Medical Waste-Sorting and Management Practices in Five Hospitals in Ghana.

Hospital waste management in Ghana faces the risk of cross-contamination from the lack of thorough sorting of the waste at the points of generation, codisposal of hazardous and nonhazardous waste types, and use of open-fire pits and substandard incinerators for burning infectious waste. This has increased the potential for the spread of infections and chemical pollutants. A cross-sectional study was conducted in five hospitals in Ghana to assess behavioral patterns on waste sorting and the effectiveness of hospital waste management in Ghana. A total of 250 questionnaires were distributed purposively to some staff of the five hospitals to assess workers' perceptions on medical waste sorting and handling. Additionally, focused group discussions and transect walks were adopted to examine the current collection, storage, treatment, and disposal methods used in the health facilities. Chi-square analyses showed significant differences in waste-sorting behavior based only on occupation (p < 0.0001, n=180) and not on gender, education, or experience in the health sector. Even though contaminated sharps were separated into brown safety boxes, color coding for other infectious waste containers was inconsistent across the health facilities. The study revealed that incineration is still the modal method of treatment in Ghanaian hospitals and therefore new approaches such as an engineering approach were required to minimize its environmental effects. It is recommended that periodic in-service training workshops be held for healthcare staff on the right source-segregation of medical waste, in order to facilitate the effective and safe handling, transport, treatment, and disposal of waste from health facilities.

Adverse pregnancy outcomes in women with changing patterns of exposure to the emissions of a municipal waste incinerator.

Municipal solid waste incinerators emissions contain pollutants that, despite their low concentration, might adversely affect reproductive health. In the present study, we examined rates of miscarriage and birth defects among women who resided or were employed in the vicinity of a municipal solid waste incinerator plant from 2003 to 2013. In 2009, a progressive shutdown of the old incineration lines and operation of a new line caused considerably higher atmospheric release of polycyclic aromatic hydrocarbons, particularly of dioxins, due to these irregular operating conditions, technological renovation, and increased capacity. We used dioxin emission levels, based on a dispersion model, to define exposure status of the residing population to air pollutants emitted by the waste incinerator. In women who resided in areas characterized by higher emission exposures compared with a referent area, the relative risk (RR) of miscarriage was 1.04 (95% confidence interval (CI) 0.80-1.32) based on 62 cases overall, with little evidence of a dose-response relation. RRs were similarly null for both 2003-2008 and 2010-2013 periods (RR 1.12 (95% CI 0.80-1.53) and 0.98 (95% CI 0.63-1.48), respectively). Concerning birth defects in the offspring of women residing in the exposed area, no evidence of increased risk emerged, since the prevalence ratio at birth was 0.64 (95% CI 0.29-1.26), with comparable results in the 2003-2008 and 2010-2013 period. Corresponding analyses carried out in municipal residents who worked in the exposed area confirmed these findings. We also did not detect abnormally high rates of miscarriage and birth defects in the exposed cohorts in the single year 2009. Overall, these results do not suggest an effect of exposure to the emissions of the municipal solid waste incinerator we investigated on two indicators of reproductive health. However, the limited statistical stability of the estimates and the absence of individual-based information on some potential confounders suggest caution in the interpretation of study findings.

Análise morfoestrutural de biomateriais para auxílio no processo de identificação humana / Morphostructural analysis of biomaterials for assistance in the human identification process

O objetivo do estudo foi avaliar as alterações de biomateriais restauradores e protéticos submetidos a temperaturas elevadas para o estabelecimento de parâmetros físicos que auxiliem nos casos de identificação humana em corpos carbonizados. A amostra do estudo experimental in vitro foi composta por 40 corpos de prova dividida em quatro grupos: GI (corpos de prova de cimentos de iônomero de vidro químico), GII (amálgamade prata), GIII (resina composta híbrida) e GIV (liga de cobre alumínio). Os corpos de prova foram submetidosa temperaturas de 300°C, 500°C, 700°C e 900°C. Após a incineração, os biomateriais foram submetidos a análises macroscópicas sobre as modificações de estrutura, coloração, forma e estabilidade dimensional e os dados analisados pela Análise de Variância e teste de Dunn (p<0,05). Os dados obtidos demonstraram em relação à radiopacidade uma diferença estatisticamente significante para as médias de densidade radiográfica no GI entre as temperaturas 700°C e 900°C; GIV entre as temperaturas 300°C e 900°C; 500° e 900°C. O GII atingiu seu ponto de fusão à 700ºC com aspecto pulverulento e lojas isoladas de mercúrio a 900°C. O GIII apresentou mudança estrutural nas temperaturas à 700°C e 900°C. No GIV não se constatou modificações relevantes. Assim, pode-se coligir que a resina composta micro hibrida e o amálgama apresentam severas alterações morfoestruturais enquanto o ionômero de vidro e o cobre alumínio não sofrem mudanças significativas em suas características originais. As alterações sofridas pelos materiais fornecem dados relevantes para o auxilio no processo de identificação humana de corpos carbonizados.

The aim of this study was to evaluate the changes of restorative and prosthetic biomaterials subjected to high temperatures for the establishment of physical parameters that assist in cases of charred bodies in human identification. The sample of the experimental in vitro study was composed by 40 specimens divided into 4 groups: GI (specimens of cements of ionomer of chemical glass), GII(silver amalgam), GIII (hybrid composite resin) and GIV (copper alloy aluminum). The specimens were subjected to temperatures of 300°C, 500°C, 700°C and 900°C. After incineration the biomaterials were submitted macroscopic analysis on changes of structure, color, shape and dimensional stability and all data were analyzed by ANOVA and Dunn’s test (p <0.05). Regarding the radiopacity there was statistically significant difference for the mean radiographic density in GI temperatures within 700°C and 900°C; GIV temperatures within 300°C and 900°C, 500°C and 900°C. The GII has reached its melting point at 700ºC with powdery appearance and isolated stores of mercury at 900°C. The GIIIhad structural change at 700°C and 900°C. In GIV it not observed significant changes. Thus, one cangather that the micro hybrid composite resin and amalgam exhibit severe morpho structural changes while the glass ionomer aluminum and copper does not undergo significant changes in their original characteristics. The changes undergone by materials provide relevant data to aid in the identification process of human bodies charred.

Municipal solid waste incineration in China and the issue of acidification: A review.

In China, incineration is essential for reducing the volume of municipal solid waste arising in its numerous megacities. The evolution of incinerator capacity has been huge, yet it creates strong opposition from a small, but vocal part of the population. The characteristics of Chinese municipal solid waste are analysed and data presented on its calorific value and composition. These are not so favourable for incineration, since the sustained use of auxiliary fuel is necessary for ensuring adequate combustion temperatures. Also, the emission standard for acid gases is more lenient in China than in the European Union, so special attention should be paid to the issue of acidification arising from flue gas. Next, the techniques used in flue gas cleaning in China are reviewed and the acidification potential by cleaned flue gas is estimated. Still, acidification induced by municipal solid waste incinerators remains marginal compared with the effects of coal-fired power plants.

A comparative assessment of waste incinerators in the UK.

The uptake in Europe of Energy from Waste (EfW) incinerator plants has increased rapidly in recent years. In the UK, 25 municipal waste incinerators with energy recovery are now in operation; however, their waste supply chains and business practices vary significantly. With over a hundred more plant developments being considered it is important to establish best business practices for ensuring efficient environmental and operational performance. By reviewing the 25 plants we identify four suitable case study plants to compare technologies (moving grate, fluidised bed and rotary kiln), plant economics and operations. Using data collected from annual reports and through interviews and site visits we provide recommendations for improving the supply chain for waste incinerators and highlight the current issues and challenges faced by the industry. We find that plants using moving grate have a high availability of 87-92%. However, compared to the fluidised bed and rotary kiln, quantities of bottom ash and emissions of hydrogen chloride and carbon monoxide are high. The uptake of integrated recycling practices, combined heat and power, and post incineration non-ferrous metal collections needs to be increased among EfW incinerators in the UK. We conclude that one of the major difficulties encountered by waste facilities is the appropriate selection of technology, capacity, site, waste suppliers and heat consumers. This study will be of particular value to EfW plant developers, government authorities and researchers working within the sector of waste management.

Assessment of the health care waste generation rates and its management system in hospitals of Addis Ababa, Ethiopia, 2011.

BACKGROUND: Healthcare waste management options are varying in Ethiopia. One of the first critical steps in the process of developing a reliable waste management plan requires a widespread understanding of the amount and the management system. This study aimed to assess the health care waste generation rate and its management system in some selected hospitals located in Addis Ababa, Ethiopia. METHODS: Six hospitals in Addis Ababa, (three private and three public), were selected using simple random sampling method for this work. Data was recorded by using an appropriately designed questionnaire, which was completed for the period of two months. The calculations were based on the weights of the health care wastes that were regularly generated in the selected hospitals over a one week period during the year 2011. Average generation indexes were determined in relation to certain important factors, like the type of hospitals (public vs private). RESULTS: The median waste generation rate was found to be varied from 0.361- 0.669 kg/patient/day, comprised of 58.69% non-hazardous and 41.31% hazardous wastes. The amount of waste generated was increased as the number of patients flow increased (rs=1). Public hospitals generated high proportion of total health care wastes (59.22%) in comparison with private hospitals (40.48%). The median waste generation rate was significantly vary between hospitals with Kruskal-Wallis test (X2=30.65, p=0.0001). The amount of waste was positively correlated with the number of patients (p < 0.05). The waste separation and treatment practices were very poor. Other alternatives for waste treatment rather than incineration such as a locally made autoclave should be evaluated and implemented. CONCLUSION: These findings revealed that the management of health care waste at hospitals in Addis Ababa city was poor.

Long-term automated sampling of PCDD/PCDF flue gas: current status and critical issues.

After entry into force of the Stockholm Convention and Aarhus Protocol and in order to implement the upcoming European legal background, the European countries are asked to apply control measures to reduce the release of persistent organic pollutants (POPs) such as dioxins and furans (PCDD/PCDF) and polychlorinated biphenyls as well as to establish POPs release inventories. In this perspective, development of measuring techniques of emissions is a focal issue in acquiring useful information. In this paper, results of various measurement campaigns at different municipal waste incineration (MWI) plants using long-term automated sampling of PCDD/PCDF are presented. The samples collected from both manual and automated campaigns were analyzed following the European Standard EN-1948:2006 by high-resolution gas chromatograph/high-resolution mass spectrometer. Performances of two different commercial systems have been investigated. Anomalous values occurred during one long-term campaign (22.16 pg I-toxic equivalent (TEQ)/Nm(3)), compared to average values (4-5 pg I-TEQ/Nm(3)) of the MWI. At this maximum value, a main occurrence of abnormal and instable operating conditions has been found. Sampling based on long-term basis was found to be more reliable to monitor PCDD/PCDF emissions than occasional short-term sampling. Nevertheless, the results of long-term campaigns demonstrate that emission levels detected in 15-30 days campaigns, when unsteady operating conditions can occur, as start-up and shut down, are not immediately comparable to the typical levels in a 6-8 h, when operating conditions are generally stable. Moreover, there are often differences observed in the congener profiles between short- and long-term campaigns.

Clinical waste incinerators in Cameroon--a case study.

PURPOSE: Incinerators are widely used to treat clinical waste in Cameroon's Northwest Region. These incinerators cause public apprehension owing to purported risks to operators, communities and the environment. This article aims to summarize findings from an April 2008 case study. DESIGN/METHODOLOGY/APPROACH: Three incinerators were randomly selected and investigated for site, design and operating standards. Empirical field observation was adopted and data collected through inventory and informal interviews. Bottom ash samples collected from the incinerators were prepared according to standard procedures and analyzed for heavy metals using Inductively Coupled Plasma (ICP) Emission Spectroscopy. FINDINGS: Shortcomings associated with site selection, design and operation standards were identified. Chemical analysis revealed that Cr, Cu, Fe, Mn, Ni, Pb, Zn, Mg and Ca were present in the bottom ash with mean concentration ranging from 10 mg/kg for Pb to 178080 mg/kg for Ca. RESEARCH LIMITATIONS/IMPLICATIONS: For logistic reasons, feedstock quantity and quality into the incinerators were not investigated. Neither were soil samples around and away from the incinerators. PRACTICAL IMPLICATIONS: Although highly favored, clinical waste incineration methods in this region have to be reconsidered. A thorough health and environmental impact assessment is suggested before subsequent decisions on choice and disposal site is made. This will curb potential negative impacts to the environment and public health. ORIGINALITY/VALUE: This article adds a different perspective and sheds additional information to the debate on unsatisfactory clinical waste incinerators in resources-poor countries. Alternative methods to incineration are presented that will be helpful to practitioners.

Preliminary evaluation of risks related to waste incineration of polymer nanocomposites.

If nanotechnology proves to be successful for bulk applications, large quantities of nanocomposites are likely to end up in municipal solid waste incineration (MSWI) plants. Various studies indicate that nanoobjects might be harmful to human health and the environment. At this moment there is no evidence that all nanoobjects are safely removed from the off-gas when incinerating nanocomposites in MSWI plants. This paper presents a preliminary assessment of the fate of nanoobjects during waste incineration and the ability of MSWI plants to remove them. It appears that nanoobject emission levels will increase if bulk quantities of nanocomposites end up in municipal solid waste. Many primary and secondary nanoobjects arise from the incineration of nanocomposites and removal seems insufficient for objects that are smaller than 100nm. For the nanoobjects studied in this paper, risks occur for aluminum oxide, calcium carbonate, magnesium hydroxide, POSS, silica, titanium oxide, zinc oxide, zirconia, mica, montmorillonite, talc, cobalt, gold, silver, carbon black and fullerenes. Since this conclusion is based on a desktop study without accompanying experiments, further research is required to reveal which nanoobjects will actually be emitted to the environment and to determine their toxicity to human health.

Baseline soil levels of PCDD/Fs established prior to the construction of municipal solid waste incinerators in China.

In order to determine the baseline contamination by polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) in different areas in China, prior to the construction of municipal solid waste incinerators (MSWIs), a total of 32 representative soil samples was collected near 16 incinerators and analyzed for their PCDD/F concentrations. The PCDD/F baseline concentrations in the soil samples ranged from 0.32 to 11.4 ng I-TEQ kg(-1) (dry matter), with average and median value of 2.73 and 2.24 ng I-TEQ kg(-1) (dry matter), respectively, and a span between maximum and minimum recorded value of 36. The PCDD homologues predominated in 26 out of 32 soil samples, with the ratio (PCDDs)/(PCDFs) ranging from 1.1 to 164; however in the other 6 samples, PCDF homologues were larger, with the same ratio varying from 0.04 to 0.8. Principal component analysis (PCA) and hierarchical cluster analysis (HCA) were used to examine PCDD/F amount and profile in these soil samples, and their possible associations with known emission sources: in this process 6 really distinct isomer fingerprints were identified. Background PCDD/F levels and profiles were comparable to those found in soils from China and other countries and indicate a rather low baseline PCDD/F contamination of soils. The present data provide the tools for future assessment of a possible impact of these MSWIs.

Performance measurement for incineration plants using multi-activity network data envelopment analysis: The case of Taiwan.

This study proposes the use of multi-activity network data envelopment analysis to appraise how incineration plants in Taiwan perform. Sample data from 2006 is used to examine the trade-offs between efficiency enhancement and pollution abatement. The respective efficiencies of the waste treatment and electricity generation are also assessed in a unified framework. The empirical results indicate that it is more important to improve the efficiency of waste treatment activity than of electricity generation activity in order to enhance the overall performance of Taiwan's incinerators. Since ownership, location and length of operations do not in general affect their performance, any improvement has to come from the careful monitoring of each process of the waste treatment operations. Furthermore, given that the policy in Taiwan has moved away from incineration to recycling, the problem of an over-supply of incinerators may become apparent in the near future. Our results indicate that the availability of capacity size may be an important factor when policy-makers consider whether to close down some existing incinerators.

Global warming contributions from alternative approaches to waste management in the Norwegian Armed Forces.

Greenhouse gas (GHG) emissions emanating from waste management practices in five Norwegian military camps were assessed. The GHG emission accounting practices examined included fuel provision upstream of a material recovery facility (MRF), operational activities at the MRF, and downstream processes. The latter means recycling of waste compared to primary production using virgin materials, or the incineration of waste with energy recovery compared to heating based on the average energy mix for both EU and Norway. The results show that the operational activities at the MRF cause more GHG emissions than the provision of fuel upstream of the MRF (116 vs. 16-21 tonnes CO2-eq., respectively). Furthermore, the downstream activities provided far greater avoidance of GHG emissions than the load caused by upstream activities and the activities at the MRF. Recycling proves to be beneficial over incineration of waste when compared to the EU energy mix (savings of--257 tonnes CO2-eq.), and the advantage is even larger when compared to the average energy mix for Norway (savings of--779 tonnes CO2-eq.). In conclusion, the results show that sorting of mixed waste at military camp collection sites followed by recycling of the separated fractions at MRF would result in significant avoidance of GHG emissions, compared to the current practice of incineration with energy recovery of the mixed waste.

[Moniter Project: a model of HIA for Incinerators]. / Progetto Moniter: un modello di VIS per gli impianti di incenerimento.

The Emilia-Romagna regional government decided to develop a monitoring and surveillance system, known as MonITER (Incineration Monitoring on the Emilia-Romagna Territory), in 8 areas characterized by the presence of municipal waste incinerating plants.The project was divided into 7 lines, among these the number 6 developed a procedure of Health Impact Assessments (HIA) to support the planning of new facilities for incineration or combustion. Line number 6 is divided into 3 actions n action 1 aimed to developing and validating a participative HIA methodology, as well tools for the impact assessment and recommendations for implementing HIA on future plants; n action 2 analysed connected issues on communication; n action 3 was focused to developing a methodology for integrating HIA models into existing tools for mandatory impact assessment.Tailoring the HIA model development to the waste management context has highlighted the fundamental differences of the HIA approach with the other mandatory assessment tools, being theoretically founded on the principles of public involvement, equity, sustainable development and ethical use of evidence.

Greenhouse gas emissions from waste management--assessment of quantification methods.

Of the many sources of urban greenhouse gas (GHG) emissions, solid waste is the only one for which management decisions are undertaken primarily by municipal governments themselves and is hence often the largest component of cities' corporate inventories. It is essential that decision-makers select an appropriate quantification methodology and have an appreciation of methodological strengths and shortcomings. This work compares four different waste emissions quantification methods, including Intergovernmental Panel on Climate Change (IPCC) 1996 guidelines, IPCC 2006 guidelines, U.S. Environmental Protection Agency (EPA) Waste Reduction Model (WARM), and the Federation of Canadian Municipalities-Partners for Climate Protection (FCM-PCP) quantification tool. Waste disposal data for the greater Toronto area (GTA) in 2005 are used for all methodologies; treatment options (including landfill, incineration, compost, and anaerobic digestion) are examined where available in methodologies. Landfill was shown to be the greatest source of GHG emissions, contributing more than three-quarters of total emissions associated with waste management. Results from the different landfill gas (LFG) quantification approaches ranged from an emissions source of 557 kt carbon dioxide equivalents (CO2e) (FCM-PCP) to a carbon sink of -53 kt CO2e (EPA WARM). Similar values were obtained between IPCC approaches. The IPCC 2006 method was found to be more appropriate for inventorying applications because it uses a waste-in-place (WIP) approach, rather than a methane commitment (MC) approach, despite perceived onerous data requirements for WIP. MC approaches were found to be useful from a planning standpoint; however, uncertainty associated with their projections of future parameter values limits their applicability for GHG inventorying. MC and WIP methods provided similar results in this case study; however, this is case specific because of similarity in assumptions of present and future landfill parameters and quantities of annual waste deposited in recent years being relatively consistent.

The reduction of dioxin emissions from the processes of heat and power generation.

The first reports that it is possible to emit dioxins from the heat and power generation sector are from the beginning of the 1980s. Detailed research proved that the emission of dioxins might occur during combustion of hard coal, brown coal, and furnace oil as well as coke-oven gas. The emission of dioxins occurs in wood incineration; wood that is clean and understood as biomass; or, in particular, wood waste (polluted). This paper thoroughly discusses the mechanism of dioxin formation in thermal processes, first and foremost in combustion processes. The parameters influencing the quantity of dioxins formed and the dependence of their quantity on the conditions of combustion are highlighted. Furthermore, the methods of reducing dioxin emissions from combustion processes (primary and secondary) are discussed. The most efficacious methods that may find application in the heat and power generation sector are proposed; this is relevant from the point of view of the implementation of the Stockholm Convention resolutions in Poland with regard to persistent organic pollutants.

Removal of propylene and butylene as individual compounds with compost and wood chip biofilters.

Propylene and butylene are highly reactive volatile organic compounds (HRVOCs) in terms of ground-level ozone formation. This study examined the effectiveness of biofiltration in removing propylene and butylene as separate compounds. Specific objectives were (1) to measure maximum removal efficiencies for propylene and butylene and the corresponding microbial acclimation times, which will be useful in the design of future biofilters for removal of these compounds; (2) to compare removal efficiencies of propylene and butylene for different ratios of compost/hard wood-chip media; and (3) to identify the microorganisms responsible for propylene and butylene degradation. Two laboratory-scale polyvinyl chloride biofilter columns were filled with 28 in. of biofilter media (compost/wood-chip mixtures of 80:20 and 50:50 ratios). Close to 100% removal efficiency was obtained for propylene for inlet concentrations ranging from 2.9 x 10(4) to 6.3 x 10(4) parts per million (ppm) (232-602 g/m3-hr) and for butylene for inlet concentrations ranging from 91 to 643 ppm (1.7-13.6 g/m3-hr). The microbial acclimation period to attain 100% removal efficiency was 12-13 weeks for both compounds. The lack of similar microbial species in the fresh and used media likely accounts for the long acclimation time required. Both ratios of compost/wood chips (80:20 and 50:50) gave similar results. During the testing, media pH increased slightly from 7.1 to 7.5-7.7. None of the species in the used media that treated butylene were the same as those in the used media that treated propylene, indicating that different microbes are adept at degrading the two compounds.

Study of the transference rules for bromine in waste printed circuit boards during microwave-induced pyrolysis.

The production of waste printed circuit boards (WPCBs) has drawn increasing global concern, especially because the high bromine (Br) content (5-15%) places obstacles in the way of simple disposal techniques. Microwave-induced pyrolysis of WPCBs provides a promising way to dispose of these hazardous and resource-filled wastes. The transference rules for Br during microwave-induced pyrolysis have been investigated experimentally. It was found that the microwave energy could be used more efficiently to accelerate the heating rate and improve the final pyrolysis temperature by adding some activated carbon (AC) as microwave absorbents. The high temperature and rapid pyrolysis process promoted the yields of gaseous products and the decomposition of brominated compounds into hydrogen bromide and then benefited the capture of Br and the debromination of byproducts. The application of a calcium carbonate (CaCO3) layer overhead led to over 95% debromination of the liquid products and over 50% capture of the total Br. It can be concluded that the presented method is suitable for the control of Br transference in the recycling of WPCBs. This method can also be extended to the disposal of the electronic scraps.

Monitoring, fault detection and operation prediction of MSW incinerators using multivariate statistical methods.

This work proposes the application of two multivariate statistical methods, principal component analysis (PCA) and partial least square (PLS), to a continuous process of a municipal solid waste (MSW) moving grate-type incinerator for process control--monitoring, fault detection and diagnosis--through the extraction of information from historical data. PCA model is built for process monitoring capable of detecting abnormal situations and the original 16-variable process dimension is reduced to eight, the first 4 being able to capture together 86% of the total process variation. PLS model is constructed to predict the generated superheated steam flow rate allowing for control of its set points. The model retained six of the original 13 variables, explaining together 90% of the input variation and almost 98% of the output variation. The proposed methodology is demonstrated by applying those multivariate statistical methods to process data continuously measured in an actual incinerator. Both models exhibited very good performance in fault detection and isolation. In predicting the generated superheated steam flow rate for its set point control the PLS model performed very well with low prediction errors (RMSE of 3.1 and 4.1).

Assessment of waste management technology using BATNEEC options, technology quality method and multi-criteria analysis.

Best Available Techniques Not Entailing Excessive Costs (BATNEEC) options, technology quality method and multi-criteria analysis were proposed as means of developing indices for evaluating municipal waste management systems. The proposed indices can be treated as a tool for ranking the system taking into account technical, environmental, economic, social and other objectives, bearing in mind specific features of the area involved. The analysis was made for three different incineration plants (Spittelau in Vienna, Warsaw and Tarnobrzeg) together with alternative waste disposal versions (with or without biogas burning and with MBP Mechanical-Biological Process) and the waste management infrastructure. The results showed that incineration of waste is much more beneficial than disposal. These results conform to the waste hierarchy identified in EU Directive 2008/98, but the indices created are easy to interpret and useful as a tool for communicating with the public, which is often a crucial factor in determining the location of investment.

Effectiveness of incinerators in the management of medical wastes in hospitals within Eldoret municipality.

INTRODUCTION AND OBJECTIVES: Medical waste incinerators release into the air a host of pollutants that have serious adverse consequences on public health and the environment. This study aimed at determining the effectiveness of incinerators in Eldoret municipality in the management of medical wastes in relation to its maintenance and operation with an aim of giving recommendations towards reducing environmental pollution caused by emission of toxic pollutants and safeguarding the health of the incinerator operators as well as the surrounding communities. METHODOLOGY: A cross sectional study was carried out at three health facilities in Eldoret Municipality namely Moi Teaching and Referral Hospital blood Bank Transfusion Centre, Elgon View and Eldoret hospitals. Questionnaires, researcher observation and laboratory investigations of ash samples were used in data collection. The questionnaires were administered to all the personnel operating the incinerators. The ash samples collected were analyzed using Atomic Absorption Spectroscopy. RESULTS: The results showed that the incinerators were operated in substandard conditions due to breakdown of the ignition starter, lack of pollution control equipment, and a low combustion temperature. Laboratory investigation of the ash showed that the levels of the heavy metals tested were high compared to the national and international standards. Forty percent (40%) of the interviewees were aware of the health risks they were exposed to and used protective clothing and equipment. CONCLUSIONS: This study showed that the incinerators investigated are maintained and operated in substandard conditions. The ashes produced contain a wide range of toxic pollutants, including concentrated levels of a number of heavy metals. This poses serious environmental health and occupational safety hazard.