“I hereby declare that I have read this report and in my opinion this

“I hereby declare that I have read this report and in my
opinion this report is sufficient in terms of scope and quality for the
award of the Bachelor of Civil Engineering”
Signature
:
__________________________
Name of Supervisor :
DR. MOHD FADHIL MD DIN
Date
__________________________
:
MOBILE INCINERATOR FOR MEDICAL WASTE
ASMAHANI BINTI ABU
A project report submitted in fulfillment of the
requirements for the award of the Bachelor of
Civil Engineering
Faculty of Civil Engineering
Universiti Teknologi Malaysia
APRIL 2010
ii
I declare that this project entitled “Mobile Incinerator for Medical Waste” is the
result of my own research except as cited in the references. The project has
not been accepted for any degree and is not concurrently
submitted in candidature of any other degree.
Signature
:
____________________
Name
:
ASMAHANI BINTI ABU
Date
:
____________________
iii
To my beloved mother, and Syed Muzani.
Thank you for the love and support.
iv
ACKNOWLADGEMENT
A thesis is the result of the work of many people, researchers, academicians,
and practitioners. They have contributed towards my understanding and thoughts. In
particular, I wish to express my sincere appreciation to my project supervisor Dr.
Mohd Fadhil Md Din, for encouragement, guidance, critics and friendship. Without
their continued support and interest, this project would not have been the same as
presented here. I am also very thankful to Mr. T. Segar, from Pantai Medivest Sdn.
Bhd. and
Mr. Mark Tan Sheng Yi, and Mr. Ahmad Azmi Arif, from IRIS
Corporation, who has been helping out to make my work successful.
Finally, I would like to thank any friends and family who supported me
towards the completion of this thesis
v
ABSTRACT
Medical waste is potentially hazardous and infectious material. The
management of medical waste is of great importance due to its potential
environmental hazards and public health risk. Management and disposal of medical
waste in Malaysia using cradle-to-grave concept is under the jurisdiction of
Environmental Quality (Scheduled Waste) Regulation 1989. The generator and the
contractor appointed bear the sole responsibilities in managing and disposing the
medical wastes. Poor management of medical waste can lead to high risk of exposure
of dangerous diseases such as hepatitis A, hepatitis B and AIDS. Incineration is the
best method of disposing medical waste since it is infectious. IRIS Green Gas
Incinerators are a new generation incinerators capable of toxin-free burning ,medical
waste and using water as a fuel sources. Green Gas is produced from water by a
process of electrolysis whereby two molecules of water is split into two molecules of
hydrogen and one molecule of oxygen in a green gas generator.
vi
ABSTRAK
Sisa klinikal berpotensi untuk menjadi sisa yang berbahaya dan berjangkit.
Pengurusan sisa klinikal adalah sangat penting disebabkan ia boleh mendatangkan
bahaya kepada alam sekitar, dan memberikan risiko kepada kesihatan orang ramai.
Pengurusan dan pelupusan sisa klinikal di Malaysia adalah menggunakan prinsip
“dari buaian ke kubur” dan di bawah kawalan Akta Kualiti Alam Sekitar (Sisa
Berjadual)1989. Penjana dan kontraktor dilantik adalah bertanggungjawab ke atas
pengurusan dan pelupusan sisa klinikal. Pengurusan yang tidak rapi boleh
menyebabkan pendedahan kepada penyakit berbahaya seperti hepatitis A, hepatitis
B, and AIDS. Kaedah penunuan merupakan kaedah yg terbaik untuk melupuskan sisa
klinikal yang dikategorikan sebagai sisa berjangkit. Insinerator gas hijau IRIS
merupakan penghasilan baru yang berupaya membakar sisa klinikal tanpa
menbebaskan toksin dan menggunakan air sebagai sumber bahan bakar. Gas hijau
dihasilkan daripada air melalui proses elektrolisis yang mana dua molekul air
dihuraikan kepada dua molekul hidrogen dan satu molekul oksigen dari penjana gas
hijau.
vii
TABLE OF CONTENTS
CHAPTER
1
2
TILTE
PAGE
DECLARATION
ii
DEDICATIONS
iii
ACKNOWLADGEMENT
iv
ABSTRACT
v
ABSTAK
vi
TABLE OF CONTENTS
vii
LIST OF TABLE
x
LIST OF FIGURE
xi
LIST OF SYMBOLS
xiii
LIST OF APPENDICES
xiv
INTRODUCTION
1
1.1 Background of the Study
1
1.2 Statement of Problem
2
1.3 Objectives of the Study
2
1.4 Scope of the Study
3
1.5 Significant of the study
3
LITERATURE REVIEW
4
2.1 Introduction to the Medical Waste
4
2.2 Medical Waste Management
6
2.2.1 Organization Structure System
6
2.2.2 Segregation System
6
2.2.3 Document System
7
2.2.4 Temporary Storage System
8
viii
2.2.5 Internal and External
8
Transportation System
2.2.6 Waste Treatment and Disposal System
3
4
8
2.3 Waste Type and Source
9
2.4 Treatment Technique
11
2.4.1 Incineration
11
2.5 Act and Legislation
13
2.6 Oxy-Hydrogen Mobile Incineration System
15
REASEARCH METHODOLOGY
17
3.1 Introduction
17
3.2 Preliminary Study
19
3.3 Data Collection
19
3.3.1 Primary Data
20
3.3.2 Secondary Data
20
3.4 Result and Analysis
3.5 Conclusion and Suggestions
20
21
RESULT AND ANALYSIS
22
4.1 Medical Waste Management in Johor
22
4.2 Waste Generation
23
4.2.1 Medical Waste Genaration (MWG)
24
at Hospital Sultanah Aminah
4.2.2 Medical Waste Generation (MWG)
31
at Hospital Sultan Ismail
4.3 Segregation and operation
38
4.4 Transportation
41
4.4.1 Internal Transportation
41
4.4.2 External Transportation
43
4.5 Temporary Storage
44
4.6 Documentation
44
4.7 Medical Waste Treatment and Disposal
46
ix
4.8 Selected of Mobile Incinerator for
48
Medical Waste
4.8.1 Combustion of Waste
50
4.8.1.1 Green Gas Generation Unit
50
4.8.1.2 High temperature incineration
50
4.8.2 Treatment of flue gas and Fly ashes
51
4.8.2.1 Combustion of flue gas
51
4.8.2.2 Scrubbing of flue gas
51
4.9 Cost Analysis
4.9.1 Conventional Medical Waste
52
53
Incinerator
5
REFERENCES
Appendices A - C
4.9.2 Mobile Incinerator
53
4.10 Proposal of Site Disposal
54
CONCLUSION
55
5.1 Conclusion
55
5.2 Recommendation
56
57
58 - 71
x
LIST OF TABLE
TABLE NO.
TITLE
PAGE
2.1
Categories of Medical Waste
9
4.1
Specification System of Mobile Incinerator
49
4.2
Cost using Mobile Incinerator
52
xi
LIST OF FIGURE
FIGURE NO
TITLE
PAGE
2.1
Medical Waste Segregation Process
7
2.2
Incinerator
12
2.3
Oxy-Hydrogen Mobile Incinerator
16
3.1
Flowchart of Methodology
18
4.1
Medical Waste Generated for January
24
4.2
Medical Waste Generated for February
25
4.3
Medical Waste Generated for March
25
4.4
Medical Waste Generated for April
26
4.5
Medical Waste Generated for May
26
4.6
Medical Waste Generated for June
27
4.7
Medical Waste Generated for July
27
4.8
Medical Waste Generated for August
28
4.9
Medical Waste Generated for September
28
4.10
Medical Waste Generated for October
29
4.11
Medical Waste Generated for November
29
4.12
Medical Waste Generated for December
30
4.13
Medical Waste Generated for January
31
4.14
Medical Waste Generated for February
32
4.15
Medical Waste Generated for March
32
4.16
Medical Waste Generated for April
33
4.17
Medical Waste Generated for May
33
4.18
Medical Waste Generated for June
34
4.19
Medical Waste Generated for July
34
4.20
Medical Waste Generated for August
35
4.21
Medical Waste Generated for September
35
4.22
Medical Waste Generated for October
36
xii
4.23
Medical Waste Generated for November
36
4.24
Medical Waste Generated for December
37
4.25
Biohazard Symbol
39
4.26
Yellow Medical Waste Plastic Bag
40
4.27
Light Blue Medical Waste Plastic Bag
41
4.28
15kg Wheeled Bin
42
4.29
Small opening for internal transportation of
42
Medical Waste
4.30
Vehicle used in external transportation
43
4.31
Temporary storage of medical waste
45
4.32
The schematic diagram of a medical waste
47
incinerator at Bukit Rambai
4.33
Oxy Hydrogen Mobile Incinerator
Process Flow
49
xiii
LIST OF SYMBOLS
Kg
-
Kilogram
o
C
-
Degree Celcius
%
-
Percent
V
-
Voltan
RM
-
Ringgit Malaysia
CO
-
Carbon Dioxide
H2
-
Hydrogen
kW
-
Kilowatt
Co2
-
Carbon Monoxide
H2O
-
Water
xiv
LIST OF APPENDICES
APPENDIX
A
TITLE
Component in Oxy-Hydrogen
PAGE
58
Mobile Incinerator
B
Consignment Note for Schedule Waste
59
C
Medical Waste Generation at Hospital
60
Sultanah Aminah.
CHAPTER 1
INTRODUCTION
1.1
Background of the Study
Medical waste is potentially hazardous and infectious material that is
produced in all healthcare premises, public, private or veterinarian practices, nursing
homes, and research centers. It is costly and troublesome commodity. According to
World Health Organization (WHO), the definition of medical waste is waste
generated by health care activities includes a broad range of materials, from used
needles and syringes to soiled dressings, body parts, diagnostic samples, blood,
chemicals, pharmaceuticals, medical devices and radioactive materials.
The management of medical waste is of great importance due to its potential
environmental hazards and public health risk. Poor management of medical waste
can lead a high risk of exposure of dangerous diseases such as human
immunodeficiency virus (HIV), hepatitis B virus (HBV), and other agents associated
with blood borne diseases. (William A et al., 1992). In Malaysia, incineration and
disposal of incinerated ash to landfill is the most common method adopted for the
disposal of medical waste. (Ibrahim, 1998)
2
1.2
Statement of Problem
Until 1980s, Malaysia has no proper system for management of medical or
clinical waste. There is increasing concern about the disposal of medical waste, the
amounts of which have increased dramatically in recent years. In 1998, MOH
hospitals generated about 3500 tones of medical waste with a mean generation rate of
0.51 kg/ occupied bed/ day. The rate of generation and type of waste varies daily
depending on the type of hospital. General hospitals generate about 0.75 kg/occupied
bed/ day, while the smaller district hospitals generate 0.37kg/occupied bed/ day.
(Agamuthu, 2000). Transporting this medical waste can be expensive and dangerous.
Additional costs to manage medical waste also increased.
Furthermore, medical waste, if not disposed of properly, can pollute the
water table, and create biohazards in landfills, open pits where infected animals were
burned, pollute the air, etc. Thus, it is very important to select a suitable system for
medical waste disposal activity by taking in account of the location, criteria and
environmental concern. So, a need has grown for an effective portable medical
incinerator that can be transported worldwide and is easy to use and maintain with
existing staff and fuel resources.
1.2
Objectives of the Study
The objectives of the study are:
1. To study the management of medical waste in Johor.
2. To propose a mobile incinerator for medical waste including the estimation
and comparison data between conventional incinerator and portable
incinerator.
3
1.4
Scope of the Study
The location of this study includes the Hospital Sultanah Aminah and
Hospital Sultan Ismail. Site visits will be carried out to the chosen hospitals to
obtain the relevant information regarding the medical waste management system
including an element of volume and component medical waste generated in the
selected area.
1.5
Significant of the Study
This study aims to identify the advantages of using mobile incinerator for
medical waste from the aspect environmental friendly, cost, and hazard & risk. With
this advantage, mobile incinerator will be proposed so that we will have a modern,
efficient and effective medical waste management system.
CHAPTER 2
LITERATURE REVIEW
2.1
Introduction to the Medical Waste
Medical waste, also known as clinical waste, normally refers to waste
products that cannot be considered general waste, produced from healthcare
premises, such as hospitals, clinics, doctors offices, labs and nursing home.
According to the Ambulance Service Association of UK, medical waste is defined as
“any waste which consists wholly or partly of human or animal tissue, blood or other
body fluids, excretions, drugs or other pharmaceutical products, soiled swabs or
dressings, or syringes, needles or other sharp instruments, being waste which, unless
rendered safe, may prove to be hazardous to any person coming into contact with it,
and any other waste arising from medical, nursing, dental, veterinary, pharmaceutical
or other similar practice, investigation, treatment care, teaching or research, or the
collection of blood for transfusion, being waste which may cause infection to any
other person coming into contact with it”
In 1982, the recommendation from Health and Safety Commission London,
The Safe Disposal of Medical Waste, medical waste is defined as “Waste arising
from medical, nursing, dental, veterinary, pharmaceutical or similar practice,
investigation, treatment, care, teaching or research which by nature of its toxic,
infectious or dangerous content may prove a hazard or give offence unless previously
rendered safe and inoffensive. Such waste includes human or animal tissue or
excretions, drug and medical product, swabs and dressings, instruments or similar
5
substance or materials”. (Collins, 1991). Poor management of clinical waste causes
serious diseases in hospital personnel, health workers, patient and the general public.
The main source of illness from infectious waste is probably injuries with used
needles, which can cause hepatitis and HIV.
For Malaysia, medical waste is classified as schedule waste from non-specific
source under the Environmental Quality (Schedule Wastes) Regulation 1989 that
includes;
i.
N251 – Discarded drugs except living vaccines and euphoric
compounds
ii.
N261 – Pathogenic and clinical waste quarantine materials
iii.
N281 – A mixture of schedule waste
iv.
N282 – A mixture of schedule waste and non-schedule wastes.
The hazardous nature of medical waste may due to one or more of following
characteristic:
i.
It contains infectious agents
ii.
It is genotoxic
iii.
It contains toxic or hazardous chemicals or pharmaceutical
iv.
It is radioactive
v.
It contains sharps
Medical waste is often separated into infectious medical waste and
noninfectious medical waste. Noninfectious medical waste typically can be disposed
of in the same way as normal garbage, as municipal solid waste. Examples of
noninfectious medical waste include used personal hygiene products, such as facial
tissues and sanitary napkins, empty pill bottles, absorbent materials (not including
waste from isolation rooms) containing small amounts of blood or body fluids,
disposable products used for routine medical or dental procedures, such as rubber
gloves, tubing and catheters.
6
2.2
Medical Waste Management
Every system in medical waste management has its own scope of work
beginning from Organization Structure System to Medical waste disposal system.
2.2.1 Organization Structure System
Organization is a structure or process where the Director can assign duty to
an individual, group or company in order to achieve the objectives. In every
department or division, organization chart is important to show the hierarchy and
scope of work or duty. Every member in the chart has their own skill depending on
the position and function. For example, the officer is the person in charge on
directing and controlling the performance for every member in the organization. In
this case, he or she will monitor whether the worker take full responsibility in doing
their job and follow the guidelines provided because the risk is everywhere.
2.2.2
Segregation System
Segregation starts at the place where the medical waste is generated until at
the place it will be disposed, internally or externally. Segregation is also done during
the transportation of the waste. In the hospital, every worker who is responsible on
waste segregation has to make sure all the clinical waste put into yellow bin. For the
sharp, it is placed in drum container. The bin and drum container must be tightly
covered and when it is there quarter full, it should ready to be disposed. Figure 2.1
shows the medical waste segregation process.
7
Medical Waste
Hospital Waste
Domestic
Waste
Black Plastic
Bag
Cleaner
Collection
Sharp
Waste
If domestic
waste
contaminated
with medical
waste
Infectious
Non
sharp
Light Blue Bag
Sharp Container
Autoclaving
Yellow Plastic Bag
Medical Waste
Porter Collection
Figure 2.1: Medical waste segregation process
2.2.3
Document System
The source of every bin and container must be recognized to trace if there is
any spills or over limit of waste. Labeling and documentation is done in certain way.
For example, by writing down to the bag or container using adhesive tag etc.
8
2.2.4
Temporary Storage System
Every hospital must have a temporary storage to minimize the movement of
waste in the open from initial storage areas. The storage area should be locked when
access is not required and should be accessible only to authorized persons. The
importance of having temporary storage is for the convenience of health workers.
Every bin and container can be taken out in „first in, first out‟ sequence and load onto
the trolley or vehicle used.
2.2.5
Internal and External Transportation System
Every single bin and container containing medical waste will be moved out
from where it is generates. Usually, trolley and minivan is used in internal and
external waste evacuation. This vehicle shall be reserved only for transportation of
medical waste. It should thoroughly clean and disinfected immediately following any
spillage or accidental discharged. Plus, the internal transport routes shall be designed
to minimize the passage of waste through patient care areas and other clean areas.
2.2.6
Waste Treatment and Disposal System
An evaluation on choosing the right place for disposal and right method for
treatment is needed to optimized effectiveness and safety. The evaluation covers
some aspect such as technology, environment, economy and geography.
Some considerations to be made are:
i.
Technology requirements and the importance
ii.
Treatment process flow
iii.
Process effectiveness and devices
9
iv.
Treatment operation effect to health workers, public and environment
v.
Size of process treatment
vi.
Operation cost and capital available
vii.
Site suitability
2.3
Waste Type and Source
Under the Environmental Quality (Schedule Waste) Regulation 1989,
Pathogenic and medical wastes, quarantined materials, discarded drugs except living
vaccines and euphoric compounds are categorized as scheduled wastes, hence need
to be managed as such. The Ministry of Health (MOH) estimated that the total
amount of clinical wastes generated from MOH hospital to be 11500kg/day or an
average of 0.51kg/occupied bed/day (Lee Heng Keng, 2001).
Medical waste is generally classified into 5 categories (A, B, C, D & E). The
main sources and the waste type generated are listed in Table 2.1.
Table 2.1: Categories of Medical Waste. (Source: RMSB, 2004)

Soiled surgical dressing, cotton
wool, gloves, swabs and all other
contaminated waste from treatment
areas, plaster and bandaging which
have come into contact with blood
Group
or
A
wounds,
cloth
and
wiping
material used to clean up body
fluids and spills of blood.

Material other than linen from cases
of infectious disease (e.g. human
biopsy
stools).
material,
blood,
urine,
10

All human tissue (whether infected
or not), limbs, placenta, animal
carcasses
and
tissue
from
laboratories and all related swabs
and dressings.

“Sharps such as discarded syringes,
Group
needles, cartridges, broken glass,
B
scalpel blades, saws and any other
sharps instrument that could cause a
cut puncture.

Clinical
waste
laboratories
arising
(e.g.
from
pathology,
hematology and blood transfusion,
Group
microbiology, histology) and post
C
mortem room waste, other than
waste included in Group A

Pharmaceutical
wastes
such
as
expired drugs, vaccines and sera,
including expired drugs that have
Group
been returned from ward, drug that
D
have been spilled or contaminated,
or are to discarded because they are
no longer required
Group E

Cytotoxic drugs

Used disposable bed-pan liner, urine
containers, incontinence pads and
stoma bags.
11
2.4
Treatment Technique
Treatment modifies the charecteristic of waste. Tratment of waste mainly
aims at rendering direct exposure to the wastes as less dangerous to human, to
recover recyclable materials, and to protect the environment. In 1986 Guide,
Environmental Protection Agency (EPA) defined treatment as any method,
technique, or process designed to change the biological character or composition of
waste. Since landfill operations may cause loss of containment integrity and dispersal
of infectious waste, the EPA recomended that all infectious waste be treated prior to
disposal. An example of treatment for medical waste is incineration.
2.4.1
Incineration
Incineration is the combustion of waste in a controlled way in other to destroy it
or transform it into less hazardouse, less bulky or more contrallable constituents.
Incineration continues to be a preferred treatment for medical waste management.
Although incineration is the most effective way, problem will occur such as air
pollution as the effect of incineration. Hard metal and toxic waste will assemble in
ash. Incineration of medical waste offers the following advantages or potential
advantages:
i.
Volume reduction, especially for bulky solids with high conbustible content.
ii.
Detoxfication,
especially
for
combustible
carcinogens,
pathalogical
contaminated material, toxic organic compounds, or biologically active
material that would effect sewage treatment plants.
iii.
Regulatory
compliance,
especially
for
fumes
containing
odourous
compounds, photo reactive organics, carbon monoxide, or other combustible
materials subject to regulatory emission limitations
iv.
Environmental impact mitigation, especially for organic materials that would
leach from landfills or create odour nuisance
12
v.
Energy recovery, especially when lagre quantities of waste are available and
reliable markets for by-product fuel or steam are nearby
(Theodore, 1987)
Most modern medical waste incinerators operate on controlled air using two
chambers. The primary chamber, into which the waste is fed, operates with restriced
air flow at 1600 to 1800oF. The waste is pyrolized, and the volatiles to a secondary
chamber where they are combusted at 1800oF or higher temperature. Excess air is
provided, in the secondary chamber, to ensure complete combustion. Ash is moved
through and exist the primary chamber by the hydraulic ram or other feed devices.
( Lee et al., 1995)
Figure 2.2: Incinerator. (Source: Blenkharn, 1995)
13
2.5
Act and Legislation
In Malaysia, there are some acts related to medical waste. The Department of
Environment (DOE) is empowered under the Environmental Quality Act 1974 to
control and prevent pollution and to protect and enhance the quality of the
environment.
A set of regulation dealing with hazadous waste management which regulates
the storage, transport, tretment and disposal of hazardous waste on May 1989:
i.
Environment Quality (Schedule waste) Regulation, 1989
ii.
Environmental Quality (Prescribe Premises) (Schedule Waste
Treatment and Disposal Facilities) Regulation, 1989
iii.
Environmental Quality (Prescribe Premises) (Schedule Waste
Treatment and Disposal Facilities) Order, 1989
The Environmental Quality (Schedule Waste) Regulation, 1989 prescribe a
listing of 107 categories of hazardous waste defined as “schedule waste“ . the wastes
are grouped into specific and non-specific sources. Medical waste is categorised as
schedule waste from non-specific source, N261 – “Pathogenic and clinical waste
materials“. The regulations specify the following requirements
i.
Schedule wastes shall as far as practicable, before disposal, be rendered
innocuous
ii.
Generation of schedule wastes shall be reduced using the best practicable
means;
iii.
Waste generators to notify the DOE of any schedule wastes generated and
keep up-to-date inventory of scheduled wastes generated, treated and
disposed of;
iv.
Scheduled wastes may be stored, recovered an treated within the premises
of a waste generators;
14
v.
Land-farming, incineration, disposal, off-site recovery, off site storage
and off-site treatment shall only be carried out at prescribed premise
licensed by DOE
vi.
Use of durable waste containers with clear labels. Storage of wastes shall
be proper and adequate;
vii.
Waste generators shall confirm the requirements of consignment note
system when transporting wastes to ensure it reaches the approve
destination and carried out by licenses transporter;
viii.
Waste generators shall provide information to transporter regarding the
nature of the wastes transported and action to be taken in case of
accidents.
The purpose of this regulation is to control the three specific groups
i.
Waste generators
ii.
Waste contractor
iii.
Waste disposal site operators
Under the Environmnent Quality (Prescribe Premises)(Scheduled Waste
Treatment and disposal Facilities) Order 1989, six types of premises are prescribed
for which thier occupation and use will require a written permission and licence from
DOE. The premises are:
i.
Land treatment facilities such as a sludge farms
ii.
Off-site recovery facilities
iii.
Off-site treatment facilities such as centralized physical/chemical
wastewater treatment
iv.
Schedule waste incinerator
v.
Off-site storage facilities including the transport vehicle
vi.
Secure landfills designated for the disposal of schedule wastes
15
Three waste generator companies in Malaysia that is concessionaire appointed by
the Ministry of Health and have off-site incinerator including transportation are:
2.6
i.
Faber Medi-Vest Sdn Bhd (northern region)
ii.
Radicare (M) Sdn Bhd (central region)
iii.
Pantai Medivest Sdn Bhd (southern region)
Oxy-Hydrogen Mobile Incineration System
Iris Green Gas Incineration System is unique for its design and environmental
friendly approach. Powered by water, the incinerator offer a practical solution to
waste management using proven technology and process engineering.
Using water as a fuel sources, the system generates green gas through an
electrolysis process and synergizes water back into its basic form, H2O which is to
parts Hydrogen and 1 part Oxygen. Termed as green gas, this auxiliary fuel has the
following characteristic:
i.
Is high in calorific value
ii.
Produced on-demand, in-situ
iii.
No carbon emission upon self-combustion
Used in combustion and has the ability to power heating equipment in a
manufacturing process or destroy hazardous toxics and pathogents in waste, making
it an ideal and alternative fuel for various industries.
16
Green gas is odourless, colourless and toxic free. And the truly remarkable fact is
that burns itself back to water. Unlike fossil fuels, green gas produces no carbon or
other contaminants to contribute to the greenhouse effect. It is a new resource that
can easily replace other environmentally damaging carbon based fuels.
Figure 2.3: Oxy-hydrogen mobile incinerator
Oxy-Hydrogen mobile incinerator has many advantages. There are capable of
toxin-free burning, and do not get carbon gases that are harmful and poisonous to our
environment. As the name suggest, the biggest advantage of the mobile incinerator is
it is mobility. The other advantages of mobile incinerator are:
i.
Ease and simplify of use
ii.
Ready to work immediately
iii.
No power or fuel supply required
iv.
Efficient on the spot disposal
v.
Reduced emission due to innovate design
vi.
No operator training required
CHAPTER 3
RESEARCH METHODOLOGY
3.1
Introduction
This chapter discuss on study methodology and its procedures. The study
methodology the steps involved in this study from the beginning until the final stage
in order to achieve the study aim and objectives. The research methodology has been
carried out which consists preliminary study, aim and objective determination, data
collection, results and analysis as well as conclusion and suggestion. Data collection
was done by observing secondary information such as interview, previous research
works and case study. Figure 3.1 shows the stages involved in the research
methodology.
18
Identify Problems
Establish Objectives and Scope of Study
Literature Review
Data Collection
Primary Data
Secondary Data
Analyze Data and Discussion
Conclusion and Recommendation
Figure 3.1: Flowchart of methodology
19
3.2
Preliminary Study
The preliminary study was the earliest work stage before commencing with
the data collection. At this stage, reading, discussion and observation were carried
out in order to obtain information regarding the study. This really helps in identifying
the scope and study area also the data to be collected. Information regarding medical
waste incinerator were obtained through readings also helps in outcome of the aim,
objectives, methodology and tentative content for this study. The determination of
the study aim and objectives are very important for proper planning of this study.
3.3
Data Collection
The collection of the data can be classified into two:
3.3.1
Primary Data
Primary data are those important sets of data in the study. Without this data,
the aim of the study is hard to be achieved. The method used in this data collection is
through interview. For this study, case study on management and disposal of medical
waste in Johor is highlighted. Hospital Sultanah Aminah, (HSA) and Hospital Sultan
Ismail, (HSI) was selected for this purpose. HSA and HSI are complete with the
capacity of 989 and 704 bed respectively and have given a contract for Pantai
Medivest Sdn Bhd on medical waste management under Department of Engineering.
Pantai Medivest Sdn Bhd is the main source of information about management and
disposal of medical waste. By interview more information regarding medical waste
incineration can be collected. Furthermore, the explanation from the interview could
give more understanding rather than referring books. The officers will explain more
20
on every element on managing medical waste. All the data of management and
disposal of medical waste is than compared to guidelines and act that relate to it.
Interviewing method is used because it is the best method of getting the
correct data. Other method such as questionnaire is not appropriate for this study
because it is not effective since all the data taken from the current data and also the
previous data.
3.3.2
Secondary Data
Secondary data attained from other studies or other sources. Secondary data
were those obtained from the literature review and other documents such as thesis,
books, journals, and papers related to the case study. Besides that the data also
obtained from unpublished data, such as the sources from internet. These materials
were analyzed based on their suitability for this study. All data related to medical
waste incineration and medical waste management are accumulated and used as
references.
3.4
Result and Analysis
All the data is arranged, process and analyzed for making some good
recommendations on proposed of mobile incinerator for medical waste. Furthermore,
data analyzing is important to achieve the objectives that were set earlier.
21
3.5
Conclusion and Suggestions
From the observation and study that will be done later, it is expected the
outcome of this study could bring benefit and will be expand. Besides that it can
change the assumption of public about the functional of incinerator.
CHAPTER 4
RESULT AND ANALYSIS
4.1
Medical Waste Management in Johor
For more effective and better management of medical waste and to ensure
that activities carried out meet DOE regulations, the medical waste services of the
Ministry of Health (MOH) hospitals and health care facilities throughout Malaysia
have been privatized to three concession companies in 1997. The concession period
is 15 years and each of this company is responsible to provide Hospital Support
Service to every hospital in Malaysia according to the region. The objectives of
privatization are to improve efficiencies of all hospitals and to provide Quality
Health Service to public.
The provision of Medical Waste Management Services is one of the five
support services, which requires the concession companies to provide collection,
storage, transportation, treatment and disposal of medical wastes to all contract
hospitals and other health care facilities over the concession period. These include
healthcare establishments in Malaysia, including government and private hospitals,
polyclinics, health centers, medical and health research institutions, diagnostic and
research laboratories, blood transfusion services, private practitioners and dental
surgeries.
23
In Johor, Pantai Medivest Sdn Bhd (PMSB) is a major provider of quality
Integrated Facilities Management services. Since 1997 Pantai Medivest continues to
provide reliable and quality services to 21 government hospitals under the Ministry
of Health Malaysia. PMSB provides hospital support service on medical waste
management, facility engineering maintenance, biomedical engineering maintenance,
linen & laundry and cleansing.
4.2
Waste Generation
Basically, every ward and hospital will generate the same type of waste. The
two most generated waste are ordinary medical waste and household waste. Medical
waste is generated by the health worker such as doctor and nurses. Household waste
comes from patients and visitors who come for the purposes of visiting the patients
and food wrappers.
According to Pantai Medivest Sdn Bhd, medical waste generation at Hospital
Sultanah Aminah and Hospital Sultan Ismail is about 1000-1500 kg per day for
weekdays and 400-800kg per day for weekend. Figure 4.1 to 4.12 shows that the
medical waste generation at Hospital Sultanah Aminah and figure 4.12 to 4.13 at
Hospital Sultan Ismail in year 2009.
24
4.2.1
Medical Waste Genaration (MWG) at Hospital Sultanah Aminah
X axis – Date
Y axis – Actual Waste Generation (KG)
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
Figure 4.1: MWG for January
25
30
35
25
1800
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
30
Figure 4.2: MWG for February
1800
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
Figure 4.3: MWG for March
25
30
35
26
1800
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
30
25
30
35
Figure 4.4: MWG for April
2500
2000
1500
1000
500
0
0
5
10
15
20
Figure 4.5: MWG for May
35
27
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
30
25
30
35
Figure 4.6: MWG for June
1800
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
Figure 4.7: MWG for July
35
28
1800
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
30
35
Figure 4.8: MWG for August
2000
1800
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
Figure 4.9: MWG for September
30
35
29
2000
1800
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
30
35
30
35
Figure 4.10: MWG for October
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
Figure 4.11: MWG for November
30
1800
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
Figure 4.12: MWG for December
30
35
31
4.2.2
Medical Waste Generation (MWG) at Hospital Sultan Ismail
X axis – Date
Y axis – Actual Waste
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
Figure 4.13: MWG for January
25
30
35
32
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
30
Figure 4.14: MWG for February
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
Figure 4.15: MWG for March
25
30
35
33
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
30
35
Figure 4.16: MWG for April
2500
2000
1500
1000
500
0
0
5
10
15
20
Figure 4.17: MWG for May
25
30
35
34
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
30
35
25
30
35
Figure 4.18: MWG for June
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
Figure 4.19: MWG for July
35
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
30
35
25
30
35
Figure 4.20: MWG for August
1800
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
Figure 4.21: MWG for September
36
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
30
35
30
35
Figure 4.22: MWG for October
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
Figure 4.23: MWG for November
37
1600
1400
1200
1000
800
600
400
200
0
0
5
10
15
20
25
30
35
Figure 4.24: MWG for December
From the graph plotted it is clearly shows that the medical waste generations
for Hospital Sultanah Aminah and Hospital Sulltan Imail have the same behavior.
For weekdays the waste generation is higher than the weekend. According to the
interview with Pantai Medivest Sdn Bhd, it‟s happen because on weekend all the
clinics in HSA and HSI were closed. The wastes come only from the ward or
emergency department.
38
4.3
Segregation and operation
From the interview, it is known that segregation is the most important
element in managing medical waste. By adding the medical waste and household
together, the waste status will change to medical waste and have to be treated exactly
as medical waste. This is stated under Environmental Quality Act (Scheduled Waste)
1989.
Segregation process started when used medical equipment are thrown away.
The basic medical waste generated in every ward and clinic at hospitals are used
syringe, cotton, gauze, dressings contaminated with blood, purulent exudates and IV
sets.
According to PMSB Management Guidelines standard code of color is used
to every plastic bag and plastic container for clinical waste. Each of the plastic must
have biohazard symbol and this action is already stated under Environment Quality
Act (Schedule Waste) 1989 in Third Schedule, (Regulation8). The colors are:
Black
-
Household waste
Yellow
-
Clinical waste to be disposed by incinerator
Light Blue
-
Clinical waste from highly risk disease
39
Figure 4.25: Biohazard symbol
Yellow plastic bag are not allowed for use for other purposes in any
circumstances basically to prevent any confusion in managing medical waste. It is
the same thing to other plastic bags. Light blue plastic will not be provided daily like
yellow plastics. For medical waste that come from highly risk diseases i.e. AIDS,
Hepatitis B, Hepatitis C the nurses will contact Radicare (M) Sdn Bhd to provide
light blue plastic bags to the ward. It will be sterilized in autoclave machine for
24hours before disposed to incinerator.
Equipment used for medical waste in wards and clinics is yellow in color
with biohazard logo printed on it. They are pedal bin, wheeled bin, sanitary bin,
plastic bag and sharp container. The location of the equipment is different depending
on demand and suitability.
Every full plastic bags containing medical waste should be sealed using
ordinary plastic band or by usual tie-tip. It is forbidden to use stapler for sealing the
plastic bags because of the piercing action onto the plastic bags. Furthermore, it will
contribute to odor problem.
40
The main duty of the porters is to carry and collect each of full plastic bags.
After collecting, it is their duty to provide new plastic bags at the bin. Size of the
plastic provided varies according to the source of waste generated. The best location
for temporary storing is the place nearest to where it is generated. It is a good
practice to place medical waste far from public passages. Collection frequency
depends on the need and demand.
Figure 4.26: Yellow medical waste plastic bag
41
Figure 4.27: Light blue medical waste plastic bag
4.4
Transportation
The next step of managing medical waste is transportation. It can be divided
into two types, internal transportation and external transportation.
4.4.1
Internal Transportation
The equipment use for internal transportation is 15kg wheeled bin. This
wheeled bin is covered to protect the porter and public from waste spills and smelly
odor.
According to PMSB, it is prohibited for the porters to transport any medical
waste at public passages. To prevent this, the storeroom in every ward and clinic will
have a small opening for medical waste. This opening come complete with inside
42
and outside door and is designed follow PMSB scope of work and to prevent any
disruption by anyone who is not related to medical waste transportation. The other
side of this opening is the public passage where the porter has already placed 15kg
capacity wheeled bin to place the plastic bags and sharp containers.
Figure 4.28: 15kg wheeled bin
Figure 4.29: Small opening for internal transportation of medical waste
43
4.4.2
External Transportation
For external transportation, the vehicle with suitable criteria is used. This
vehicle is definitely different from solid waste vehicle. The inner space of the vehicle
storage is layered by stainless steel and aluminum to give smooth surface for
cleaning purposes. Every hole and pores inside it must be closed to prevent the waste
from sticking and left behind when unloading and cleaning process. The vehicle
cannot be used for other purposes. It is always provided with all equipment for
cleaning and personal protective equipment (PPE) to clean the storage after several
processes of loading and unloading waste.
In Johor, Pantai Medivest Sdn Bhd will send a vehicle from the incinerator
plant located at Bukit Rambai, Melaka to collect medical waste daily. The vehicle
will come to Pantai Medivest Sdn Bhd branch in every hospital. The driver will bring
along empty 15kg wheeled-bin. After he had finished, the porter unloads the wheeled
bin from the temporary storage.
Figure 4.30: Vehicle used in external transportation
44
4.5
Temporary Storage
After collecting the entire medical waste generated, it is important to provide
a proper storage for it. The function of having temporary storage in managing
medical waste is to provide a place where the waste can be stored temporarily, safely
and easily for inspection.
The storage is placed far from canteen, other stores, and public passage. It is
also must have good air circulation. This area must always remain locked when no
medical waste storage activity happen. For transportation purposes, the storage must
easily entered by vehicle that will specially transport it to the incinerator located at
Bukit Rambai, Melaka.
Before deciding the dimension of temporary storage, there are some factor to
be considered. The collection frequency is most important. In HSA and HSI, Pantai
Medivest have decided that medical waste collecting activity starts at 4am, 8am, and
2pm daily. Other considerations made on medical waste temporary storage are
number of public holiday weekly and probability of having difficulties in collection.
Pantai Medivest Sdn Bhd had provided a large storeroom for this purpose.
Strorage capacity is for 2 days of collection and minimum of 1 day for storage. The
container is locked to make sure that the wheeled bin is safe while waiting for
transportation to incinerator. It can store up to 40-wheeled bin with capacity of 15kg
of each bin. In order to prevent bacteria from breeding and odor problem, the
container is installed with air conditioned system. The temperature is maintained at 4
to 6 degree Celsius. Outside of the container is marked by biohazard symbol. It is the
porter‟s duty to clean the container weekly. Pantai Medivest Sdn Bhd has provided
all equipment for cleaning and personal protective equipment (PPE) such as gloves,
safety boots, apron and mask if any leakage happened during the storage.
45
Figure 4.31: Temporary storage of medical waste
4.6
Documentation
Medical Waste is one of schedule waste listed in Environmental Quality
(Schedule Waste), Regulation 1989. According to it, every matter of documentation
for medical waste transportation must follow the regulation. It requires an inventory
to be kept and a consignment note system to be used for transport of waste from the
hospital to an approved facility.
Consignment note records the details of the waste generator, the transport
contractor and the final receiver (Pantai Medivest Sdn Bhd) together with the
information on the medical waste being transported. An inventory provides an
accurate and up-to-date record of the quantities and categories of medical wastes
being generated, treated and disposed of. The respective parties should retain the
record for a period of three years.
46
The consignment note or form is design to record the name of hospital, name
and signature of the officer who responsible in the hospital, quantity of waste
generated, name of driver and signature. This consignment note should be filling in
seven copies. It is for:
i.
Copy No. 1 (of 7), to be retained by the Waste Generator
ii.
Copy No. 2 (of 7), to be retained by the Contractor
iii.
Copy No. 4 (of 7), to be retained by the Transport
iv.
Copy No. 5 (of 7), to be sent to the Waste Generator by the
Incinerator Facility
v.
Copy No. 7 (of 7), to be retained by the Incineration Facility
The information of consignment will be used by Pantai Medivest Sdn Bhd to
get monthly statistics for annual report or any future planning. Example of
consignment note is in Appendix B
4.7
Medical Waste Treatment and Disposal
The incineration system used in Pantai Medivest Sdn Bhd in Bukit Rambai is
„Rotary kiln with Waste Heat Boiler Incinerator‟. It started operation in 2001 with
cost of more than RM15 million. It is controlled automatically with combustion
capacity of 250kg/hr or 6ton/day. In daily operation, this incinerator plant is operates
24 hours a day with 3 shift of group worker. The schematic diagram of the facility is
shown in Figure 4.32
47
Figure 4.32: The schematic diagram of a medical waste incinerator at Bukit Rambai
(Source: Sabariah et al., 2005)
The medical waste incineration plant consists of both the combustion unit and
the air pollution control system. The former serves as the destruction unit whilst the
latter serves to clean the air impurities originating from the combustion unit. The
combustion unit comprises of Primary Combustion Chamber and Secondary
Combustion Chamber.
4.8
Selected of Mobile Incinerator for Medical Waste
IRIS‟ Green Gas Incinerators are a new generation incinerators capable of
toxin-free burning waste. Unlike conventional thermal incinerators that use
hydrocarbons as fuel, Green Gas Incinerators use Green Gas as auxiliary fuel for
combustion. Green gas is produced on site as and when necessary by the green gas
generators.
48
Green Gas is produced from water by a process of electrolysis whereby two
molecules of water is split into two molecules of hydrogen and one molecule of
oxygen in a green gas generator. Green gas generator derives fuel directly from soft,
clean water.
2H2O = 2H2 + O2
The Oxy Hydrogen mobile incinerator has been chosen because this mobile
incinerator is the Malaysia‟s first environmental friendly by Iris Corporation Berhad.
The Oxy-Mobile Incinerator is a new generation incinerator capable of toxin-free
burning. The toxin free burning because when mobile incinerator make a process
combustion, hydrogen and oxygen combine and form H2O, pure water. This is very
good for energy production, because it gives rather high amount of energy with no
environmental problem.
The major way of getting big quantities hydrogen is the electrolysis of water.
This process is using in Oxy Hydrogen mobile incinerator. It is a really a cool
convention. Essentially, the invention converts H2O water through the process of
electrolysis into clean hydrogen gases to conduct safe and clean burning. Besides that
carbon gases did not occur that are harmful and poisonous to the environment. The
effort from Malaysian company to produce the green technology is certainly
laudable.
The Oxy Hydrogen mobile incinerator generates its own green gas as
auxiliary fuel for combustion. The green gases introduce in the Oxy Hydrogen gas
mixture is because its unique properties such as high caloric value, pollution free
combustion and developed at in situ generation.
Gas burners that operate on green gas produce flames at temperature
exceeding 1500oC. The temperatures level must be attained in order to destroy many
of toxic and pathogens. Therefore the proposed mobile incinerator for medical waste
49
may become a good practice of medical waste management. Table 4.1 show the
specification system of the Oxy-Hydrogen Mobile Incinerator.
Table 4.1: Specification system of mobile incinerator. (Source: Iris Corporation)
Design Capacity
160kg/hour
Fuel Type
Green Gas
Burner Type
Primary chamber – 1 x 150kcal
Re-Oxidation chamber A – 1 x 150kcal
Re-Oxidation chamber B – 1 x 150kcal
Residual control measures
Re-oxidation of flue gas
Rapid quenching using wet scrubber
Residual bottom ash
10% of batch load
In essence, the IRIS Mobile Green Gas Incinerator comprises of the
following subsystem such as a pre-treatment phase will include a shredder and
crusher unit (optional), a green gas generator, a multi-stage incineration unit
equipped with industrial gas burners and a post treatment system for residual control.
Figure showed that the mobile green gas incineration plant process flow.
Figure 4.33: Oxy-hydrogen mobile incinerator process flow
50
4.8.1
Combustion of Waste
The combustion of waste occur in the primary chamber
4.8.1.1 Green Gas Generation Unit
The Green Gas Generator produces Green Gas on demand through a unique
electrolysis process. The generator breaks down Reversed Osmosis (RO) treated
water into its constituent of oxygen and hydrogen gases. The green gas produced is
further mixed with a liquefied Hexane coolant before being piped to an industrial gas
burner. The Green Gas Generator produces 10,200 liters of Green Gas per hour. In
the process, it consumes 7.0 liter of water and 29 kW of electricity. To dissipate the
heat of electrolysis from the generator, a 5 tones cooling tower cooling tower is
installed to provide cooling water to the generator.
4.8.1.2 High temperature incineration
The rotary kiln furnace is the main component of the primary combustion
chamber. In this chamber, wastes are exposed to the green gas flame and oxygen for
incineration under very high temperatures, ranging from 7000C to 9000C. As waste
is fed into the furnace from the hopper, the furnace is rotated mechanically to agitate
the waste and expose it evenly to the surrounding high temperature condition for
effective burning. Upon combustion, flue gas is produced and directed to the
secondary combustion chamber for treatment while bottom ash is transferred to the
rear hood for removal.
The furnace is always maintained at a negative pressure generated by the
Induced Draft Fan, to prevent flue gas from escaping into the surrounding area. The
51
mobile incinerator has a disposal capacity of 1 to 5 tons per day, depending on the
composition of waste.
4.8.2
Treatment of flue gas and Fly ashes
When harmful substances are released into the air as black smoke during
incineration, it is critical to burn the smoke in the secondary combustion chamber to
remove particles such as toxic fumes, carbon dioxide, carbon monoxide, odor and
particulates.
4.8.2.1 Combustion of flue gas
The secondary combustion chamber is maintained under very high
temperatures of approximately 9000C to 10000C. Its main function is to combust the
flue gas from the primary combustion chamber and incinerates larger particulates or
fly ash in the flue gas. At this temperature, hazardous gases such as sulphur dioxide
(SOx), nitrogen oxide (NOx) and dioxins are effectively destroyed.
4.8.2.2 Scrubbing of flue gas
In the wet scrubber, treated flue gas will be mixed with water that is injected
into the chamber. All smoke particles and gaseous products are washed down by
rapid quenching, before being released into the atmosphere as cleaned emission
through a chimney. At all times, the water level in the double walled incinerator is
monitored to maintain a correct level. Purging of the ash-laden water is done at
regular interval to prevent the choking of the water pump, nozzles and circulation
system.
52
4.9
Cost Analysis
The cost acquiring and operating medical waste management equipment and
facilities is an important determinant in the design and selection of a waste
management system. The purpose of this study is to provide typical cost data on the
purchase price of medical waste management using mobile incinerator compare
conventional method. Operating cost and maintenance cost also important in this
analysis. Table 4.2 show that the cost of using Oxy Hydrogen mobile incinerator.
Table 4.2: Cost using mobile incinerator. (Source: Iris Corporation)
Item
Incinerator (160kg/hour throughput) with accessories)

Closed transport carts

1 year spare part

Incinerator loader

Fire extinguisher system

Emission compliance testing

Installation and commissioning

Compliance testing

Waste weighting equipment

training
Cost (RM)
3,500,000
Pollution Abatement Equipment
500,000
Building construction
150.000
Subtotal
10% contingency
Total
4,150,000
415,000
4,565,000
53
4.9.1
Conventional Medical Waste Incinerator
According to Pantai Medivest Sdn Bhd, cost to treat one kilogram medical
waste using conventional incinerator is RM5.40
4.9.2
Mobile Incinerator
Capital Cost
= RM4, 565,000
Maintenance Cost
= 3.5% x capital cost
= RM159, 775/year
Operation Cost
= 2.5m3 x RM2.22
Water
= RM5.50/hour
= RM48, 618/year
Electricity
= 29kW x RM 0.37
= RM10.73/hour
= RM93, 994.8/year
Diesel
= RM 100/day
= RM 36000/year
Labour
= (10 workers x RM800) + (1 driver x RM1200)
= RM92, 000/month
= RM110, 400/year
Total Operation Cost for one year is RM448, 787.8. In one year, this mobile
incinerator can treat 730tone of waste. Hence the estimation cost to treat 1kg of
medical waste using mobile incinerator is RM448, 787.8 divide by 730tone is equal
54
to RM0.62. Compared to the conventional method, the cost is RM5.40. It is clearly
shows that have a big different here which is RM4.78.
As the result from the analysis, the cost could be saving in RM 4.78 per
kilogram. In year 2009, Hospital Sultanah Aminah generates 441,704.7kg of medical
waste. By using this mobile incinerator, the cost to treat medical waste from HSI in
year 2009 is only RM 247,354,63 compared to conventional incinerator
RM2,385,205.38. The cost could save about RM 2,137,850.75. Hence, by using this
technology cost can be reduce, and more importantly, it is an environmental friendly
system for cleaner and more sustainable future for the next generations.
4.10
Proposal of Site Disposal
Site disposal have been proposed in Hospital Sultanah Aminah and Hospital
Sultan Ismail is located at temporary storage area. It is because this placed is far
from canteen, other stores, and public passage. Besides that, it also meet the local
authority zoning regulation such as a minimum 500m distance from the nearest
residential area. At the location, the trailer need to park there. Prior of that, by this
new location of waste incinerating, the cost to manage medical waste will be
reducing.
According to the data obtained from Pantai Medivest Sdn Bhd, medical waste
generation at Hospital Sultanah Aminah and Hospital Sultan Ismail is about 10001500 kg per day for weekdays and 400-800kg per day for weekend. While the design
capacity for this mobile incinerator is 3840 kg per day. Because of that, this mobile
incinerator is very suitable to select to treat this medical waste. The waste may be
incinerating only 1 time for 2days. In addition, the biggest advantage of mobile
incinerator is its mobility. Hence, this mobile incinerator can move between Hospital
Sultanah Aminah and Hospital Sultan Ismail with very easy.
CHAPTER 5
CONCLUSION
5.1
Conclusion
From the observation made by site visiting, explanation and interview, there
is obvious to state that the management and disposal of medical waste is in good
condition. Every personnel that are responsible for medical waste management know
their responsibility and scope of work. Hence, there is seldom to have major
problems happened which is caused by medical waste.
The study of medical waste management in Johor is purpose to break it down
into its basic component, its characteristic, and estimate costs to manage medical
waste management. From the chapter 4.2, the average results Hospital Sultanah
Aminah and Hospital Sultan Ismail generate 20-40 tones/month or 400-1500 kg/day
medical waste. Therefore the mobile incinerator is good practice of proper waste
minimization. It is because when using this technology the cost will be reducing
although the capital cost is expensive. However the revenue cost will be obtained
when this technology can used for different Hospital location in Johor such as
Hospital Kulai and other else.
56
Furthermore, by using this mobile incinerator, water can be using as fuel
source for waste combustion, reducing waste to less than 10% residue and leaving no
environmental contamination. It is also flexible with a waste-to-energy module and
more importantly, an environmental-friendly system for a cleaner and more
sustainable future for the next generation.
5.2
Recommendation
Even though every process on management of medical waste is good, but it
will not do any good if the porters not taking care of their own safety. By
observation, most of the porters are not wearing a proper mask and shoes. To solve
this problem, the Department of Engineering at Hospital Sultanah Aminah and
Hospital Sultan Ismail should monitor and made observation about medical waste
management at their place.
For improve the study, somebody who wants to continue this thesis, they
must considering by other people perception. The perception depends on the waste
generator, contractor, and Department of Environment.
REFERENCES
William A. Rutala, C. Glen Mayhall. (1992). “Infection Control and Hospital
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Ir. Khew Swee Lian. (2008). “Clinical Waste Management: The Malaysia
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C.C. Lee, G.L Huffman. (1995). “Medical Waste Management/Incineration”. U.S.
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J.I Blenkharn. (1995). “The Disposal of Clinical Waste”. Department if Infectious
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Ibrahim Shafii. (1998). “Schedule Waste Management in Malaysia”, Seminar
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RMSB, (2004), “CWMS Presentation to CEO”. Radicare (M) Sdn Bhd. unpublished.
APPENDIX A
Component in Oxy-Hydrogen Mobile Incinerator
A – Feeding system
B – Oxy-hydrogen burner
C – Rotary kiln incinerator
D – 2nd combustion chamber
E – Heat Exchanger
F – Induced draft fan
G – Wet scrubber
H – Chimney
I – Green gas generator system
59
APPENDIX B
60
APPENDIX C
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64
65
66
67
68
69
70
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