receptacles
Classification, Waste-Number, Kind of waste, Responsible

Disposal company, Receptacle number, Waste generator

 De-central collection points I
• Hazardous materials like chemicals, etc. are mostly produced
in small quantities.
• Packing and transportation of this small amounts would be to
costly.
• De-central collection points are working as “enlarged
segregation points”, especially in small and medium seized
hospitals.
• Obtaining of the hazards from mixing hazardous chemicals –
only same chemicals together!
 De-central collection points II
• Special care must be taken in the commissioning of small
quantities to large quantities in respect of spillages, etc.
• Obtaining of the risk of interim storage (Inflammable
products, etc.)
• To enable the logistic staff to carry out special transportations
• Must be set up out of reach of patients, visitors and strangers.
Interim storage near the generation
Generated hazardous waste is
interim stored in suitable bins,
bags or containers. Periodically or
on demand, this waste is picked
up by the internal transportation
service.
 Infectious waste is generally
periodically picked up (daily)
 Chemical, radioactive and
cytotoxic waste mostly on demand
 Personal protective equipment
(PPE)
• Specialized clothing or equipment
should be wear by the employee for
protection against hazardous
materials

• Must be properly cleaned, laundered,

repaired, and disposed

• Must be removed when leaving area

or upon contamination
Infectious waste
• Must be placed in closeable, leak-
proof bags or containers built to
contain all contents during
handling, storing, transporting
and be appropriately labeled and
color-coded.
Internal transport of chemical waste

hazard labels transport safety catch

approved transportation containers
Interim storage for infectious waste

The storage place is refrigerated, signed, lockable, easy

to clean and not accessible for any stranger or animal.
Periodically, the infectious waste is transported to a
central treatment plant.
 Some details of the interim storage

UN-approved
containers
for infectious
waste
Sterilize able
transport
carts
Tiled room,
disinfect able
Temperature: 5-7°C
Practical sample:
storage for chemical waste
Sample of an interim storage for
chemical waste:
Necessary safety equipment
Different sections
Chemical waste is packed in a
suitable packing

Additional liquid and chemical

proof chemical sump without
drainage
All waste is labelled
Pilot waste management systems:
Carrying out a demonstration projects:

•If in the demonstration hospitals the waste

generation can be reduced to 50 %, about 290
tons of hazardous waste can be avoided
• Financial savings for the hospitals: 58 Billion
TL
• Alone by the demonstration hospitals, the
total hazardous waste stream could be reduced
by >30% !
 Interim storage of infectious waste
Safe storage & transportation of hospital waste
To avoid risks for the public by spillages, etc. infectious waste must
be transported under consideration of the potential dangers by the
waste. For this, a transport in special containers is necessary.

Example:
Use of 770 l UN proved containers
Proved for the UN waste class 6.2 –
Bio hazardous waste of class I, II and III
(Low to medium infectious waste =
Typical hospital waste)
 Transport of hazardous waste
External Transportation:
 Periodically or on request, the
governmental licensed disposal
company comes and takes the
waste to the biomedical cell.
 The hazardous waste must be
transported according to the
applicable laws.
 The carrier must endorse the
receive of the quantity and quality
of the waste and will be responsible
for the waste after signing.
 Transport of hazardous waste
External Transportation:
 Periodically or on request, the
governmental licensed disposal
company comes and takes the
waste to the biomedical cell.
 The hazardous waste must be
transported according to the
applicable laws.
 The carrier must endorse the
receive of the quantity and quality
of the waste and will be responsible
for the waste after signing.
WASTE AMOUNT ???
• TOTAL
• HAZARDOUS
– BIO-MEDICAL
– CHEMICAL , etc.
Table 6.5. Total and Infectious Healthcare Waste Generation Rates by Type of Facility for Low-Income Countries
Type of facility Total HCW generation Infectious waste generation
Vietnam
Central general hospital 0.3 kg/bed-day
Provincial general hospital – cities 0.25 kg/bed-day
Provincial general hospital – other provinces 0.20 kg/bed-day
Provincial/central special hospital 0.05 – 0.30 kg/bed-day
District/branch hospital 0.20 kg/bed-day
Community health centre 0.1 kg/bed-day
Pakistan
Hospitals 2.07 kg/bed-day (range: 1.28-3.47)
Clinics and dispensars 0.075 kg/patient-day 0.06 kg/patient-day
Basic health units 0.04 kg/patient-day 0.03 kg/patient-day
Consulting clinics 0.025 kg/patient-day 0.002 kg/patient-day
Nursing homes 0.3 kg/patient-day
Maternity homes 4.1 kg/patient-day 2.9 kg/patient-day
Tanzania
Hospitals 0.14 kg/patient-day 0.08 kg/patient-day
Health centres (urban) 0.01 kg/patient-day 0.007 kg/patient-day
Rural dispensaries 0.04 kg/patient-day 0.02 kg/patient-day
Urban dispensaries 0.02 kg/patient-day 0.01 kg/patient-day
Table 6.6. Total and Infectious Healthcare Waste Generation Rates by Type of Facility for Middle-
Income Countries
Type of facility Total waste generation Infectious waste generation

South Africa
National central hospital 1.24 kg/patient-bed-day

Provincial tertiary hospital 1.53 kg/patient-bed-day

Regional hospital 1.05 kg/patient-bed-day

District hospital 0.65 kg/patient-bed-day

Specialized hospital 0.17 kg/patient-bed-day

Public clinic 0.008 kg/patient-day

Public community health centre 0.024 kg/patient-day
Private day-surgery clinic 0.39 kg/patient-day
Private community health centre 0.07 kg/patient-day
Jordan
Public hospital 6.10 kg/patient-day
Maternity hospital 5.62 kg/patient-day
Private hospital 4.02 kg/patient-day
Government clinical laboratory 0.053-0.065 kg/test-day
Private clinical laboratory 0.034-0.102 kg/test-day
Table 6.7. Total and Infectious Healthcare Waste Generation Rates by Type of Facility for a High-Income Country Type of facility
Total HCW generation Infectious waste generation
United States
Metropolitan general hospitals 10.7 kg/occupied bed-day 2.79 kg/occupied bed-day
Rural general hospitals 6.40 kg/occupied bed-day 2.03 kg/occupied bed-day
Psychiatric and other hospitals 1.83 kg/occupied bed-day 0.043 kg/occupied bed-day
Nursing homes 0.90 kg/occupied bed-day 0.038 kg/occupied bed-day
Laboratories 7.7 kg/day 1.9 kg/day
Doctor’s office (group practice, urban) 1.78 kg/physician-day 0.67 kg/physician-day
Doctor’s office (individual, urban) 1.98 kg/physician-day 0.23 kg/physician-day
Doctor’s office (rural) 0.93 kg/physician-day 0.077 kg/physician-day
Dentist’s office (group practice) 1.75 kg/dentist-day 0.13 kg/dentist-day
Dentist office (individual) 1.10 kg/dentist-day 0.17 kg/dentist-day
Dentist office (rural) 1.69 kg/dentist-day 0.12 kg/dentist-day
Veterinarian (group practice,metropolitan) 4.5 kg/veterinarian-day 0.66 kg/veterinarian-day
Veterinarian (individual, metropolitan) 0.65 kg/veterinarian-day 0.097 kg/veterinarian-day
Veterinarian (rural) 7.7 kg/veterinarian-day 1.9 kg/veterinarian-day
Table 6.8. Total and Infectious Healthcare Waste Generation Rates by Number of
Hospital Beds for a High-Income Country United States
No. of hospital beds Total waste Infectious waste
kg/bed-day kg/patient-day % of total waste kg/bed-day (calculated)

< 100 2.59 5.13 13.3 0.34

100-299 4.70 7.16 15.0 0.70
300-499 5.67 8.63 14.9 0.84
>500 5.83 .69 14.9 0.87
Total 4.18 6.93 15.0 0.63
 How to dispose
Healthcare Waste ,

Depending on the different waste

streams
 LINKS BETWEEN DEFINITIONS & DISPOSAL ROUTES ABOUT WASTES ARISING FROM
HUMAN MEDECINE

Healthcare Waste (HCW)

Healthcare Risk Waste (HCRW) Healthcare Non-Risk Waste

10 - 20% (HCNRW) 80 - 90%

Psychological Risk

Infectious Sharp HCRW Biological Radioactive Chemical

HCRW Toxic

Wastes from Hazardous

military and wastes from All Household
Corpses industrial
civil activities Wastes
activities

Infectious Recognizable Radiactive Special Household

Healthcare Body Parts Disposal Waste Disposal
Disposal Disposal Route Disposal Route
Route Route Route

Recycling Recycling
Shredding and Burial Special long
Incineration Landfill
Sterilization Cremation storage plant

8 01
Treatment and Disposal of the hospital waste

Today, international available main treatment

methods for infectious, hospital waste:

Relatively old & conventional methods:

•Land filling
•Incineration
Alternative and More Environmental Friendly &
Economic Methods:
•Chemical disinfection
•Steam disinfection/sterilization
Factors to consider in selecting a technology
• Determining the best technology or combination of technologies for a
particular facility depends on many site-specific factors. These include:
• Amount and composition of waste generated
• Available space
• Regulatory approval
• Public acceptance
• Cost
Some key factors to consider are listed below .
• Throughput capacity
• Types of waste
• Microbial inactivation efficacy
• Environmental emissions and waste
residues
• Regulatory acceptance
• Space requirements
• Utiity and other installation requirements
• Reduction of waste volume/mass
• Occupational safety and health
• Noise/odor
• Automation
• Reliability
• Level of commercialization
• Manufacturer/verndor background
• Cost
• Community /staff acceptance
 Landfilling of healthcare waste

Recommended Operation:
• Special cassette for biomedical waste secured by
fence and guard
• Unloading of the waste from the transportation
container direct in the shovel of the wheel loader
• Bedding of the waste in the special cassette by the
wheel loader
• Covering of the infectious waste every evening
with a 0,15 m – 0,20 m thick soil layer
• If necessary, first covering with gypsum
• After one layer is filled, stabilization of the layer
with 0,5 m of construction waste
Landfilling of healthcare waste
Recommended Operation:
• Special cassette for biomedical waste secured by fence and guard
• Unloading of the waste from the transportation container direct
in the shovel of the wheel loader
• Bedding of the waste in the special cassette by the wheel loader
• Covering of the infectious waste every evening with a 0,15 m –
0,20 m thick soil layer
• If necessary, first covering with gypsum
• After one layer is filled, stabilization of the layer with 0,5 m of
construction waste
Example

Fence Storage: covering

material
Waste water pool
Entrance

Proposed Place
 Way of working: Incineration
By incineration, hospital waste and the
pathogen agents are oxidized. State of
the art incinerators are two chamber
systems equipped with a two stage flue
gas treatment and a CEM-System.
While in the first chamber the waste is
pyrolsed at a temperature of 300 – 500°C,
in the second chamber the pyrolysis gas
is treated at a temperature of 800 –
1200°C.
The Existing Europeam Incinerating
Directives Require the Implementation
of Very Strict Emission Control and
Monitoring ( Directive 2000/76/EC )

Healthcare waste incinerator, Hoval,

An example
CAPEGATE
Incinerating should only be
preferred for
Hazardous healtcare waste!!!
 Alternative Methods
for
Medical Waste Disposal

STERILIZATION
 HOSPlTAL WASTE SUITABLE
FOR STERILIZATION

Infectious medical waste

Sharps & Neeedles
Some of pathological waste
18 01 03 & 18 02 02
18 01 01 & 18 02 01
18 01 02

METAN
HOSPITAL WASTE NOT SUITABLE
FOR STERILIZATION

Pharmaceuticals
Chemicals
Cytotoxic & Mycotoxic waste
Radioisotopes
Metals,equipment, lamps, furniture , etc.

METAN
WHICH ONE TO CHOOSE

ON-SITE
or
OFF-SITE
TREATMENT

METAN
 Reasons for for preferring
OFF-SITE STERILIZATION,
central treatment plants
• More economic total investment cost (compared to the
opposite solution of on-site installations at each hospital ) for
the entire region where the plant is serving
• More economic operating costs compared to the opposite
solution of on-site installations at each hospital )
• So, cheaper solution in cost-concerned countries
• Easier to control by governmental or private authorities
• Possibility of Recovery of Recylable material from central
treatment plants
• Business oppurtunity for operating private companies or
municipalities

METAN
Akar Manufactures Medical Waste
Sterilizers in Two main Categories
• Post-shredding kind of medical waste
sterilizers ( Conventional autoclave
type )
• Pre-shredding kind of medical waste
sterilizers in Two Different Design
Concept
* Vertical
* Vertical + Horizontal ( L Type)
METAN
 STANDAR MODELS WITH CAPACITIES

• L 750 kg/h pre-shredding

• L 500 kg/h
• L 300 kg/h
• L 100 kg/h
• L 50 kg/h
• Aut 1500 kg/h post-shredding
• Aut 1000 kg/h
• Aut 500 kg/h
• (based on bulk density of 120 kg/m3 )
METAN
L TYPE ( Vertical + Horizontal )
Schematic drawing of L type sterilizer

METAN
Post-shredding type
Shredder

METAN
 FINALLY ENTIRELY NEW
CONCEPT HAS BECOME A TRUTH
RECYCLING OF STERILE MEDICAL
WASTE

PYROLYSIS TO PRODUCE
OIL AND CARBON BLACK
METAN
 PROJECT PROPOSAL

•TRAINING
•PRACTICING HCWM
•STORAGE
•INTERNAL & EXTERNAL
LOGISTICS
•STERILIZATION
•INCINERATION
•PYROLYSIS
 MAIN STAGES OF THE PROJECT
DEVELOPMENT OF
IN-HOUSE HCWM PRACTICING

I . HCWM TRAINING : BASIC

II. FURNISHING THE HOSPITALS WITH PROPER WASTE
MANAGEMENT EQUIPMENT, INSTRUMENTS AND REAGENTS
III. PREPARING THE INTERNAL WASTE MANAGEMENT
GUIDELINES AND DIRECTIVES
IV. ASSIGNING AND DELEGATING THE RESPONSIBLE STAFF
IV. PRACTICING THE PROPER WASTE MANAGEMENT
GUIDELINES
V. DESIGNING AND INSTALLING THE INTERIM WASTE STORAGE
ROOMS
VI: DESIGNING AND INSTALLING IN-HOUSE WASTE STORAGE
ROOMS AND PREAPRING FOR EXTERNAL LOGISTICS
BASIC TRAINING, 5 DAYS

A ) HAZARDOUS WASTE
THE FOLLOWING STEPS WILL BE IMPLEMENTED
1. AWARENESS AND UNDERSTANDING THE CURRENT SITUATION
2. WASTE MINIMIZATION
3. WASTE SORTING
NON-HAZARDOUS
RECYCLABLES
HAZARDOUS
BIO-MEDICAL ( INFECTIOUS, SHARP AND
NEEDLES )
PATHOLOGIC
CHEMICAL
RADIOACTIVE
4. CONTAINERIZATION
5. LABELING
5. INTERIM STORAGE AND IN-HOUSE TRANSPORT FOR
DIFFERENT WASTE STREAMS
B ) HOSPITAL HYGIENE AND SANITATION
ENVIRONMENTAL SAFETY AND CLEANING
DISINFECTION
OHSA AND PERSONAL SAFETY MEASURES

C ) WASTE WATER MANAGEMENT

WATER SANITATION
MEASURES FOR WASTE WATER SAFETY AND PURIFICATION
SETTING UP
EXTERNAL LOGISTICS
A ) FOR BIO-MEDICAL WASTE ( QTY: 4 )
With specially designed compartment, refrigerated and with safety
measures
Lift for container placement
Poprtable scale for waste weighing
Radiation detector for radioactivity check
 B ) FOR CHEMICAL NATURE
HAZARDOUS WASTE ( QTY: 3-4 )
With specially designed compartment, refrigerated and with safety
measures
Lift for container placement
Poprtable scale for waste weighing
Radiation detector for radioactivity check
STERILIZATION PLANT
FOR
BIO-MEDICAL WASTE
BASIC MODALITIES IN THE STERILIZATION PLANT

•MEDICAL WASTE STERILIZER, AKAR 1000-1500 kg/h CAPACITY MEDICAL

WASTE STERILIZER
•STEAM GENERATOR
•WATER SOFTENING UNIT
•PLATFORM SCALE
•TILTER FOR WASTE FEEDING TO THE STERILIZER
•SHREDDER FOR STERILE MEDICAL WASTE
•LIFT FOR STERILE WASTE FEEDING TO SHREDDER
•CONTAINER WASH UNIT, AUTOMATIC
•TRUCK WASHING, CLEANING, DISENFECTING FACILITY
•TROLLEYS AND CONTAINERS
•LABORATORY
•HOUSING FOR THE ABOVE UNITS AND MODALITIES
•REFRIGERATED WASTE STORAGE ROOM
•CLEAN CONTAINER STORAGE AREA
•HYGIENIC, TECHNICAL , SOCIAL ROOMS AND OFFICES
•SAFETY MEASURES FOR FIRE, ENVIRONMENTAL SAFETY, PERSONAL
SAFETY AND HYGIENE
•POWER DISTRIBUTION SYSTEM
•EMERGENCY POWER SUPPLIES ( SOLAR OR/AND GENERATOR )
•STERILE WASTE STORAGE AREA
•DISCHARGED WATER STORAGE AND SETTLING AREA
•MISCELLANEOUS
 General lay-out and logistics -
HWC
Guard C ar Park

7 7 6 7
5 9

4
3 12 10

8
1
3 13 2
13

11

1 R efrigerated storage 2 Energy/W ater Supply, 3 Delivery Zone 4 S cale/Scanning Zone 5 Social room s

6 Entrance Zone 7 O ffice, A dm inis. 8 C ontainer W ashing P lant 9 Interim S torage 10 Pick U p Zone

11 H ollow Container 12 Store/Treatm ent Photo chem icals 13 Autoclave

 Lay-out of the Building
6 7
7 7 9
5

4
3 12 10

8
1 13 2
3

11

1 Refrigerated storage 2 Energy/Water Supply, 3 Delivery Zone 4 Scale/Scanning Zone 5 Social rooms
6 Entrance Zone 7 Office, Adminis. 8 Container Washing Plant 9 Interim Storage 10 Pick Up Zone

11 Hollow Container 12 Store/Treatment Photo chemicals 13 Autoclave

Post-shredding kind

METAN
 HAZARDOUS WASTE
DISPOSAL
STATE OF THE ART
ENVIRONMENTAL FRIENDLY
INCINERATOR

FROM SANTES, TURKEY

SANTES INCINERATOR FOR
HAZARDOUS WASTE
500 kg / h capacity
A ) INCINERATOR
1.01. Automatic Loading Unit
1.02. Primary Combustion System @1000 C -
Rotary Kiln
1.03. Secondary Combustion Chamber @1100C for
2sec
1.04. Ash Removal Conveyor
1.05 Main Stack
1.06. Control Panel

B ) EMISSION CONTROL SYSTEM, Flue Gas Treatment System

2.01. Heat Exchanger

2.02. Dry Scrubber - Activated Carbon Dosage
System
2.03. Dry Scrubber - Chemical Dosage Unit
2.04. Dry Scrubber - Bag Filter

2.05. Wet Scrubber2.06. ID Fan

 BASIC MODALITIES IN THE
INSINERATING PLANT

• INCINERATOR
As one of the systems above ( The above prices are net buying prices )
• HOUSING:
Industrial plant specifications, may be steel construction, laminated sandwich panel
side walls and roof,
25 x 30 x 10 m (width x length x height) indoor
10 x 30 m + 20 x 20 m ( w x l ) outdoor
Indoor: Incinerator, operation control room, office, hygiene rooms, laboratory, technical
room
Outdoor: fuel tank, waste un-loading area, truck wash area, truck parking area, ask
storage area,
Waste storage containers room, hazardous waste storage rooms, Scale for waste
weighing
To be detailed alter upon acceptance of the incinerator offer
Requires architectural works and relevant expenses
• Laboratory and technical room:
A chemical analysis laboratory with the below equipment (minimum) is required to be
set up and operated:
• Flash point determination device
• Automatic bomb calorimeter
• Muffle furnace
• Laboratory oven
• Balance
• Moisture balance
• Basic laboratory apparatus and glassware
• Waste transport trucks :
Qty. 2-3-4
With hazardous waste transport compartments, air conditioned, lift and scale
• Waste storage containers & ash storage containers.
Galvanized steel waste bins
Qty. 200 -500 of 0.4 m3 capacity
• Fire fighting, first aid, hygiene equipment and reagents for the plant safety:
(depends on the local directives, regulations and laws)
• Truck wash and container wash unit:
Varies from manual to automatic:
CAPEGATE
WHAT WE NEED TO START THE PROJECT
1-WILLINGNESS
2-MOU TO ENTITLE CAPEGATE
EXLUSIVELY TO IMPLEMENT THE
PROJECT
3- CONTRACT WITH THE WASTE
GENERTATORS FOR 10-15 YEARS
4- LAND FOR INSTALLATION , 5 HECTARS
5-COOPERATION BETWEEN
GOVERNMENTAL AND PRIVATE PARTIES