Microbiological Waste fka MBWS

[mikeyrags]

Bio-hazardous waste management in Kuwait: towards a sustainable vision


This paper highlights the importance of using an Environmental Impact Assessment (EIA) as a tool to assess new, environmentally friendly technologies for the treatment of biomedical waste in order to protect and preserve the quality of life for present and future generations. The paper focuses on Sanitec microwave disinfection technology providing an independent assessment of system operation, health and safety factors, and environmental impacts.


Dr. Ali Muhammad Khuraibet
General Manager, ECO Environmental Consultants, Kuwait
State of Kuwait, P.O.Box 23977, Safat, Postal code 13100
Website: www.environmmentalfirm.org


Abstract:
It is well established that the application of Environmental Impact Assessment (EIA) at the environmental problems, projects, plans, programs, policies and technology levels can aid in achieving the concept and objectives of sustainable development. This paper aims to illustrate that, neglecting environmental factors when implementing development activities without considering new technologies can lead to severe environmental and health problems. If such problems are occurring then there will be obstacles in achieving the targets of sustainable development. This illustration will be achieved by looking at problems associated with the current practice of treating bio-medical waste in the State of Kuwait. This paper also highlights the importance of using Environmental Impact Assessment (EIA) as a tool to assess new environmental friendly technologies for the treatment of bio-medical waste; in order to protect the peoples health and environment and preserve the quality of life for present and fixture generations.

Introduction:
It is very important to shed the light on the term development, in an attempt to analyse the concept of sustainable development. The term development in its simplest meaning indicates, theoretically, a change and transformation, in any given society, from a situation to a better situation. This can be achieved by meeting specific sets of objectives through short-term and long-term strategies, policies, programmes, projects and plans. In the past decades the term development was associated with economic development, for example, an increase in GNP. The new concept of development incorporates new objectives, that is, the promotion of sustainable rational use of natural resources and the preservation of quality of life and environment and respecting human rights. Barbier and Mc'craken, (1988) suggest two definitions for sustainable development. The first is a wider definition that emphasises concepts of sustainable economic, ecological and social development. This concept was promoted by the World Commission on Environment and Development (WCED) through their renowned document "Our Common Future" which is also known as the "Brundtland Report". The report was published in 1987 and defines sustainable development as:

"Development that meets the needs of the present without compromising the ability of future generations to meet their own needs".

This concept debate that social, economic and ecological and environmental improvements in developing countries can not occur without stressing on the fact that development strategies and policies, and subsequently projects, should be environmentally sustainable in the short, mid and long terms. The objectives of such development strategies, policies and projects are to reduce poverty, deal with the depletion of natural resources, environmental degradation, cultural disruption, social instability and finding solutions to external debts problems and finally respectinghuman rights. However, the narrower concept emphasises on sustainable economic development. For example, Pearce et al., (1987) define sustainable development as:

"Sustainable economic development involves maximising the net benefits of economic development, subject to maintaining the services and quality of natural resources over time".

This definition sets certain conditions to reach targets for achieving sustainable development objectives. These include:

That renewable natural resources are to be utilised at rates less or equal to natural or managed rates that they generates.
That waste generated must be disposed of at rates less than or equal to the rates of absorption by the environment.
That exhaustible resources are utilised in an optimum way through sound technologies.
Pearce, Markandya and Barbier, (1989) emphasise on such issues by indicating that sustainable development should direct all resources towards the sound utilisation of natural resources and at the same time creating equity for present and future generations. This means that the latter should inherit a non-declining capital stock. Such stock includes roads, factories knowledge, skills and biological diversity ... etc. They also argue that to maintain sustainable development it is essential that such capital stock is ensured for both present and future generations. This means that quality of life, health of population, education standards and general social well being should improve with time and does not degrades.

To inter-relate the issues discussed earlier, a case study will be presented in this paper to indicate that the current practice of bio-medical waste treatment in Kuwait is not environmentally sustainable. This is true because site selection for bio-medical waste treatment facilities, environmental assessment for the type of technologies that will be used to treat bio-medical waste and conducting full EIA are not practiced. Thus, the adverse health and environmental impacts associated with the treatment of biomedical waste are not considered and assessed. This in turn is creating severe environmental and health problems due to the release of air pollutants such as dioxins.

To inter-relate the issues discussed earlier, a case study will be presented in this paper to indicate that the current practice of bio-medical waste treatment in Kuwait is not environmentally sustainable. This is true because site selection for bio-medical waste treatment facilities, environmental assessment for the type of technologies that will be used to treat bio-medical waste and conducting full EIA are not practiced. Thus, the adverse health and environmental impacts associated with the treatment of biomedical waste are not considered and assessed. This in turn is creating severe environmental and health problems due to the release of air pollutants such as dioxins.

The current bio-medical waste treatment and management status in Kuwait:
Kuwait is facing a massive environmental crisis related to the management of wastes. The consumption of lands for waste tipping practice is in increase. This is creating conflicts with land-use and housing policies and at the same time is putting a financial burden on the government to rehabilitate the sites for different types of projects. In 1997 the government paid about 5 million pounds to rehabilitate a solid waste disposal tipping site at Sabah Al-Salim area in order to be used for a housing project to accommodate 306 housing units. The quantity of waste generated in Kuwait is increasing year by year. For example, rubble waste constitutes a major component of waste generated in Kuwait. It is estimated that the amount of such waste was 3909 thousand tons in 1995 and projected to be 8056 thousand tons in 2020 (KM, 1997).

The land requirement for the same period and quantity is 260-537 thousand m2 (Ibid.). Waste disposal sites are neither designed in an environmental friendly manner nor meets the construction standards of landfill sites. They are decommissioned sand and gravel quarries. Domestic, industrial and non-infectious medical wastes are usually disposed of in Kuwait in landfills. These landfills are not designed to accept such waste. Also, they are not lined. In fact, in technical terms, they cannot be considered as landfill site but pits. These pits are decommissioned gravel and sand quarries. After decommissioning they are used to dump all types of waste in them (Al-Attar, 1989; Khuraibet 1987 and Khuraibet 1990).

This current practice is creating severe environmental and financial burdens on the national level. For example, parts of Al-Qurain residential area were decommissioned domestic waste pits. Major housing projects were built near the decommissioned site. Methane, odor, leachate and land slides stem as major impacts. The total cost to rehabilitate the sites was estimated to be 12 million pounds. On the other hand, biomedical waste is incinerated within certain hospitals boundaries by using old and non-environmentally friendly incinerators. Some incinerators are only 20 meter far from residential areas and housing units. Creating severe odor and air pollutants problems. If this practice is not modified and sound sustainable alternatives are used and encouraged then severe health and environmental problems will be arising year after year.

The "First Environmental Projects Company" proposed an environmentally sustainable project in Kuwait to treat bio-medical waste in by using microwave, an environmentally friendly technology, instead of incineration. EIA was used to assess this new technology in order to achieve some objectives of sustainable development, that is, to prevent air quality degradation and protect the health of the people on the short and long terms. The proposed project is in line with Kuwait Municipality (KM) policy, Environmental Affairs Department Integrated Waste Management Policy. The proposed project is also in line with the Gulf Co-operation Council (GCC) health officials' recommendations (AI-Qabas, 1999). The Gulf committee for the safe disposal of health care facilities biomedical waste recommended in their meeting, in the State of Kuwait 4-5/9/1999, the following:


That the private sector should be encouraged in playing an important role in investing in aspects related to the safe treatment and disposal of biomedical waste.
That those all-existing incinerators in the GCC countries health care facilities should be decommissioned by the year 2004.
That workshops and training courses related to the safe disposal of biomedical waste to be encouraged to take place.
That a national committee to be established in the State of Kuwait and its members to be from KM, Kuwait's EPA, Kuwait's Ministry of Health and Kuwait's research centres.
Medical waste generated at the State of Kuwait can be divided into 2 types. The first is non-infectious whilst the second is infectious. The former is waste that is not considered as a biohazard. The typical practice in Kuwait to dispose of such waste at tips. These tips, as mentioned earlier, are not designed to accept such waste. The majority of the latter are incinerated in incinerators within government hospital boundaries. The majority of Kuwait's hospital incinerators are worn and old, that is, plus 15 years old. They are not efficient in incinerating biomedical waste. According to information obtained from Kuwait's Environment Protection Authority (KEPA). The temperature inside the second chamber at the majority of the incinerators is within 850 °C. In reality the temperature in the first and second chambers should be kept between 900° C-1000 °C and 1200 °C, consequently (Table 1).

One of the major adverse impacts associated with incineration and incinerators is failing to reach the optimal recommended temperature due to operational and mechanical problems. As a result the release of dioxins and other hazardous pollutants become inevitable and related health risk are prone to happen. This issue is getting complicated because there is an increase in the amounts of biomedical waste generated from the various governmental and private health care facilities and labs. Health care facilities in Kuwait, both private and public sectors, produce a massive amount of medical waste. This can be related to an increase in patients and outpatients visits and follow ups in all health care facilities, an increase in medical operations and treatments and finally an increase in medical laboratories' routine work (Table 2). Environmental and public health issues are being raised in Kuwait in relation to the way biomedical waste is being treated and disposed of. Few months ago the British Embassy in Kuwait asked for the closure of Al-Amiri Hospital incinerator due to the potential emission of dioxins. Therefore, a sound biomedical waste treatment alternative is required.

Assessment of an alternative method for bio-medical waste treatment, the SANITEC System:
A project is proposed by the private sector, Kuwait Environmental Projects Company, in the State of Kuwait to manage and treat biomedical waste generated from all health care facilities including medical labs. The environmentally sound alternative is a biomedical waste treatment system that uses microwave radiation to treat biomedical waste in order to make it safe for disposal in municipal landfill sites or tips. This microwave system was designed and made by the American company SANITEC Inc. which is located in West Caldwell, New Jersey, USA. SANITEC Inc. was a division of Asea Brown Boveri (ABB) a world-wide leader and the largest engineering and technology development firm in the world. The plant in NJ manufactures and distributes 3 line of microwave disinfecting systems. These are:


The HG-A 100S SANITEC system, is a small system that can treat 100-181 kg of biomedical waste per hour by microwave radiation.
The HG-A 250S SANITEC system is larger in terms of its capacity to treat biomedical waste as it treats 250-408 kg of waste per hour. This system is a microwave system that has the efficiency in reducing the volume of medical waste being treated by 80% through shredding and then disinfects it slowly. The system treats and destroys a variety of biomedical wastes such as syringes, vials, hypodermic needles, plastic tubing, bacteria cultures and needles. Also, it can deal with surgery materials, human parts, although not recommended by SANITEC due to aesthetic reasons, radioactive materials with expired life span blood and urine samples. The only limitations are chemicals, radioactive materials and metal objects such as surgery equipment. The whole HG-A 2505 SANITEC system unit is relatively small in size. The unit length, height, width and weight are 24, 11 and 17 feet and 27,000 lbs., respectively (Table 3). The system is characterised by moderately low electricity consumption (75 W/hr) and very low consumption of water (0.147 litres/kg).
As in 1999 SANITEC Inc. have installed more than 58 medical waste disinfecting units' world-wide. There are 47 units installed in many states and 5 in Brazil, 3 in Japan and one unit each in in UK, Saudi Arabia, Korea, Canada and 1 system to be installed soon in the State of Qatar. SANITEC Inc. recorded that their units installed world-wide, processes more than 6 million pounds of infectious biomedical waste every month. Their system achieved not only the treatment of more than 200 million pounds of biomedical waste but also reduced their volume by 80% and made them safe to be disposed of in typical municipal landfill sites. To indicate the efficacy of the SANITEC system, when first introduced commercially, tests were carried out by a certified and independent laboratory called North America Laboratory Group and Stanford University School of Medicine, USA. This was to conform with the New York State Department of Health. The conclusion they reached was the following:

"The high level of disinfection/sterlization from this data clearly demonstrates the ABB (ASEA Brown Boveri) SANITEC Microwave Disinfection System is capable of meeting the parameters set for alternative technologies to treat and destroy biomedical waste as established by the State of New York."

The treatment and disinfecting process, by the SANITEC system, is totally a computer-controlled process. An on-board microprocessor controls the entire treatment process. Also, a special computer program monitors the whole waste treatment cycle. This program assures, all the time, that the biomedical waste under treatment is constantly exposed all the way and uniformly to microwave radiation, that is, thermal treatment. This is very important in order to make the end product suitable for normal handling and safe disposal. The out-side casing of the SANITEC system is made from steel to withstand all weather conditions. The system unit can be installed out-door or in-door. It is very easy to install and operate. The manufacturer of the SANITEC system indicated that the whole unit could be installed within one full working day. The essential two things needed for instant sound mechanical operation are:


A single-electrical main.
One water connection for steam generation.
"The high level of disinfection/sterlization from this data clearly demonstrates the ABB (ASEA Brown Boveri) SANITEC Microwave Disinfection System is capable of meeting the parameters set for alternative technologies to treat and destroy biomedical waste as established by the State of New York."

The successful operation of the SANITEC system is based on two integrated components. The first is proper sorting, tipping and handling of biomedical wastes in special colour coded bags and carts in health care facilities. This requires training of staff in such aspects. It is presumed that staffs working in health care facilities are already knowledgeable about such aspects. The second is to maintain the unit in a sound condition, through proper spare parts replacement according to SANITEC scheme. This is very important in order to make the automated biomedical waste treatment process run smoothly for a long term. The stages of biomedical waste treatment in the SANITEC system is simple and direct. Biomedical waste is brought to the unit via special carts. The carts are then attached to the unit. A lift and charging system uplift the waste cart. The unit in-feed hopper flap is opened. And just before opening the air inside is treated with high temperature steam then extracted and again treated by passing through 3 stages filtration system. A fan draws air from inside the system and forces the air trapped inside to pass through a filtration system. The system comprises from 3 filtration stages to prevent any potentially harmful airborne emissions from escaping outside. No harmful air emissions are released during this process. The 3 stages of filtration are:


Stage one, which is comprised of a pre-filter. This filter acts as a catcher for large debris and steam as air is extracted out from the in-feed hopper. This filter is made from pleated fabric screen. The pre-filter protect the second stage filter, the HEPA filter, from damage as a result of large biomedical size particles.
Stage two, which is comprised of a HEPA filter. This filter acts as a remover of very fine particles, 0.12-5 pm, present in the air inside the unit before letting the air released to the atmosphere. With time the filter will be saturated and needs to be replaced. This saturation tends to increase difference in pressure on both sides of the filter. This is indicated by the Manometer display by given a reading of a differential pressure of 0.750 kPa. The Manometer is situated in the casing support frame of the extraction filter. This filter and under normal operational conditions needs to be replaced twice annually. The type of HEPA filter is D type (VLSI Laminar Flow) manufactured by Flanders Filters Inc. It has fiberglass HEPA media with efficiency of 99.9995% to 0.12 pm.
Stage three, which is comprised of a carbon filter. This filter is housed and contains 10 changeable carbon filter trays. These trays are filled with an activated carbon with a minimum carbon tetra chloride activity rating of 50%. The main function of the activated carbon is to absorb a wide spectrum of materials that can be present inside the unit in vaporised or gaseous forms. The waste is discharged into the in-feed hopper. The cart is lowered down and the hopper flab is closed and sealed in order to start the treatment process. A rotating feed arm breaks down the biomedical waste material into small particles. Then it is shredded into ground small particles through a shredder. Biomedical waste volume is reduced by 80%. The granulator is considered as a secondary-shredding unit. It reduces the size of medical waste to ensure that the final waste treated is completely unrecognizable as biomedical waste. As the shaft turn, the cutting system pulls waste to stationary knives called the bed knives. The knives cut the biomedical waste into finer pieces. Only pieces with acceptable size are allowed to enter the screw conveyer. A screen under the granulator unit determines which pieces are allowed or not allowed to pass. Large size pieces are allowed to be re-circulated back to the bed knives until are cut finer. To ensure no jamming, during this process, the granulator is turned on before the screw conveyer starts operating. This allows the granulator to rise it speed before accepting any additional biomedical waste. If the system stops the granulator will operate to clear any biomedical waste that might be present; in order to prevent any jamming when starting the unit on after normal shutdown operation.
A stainless steel screw conveyor transfers the shredded biomedical waste to a steam treatment stage. Each tiny waste particle is subjected to steam in order to be moistened to increase its ability to accept heat from the microwave generators. The steam treated biomedical waste is then passes through six microwave generators units each with 1.2 kw output to thermally treat each shredded medical waste from inside out to ensure complete disinfection. The biomedical waste is heated between 95° C - 100° C and maintained at this constant rate for 30 minutes as a minimum. Note: The SANITEC system can operate with a minimum of 4 microwave generators to achieve complete disinfection. The treated biomedical medical waste is then transported by a secondary screw conveyor outside the SANITEC system and is deposited into a waste container or a compactor for safe disposal in municipal landfill.

The SANITEC unit primary shredder reduces the volume of biomedical waste by a factor of 80%. An optional secondary granulator can be attached to the system. This granulator will not significantly reduce the volume of the biomedical waste but it will serve in reducing each individual biomedical particle size especially sharp materials. The biomedical waste exiting the unit has a density of approximately 600 pounds/cubic yard. Compacting such waste will increase this density to 1000 pounds/cubic yard. Using a compaction device is optional. A stationary compactor unit type BME model 2250 manufactured by BME Engineering, Inc, USA can be installed to the system. It has a packing force of 43,800 Ibs. and 56,500 Ibs. under normal and maximum operations conditions, respectively.

The spore forming micro-organism Bacillus subtilis is used as a bioindicator to indicate whether pathogens present in the biomedical waste are treated and killed adequately; and that waste is disinfected properly during the whole waste treatment process inside the SANITEC system. Capsule that contains the micro-organism Bacilhis subtilis is placed in a small sample bag and dropped inside the system after the shredding stage. Then it is collected, after the last treatment stage, and inspected for spore growth or non-growth. The results are mainly non-growth because of the six' stages slow microwave thermal treatment of the biomedical waste inside the SANITEC system. The habitat of this genus is in the environment and soil. They tend to grow better in air. The genus Bacillus includes more than 40 species of microorganisms. They are spore forming, gram-positive and aerobic bacilli. Bacillus subtilis is an aerobic, endospore forming, rod shaped bacterium. It is commonly found in water resources, soil and plants.

It is well documented that Bacillus subtilis are very well known organisms that can be found in soil and play an important role in natural cycle of carbon and nitrogen (Gorbach, Bartlet and Blacklow, 1998). Bacillus subtilis (Var. niger spore ATCC 9372) is used as a bioindicator for quality assurance for the whole disinfection process. This type of industrial spores is manufactured under the product number 1264 by 3M Company, Medical Products Division, St. Paul, Minnesota, USA. A chemical within the capsule changes colour in the presence of bacteria. The capsules are green colour-coded and are not reusable. The capsules are placed in a special marked bag and inserted into the system after the shredding stage. The bag is subjected to microwave radiation. Afterwards it can be retrieved at the last stages of treatment. If the capsule appearance is yellow in colour then it indicates bacterial growth. However, if there is no colour changes then it indicates that the disinfection process is sound and adequate. At standard operation conditions no growth is the typical result.

Impacts characteristics and assessment:
Impacts can have their own characteristics and dimension. These characteristics are discussed in details as follows:


Social dimension. Various groups in a society can place different values on an impact. For example, the impact on an endangered plant or animal species can be of great importance ecologically, aesthetically and in terms of environmental conservation to ecologists or naturalist groups However, to the unemployed the impact on such species is of no relevance and significance. Assigning different values to impacts by various groups must be considered by the multidisciplinary E.I.A team which should takes into consideration the environmental, ethical and socio-economic settings of relevance to all affected parties. There is no significant social dimension present with the installation and operation of the SANITEC system.
System dimension. The direct effect on one component of the environment must not be interpreted on its own. The component systems of the environment and their attributes do not exist separately as there is an interaction and relationship between them. When an impact directly occurs on a component system, it can directly affect other component systems and their attributes. For example, using old incinerators in Kuwait's hospitals is leading to inefficiency in treating biomedical waste. This will have a direct negative effect on air duality due to the release of harmful pollutants such as dioxins. The indirect effect is represented by the increase of health problems of people being exposed to such pollutants and also the burden of cost on the government to treat the exposed people. This example of an integrated cycle of direct mechanical effect that leads to indirect socio-economic effects is rarely discussed in EIA studies. The SANITEC system is a low impact biomedical medical waste treatment technology. Therefore, no significant system dimension exist (Tables 4-6B).
Spatial dimension. Impacts not only occur in areas where the activity will be located, but can cross boundaries. For example, pollutants emitted from incinerators with hospitals boundaries will be transported to nearby and far areas according to weather conditions. This is not the case with the SANITEC system as there are no harmful air emissions or water discharges being released during the whole treatment process.
Cumulative dimensions. Impacts can interact together to produce significant cumulative effects. For the example, the combined effect of dioxins, heat, noise and exposure to chemicals used for scrubbing can generate a cumulative negative health effect on workers health. The SANITEC system is characterised by the absence of liquid discharges, low noise levels, no microwave leakage and no harmful air emissions. Therefore, significant cumulative effects are not present.
Probability dimension. Identified and predicted impacts may not occur the same way that they are predicted. This is because of the difficulties associated with simulating exact existing conditions of natural systems under impact. In reality and from literature review it is well documented that such simulation is currently far from being reached. It is only good science and value judgement together with multidisciplinary teamwork that can reduce the possibility of an impact occurring not as predicted. The scientific judgement for predicting and assessing impacts associated with the use of the SANITEC system was based on observing the system on reality. The whole SANITEC system is totally computerised and no manual interference is allowed under normal operational conditions. The system automatically detects any faults. Therefore, the probability dimension of impacts identified but not occurring is insignificant.
Reversibility and irreversibility dimension. Impacts resulting from an activity can affect the environment. It is often very difficult to restore the environment or its effected components, including humans, swiftly to its exact or natural setting. For example, a person exposed to dioxins emitted from an incinerator will probably suffer from a cancer disease. If he was diagnosed with cancer and at the same time the incinerator was decommissioned he will be still suffering from cancer as a result of previous exposure to dioxin. The main significant irreversible impact associated with the proposed facility is the need to remove the soil cover and it's associated components. It is estimated that about 60% of the soil cover is expected to be removed. This is irreversible impact but it can be mitigated.
Time dimension. Impacts may not all occur at one phase of the project life cycle but at different phases, that is, at site preparation, construction, operation and decommissioning phases. All significant impacts that might occur during these phases should be identified and assessed. Special consideration is given to the operation phase. This is because significant impacts will be occurring as long as the SANITEC system is on operation. The impacts associated with these stages are discussed in the next section.
The noise level at several sources were measure by using TES 1350A digital sound level meter for professional use. The meter is precisely calibrated by internal oscillation system (1KHz) sine wave general 94 dB. The meter has a 1/2 inch electric condenser microphone. Also, it has a A and C weighting for checking compliance with safety regulations as well as acoustic analysis. The meter has a fast and slow dynamic response setting to check peak and average noise levels. The instrument accuracy is +- 2dB at 94-dB sound level, 1 kHz sine wave. The measurement taken at SEPCO facility were compliance with operation conditions in terms of temperature and humidity, that is, 0 °C-50° C and below 80% relative humidity. No noise levels exceeding standards levels were recorded.

Another meter was used to measure the possibility of any microwave leakage emitting from the SANITEC unit during operation. Holaday Industrial Inc., USA, manufactures the meter that was used to measure microwave radiation leakage. The type used to detect microwave leakage was the HI-1501. No microwave leakage was indicated or measured during the operation phase.

Impacts at the site preparation and construction phases:
The impacts associated with site preparation and construction phases are the following:


The removal of vegetation and soil covers and possible effect on desert fauna and flora.
The release of suspended dust as a result of site preparation and machinery movement activities.
Limited traffic congestion at major roads as a result of heavy truck and other equipment moving in and out of the site.
Health and safety effect due to inhaling less than 10 micron dust and also possible out-door noise pollution due to machinery operation.
Environmental impacts, that is, the removal of the proposed site soil and cover, will be dealt with by preserving 10% of the site. For health and safety issues, workers should wear earplugs, dust masks and follow safety signs and procedures to minimize the risk of any harmful incident.

Impacts at the operation phase:
To illustrate all possible impacts in relation to the initiation of the proposed facility, including SEPCO facility, several Ad Hoc matrices was used to achieve this purpose (Tables 4-6B). (Table 4), (Tables 5-6), (Table 6B), The impacts associated with the operation phase are the following:


Environmental:
The SANITEC system generates no malodour. Any odour inside the system is drawn into the filtration system. Therefore, no malodur is released to the air during normal operational conditions. Also, no harmful air emissions are released during the treatment process. This is because there is no incineration activity, no chemicals are used to treat the biomedical waste and also due to efficiency of the 3 stages filtration system that prevent malodour and the escape of pathogens. Also, no water discharges are released into the sewer system because the system does not discharge any wastewater.
Also, general cleaning practice and good house keeping will ensure that the facility produces no malodour beyond its boundary. The air filtration system inside the building where the SANITEC is installed is to be a UV type in order to enhance the air quality inside the building. All detergents that will be used for house keeping are biodegradable. Also, the green area of the site will be maintained in an optimal condition.
Health and safety:
To ensure that the unit does not leak and microwave radiation, the two authors kindly requested from SANITEC Inc. to provide any history of microwave radiation leakage since the first unit was installed in the USA. SANITEC Inc. indicated and assured that during 10 years of operation of SANITEC systems world-wide no serious microwave leakage was detected. This is because the systems are checked daily for leakage and spare parts are replaced according to SANITEC scheme. Therefore, the possibility of any leakage is insignificant.
Also, the unit generates no significant noise. Noise level measured when the unit doors are shut is 47 dBA. Noise may be generated from vehicles entering and leaving the facility and when unloading their biomedical waste. From literature review it is established that exposure to noise is linked to a variety of illnesses. Kryter, (1994) indicate that noise is: "An audible acoustic energy that is unwanted because it has auditory and non auditory physiological or psychological effects on people."

Yang and Ellison, (1985) indicated that noise fields forms around a sources that generate noise. If there are sound reflecting surfaces near by the noise generated source such as walls or corners then sound waves tend to reflect. This reflection can make the noise field around the noise source either strong or weak. If the direct and reflected waves, from the generated source, are in phase at certain points of time and location in space then the noise field becomes strong. However, if they are opposite then the field becomes weak. According to Yang and Ellison, there are five factors that determine the intensity or weakness of noise fields around machinery. These are:


Direction of the machinery.
Time of operation.
Characteristics of the acoustic environment.
Types of operation.
Mounting conditions of the machinery.

"An audible acoustic energy that is unwanted because it has auditory and non auditory physiological or psychological effects on people."

Short-term exposure to noise levels of 140 dB(A) are known to be an instant threshold of pain to any human recipient. However, long term exposure to noise can have gradual adverse auditory and non-auditory problems. Long term exposure to noise is known to lead to alterations in heart beat rate and changes in blood pressure (Harrington and Gill, 1992). However, because the SANITEC system is a low source of noise then positioning the unit will not have a significant impact on the intensity or weakness of noise fields.

The British Noise at Work Regulations of 1989 suggests three different categories of action levels for noise exposure abatement. These are:


First action level, at this level the acceptable daily exposure to noise must be within 85 dB(A).
Second action level, at this level the acceptable daily exposure to noise must not exceeds 90 dB(A).
Peak action level, at this level the acceptable daily exposure to noise must be within 140 dB(A).

High noise levels can be controlled at source, along the path they are taking and at the recipient (Mulholand, 1985). Khuraibet, (1997) indicated that this control can be accomplished through containment, sound insulation, sound absorption and through enclosures. However, as mentioned earlier, operation of the SANITEC system is very quite. Workers need not to wear ear protectors. However, as extra precaution measure workers may wear standard earplug when needed. Employees and workers dealing with biomedical waste can be exposed to certain hazards or sources of risk. Risk can be defined as the possibility of suffering harm from a source or sources of hazards e.g. biomedical waste, electrical circuits, mechanical parts, steam units and microwave generators during operation and maintenance phases. For example, all employees should take care when handling biomedical waste. Exposure might occur during loading due to tear bags or sharp objects such as needles that are not properly disposed of in special containers. All personnel dealing with biomedical waste, according to SANITEC regulations, should:


Wear protective gear as recommended by OSHA such as gloves that are puncture resistance.
Wear safety goggles.
Wear Tyvek suite to cover the body and clothes.
Wear shoe covers and steel toe boots with puncture resistance sole.
Wear half face Air Purifying Respirator that meets NIOSH standards for such jobs.
Lock-out not only the power but disconnecting the power supply when conducting electrical service, spare parts replacement and adjustment to the unit. This is very important especially for the microwave generators as electrical charges are retained by the capacitors and might lead to electrical shocks.
Take care from mechanical parts such as waste cart lifting system, hydraulic compressors and drive belts to prevent an accident.
Replace spare parts and maintain the unit in a sound operation condition according to the manufacture manual to prevent any unnecessary malfunction.
Take care from the unit that produces steam as the temperature of this steam can reach 300° F which can cause severe burns. All hot surfaces and pipes are labeled to indicate such hazard.


Impacts at the decommissioning phase:
When the life expectancy of the project is expired (15 years +) and the whole site and project are decommissioned the whole facility should be sealed and closed to prevent any access to the site. However, the site can be rehabilitated and used for similar or other projects in accordance with the concerned authorities laws and regulations.
Discussion and conclusion:
Sadler and Jacobs, (1989) emphasize the need to change the attitude of decision makers, that is, restructuring the way decisions are taken, to include environmental considerations as well as economic and social considerations. The Brundtland report, (1987) stressed about introducing a new concept for economic growth, that is, sustainable socio?economic and environmental growth. It was remarked that:

"Economic and fiscal policies, trade and foreign policies, energy, agriculture and industrial policies all aim to induce development paths that are economically, socially and ecologically sustainable".

Within this framework, the World Bank, (1998) indicated the significance of linking environmental management with development activities in order to control the adverse environmental and health impacts associated with development activities. To achieve such objective, it is indicated the importance of establishing the following:


A systematic system of identifying internal and external pollution sources, impacts of these forces on environment, and the costs associated with curtailing the impacts of such forces on the environment and human health.
Environmental indicators to monitor and control changes in environment and its natural resources.
Environmental database to be used as a mean to aware the public of changes.
A system of information gathering and dissemination to improve government and private sectors environmental policies and sound management of resources.

These criteria are very important to establish a link between environment and improvement of quality of life for present and future generations. However, the establishments of these criteria are not enough to achieve the targets of sustainable development. This is because there are always factors that question the ability of stake-holders including governmental establishments to formulate proper arrangement to deal with development problems due to internal and external factors. The crucial issue is, are the stake-holders interested to solve problems. If yes then environmentally sound tools should be utilized to assess the adverse impacts of projects and technologies. This paper demonstrated that EIA is a very crucial and important tool that can be used to assess technologies and to identify and assess impacts.

These criteria are very important to establish a link between environment and improvement of quality of life for present and future generations. However, the establishments of these criteria are not enough to achieve the targets of sustainable development. This is because there are always factors that question the ability of stake-holders including governmental establishments to formulate proper arrangement to deal with development problems due to internal and external factors. The crucial issue is, are the stake-holders interested to solve problems. If yes then environmentally sound tools should be utilized to assess the adverse impacts of projects and technologies. This paper demonstrated that EIA is a very crucial and important tool that can be used to assess technologies and to identify and assess impacts.

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