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REGIONAL SYSTEM OF MEDICAL, BIOLOGICAL AND VETERINARY WASTE MANAGEMENT
Medical, biological and veterinary waste management requires system approach and includes observance of three main principles: epidemiological safety, environmental safety and economy. As practice demonstrates main drawbacks of the existing system of medical and biological waste management are: - absence of sufficient quantity of disposable containers and packing (bags, boxes, etc) in medical and prophylactic institutions for separate collection of medical waste in places of origin; - use of non-uniform containers and packing, which favors influence of human factor at separate collection of medical waste in places of origin; - leakiness of disposable polymeric bags in the process and after packing with the use of mechanical mouth buckle and their low mechanical durability; - absence of full personnel safety in the process of collection, temporary storage and transportation of used syringes and needles; - possibility to mix waste of different hazard classes in the process of collection and movement around the institution; - negative influence of service personnel, low efficiency and high cost price of work in the process of neutralization of medical waste with disinfectants; - unauthorized discharge of laboratory waste and used disinfectants into city sewage. JSC CIS NATURAL RESOURCES carries out practical activity for formation of the medical and biological waste management system observing the above three principles and not having the listed drawbacks at all stages of its life cycle. The organization has the objective to work out and to introduce, under commission of regional and municipal authorities, the medical and biological waste management system using disposable containers, temporary storage in uniform trays, transportation in specialized vans and neutralization in autothermal plant.
Stage 1 – Separated collection of medical and biological waste in places of origin using uniform disposable containers For stage 1 (collection) we have developed the uniform disposable container ensuring: simplicity of waste collection in places of primary origin without influence of human factor, complete airtight sealing of waste packing and personnel safety at waste handling. The disposable container is a cardboard box laminated inside. The open butt of the container has grooves (1), along which its facets are folded in pairs forming the double cover (2) of body closure, joint (3) of which after filling with waste is closed up in the clamping electrically heated device with solid lengthwise junction ensuring reliable mechanical fastening and airtightness of packing. The planned capacity of the disposable container – 16 liters. Thermal soldering of the cover ensures airtightness of the container, non-punching from inside at compression, watertightness and firmness at moving of carts containing them around the institution, temporary storage and transportation in vehicles with specialized vans to places of neutralization in autothermal plants. Use of disposable containers allows to avoid such operation as prophylactic disinfection of waste. Disposable containers are placed in departments of medical and prophylactic institutions in places of primary origin of B-class and C-class waste. The disposable container has a barcode allowing identification of waste origin place and removing organization, which is especially important in case of their unauthorized placement. Use of disposable containers for collection and transportation of medical and biological waste will allow: - to reduce to minimum the risk level for medical staff during handling B-class and C-class waste; - to reduce costs of medical institution for purchase of disinfectants; - to ensure environmental and epidemiological safety as temporary storage and transportation of medical and biological waste to places of neutralization. At the present moment the company is holding negotiations about production of disposable containers, and after joint industrial tests with Sysin R&D Institute and CLATM the pilot project will be launched in one of municipal units of Moscow Region in 2010. Stage 2 – Movement of disposable containers inside medical and prophylactic institutions on uniform carts. Disposable containers are laid by 6 units in three uniform trays of the inter-building cart in which they are moved to places of temporary storage in the territory of the institution. Loading into the specialized van of the vehicle is carried out by way of carrying over uniform trays with disposable containers into special racks in the van ensuring their stable placement and safety during moving to places of neutralization. Stage 3 – Temporary storage of medical and biological waste on inter-building container sites with the use of uniform trays. Temporary storage of disposable containers is carried out in uniform trays places in module-type racks sizes of which are determined in accordance with the volume of formed waste and periodicity of removal. Racks and inter-building site are elements of the module range developed by the company for complete unification of the whole process of medical and biological waste management at all stages of its life cycle. Stage 4 of medical and biological waste management system – Removal of disposable containers from the territory of medical and prophylactic institutions using specialized vehicles Jointly with GAZ commercial vehicle plant, in accordance with the requirements specification of the company, a specialized van equipped with a refrigerating plant and bactericidal lamps has been developed. The refrigerating system in the specialized van ensures storage of waste during transportation with optimum temperature of +5°С notwithstanding surrounding temperature. The ultraviolet recirculating plant ensures forced ventilation of the closed air volume undergoing constant bactericidal treatment which prevents uncontrolled air pollution. The vehicle (on the basis of GAZelle) with specialized van allows to transport disposable containers with total weight of 900 kg (about 300 containers) in one trip, which is twice higher than the present load of vehicles transporting medical and biological waste. The inner casing of the van – reinforced plastic – ensures steadiness against chemical impact of disinfectants at prophylactic disinfection. The special van is designed for transportation of both disposable containers and 120-liter containers. The special van with disposable containers can stand front crash of vehicles without emergency situation connected with spillage of waste in the place of accident. Waste Transportation Management Center (WTMC) The vehicle with special van is equipped with the system of satellite positioning and control, which allows online determination of its location, electronic registration of all technological operations from loading of disposable containers to feeding to autothermal plants, including unauthorized stops and deviations from the guided path. The Waste Transportation Management Center (WTMC) systematizes incoming reports about all transportations during the day, forms the list of enterprises with statement of hazardous waste volumes received for neutralization. The WTMC determines the route of specialized vehicles, at that the software allows to record and to reproduce information about movement and stops of vehicles during any period of time. The WTMC presents the report to executive bodies and enterprises operating in this area, fixes all cases of breach of the set waste movement schedule, directs information about deviations from approved routes. Information is displayed and fixed online in electronic maps and displays. All events are automatically documented in the WTMC database, are archived and used for daily analysis. Stage 5 – Medical and biological waste neutralization in autothermal plants JSC CIS – Natural Resources has developed, manufactured and tested the production prototype of autothermal waste neutralization complex IMA-2006F for disposal of B-class and C-class waste, biological waste, fallen animals with complete measurement of outgoing gases (including dioxins and furans) and slag and ash residues. At the present moment the adjustment series of the complex is put into production. IMA-2006F complex is operating in the open air with atmospheric temperature from - 45 to + 40°С in conditionally clean and industrial atmosphere. Productivity of the complex – 120 kg of waste per hour. Complex operation mode – continuous. For the present the complex is equipped with the mechanism for listing and turnover of 120-liter containers into the loading facility. Periodicity of loading – each 10-20 minutes (depending on waste calorific capacity). In the future it will have the modified lift for disposable containers as well. The differential characteristic of the complex is absence of associate (outside) fuel for maintenance of the combustion process. The fuel is waste itself, and decreasing expenses for fuel we decrease the cost price of waste disposal. The filter system allows to purify outgoing gases at the level of compliance with the standards of the Russian legislation and European Union (17 BlmSchV). Therefore the developed and implemented medical waste management system allows to solve the above problems of intra-institutional collection, safety of waste transportation and neutralization taking into account the requirements of the current regulatory and legal framework of the Russian Federation and of tomorrow.
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