Environmental consequences of biomedical waste incinerators in residential areas

Note:Delhi Government's Department of Health had constituted an independent committee to look into the complaints of residents of Sukhdev Vihar against working of biomedical waste incinerator in the their residential area. The committee has submitted its report.


Over the years the world has learned that incineration is a leading source of highly toxic dioxin, mercury, lead and other dangerous air pollutants that threaten human health and environment.

A medical waste incinerator releases into the air a wide variety of pollutants including dioxin and furans, metals (such as lead, mercury and cadmium), particulate matter, acid gasses (hydrogen chloride, sulphur dioxide) carbon monoxide and nitrogen oxides. These emissions have adverse consequences on public health and the environment. Dioxin is a known carcinogen that has been linked to birth defects, immune system disorders and other harmful health effects. Mercury is a potent neurotoxin that can cause developmental defects and harm the brain, kidneys and lungs.

Medical waste incineration has been identified by the US EPA as the third largest source of dioxin in air emissions 1and as the contributor of 10 percent of mercury emissions to the environment from human activities 2

Incineration produces both toxic air emissions and toxic ash residue.3.The air emissions affect the local environment and may affect communities hundreds or thousands of miles away. The ash residue is sent to landfills for disposal, where the pollutants have the potential to leach into groundwater.

While the industrialized nations are beginning to phase out incinerators, India is poised to acquire these toxic, out-dated equipments. Unfortunately, decision makers are ill-informed and fail to prevent the public from poisoning.

The burning of waste is a poor mismatch between the problem and the solution. There have been two explanations why medical waste incinerator should produces more dioxin and furans, per ton of waste burned than municipal waste incinerators. The first suggestion is that medical waste contains more plastic per volume (approximately 30% versus 7% ) than municipal waste 4 and much of this plastic is chlorinated (PVC). The Biomedical waste management and handling rules, although lay down that no PVC waste should enter the yellow bag meant for incineration, this is far from reality.

Medical waste incinerators do not have advanced air pollution control devices and are frequently run by janitorial staff of the hospital, who are not professionally trained.

Once an incinerator is built or installed, it represents a long term financial commitment from the healthcare institutes. It removes any incentive to pursue more rational and cost effective approaches to the problem.
Medical waste comprises of blood soaked bandages, syringes, IV sets, broken glasses, ampoules, urine and blood bags, amputated limbs and other body parts. Medical waste is highly infective and can cause serious harm if not managed properly. Improper management of medical waste causes threat to patients, healthcare workers, community and the environment. But it is important to remember that not all of it is infective.
Several national and international studies have shown that out of the entire medical waste stream only 15- 20% is infectious or hazardous; and the rest is simply general waste. The problem becomes mammoth only when this small quantity of hazardous waste is mixed with the innocuous bulk of general waste
In view of the above facts, it is surprising that the authorities are permitting operation of a medical waste incinerator in a residential area. It is only the pathological waste category which requires incineration and is not amenable to non burn technologies.

The management of healthcare waste is an integral part of a national heath care system. A holistic approach to healthcare waste management should promote adoption of safe and environmentally sound technologies.
In India, despite the new Guidelines from Central Pollution Control Board (CPCB) on design and construction of incinerators, which clearly state that no new incinerators would be permitted, incinerators still continue to be installed, and some even in residential areas.

REFERENCES

1. Inventory of sources of dioxin in the United States EPA/ 600/P-98/002Aa national centre for Environmental Assesment,USEPA,April1998 p2-13
2. Mercury Study report to Congress, Volume -1: Executive Summary, USEPA, Office of Air, December 1997 pp 3-6.
3. Issues in medical waste management background paper. Office of technology Assessment, Congress of the united states,OTA-BP-O-49,October 1988
4. Dr Paul Conett Medical Waste Incinerators: Mismatch between problem and solution

Ratna Singh