Health Policy Issues and Health Programmes in ... - Amazon S3

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Hospital Waste ManagementTreatment Technologies for Liquid WasteTable 3. Advantages and Disadvantages of Medical Waste Treatment and Disposal MethodsMethod Advantages DisadvantagesSanitary sewer l Most suitable for liquid, body fluids l Least suitable for solids and non-(dilution of liquid and other bulk liquids biodegradable wastes (metals orwaste l Sanitary sewer systems are designed plastics)to treat biological waste l Requires safety precautions (andsometimes facility modification) toprotect workers from splashes andaerosolsl Requires approval of local wastewater treatment worksThe standards for effluents generated from the hospital as recommended by the CentralPollution Control Board (CPCB), GoI, are shown in Table 4.Table 4. Effluents Generated from the Hospital Shall Conform to the Following Limits:ParametersPermissible LimitpH 6.5–9.0Suspended solids100 mg/1Oil and grease10 mg/1Biochemical Oxygen Demand30 mg/1Chemical Oxygen Demand250 mg/1Bioassay test90% survival of fish after 96 hours in 100% effluentNote:These limits are applicable to hospitals that are either connected with sewers without a terminal sewagetreatment plant or not connected to public sewers at all.Waste Treatment Process Categoriesl Thermal systemsn Incinerator systemsn Autoclave/hydroclave/autoclave systemsn Microwave systemsn Pyrolysis and plasma pyrolysis systems.l Chemical treatment systemsl Irradiation systemsl Biological process systems.Thermal Treatment Systems (Incinerator Systems)State-of-the-art combustion technology includes the following:l Two-stage controlled air combustion: first chamber temperature 800°C ± 50°C and secondchamber 1200°C ± 50°C with a pollution prevention device called a scrubberl Modulating burners and combustion air blowersl Automatic loading and ash removall Controls, instrumentation, and monitoring.210
Hospital Waste ManagementTable 5. Present Scenario of Incineration System PerformanceNo. Major Performance Difficulties Examples1. Objectionable stack emission l Out of compliance with air pollution control regulationsl Visible emissionsl Odoursl Hydrochloric acid gas deposition and deteriorationl Entrapment of stack emissions into building air intakes2. Poor burnout l Low waste volume reductionl Recognizable waste items in ash residuel High ash residue carbon content (combustibles)3. Excessive repairs and l Frequent breakdowns and component failuresdowntime l High maintenance and repair costsl Low system reliability4. Unacceptable working l High dust conditions and fugitive emissionsenvironment l Excessive waste spillsl Excessive heat surfaces (global warming)5. System inefficiencies l Excessive auxiliary fuel usage (oil or electricity)l Low steam recovery ratesl Excessive operating-labour costsThe Common reasons for incineration failure in installation are as follows.l Incineration equipment manufacturer unqualifiedl Equipment installation contractor unqualifiedl Inadequate instructions and supervision from the manufacturer for system installation bythe general contractorl No clear lines of system performance responsibility between the manufacturer and thegeneral contractor/supplierl Failure to review manufacturer’s shop drawings, catalogues, and materials and constructiondata to assure compliance with contract design documentsl Inadequate quality control during and following construction to assure compliance withdesign (contract) documentsl Payment schedules inadequately related to systems performance milestonesl Final acceptance testing not required for demonstrating system performance in accordancewith contact requirements.There are the following categories of performance problems with incinerators.1. An unacceptable working environment often arises, such as excessive ambient temperatures,uncontrolled waste spillage, and fugitive emissions of fly ash, and sometimes even flames.2. The combustion efficiency according to the CPCB guidelines is achievable only theoreticallyand never practically. All the certificates issued by state pollution control boards or the CPCBare either false or bogus.3. As the fuel is to be arranged from the market, the staff generally sells the fuel, runs only theprimary chamber, and adjusts the fuel sold.211
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Health Policy IssuesandHealth Progr
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ContentsContentsPrefaceList of Part
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I would also like to thank our tech
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List of ParticipantsIndu Kumar Pand
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List of ParticipantsMohmed ShaukatD
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List of ParticipantsR K PurohitAddi
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GlossaryGlossaryAbbreviationsAIIMSA
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GlossaryLHVLILMISMAPMCMCHMDRTBMDTM&
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GlossaryTHRTRCTRIPsTTTUUDCUIPUPUTVC
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Inaugural Sessionwould be the first
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Inaugural SessionOnly 18% of the pr
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Inaugural SessionMadhukar Gupta, Ch
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Inaugural Sessionrotational basis f
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Inaugural Sessiontell you more abou
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Public Health Issues, Priorities, a
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National Health Programmes: An Over
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Implementation of National Health P
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Use of Epidemiological Surveillance
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Designing a Surveillance SystemFurt
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Designing a Surveillance Systemsurv
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National Health Programme in Uttara
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IEC Strategies for Health in IndiaS
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IEC Strategies for Health in Indial
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IEC Strategies for Health in IndiaS
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IEC Strategies for Health in IndiaA
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IEC for Health Programmes in Uttara
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Session 3Private and Public SectorP
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Public-Private Interaction in Healt
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Cost Recovery Measures in Governmen
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Arogya Raksha: Health Insurance Sch
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Session 1Session 4Health Financing
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Health Financing in India: Some Iss
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Household Health Care Costs in Indi
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Session 1Session 4Access to Health
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Access to Health Services in Uttara
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Page 170 and 171: Session 5STI/RTI, AIDS, and TB Cont
Page 172 and 173: Quality of RTI/STI Case Management
Page 182 and 183: HIV/AIDS: International Perspective
Page 188 and 189: HIV/AIDS in India and UttaranchalSe
Page 190 and 191: HIV/AIDS in India and UttaranchalFi
Page 192 and 193: HIV/AIDS in India and Uttaranchalpr
Page 198 and 199: Tuberculosis Control Efforts in Ind
Page 208 and 209: Session 6Other Health IssuesChairpe
Page 210 and 211: Care of the ElderlySocial care is u
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Page 214 and 215: Hospital Waste ManagementSession 6H
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Page 222 and 223: Hospital Waste Management4. Tempera
Page 224 and 225: Hospital Waste ManagementTable 6. U
Page 226 and 227: Streamlining the Drug Procurement a
Page 240 and 241: Sanitation and Public Health Issues
Page 246 and 247: Ayurveda and Unani Department and t
Page 252 and 253: Specific Health Policy and Programm
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