POST 00842E : DESTRUCTION OF PLASTIC SYRINGES
Follow-up on Posts 00819E, 00824E, 00830E, 00832E and 00835E
10 October 2005
_____________________________________
This posting contains five contributions. The first is from Michael R.
Werner (mailto:[email protected]) from the United States.
Note : I would suggest that Michael and others interested in the system he
described also consult Annex 3 of the Antalya Meeting report.
The second contribution, originally in French is from Bibata Pare
(mailto:[email protected]) from Burkina Faso. The third and fourth
contributions are respectively from Anil Varshney
(mailto:[email protected]) from India and Ville Lehto
(mailto:[email protected]) from Finland, who continue their
exchange. I am not too clear on which basis Anil's cost calculations are
made. However, he rightly raises the issue of poorly-operated, poorly
maintained and/or non-functional incinerators, not only in India, but
around the world.
Finally, a contribution from Yves Chartier (mailto:[email protected]) from
WHO in Geneva.
_____________________________________
I am new to this forum and would beg forgiveness in advance if this message
is off topic.
My group just completed a project in which the intent was to create a
simple robust and inexpensive device that would render used sharps safe
while reducing their volume and obviate the need for, and the problems
associated with, incineration. The system was to use locally available
fuels and no electricity.
We developed a stove capable of melting ten ounces of syringe/needle
combination (roughly equivalent to a small collection box) using between
four and six ounces of locally available fuel (sticks, crop waste, dung or
equivalent from a btu/lb standpoint). The sharps are fully encapsulated in
the syringe/box matrix material rendering them 'safe'.
The system : The process does not reach decomposition temperatures so very
little emissions result aside from those produced by the fuel. Temperatures
and cycle duration ensure sterilization of pathogens. The final product is
a compact poly brick that could be buried safely or transported more easily
and at a much lower cost.
This system is simple, scalable, durable and relatively compact. We expect
the system could easily be produced for between US$50 and US$100.
At this time the project is shelved as it is not clear that there is a
need/interest for this device or a channel through which to distribute it.
I intend to post a summary of our development project on the web in the
next week or two.
Any input or thoughts on this matter would be appreciated.
Sincerely,
Michael R. Werner,
New Paradigm Automation
Williston, Vermont 05495
---------------------------
I do agree with the moderator's comments.
I am not sure if this is recommended by WHO, but it seems logical that a
waste collection circuit be identified within a region or district in order
to have all the wastes at a single point. There incineration could be
better controlled with adequate destruction means, instead of having them
scattered in multi9ple sites. In any event this is the system we are trying
to put in place in our countries.
For that purpose, the circuit for vaccines supply could be used effectively
and at a lower cost, at least for routine EPI.
While waiting for better solutions for the destruction of medical wastes
(in cases where incineration is unsuitable), it is our duty to do
everything possible to protect our populations from risks.
Mme PARE Bibata
Logistique/Burkina Faso
--------------------------
Dear Ville
Thanks for the information on uncontrolled burning.
My inference has been drawn from the field, where small incinerators at
CHC, District hospitals have failed to function thus syringes and hospital
waste lies half burnt to unburnt and later ends up in the municipal waste
while absolute total additions of the waste burning will be constant , the
difference is when burnt in large quantities emissions are confined to
small area while small amounts are sufficiently burnt with good air
circulation by prodding with a wooden stick ( In India people use lots of
material like cow dung, wood, old news paper, dried leaves, wood etc for
burning and prodding the fire to have good air supply thus ensuring full
burning in small towns and villages)
When small amounts say 10 syringes are burnt at a distance of 20 - 40 kms
apart the pollution due to emission is relatively is very very low than
burning 10000 syringes at one spot ( which will be 1000 times more)
The system to collect and store syringes is non existant and not cost
effective.
For example : The ANM will have to bring back the syringes from
immunization site to Sub centre every week. Carrying a 100 syringes box or
small boxes is in addition to other weights, when most of them do not have
any transport support. Find safe storage at SC rather than every month
carry them to PHC
Vaccine are delivered at PHC ; Sub centre collects from PHC ; no mechanism
of delivery to sub centre
Storage at PHC to be picked up every month thus needing additional space in
the vehicle that delivers vaccines in cold boxes or the PHC will have to
carry the syringes to District when they go for collecting the vaccines.
The choice is between carrying used syringes or staff and other items to
district.
An independent collection system will cost USD 2 dollars per SC to PHC = 15
dollars a
month, from PHC to district 20 USd a month = 20 x 50 = 1000 USd a month
on an average
= total 15 x 50 + 20 x 50 = 1750 USd a month = 20000 USD a year.
This is many times more than the cost of vaccines, syringes.
The choice is to choose to spend on this or buy more medicines for the
people which will have greater benefit and value ( not counting cost of
reforestration) and loss of value of the trees hence the inference that
burning in a tin box or burying is the most suitable practical answer at
the moment, until we are able to make finances available and functioning
incinerators that burn the waste completely.
with kind regards
Anil Varshney
--------------------------
Dear Claude and Anil,
Many thanks for your comments!
First of all I would like to correct what seems to be a misunderstanding.
On-site solution doesn't necessary mean open burning. Uncontrolled burning
will most probably result in harmful emissions whether or not the safety
boxes are used, and I do not support that!
When comparing the features of different waste management options I guess
we have had visions of a different scale in our minds, and I think this has
caused the confusion. For the sterilization and recycling to be feasible,
the scale should be very large, the distances short and there should be a
buyer for the recycled material. When I talked about an on-site solution, I
thought about a site that produces less waste that is required for the
profitable recycling (need for transport), but enough for the on-site small
scale incineration to be cost effective. In a well controlled process the
POPs would not be created and the solution would be well in line with the
requirements of the Stockholm Convention.
Anil's example instead is of totally different scale, when on average 10
syringes is used per site and the distance between sites is 20-40km. At
this scale, I feel the suggestion of Claude is reasonable. As approximately
100 syringes can be stored in one 5 liter safety box, the additional load
for the immunization team would be only one box per 10 sites (journey of
200-400km). I don't have practical experience of conducting the
immunization campaigns, but one could presume that the space occupied by
the safety boxes would not be too much. There would be no other related
additional transport costs, as the team would visit the site anyway.
I hope this time I could make things more clear than confusing! Thank you
again and kind regards!
Ville Lehto
Marketing Manager,
Mediburner Ltd
Oulu, FINLAND
--------------------------
Regarding the current exchange on the destruction of plastic syringes,
comments made by Claude (the Moderator) reflect rather well WHO's position
on the subject.
The Health Care Waste Management policy document published in 2004 clearly
states WHO's position regarding incineration
(http://www.technet21.org/pdf_file/SHCWMen.pdf).
Burning or incinerating plastic materials without any smoke control system
is not a sustainable solution because of its impact on the environment and
communities.
Even if incinerated volumes are small, WHO adheres to the Stockholm
Convention and therefore can not promote this method of waste handling.
The option of removing needles from syringes is strong, but although there
is a need to validate it regarding the safety of medical personnel, it has
nevertheless an important advantage for the safety of waste handlers and
communities.
Needles can be discarded in a protected pit while syringes are collected
and sent to a treatment facility that can ensure disinfection in line with
country policies and shredding to reduce volume. Final disposal can be on a
ground specially set for the purpose or, depending on countries materials
can be recycled for producing non-food and non-medical sector items.
Yves CHARTIER
Public health engineer
Water, Sanitation and Health
Protection of the Human Environment
World Health Organization
______________________________________________________________________________
___________________________
Visit the TECHNET21 Website at http://www.technet21.org
You will find instructions to subscribe, a direct access to archives, links to reference documents and other features.
______________________________________________________________________________
To UNSUBSCRIBE, send a message to : mailto:[email protected]
Leave the subject area BLANK
In the message body, write unsubscribe TECHNET21E
______________________________________________________________________________
The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada (http://www.ccisd.org)
______________________________________________________________________________
Il n'y a pas encore de réponse à ce message.