Minimum Specifications for Health Care Waste Incineration

Quantities of health care waste generated monthly range from a few kilograms at remote health care facilities, to hundreds or possibly thousands of kg at central hospitals. Poorly disposed off health care waste such as syringes and needles may be scavenged and reused resulting in people being infected with hepatitis Band C, HIV and other blood-borne infections. The need for adequate and safe disposal of health care waste cannot be thus over emphasised. To avoid these serious health problems and the lack of minimum specifications for health care waste incinerators, the Environmental Council of Zambia (ECZ) and Ministry of Health (MoH), with the support of partner stakeholders, embarked on the development of these specifications for use by all health care facilities in the country. Countrywide surveys of incinerator use, maintenance and management have revealed widespread deficiencies in the construction, siting, operation and management of these units. These deficiencies can result in poor performance of the incinerator, e.g. low temperatures, incomplete waste destruction, inappropriate ash disposal, high smoke emissions, fugitive emissions, etc. Still, user acceptance of incinerators appears generally high and the use of incinerators is preferable to the disposal of waste in unsecured pits or landfills, or (uncontrolled) burning in drums or pits. However, the combustion of health care waste can form particulate matter, dioxins, furans and other toxic air pollutants. It is with the foregoing that these minimum specifications have been developed to ensure a sound management of the incineration process, disposal of health care waste, minimizing emissions, and reducing occupational exposures and other hazards.