Transcript Introduction to ChinaMedWast Project

Sustainable Environmental Management of
Medical Waste in China
Zoltan Csizer, Senior Advisor
United Nations Development Organization (UNIDO)
Kazan, Russian Federation, 14 May 2009
Outline
 Medical waste in China
 Brief Project Introduction
 Progress Achieved
 Findings
 International Experience
 Summary of COP4 Decisions
MW in China
– Annual Production of MW: ~ 670,000 tons (i.e. 1,780 tons/day)!
– Incineration is a convenient solution of MW disposal
– However, MW incineration is an environmental burden as the
release source of DIOXINS and other nonintentionally produced
POPs!
MW in China
– MW Incineration has been identified as one of major source of
dioxins release in China
– Annual release of dioxins was estimated to be 450g TEQ,
accounting for above 8% of the total releases to air from all
sources (reference year: 2004).
– National Programme for Construction of Facilities for Disposal of
Hazardous Waste and Medical Waste
 An important program for ESM of HW;
MW in China
 to construct 332 medical waste disposal facilities, most of which
would be incinerators. The construction of most facilities is
ongoing;
 Dioxins release have been considered, but not meeting the
requirements of BAT/BEP Guideline
• Emission standard for dioxins is: 0.5 ng TEQ/Nm3
• There’s a gap between the standard and the level in line with BAT/BEP
measures (0.1 ng TEQ/Nm3)
Various MW
Typical cycle MW in China
Hospital
Disposal
Collection
Transport
Project Introduction
– The full-sized PD was formally reported to GEF in March 2007
– GEF-CEO approved in November 2007.
– Financial scheme:
Source
Amount
(million USD)
GEF
12
Chinese Government
3.8
Other multilateral, bilateral sources and
private sector
29.2
Project Introduction
Project Goal: to introduce BAT/BEP to MW disposal
Incinerator
Segregated MW
Alternative
treatment
techniques
Segregated MW
Valuable waste
Recycling
Treated residue
Landfilled as
municipal
waste
Landfilled as
hazardous
waste
Landfilled as
municipal
waste
Project Introduction
Major components of the Project:
1. Upgrade the incineration equipment to the BAT performance level
2. Replace outdated or non-viable incineration facilities with alternative
non-incineration techniques that avoid the formation and emission of
dioxins
3. Promote BEP in medical institutions
4. Comprehensively apply regulatory, administrative, technical and
market instruments to
• Promote affordable or commercially available supply of
technologies and equipment
• Promote the commercialization of MW disposal
Environmentally Sustainable
Management of Medical Waste
BATs/BEPs
demonstration
Institutional
strengthening
Environmental Management
Upgrading
Technology
& Equipment
Replication
Regulatory framework
strengthening
Replication
Overall
Strategy
Promoting
Service Market
BATs/BEPs
demonstration
Institutional
strengthening
Regulatory framework
strengthening
Baseline
National MWMSC
UNIDO
NPMO
Prov. MWMSC
NDRC
MOC
SPA
Muni. MWMSC
Prov.
DRC
Prov.
DOC
Prov.
PB
MEP
Prov.
EPB
MOH
Prov.
DOH
National MIs
Prov. MIs
Muni.
DRC
Muni.
DOC
Muni.
PB
Muni.
EPB
Muni. DOH
County DOH
Muni. MIs
MIs in remote areas
Central MW Treatment Facility (ies)
MWMSC: Medical waste management steering committee; NPMO: National Project Management Office; MI: Medical institutions; Prov.: Provincial;
Muni.: Municipal; NDRC: National Development and Reform Commission; MOC: Ministry of Construction; SPA: State Pricing Administration; MEP:
Ministry of Environment Protection ; MOH: Ministry of Health; DRC: Development and Reform Commission; DOC: Department of Construction; PB:
Pricing Bureau; EPB: Environment Protection Bureau; DOH: Department of Health; MW: Medical waste
Progresses up to now
 Gaps between National Program and requirements of
Stockholm Convention identified
 Relevant stakeholders actively participate in the project
to take timely and joint actions by:
• Experience learning from other countries on MW
• Involving environmental protection planning agencies to
implement the project
• Cooperation with policy makers and regulators
• Medical institutions and disposal operators welcome the
incentive packages of the project
Progresses up to now
 Regulations of MEP changed to allow the use of noncombustion technologies – A leap forward
 Over 50 non-combustion disposal facilities are being
planed or built, accounting for about 35% of Project goal
 Biggest Winners: GEF (the catalytic role )
Findings
 Project fits to and reorients the National Program though
it is regretted that the Project started only after the
National Program being launched
 Dioxins control may not be a priority at current stage and
needs to be main-streamed in national actions for
environmental protection
 Application of BAT is always very costly
Upgrade incinerators to meet project requirements of 0.1 ng
TEQ/Nm3 release limits; retrofitting cost is quite high and lack of cost
effective technologies
 Changing human mentality is always the most difficult
matter
MEDICAL WASTE MANAGEMENT
AND TREATMENT INTERNATIONAL EXPERIENCE
WASTE ANALYSIS IS AN IMPORTANT STEP IN SELECTING A
DISPOSAL TECHNOLOGY
WASTE FROM CLINIC AND
HOSPITALS
INFECTIOUS
(HAZARDOUS)
CHEMICAL
RADIOACTIVE
(HAZARDOUS)
GENERAL
NON
INFECTIOUS
HOSPITAL WASTE STREAM CONTAINS LESS THAN 15 % OF
MATERIALS THAT COULD BE CONSIDERED "POTENTIALLY INFECTIOUS"
IF PROPERLY SEGREGATED, THE CONTENT OF INFECTIOUS WASTE
CAN BE REDUCED TO 1-5 %.
AUTOCLAVING
THE WASTE IS EXPOSED TO HIGH TEMPERATURE STEAM
(135 TO 150 °C) IN A CLOSED, EVACUATED CHAMBER
AFTER THE REQUIRED TREATMENT PERIOD, THE STEAM IS ROUTED
THROUGH A CONDENSATE TANK TO REMOVE ODOURS
THE WASTE IS THEN SHREDDED AND COMPACTED FOR DISPOSAL,
NORMALLY IN A MUNICIPAL SOLID WASTE LANDFILL
TWO TRADITIONAL TYPES OF
EQUIPMENT USED :
AUTOCLAVES AND RETORTS.
OTHER SYSTEMS, CALLED
ADVANCED AUTOCLAVES,
HAVE BEEN DEVELOPED IN
RECENT YEARS:
ECODAS, HYDROCLAVE,
STERIVAL,
STICHEMCLAV, STS,
SYSTEM DRAUSCHKE.
OPERATING CONDITIONS
TYPICAL EXPOSURE TIMES ARE BASED ON TWICE THE
MINIMUM TIME REQUIRED TO ACHIEVE AN ALMOST TOTAL KILL
OF BACTERIAL SPORES UNDER IDEAL CONDITIONS
A COMMON EXPOSURE TEMPERATURE - TIME
IS 121°C FOR 30 MINUTES.
USE OF :
BIOLOGICAL MONITORS
(E.G., B. STEAROTHERMOPHILUS OR B. SUBTILIS SPORE STRIPS)
COLOUR-CHANGING CHEMICAL INDICATORS
PLACED AT THE CENTRE OF TEST LOADS SHOULD BE
USED TO VERIFY THAT SUFFICIENT STEAM PENETRATION
AND EXPOSURE TIME HAVE OCCURRED.
MICROWAVE
IN THE MICROWAVING PROCESS, INFECTIOUS WASTE IS EXPOSED
TO HIGH-TEMPERATURE STEAM, SHREDDED, AND THEN HEATED
BY A SERIES OF MICROWAVE GENERATORS (MAGNETRON)
TYPICALLY,2 TO 6 MAGNETRONS ARE USED WITH AN OUTPUT
OF ABOUT 1.2 KW EACH.
MICRO-ORGANISMS ARE KILLED IN THE PROCESS AND THE
WASTE IS CHANGED INTO A SLIGHTLY MOIST RESIDUE
SOME SYSTEMS ARE DESIGNED AS BATCH PROCESSES AND
OTHERS ARE SEMICONTINUOUS
THE MICROWAVE TREATMENT SYSTEMS
COMMERCIALLY AVAILABLE IN EUROPE ARE:
MEDISTER, SANITEC, SINTION, STERIFANT
JAPAN AND EUROPE
ACTIVATED COKE FIXED BED SYSTEM
POLLUTANT
REMOVAL RATE
ACHIEVABLE
AIR EMISSION
PCDD/PCDF
> 99%
0.01-0.1 ng TEQ/nm3
HCL
1ppm or less
SOx
1ppm or less
MERCURY
90-97%,
0.05mg/m3n or less
DIOXINS AND OTHER ORGANIC POLLUTANTS
AS WELL AS HEAVY METALS SUCH AS MERCURY ARE ABSORBED IN THE PROCESS
LARGE AMOUNT OF ACTIVATED COKE MUST BE USED
ACFB IS LOCATED USUALLY DOWNSTREAM OF FILTERS AND SCRUBBERS
ATTENTION MUST BE PAID FOR FIRE RISKS
THE FOURTH CONFERENCE OF THE
PARTIES OF THE STOCKHOLM CONVENTION
ON PERSISTENT ORGANIC POLLUTANTS
(POPs)
GENEVA, SWITZERLAND, 3-8 MAY 2009
COP4
Over 800 participants, representing more than 149
governments, as well as intergovernmental and
non-governmental organizations, and UN
agencies, attended the meeting. COP4
considered several reports on activities within the
Convention’s mandate and adopted 33 decisions
on, inter alia, nine new chemicals, financial
resources, guidance to the financial mechanism,
implementation plans, technical assistance,
synergies and effectiveness evaluation.
STOCKHOLM CONVENTION ON
PERSISTENT ORGANIC POLLUTANTS
(POPs)
Objective: Mindful of the precautionary approach as set forth
in Principle 15 of the Rio Declaration on Environment and
Development, the objective of the Stockholm Convention
is to protect human health and the environment from the
harmful impacts of persistent organic pollutants
PERSISTENCE, BIO-ACCUMULATION AND LONG-RANGE TRANSPORT OF
POPs
Atmospheric pollutants
Industrial
Discharges
Food Chain
Particulates
Sediment
Sediment
POPs =The "Dirty Dozen"
Aldrin
 Dieldrin
 Endrin
 Toxaphene
PESTICIDES AND INDUSTRIAL
CHEMICALS - ELIMINATION - (ANNEX A)
 Heptachlor
 Mirex
 Chlordane
UNINTENTIONAL PRODUCTION  PCBs
(ANNEX C)
 HCB
 Dioxins & Furans
PESTICIDE - RESTRICTION - (ANNEX B)
 DDT

New POPs Chemicals recommended by PORC to be
added to Annexes A, B and C of Stockholm
Convention by COP-4 to be held in Geneva,
Switzerland, 4-8 May 2009:
•
Alpha hexachlorocyclohexane (pesticide) –Annex A
•
Beta hexachlorocyclohexane (pesticide) –Annex A
•
Lindane (pesticide) – Annex A
•
Chlordecone (pesticide) – Annex A
•
Pentachlorobenzene – (pesticide) – Annex A
•
Hexabromobiphenyl (flame retardant) – Annex A
•
Commercial pentabromodiphenyl ether (flame retardant) –
Annex A
•
Commercial octabromodiphenyl ether (flame retardant) – Annex
A
•
Perfluorooctane sulfonate (surfactant) – Annex B
Perfluorooctane sulfonate
COP decided to amend Part I of Annex B of the
Convention to list PFOS, its salts and
perfluorooctane sulfonyl fluoride (PFOSF) with
acceptable purposes including, inter alia: photoimaging, fire-fighting foam, and insect baits for leafcutting ants; and specific exemptions including, inter
alia: metal plating, leather and apparel, textiles and
upholstery, paper and packaging, and rubber and
plastics
EXEMPTIONS
•
Notes the cancellation of all specific exemptions
recorded in the register for the first twelve POPs and,
with the exception of polychlorinated biphenyls
(PCBs), all current exemptions listed in Annex A and
Annex B will no longer be available to parties after 17
May 2009;
•
Agrees to extend the expiration date in paragraph 6
of the review process for entries in the Register of
Specific Exemptions to 2015; and
•
Encourages parties that may seek a specific
exemption for future POPs to make efforts to
introduce alternative measures as soon as possible.
IMPLEMENTATION PLANS
Updated NIPs would be due within three years of listing
new chemicals
Regional and subregional centres
• Endorses, for four years, eight nominated Stockholm
Convention centres, namely centres located in China,
Kuwait, the Czech Republic, Brazil, Mexico, Panama,
Uruguay and Spain;
• Invites four nominated centres, namely those in
Algeria, Senegal, Iran and the Russian Federation, to
continue their activities, seek support in complying
with the decision SC-2/9 criteria, and be considered
for endorsement at COP5; and
• Decides to evaluate the performance and
sustainability of the centres and to reconsider their
status at COP6
Guidance to the financial
mechanism
A proposal put forward by China with Bangladesh,
Brazil, Cambodia, India, Iran, Jamaica, Kuwait and
Laos:
• calling for the GEF to increase by five times
financial support in the POPs focal area in light of
the listing of new chemicals;
• the Resource Allocation Framework (RAF) should
not be applied to the POPs focal area;
• the co-financing ratio for POPs projects is too
high and should be lowered;
• and initial financial support should be provided
for project preparation
UPCOMING MEETINGS
EXTRAORDINARY MEETING OF THE
CONFERENCES OF THE PARTIES TO THE
BASEL, ROTTERDAM AND STOCKHOLM
CONVENTIONS: The ExCOP of the three chemicals
conventions will take place in February 2010, at a
venue to be decided, back-to-back with the eleventh
special session of the UNEP Governing
Council/Global Ministerial Environment Forum. These
simultaneous meetings are aimed at giving high-level
political support to the process of enhancing
cooperation and coordination among the three
conventions
FIFTH MEETING OF THE CONFERENCE OF THE
PARTIES TO THE STOCKHOLM CONVENTION
(POPs COP5): This meeting is scheduled to take
place in May 2011, in Argentina
Thanks for your attention!