Hastane atıklarının atık azaltımı yöntemi ile değerlendirilmesi
Başlık çevirisi mevcut değil.
- Tez No: 66878
- Danışmanlar: PROF. DR. İLHAN TALINLI
- Tez Türü: Yüksek Lisans
- Konular: Çevre Mühendisliği, Environmental Engineering
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 1997
- Dil: Türkçe
- Üniversite: İstanbul Teknik Üniversitesi
- Enstitü: Fen Bilimleri Enstitüsü
- Ana Bilim Dalı: Çevre Mühendisliği Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 222
Özet
ÖZET Bu çalışmada, atık azaltımı yaklaşımı tanımlanarak, esasları açıklanmış, bir kuruluşta atık azaltımı programının yürütülebilmesine temel teşkil eden atık azaltımı değerlendirme prosedürü ortaya koyularak, hastane atıkları kapsamında atık azaltımı yaklaşımı değerlendirilmiş ve iki genel tıbbi ve cerrahi hastanede oluşan atıklar incelenerek atık azaltımı önerileri geliştirilmiştir. Birinci bölümde, çalışmanın amaç ve kapsamı belirtilerek atık azaltımının çevresel açıdan önemi üzerinde durulmuştur. İkinci bölümde, atık azaltımı yaklaşımının esasları tanımlanarak, atık azaltımı değerlendirme prosedürünün aşamaları incelenmiştir. Üçüncü bölümde, hastane atık kirlenme profili çıkarılarak, hastane geneline ve spesifik atık akımlarına yönelik atık azaltımı seçenekleri oluşturulmuştur. Dördüncü bölümde, hastane atıklarının azaltılması kapsamında, iki farklı hastanedeki atıklar incelenmiş ve hastane atık yönetimi uygulamaları değerlendirilmiştir. Beşinci bölümde, incelenen hastanelerde oluşan atıkların azaltımı ile ilgili olarak varılan sonuçlar açıklanarak, önerilerde bulunulmuştur. vııı
Özet (Çeviri)
SUMMARY As a global problem, accelerating industrialization caused an increasing damage on the environment and human health. Unconsciously usage of natural sources, failing to take required precautions and disregarding environmentally-friend technologies resulted in an unrecoverable hazard on natural sources and also caused pollution of air, water and soil. As the global pollution get denser and threaten the human health, the concept of waste management come to priority within the aim to reduce and control the pollution in the receiving bodies by the help of a number of legal regulations. Studies that are carried out within the scope of waste management put forward the fact that some wastes have potential hazards because of their various characteristics and those wastes would better be handled specifically respect to other wastes. Depending on the necessity of providing the accordance with legal regulations, the increase in the costs of waste management directed the scientific studies on the minimizatiomelimination of the wastes. It is the waste minimization that includes not only the hazardous wastes but also all the rest basing on the principle of reducing the generation of waste, waste minimization deals with the reduction of waste at source with some precautions also considers the recycling of waste after generation by the way of some applications. In this study, hospital wastes are assessed in the scope of general medical and surgical hospital wastes which are all have to be handled and managed specifically, then waste minimization opportunities are presented. Minimization of hospital wastes at source or recycling of such wastes either on-site or off-site has substantial importance on the preservation of human health and environment, reduction in costs of operation and disposal and execution of legal regulations. In the first section; the scope of this study are presented and the importance of waste minimization by means of hospital wastes are emphasized. The aim of the study is to determine the processes that produce wastes at the general medical and surgical hospitals and to constitute waste minimization options for the reducing of the waste generation in these processes with the assistance of source reduction and recycling techniques. In the second section, general layout figures for the principles of waste minimization approach are given, also basic concepts of this approach are presented and waste minimization assessment procedure are laid out IXWaste minimization consists of source reduction and recycling. EPA reports that waste minimization is somehow feasible reduction of generated waste before its treatment, storage and final disposal. Waste minimization is the activity of reduction or recycling that results in the 1. reduction in the volume or amount of the hazardous waste, 2. reduction in its toxicity 3. reduction in both. With an environmental point of view source reduction should be regarded prior to recycling. The main aim of waste minimization is reducing the potential detrimental effects on human health and environment today and in the future. Source Reduction : is the reduction of waste in the its source from where it generates and generally in the process. Recycling : Reuse or reclamation of a substance is called recycling. Reuse; is the addition of the substance to the process for a commercial product at a certain functionality or the use of the substance as raw matter in production. Reclamation is the processing or regeneration of substance for the recovery of a useful product. Waste minimization program : It is a well-organized, enlarged and continuous study for the systematic reduction of waste generation. An effective waste minimization program should reflect the waste minimization purposes and policies which are put forward by the management. Waste minimization assessment; is a procedure that is formed so as to carry out the waste minimization program. The first step of the assessment is the inspection of the operations in the plant, specific areas and waste streams. Then waste streams or areas that will be the focus of the waste minimization assessment are determined, following the options that have waste minimization potential are developed and the adequate ones amongst these options are selected. Following the technical and economical feasibility of these options the most promising ones are selected for implementation. Waste minimization assessment consists of four stages which are;. Planning and organization. Assessment phase. Feasibility analysis phase. Implementation At this stage first source reduction options and then recycling options should have to be put out. In the third section, the pollution profile of the waste streams which will be assessed in the scope of hospital wastes are determined, defined and waste minimization options are formed for both hospital and defined specific waste streams.The recognized need to minimize waste I PLANNING AND ORGANIZATION Getting management commitment Set overall assessment program goals Organize assessment program task force Assessment organization and commitment to proceed Assessment report of selected options Repeat the process FEASIBILITY ANALYSIS PHASE Technical evaluation Economical evaluation Select options for implementation Final report, including recommended options I IMPLEMENTATION Justify projects and obtain funding Installation (equipment) Implementation (procedure) Evaluate performance Successfully implemented waste minimization projects Figure 1 The Waste Minimization Assessment Procedure xico cu çr 'E.c o cu I- c o cu N I c 05 cu CM £ O) XIIHospital wastes can be classified as; Chemotherapy and antineoplastic chemicals Formaldehyde Photographic chemicals Radionuclides Solvents Mercury Waste anesthetic gases Other toxic, corrosive and miscellaneous chemicals Infectious wastes Domestic wastes Chemotherapy is the method of treatment (cure) for which certain chemical medicines are used. A high portion of chemotherapy wastes include slightly contaminated items like gauze materials and personnel protective clothing. The preparation and mixing of the medicines are applied in a hood that prevents the workman from any hazard and keeps the medicine sterile. Formaldehyde are widely used in dialyze, pathology, autopsy and nursing units. The purpose of formaldehyde use in dialyze is cleaning the membranes. In other units it is used to preserve specimen. Photographic chemicals are photographic developer solutions. These solutions are divided into two sub-groups as fixers and developers. The waste water of such solutions from radiology units contain silver and they are generally discharged to sewers. Radionucleids are consumed in the departments of nuclear medicine and clinical testing laboratory. Radioactive substances used in the hospitals are generally of low level, hence such wastes should be retained in a temporary on-site storage in order to provide decomposition to levels low enough for nonhazardous state and should then be disposed. Solvent wastes generate from the pathology, histology, laboratory and engineering units of the hospitals and typically disposed either by discharge to sewers or by lab packing. At hospitals, mercury is used for mercury containing thermometers and blood pressure measuring devices. Breaking of such devices or obsolete equipment cause mercury containing wastes. Although seems to be an expensive method, the most appropriate way to minimize the mercury wastes is making use of solid state electronic sensing instruments instead of mercury containing ones. Inhalation anesthetics are, nitrous oxide and the halogenated agents halothane (Fluothane), enflurane (Ethrane), isoflurane (Forane). Exposure of sanitary service personnel to such substances may result in not only acute and toxic effects, but also reproductive disorders as well as carcinogenesis. XIIIToxic, corrosive and various chemicals; poisons, oxidizers and caustics are generally consumed at low amounts at hospitals. Among these chemicals one can count ethileneoxide, disinfecting cleaning solutions, utility wastes and maintenance wastes. Infected wastes may be defined as a waste that can cause an infectious disease. For the arise of an infectious disease, the existence of a pathogen, its dosage, its introduction and the immune of the host are all effective. Infectious wastes are isolation wastes, cultures and stocks of infectious agents and associated biologicals, human blood and blood products, pathological waste, contaminated sharps, contaminated animal carcasses, body parts and bedding. Domestic wastes are non-infected kitchen waste, packaging utilities, office wastes, garden wastes and glass and alike wastes. The sources for such wastes are administrative buildings, patient, doctor and nurse rooms, dining halls and luncheon facilities. It is imperative that the domestic wastes be managed separate from other medical wastes. The waste minimization options for hospital wastes are better operating practices and control methods that are determined on case by case basis for specific waste streams. These cited methods can be classified as material substitution process and equipment modification, good operating practices and recycling. Those waste minimization techniques are given in the cited table. In the fourth section, waste management studies are researched at Şişli Etfal and Muğla State Hospital which represent general medical and surgical hospital characteristics, wastes generating at these hospitals are given in quantities and waste minimization questionnaire forms are filled in by surveying with hospital personnel. As a result of these studies it is observed for the hospitals that handling the wastes are not executed in accordance with waste minimization and that all the operations regarding the hospital wastes are applied depending on the principle of appropriate management of waste handling. Considering the conditions of our country, this occasion may be considered as a improvement for our hospitals. In the fifth section, for the two hospitals surveyed, possible waste minimization options are laid out and precautions about waste management are determined. Hence, within this scope proposals regarding the surveyed hospitals are developed. XIVTable 1 Waste Minimization Methods for General Medical and Surgical Hospitals Waste Category Waste Minimization Method Chemotherapy and Antineoplastics Formaldehyde Photographic Chemicals Radionuclides Solvents Mercury Waste Anesthetic Gases Toxics, Corrosives and Miscellaneous Chemicals Reduce volumes used. Optimize drug container sizes in purchasing. Return outdated drugs to manufacturer. Centralize chemotherapy compounding location. Minimize waste from compounding hood cleaning. Provide spill cleanup kits. Segregate wastes. Minimize strength of formaldehyde solutions. Minimize wastes from cleaning of dialysis machines and RO units. Use reverse osmosis water treatment to reduce dialysis cleaning demands. Capture waste formaldehyde. Investigate reuse in pathology, autopsy laboratories. Return off-spec developer to manufacturer. Cover developer and fixer tanks to reduce evaporation, oxidation. Recover silver efficiently. Recycle waste film and paper. Use squeegees to reduce bath losses. Use countercurrent washing. Use less hazardous isotopes whenever possible. Segregate and properly label radioactive wastes, and store short-lived radioactive wastes in isolation on site until decay permits disposal in trash. Substitute less hazardous cleaning agents, methods for solvents cleaners. Reduce analyte volume requirements. Use pre-mixed kits for tests involving solvent fixation. Use calibrated solvent dispensers for routine tests. Segregate solvent wastes. Recover/reuse solvents through distillation. Substitute electronic sensing devices for mercury-containing devices. Provide mercury spill cleanup kits and train personnel. Recycle uncontaminated mercury wastes using proper safety safety controls. Employ low leakage work practices. Purchase low-leakage equipment. Maintain equipment properly to avoid leaks. Inspection and proper equipment maintenance for ethylene oxide sterilizers. Substitute less toxic compounds, cleaning agents. Reduce volumes used in experiments. Return containers for reuse, use recyclable drums. Neutralize acid waste with basic waste. Use mechanical handling aids for drums to reduce spills. Use automated systems for laundry chemicals. Use physical instead of chemical cleaning methods. XV
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