Republic of Iraq

Ministry of Higher Education

Al – Mansour University College

Medical Instrumentations Engineering Department

Evaluation of solid and liquid pollutants in Sheikh Zayed

Hospital
A Project
Submitted to the department of Medical Instrumentations Engineering at Al – Mansour
University College in partial fulfillment of the Requirements for the degree of B. Eng. In
Medical Instrumentations Engineering

BY
Zainab Radwan Wafiq Abdul Rahman

Hawraa saad Jassim Hassan

Ali Abbas Daoud Salman

Ali Hussein Lafta Issa

Supervised by
Prof.Dr. Hamed Hussein Rajab Al-joubory

2024 1445
Web Site: WWW.muc.edu.iq
1
 Supervisor Certification
I certify that this project entitled

Evaluation of solid and liquid pollutants in Sheikh Zayed

Hospital
Was prepared under my supervision in Ai-Mansour University

College as partial fulfillment of requirement for the degree of B.Sc. in Medical

Instrumentations Engineering.

Signature:

Name: Prof. Dr. Hamed Hussein Rajab Al-joubory

Date:

Web Site: WWW.muc.edu.iq

2
 Committee Certification
We certify we have read this project titled

Evaluation of solid and liquid pollutants in Sheikh Zayed

Hospital
As the examining committee exam8ned the students in its content and they did all
the changes that we make a sign to on that in our opinion meet the standard of
project for the B. Sc. in Medical Instrumentations Engineering

Signature: Signature:

Name: Name:

Date: Date:

(Chairman) (Member)

Signature:

Name:

Date:

(Supervisor)

Web Site: WWW.muc.edu.iq

3
 ‫اهداء‬

‫شكشا ً ٔايزُبَب عهى انجذء ٔانخزبو‬

‫ذّٰلل ُدجب ً ٔ ُ‬
‫انذً ه‬
‫ة ْان َعبنَ ًٍٍَِ (‬
‫آخ ُش دَع َْٕا ُْ ُى أٌ ان َذ ًْذُ ِ ّّٰللِ َس ّ‬
‫) َٔ ِ‬

‫نى ركٍ انشدهخ لظٍشح ٔال انطشٌك يذفٕفب ثبنزسٍٓالد‪ ،‬نكًُُ فعهزٓب‪،‬‬
‫فبنذًذهلل انزي ٌسش انجذاٌبد ٔثهغُب انُٓبٌبد ثفؼهّ ٔكشيّ‪ ،‬فٓب اًَ انٍٕو‬
‫ألف عهى عزجخ رخشجً الطف ثًبس رعجً ٔاسفع لجعزً ثكم فخش‪ ،‬فبنهٓى نك‬
‫انذًذ لجم أٌ رشػى ٔنك انذًذ إرا سػٍذ ٔنك انذًذ ثعذ انشػب‪ ،‬ألَك‬
‫ٔفمزًُ عهى إرًبو ْزا انُجبح ٔرذمٍك دهًً‬

‫ٔثكم دت اْذي ثًشح ْزا انُجبح نُفسً انطًٕدخ أال اثزذأد ثطًٕح‬
‫ٔاَزٓذ ثُجبح ثى إنى كم يٍ سعى يعً إلرًبو ْزِ انًسٍشح‬

‫‪4‬‬
 Abstract

The recycling of medical waste is an important process that helps to reduce the
amount of waste that ends up in landfills and incinerators. Medical waste includes
materials that are generated in hospitals, clinics, and other healthcare facilities,
such as used syringes, contaminated gloves, and expired medications. Recycling
medical waste involves a series of steps that ensure the waste is properly treated
and disposed of in an environmentally friendly manner. The first step in the
medical waste recycling process is to collect the waste materials and sort them into
different categories, such as sharps, non-sharps, and pharmaceutical waste. This
helps to ensure that the waste is properly segregated and treated accordingly. The
waste is then transported to a recycling facility, where it is weighed and recorded.
Next, the medical waste is treated using various methods, such as autoclaving,
incineration, or chemical treatment. Autoclaving involves subjecting the waste to
high temperatures and pressure to sterilize it, while incineration involves burning
the waste at high temperatures to destroy any pathogens. Chemical treatment
involves using chemicals to neutralize the waste and render it safe for disposal.
Once the medical waste has been treated, it is then packaged and transported to a
landfill or other disposal site. The waste is typically placed in special containers
that are designed to prevent leakage or spills. The disposal site is carefully chosen
to ensure that it meets all regulatory requirements and is located away from
residential areas and other sensitive locations. In conclusion, the recycling of
medical waste is an important process that helps to protect public health and the
environment. By properly collecting, sorting, and treating medical waste, we can
reduce the amount of waste that ends up in landfills and incinerators, and ensure
that it is disposed of in a safe and responsible manner.

5
Chapter one

6
1.1 Introduction

The purpose of any health facility (HF) is to provide healthcare and services
that will improve the health of the populations it serves. All over the world, health
facilities provide care and services to populations while producing waste that
should be properly managed to minimize health and environmental risks.
Biomedical waste, ordinary waste, excreta, and wastewater (WW) represent
anenvironmental concern and a risk to healthcare workers, healthcare users, and
surrounding populations. Healthcare waste with infectious risks (HCWI) is one of
the most hazardous wastes in the world [1]. Biomedical waste, accounting for 10%
- 25% of HF waste, poses a high infectious risk and its management should be of
general concern [2] [3] [4]. Such waste includes general waste that can be
assimilated into household waste (GHW) and waste from healthcare activities with
infectious risks (HCWI). The latter is considered the second most dangerous waste
in the world on top of radioactive waste [1] [5]. GHW includes solid wastes such
as empty cardboard boxes, empty pharmaceutical packaging, paper leftovers from
offices, food leftovers, liquid wastes such as WW from kitchen sinks, office sinks,
showers and excreta from toilets (Water Closet). HCWI includes waste such as
sharps, anatomical waste, bloody swabs, chemical waste, pharmaceutical waste,
waste from the various departments, waste from the mortuary, and so on [1] [2]
[6]. These wastes are mainly generated in larger quantities by university hospitals,
due to their numerous departments. Quantities produced increase year by year with
population growth, especially in developing countries, and with the single-use
consumables concept [7] [8].

7
1.2 Aim of Research
The research aims to evaluate the environmental reality of health institutions
in the city of Baghdad in general and Sheikh Zayed Hospital in particular, and to
shed light on the most important environmental problems that hospitals suffer due
to the direct release of liquid waste into the water environment and the lack of
modern methods in treating pollutants and the environmental effects resulting from
them.

8
Chapter two

9
2. Literature review

2.1 Liquid wastes

Hospital and health care facility provide patient care services during which
certain amount of waste like cotton swabs, discarded syringes and unused
specimens etc. are produced which are collectively called as Biomedical waste.
This can be either solid or liquid, which is generated during the diagnosis and need
to be disposed off safely and effectively [9]. Bio waste in health care facility
should be properly managed, if not will impact the society and natural
environment.

WHO stated 85%responsibility of municipal or government authorities in

liquid waste management but in 1988 Government of India has implemented the
Biomedical waste management and handling rules, 1988 which specifies that the
hospital waste management is a part of hospital hygiene and maintenance activities
such as collection, transportation, treatment, operation of processing systems and
appropriate disposal of waste is a liability for the hospital management [10]. The
implementation of the biomedical waste management and handling rules 1998 is
made mandatory for hospitals, clinics and other medical institutions.

2.2 Liquid Biomedical Waste

Liquid waste give serious threat to human health and environment because of their
ability to enter watersheds, pollute ground and drinking water when improperly
handled and disposed. Illegal and unethical reuse of this untreated waste, can be
extremely dangerous and even fatal in causing diseases like cholera, plague,
tuberculosis, hepatitis B, diphtheria etc.

10
 in either epidemic or even in endemic form, which can pose grave public health
risks and consequences and this is a major problem for healthcare facilities, their
employees and the community at a large [11].

Wastewater is not similar to sewage for the former is any water that has been
adversely affected in quality by anthropogenic influence and comprises liquid
waste either discharged from health care facilities or from domestic residences.

2. 3 Types of Liquid Waste

The liquid waste generated from Hospital care facility is of the following type
which includes:

• Infectious waste i.e. blood and body fluids, laboratory waste (cultures of
infectious agents, cultures from laboratories, biological discarded vaccines, culture
dishes and devices.)

• Hazardous chemical which includes formaldehyde (obtained from pathology labs,

autopsy, dialysis, embalming), Mercury (broken thermometers, sphygmanometers,
dental amalgams), solvents (Pathology and embalming), Radioactive isotopes.

• Pharmaceutical liquid waste (which includes discarded, unused, expired

medicines).

• Photographic chemicals (i.e. fixer and developer)

• Waste from cleaning and washing water channelled into the drain.

2.3.1 Hazards and Challenges of Liquid Bio medical waste

Most existing systems and technologies being used in handling liquid biomedical
waste are failing to address the problem of effective management of liquid waste.
Like pouring biomedical liquid waste in

11
 drain which can pose higher infection threat to medical staff due to chances
of spilling, splashing, and aerosolizing. Untreated liquid waste is a threat to the
society or community. The wastewater treatment plants can be additional source of
release of methane gas into the atmosphere, which requires capture, destruction or
utilisation to reduce the possibility for reducing greenhouse gas emissions. Almost
90% of the waste water produced from the hospital care facility remains untreated
and is a major cause of water pollution in low income countries. Besides there is
increase in the use of his intreated wastewater for irrigation due to the scarce water
resources.

2.3.2 Segregation and Management of Liquid Waste

Biomedical and waste management handling rules 1998 state that liquid and
chemical waste produced should be properly treated before it is discarded into
public sewer system. It should be pre-treated before it id discarded as well as
neutralised and then can be flushed into the sewage system while the chemical
waste need to be first neutralized with appropriate reagents before been flushed
into the sewer. Thus, it is seen that liquid waste management includes.

Thus it can be said that liquid waste management includes practices which prevent
discharge of untreated pollutants to the drainage system or to water bodies to avoid
disposal of non hazardous liquid wastes. Therefore these wastes are first
segregated and stored in leak proof containers and then disinfected or neutralised
with approved chemical decontamination at the site of generation [11]. These
containers are labelled with biohazard symbol. If the waste require transport before
decontamination, then it is advised to be stored in a twin bin containers. This twin
bin containers consists of primary and secondary containers, in this primary
container is placed into secondary one to avoid spillage and leakage during
transport. Secondary container is labelled with biohazard symbol denoting
presence of biomedical waste.

12
2.3.3 Disposal Procedures for Infectious Liquid Waste

2.3.3.1 Sanitary Sewer Disposal Methods

This type of system is used for the disposal for certain liquid wastes, it not
only checks the leaks but reduces the disposal cost [12]. Disinfection is done
chemically prior to its disposal to eliminate microorganisms or microbial load.

Chemical treatment uses 1% sodium hypochlorite solution with a minimum

contact for 30 mins or it is done with other standard disinfectants e.g., 10–14 gms
of bleaching powder in 1 Litreswater, 4% formaldehyde, 70% ethanol, 70%
isopropyl alcohol, 6% hydrogen peroxide, 2.5% povidone iodine.

Disinfection of culture media is totally different from the usual disinfection,

because of high microbial load and rich protein content rigorous disinfection is
required, where inactivation will be done by 5.23% sodium hypochlorite in a 1:10
dilution and should be left for minimum of 8 hours and finally disposed into
sanitary sewer which is followed by flushing with a lot of cold water for a
minimum period of 10 mins. Sodium hypochlorite which is also called as bleach is
having a broad spectrum disinfectant which is effective for enveloped virus like
HIV, HBV, HSV, vegetative bacteria which includes Pseudomonas,
staphylococcus and salmonella, fungi like Candida, mycobacterium and non
enveloped virus should be stored between 50 and 70 F. Household undiluted
bleach has a shelf life ranging from 6 months to 1 year from the date of
manufacturing, it undergoes degradation of 20% per year until a total degration of
salt and water.

13
2.3.3.2 Guidelines for Pouring Biomedical Liquid Waste down the Sanitary
Sewer

Microbial biohaardous liquid waste, should be necessarily autoclaved and

finally put down into the sewer system.

• Hospital workers should wear protective equipments which normally include lab
coat, gloves and safety glasses to protect from spillage and aerosols generated from
disposal.

• Two different basins should be used one to wash their hands and the other for
pouring biomedical liquid waste which is disinfected in order to avoid splashing.

• Proper inactivation time should be documented by the lab supervisor in the

official log book. Supervisor has the responsibility to document every event in log
book regarding bleach addition. Any waste lacking this is considered to be
violation of the approved inactivation process. Such a log book must be kept for a
minimum of 3 years and finally be handed to the safety officer for long term
retention.

• Supervisor should have proper knowledge about chlorine inactivation like

microbial cell culture plates should be disinfected for hours to days. In charge
should have judgment regarding chlorine inactivation like inactivation of microbial
cell culture plates by disinfectants require hours to days, as the protein levels are
high microbial culture wastes should be treated for at least 8 hours to allow the
bleach to kill the microbes and time of exposure and its recording will ensure
adequate killing time.

14
• Microorganisms like legionella is readily transmitted in humans by aerosols, they
can’t be inactivated by the bleach exposure, therefore can infect the worker, so
they need to be autoclaved, therefore during transportation to the autoclave site
they should be tightly packed to prevent aerosolization of legionella [13, 14].

2.3.4 Liquid waste Solidification

This involves adding of powdered solidifying agent to the liquid waste containers
which turns the liquid content into gelatinous solid mass after 5 to 10 mins, thus
eliminates the need to transport the biohazard fluids in a liquid form. The
solidification can be disposed of as red bag waste. Here microencapsulation
technology is used in which liquid waste is converted to solid waste, it used dry
granular super absorbent polymers that can retain large volume of liquids. Some
solidifiers also include sanitising agents like chlorine or glutaraldehyde which help
in disinfection before solidification is done [15]. These absorbent polymers can
absorb fluids up to 300 times having there volume expansion to less than 1%
which therefore reduced the water based spills along with the transport cost by
around 50%.

There are many disadvantages as well linked to this system, the canisters
become too heavy after solidification, besides this the hospital has to check for the
landfill operators to dump the solidified waste. The effectiveness of these powders
have not been tested on the body fluids so there actions are questionable as well as
these powders add more pollutants to the landfills.

2.3.5 Closed Disposal Systems

By and large, the majority of hospitals and other healthcare facilities either pour
the treated or untreated liquid waste down the drain,

15
 dispose of full or partially filled containers of liquid waste, intact as red bag
waste or it is solidified which is further disposed in either red or yellow bag if the
state in which the facility is available consider it as legal. Nowadays fluid waste
are designed in such a way that they use closed disposal system, they dispose fluid
waste down in the sewer with very minimal contact with the humans. Many of
them are attached to the vacuum system that directly empties the canisters into the
sewer therefore reducing exposure risk.

There are many drawbacks associated with the closed disposal system which
includes big capital investment as well as such system requires labour activities
like someone to collect, process, maintaining of log book, clean, disinfect, collect
and then finally redistribute them. Maintenance of these canisters should also be
taken care of when repair is needed [16].

2.3.6 Water Treatment Plant

Liquid waste generated from places like operation theatre, labour rooms, lab,
laundry, canteen and toilet is firstly segregated and treated with disinfectant and
then finally poured into common drainage facility. This waste produced could lead
to infections and if the discard is done in local bodies like lakes and rivers it will be
hazardous. To avoid this biomedical waste guidelines 1998 has to be followed, as
well as hospital should make their own Effluent treatment plant so that waste water
can be reused eventually. Hospitals not having effluent treatment plant here waste
water is first chemically treated and then released into common sewage facility
which is further connected to local municipal water treatment facilities. BOD and
COD tests can measure organic, inorganic or microbial contents inside the waste
water. BOD measures the oxygen demand of biodegradable pollutants while COD
measures oxygen demand of oxidizable pollutants.

16
 High BOD in waste water indicates excess amount of organic carbon which
have higher polluting capacity. Waste water should follow permissible limits
before discarding it, waste [17] water should remove majority of contaminant and
produce effluent that is suitable for disposal to the natural environment. Hospitals
which have their own effluent treatment plant follow three stage treatment i.e.
primary, secondary and tertiary [18].

2.3.6 Primary Treatment

In this sewage is stopped in a basin, in which the settled as well as floating material
is removed and the remaining liquid is subjected to secondary treatment. By this
treatment BOD and COD levels comes down to 25% of its initial levels.

2.3.7 Secondary Treatment

It removes dissolved and suspended biological matter and is performed by

indigenous, water borne microorganisms. Secondary treatment uses microbial
degradation, aerobic or anaerobic which help in reduction of organic compounds.
This primary and secondary treatment reduces BOD by 80 to 90%. Suspended
solids which settled down as slurry called as sludge. The treated fluid then
undergoes tertiary treatment which remains 95% of the pollutants from the waste
water.

2.3.8 Tertiary Treatment

In this chemicals are used to remove inorganic compounds and pathogens. This is
the final stage of treatment. In this the effluent is mixed with sodium hypochlorite,
which is followed by passing through dual media filter (DMF) and then activated
carbon filter (ACF) where sand, anthracite and activated carbon are used as
filtration media [19].
17
2.4 Solid wastes

The type and composition of the solid waste generated by individual states
can vary greatly. This variation is a function of several factors including climatic
conditions, population characteristics,type of industries and businesses located
within the state, landownership, culture, and others. Reliableestimates of the solid
waste being generated are a crucial component of any solid waste plan.Estimates of
current generation rates provide a snapshot view of present conditions and form the
foundation for future estimates and related projections. [19]These projections
determine the expected life of facilities, future operation costs and revenues, and
ultimately the selection of the integrated solid waste management system to be
used. Detailed waste characterization can be expensive and time consuming but
may be desirable and appropriate for capital intensive projects. The use of
secondary information may provide solid waste generation estimates adequate for
planning purposes. The county solid waste planners were given the flexibility to
determine and select the best method to estimate their solid waste stream. [20]

Municipal solid waste, as defined by the EPA, includes wastes such as

durable goods, nondurable goods, containers and packaging, food scraps, yard
trimmings, and miscellaneous inorganic wastes from residential, commercial,
institutional, and industrial sources. Examples of waste from these categories
include appliances, newspapers, clothing, boxes, disposable tableware, office and
classroom paper, wood pallets, and cafeteria wastes. MSW does not include wastes
from other sources, such as construction/demolition wastes, municipal sludge,
combustion ash, and industrial process wastes that might also be disposed of in
municipal waste landfills or incinerators. [21]

18
 Medical facilities such as hospitals, dental offices, and veterinary facilities
produce infectious waste which has the potential to transmit disease. To be capable
of transmitting infection, a waste must contain a pathogenic agent in a large
enough quantity to cause infection; a susceptible host (individual) must come in
contact with the infectious agent; and there must be a portal of entry through which
a sufficient number of organisms is deposited to cause infection. The solid waste
emerge during diagnosis and treatment, clinical and pharmaceutical research,
besides the that emerge in medicine production, hospital waste or in other words
they are referred as clinical waste. [22]

2.5 : Classification of Hospital Waste

"Biomedical waste" means, and is limited to, the following types of waste:

(a) "Animal waste" is waste animal carcasses, body parts, and bedding of animals
that are known to be infected with, or that have been inoculated with, human
pathogenic microorganisms infectious to humans.

(b) "Biosafety level 4 disease waste" is waste contaminated with blood, excretions,
exudates, or secretions from humans or animals who are isolated to protect others
from highly communicable infectious diseases that are identified as pathogenic
organisms assigned to biosafety level 4 by the centers for disease control, national
institute of health, biosafety in microbiological and biomedical laboratories,
current edition.

(c) "Cultures and stocks" are wastes infectious to humans and includes specimen
cultures, cultures and stocks of etiologic agents, wastes from production of
biologicals and serums, discarded live and attenuated vaccines, and laboratory
waste that has come into contact with cultures and stocks of etiologic agents or

19
blood specimens. Such waste includes but is not limited to culture dishes, blood
specimen tubes, and devices used to transfer, inoculate, and mix cultures.

(d) "Human blood and blood products" is discarded waste human blood and blood
components, and materials containing free-flowing blood and blood products.

(e) "Pathological waste" is waste human source biopsy materials, tissues, and
anatomical parts that emanate from surgery, obstetrical procedures, and autopsy.
"Pathological waste" does not include teeth, human corpses, remains, and
anatomical parts that are intended for interment or cremation.

(f) "Sharps waste" is all hypodermic needles, syringes with needles attached, IV
tubing with needles attached, scalpel blades, and lancets that have been removed
from the original sterile package. [23]

2.6 : Medical Waste Generation

Medical waste is also sometimes referred to as pathological waste or infectious

waste. As used in this chapter, the term will not include toxic waste, hazardous
waste, or radiological waste. However, these wastes may also be generated at
health care facilities and may or may not be part of a private contractor‟s
responsibilities because of their unique properties.

Infectious Waste: [24]

20
Table 1. Medical Waste Generation

National Income Level Annual Waste

Generation
(kg / person)
High income countries: 1.1 - 12.0
• All health care waste
• Hazardous health care waste 0.4 - 5.5
Middle income countries: 0.8 - 6.0
• All health care waste
• Hazardous heath care waste 0.3 -0.4
Low income countries 0.5 - 3.0
• All health care waste

The following are a number of the common procedures followed at health

care facilities in managing medical waste. Many of these procedures will influence
the contractor‟s point of waste collection.

1. General non-medical waste should be handled within the health care facility‟s
domestic refuse system.

2. Sharps should all be collected together, regardless of whether or not they are
contaminated. Sharps containers should be puncture-proof and usually are made of
metal or high-density plastics. Sharps containers should be tamperproof and fitted
with covers that do not allow access to the sharps contained within. The containers
should be rigid and impermeable so that they safely retain not only the sharps but
also residual liquids from syringes.

21
3. Bags for infectious waste should be red and marked with the international
infectious substance symbol. [25]

4. Bags and containers should be removed when they are no more than three
quarters full to enhance their safe handling. Some bags can be closed by tying the
neck of the bag while heavier gauge bags may require plastic sealing ties of the self
locking type.

5. Cytotoxic waste should be collected in strong, leak proof containers that are
clearly labeled as cytotoxic wastes.

6. Large quantities of obsolete or expired pharmaceuticals stored at hospital wards

or departments should be returned to the pharmacy for disposal.

7. Large quantities of chemical waste should be placed in chemical resistant

containers and sent to specialized treatment facilities if they are available. The
identity of the chemicals should be clearly marked in the containers and hazardous
chemical wastes of different types should not be mixed.

8. Wastes with high content of heavy metals such as cadmium and mercury should
be collected separately for disposal at appropriate locations. [26]

9. Aerosol containers may be collected with the general health care waste once
they are completely empty provided that the waste is not destined for incineration.

10. The internal waste management plan for the health care facility should stipulate
regular procedures and schedules by which waste is collected daily or as frequently
as required and transported to a designated central storage site which, more than
likely, will be the contractor‟s point of collection.

22
11. If it is necessary to transport medical waste on-site from generation locations to
the point of collection or storage, health care facilities must assure that this is done
safely. This may require the use of wheeled trolleys, containers, or carts that are
not used for any other purpose. [27]Generally these will meet the following
specifications:

2.7: Medical Waste Environmental Control Plan

The contractor should be required to prepare a medical waste environmental

control plan defining environmental control testing procedures and standards for
process air emissions, vented air, effluent, wash-down water, odours, noise, etc.
The environmental control plan should describe the remedial actions to be taken
whenever environmental control standards are not met. At a minimum, the
environmental testing and control stipulated in this plan should include: [28]

1. Vented Air: Vented air from the treatment process should be filtered or treated
to remove pathogens, dust, and chemical contaminants.

2. Effluent: The treatment system should not produce a liquid effluent that does not
conform to national and local regulations and limits for wastewater.

3. Off-Site Run-Off: Surface run-off from precipitation falling outside of the

medical waste receiving, holding, and treatment areas and the treated residue
holding and loading areas, should be diverted by drainage ditches and swales to
off-site drainage features.

4.Wash-Down Water: Wash-down water from any area where medical waste or
treated medical waste residue is handled should be separated from all other run-off,
collected, and contained in a holding tank. The holding tank and any water therein

23
should be disinfected at least once a day. Collected wash-down water may be
treated or used in the medical waste treatment system if it is technically feasible,
and approved by the government. Alternately, it may be disposed at a wastewater
treatment facility designated by the government.

5. Litter Control: The contractor should inspect the entire perimeter of the facility
daily and collect all litter. Collected litter must be disposed along with all other
MSW generated atthe facility on a daily basis.

Because of the hospital solid waste; hospital staff, clinical waste carries and society
are at risk.

The risk of hospital staff: That causes the passage of infectious medical wastes
are sharp and cutting ones. There is at risk of infection of infectious due to errors
of using sharp tools and packaging them. [29]

The risk of clinical waste carriers: The contaminated instruments, that are not
well packaged, are atthe higher risk. During the processing of medical wastes some
risks may arise. These are the high heat of steam sterilizers or the toxic gases that
leaked to the atmosphere. These constitute hazard for health. [30]

The risk of society: The chemical residues that left in the sewage system can have
effects on the natural ecosystem and this may contaminate water sources.
Discharging of waste improper site creates problem in terms of overall
environmental pollution. These wastes should not be kept a place where we can
reach easily. [31]

Red plastic bags marked with on „‟ “INTERNATIONAL BIOHAZARD” and

“ATTENTION!

24
BIOHAZARD‟‟ and “ATTENTION! CUTTING AND DRILLING” are used. [32]

2.8: Waste treatment technologies

(1) At the request of an applicant, the department of health, in consultation with the
department of ecology and local health departments, may evaluate the
environmental and public health impacts of biomedical waste treatment
technologies. The department shall make available the results of any evaluation to
local health departments. [33]

(2) All direct costs associated with the evaluation shall be paid by the applicant to
the department of health or to a state or local entity designated by the department
of health.

(3) For the purposes of this section, "applicant" means any person representing a
biomedical waste treatment technology that seeks an evaluation under subsection
(1) of this section. [34]

25
(4) The department of health may adopt rules to implement this section. [35,36]

CLINICAL WASTE” are used in collecting of medical wastes. For medical

wastes, which are sharp and cutting , plastics, laminated cardboard boxes or
containers marked with on „‟ INTERNATIONAL

26
Chapter three

27
Materials and methods of work

3.1 The MWI

autoclave is designed to treat medical waste in places such as hospitals and small
to medium sized medical waste disposal plants. The processing process is fully
automated, with cutting and sterilization taking place in one closed vessel,
minimizing the impact on the environment.

Figure :4 The MWI

28
3.2 Atomic absorption device

This device depends on breaking up the particles of matter into their atoms and
studying the radiation energy absorbed by these atoms, as electronic transfers
occur between energy levels as a result of the absorption of energy. The substance
to be determined must be in the liquid state.

The model in atomic absorption goes through the following steps, i.e. the processes
that occur to transfer the model to the flame:

What happens in flame:

1- Converting the model solution into a spray (nebulization process).

2- Removal of the solvent.

3- Evaporation of the form, i.e. the conversion of vapor from the solid form into a
gas

4- Atomization, i.e. converting the model into free atoms.

-5 Excitation of free atoms Excitation.

-6 Absorption.

29
 Figure : 5 Atomic absorption device

3.3 Waste incinerator

Double-chamber incinerators have the advantage of high sterilization capacity,

especially when dealing with infectious medical waste and some pharmaceutical
and chemical waste. Their temperature ranges from 800-900 degrees Celsius and
they have a capacity of 200 kg/day to 10 tons/day. This is due to the size of
hospitals and incinerators are usually used. With a capacity of 1 ton/day for large
hospitals.

Figure:6 Double-chamber incinerators Figure:7 Waste incinerator

30
3.4 The difference between hospital wastewater and city wastewater

There is a big difference between hospital wastewater and other types of

wastewater (home wastewater, factories, and farms), as hospital wastewater is
characterized by its diversity and contains the following:

The presence of bacteria capable of resisting a large number of antibiotics in

hospital wastewater. In general, the concentration of bacteria in hospital
wastewater is higher than in city wastewater. The presence of viral water
pollutants, such as enteroviruses, in large quantities compared to city sewage, and
blood viruses, such as the liver cirrhosis virus and the AIDS virus, which are
present in large quantities in the body fluids of infected patients from medical
departments and laboratories, which go directly to the hospital sewage network.
Some studies have proven that parts of the HIV virus have been found. In hospital
sewage in larger quantities than other wastewater, there are larger quantities of
heavy metals such as mercury and silver, quantities of hallucinogenic chemical
compounds and environmental hormones, and the presence of large quantities of
antibiotics compared to city sewage.

31
Examples of liquid waste:

Figure:8 Blood samples Figure:9 Urine samples

Figure :10Wastewater for hospitals

32
Chapter Four

33
4.1 Discussion and Result

The month Bed capacity Clinical works Weight of waste Number of bags
Month 4 104 209 (1005)Kg 1271
Month 5 104 236 (2334)Kg 2384
Month 6 104 234 (963)Kg 1866
Month 7 104 216 (939)Kg 1170
Month 8 104 237 (1005)Kg 1213
Month 9 104 318 (944)Kg 1384
Month 10 104 170 (785)Kg 1152
Month 11 104 173 (788)Kg 1635

This chapter presents the results and data extracted from Sheikh Zayed
Hospital regarding the amount of medical waste for the fourth to eleventh
months

We observe from the table below The bed capacity is 208 for the entire
hospital

The clinical occupancy in the ninth month was more than the rest of the
months, due to the increase in the number of patients, as it was 318 patients,
so the weight of the waste was 944 kg and the number of bags was 1384, while
the clinical occupancy in the tenth month was less than the rest of the months,
so it was 170, and the weight of the waste was 785 kg and the number of bags
was 1152. This is because the number of patients in The hospital was less,
while the number of bags increased in the fifth month and was 2384.

34
This is due to the increase in the weight of the waste, as the number of bags is
directly proportional to the weight of the waste. The more it is, the more the
number of bags increases, noting that the clinical occupancy was 236.

35
Chapter Five

36
5.1 Conclusion and Recommendations

An evaluation of the management of solid and liquid hospital waste in hospitals

has been presented, and difficulties remain at several levels of the management
chain, from sorting at source to waste disposal. Inadequate financial and human
resources and inappropriate materials are one of the bottlenecks in this department.
Moreover, the lack of organization, such as the absence of administrative plans and
departments, and the absence of hygiene committees in hospitals, does not
encourage optimal waste management. Likewise, lack of training for service
providers, lack of use of management guidelines, lack of coordination of activities,
lack of supervision of service providers and collection agents, and lack of
monitoring and evaluation of waste management activities negatively affect
quality. Waste management. Sorting at source is not systematic, resulting in a
mixture of GHW and HCWI, thus increasing the volume of hazardous waste.
Effluent management facilities do not meet standards, making treatment
ineffective. The management of solid and liquid hospital waste in hospitals is a
major concern due to the potential high risks to human health and the environment.

37
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42
 ‫الخالصت‬

‫رعذ إعبدح رذٌٔش انُفبٌبد انطجٍخ عًهٍخ يًٓخ رسبعذ عهى رمهٍم كًٍخ انُفبٌبد انزً رُزًٓ فً يذافٍ انُفبٌبد‬
‫ٔانًذبسق‪ .‬رشًم انُفبٌبد انطجٍخ انًٕاد انزً ٌزى إَزبجٓب فً انًسزشفٍبد ٔانعٍبداد ٔغٍشْب يٍ يشافك‬
‫انشعبٌخ انظذٍخ‪ ،‬يثم انًذبلٍ انًسزعًهخ ٔانمفبصاد انًهٕثخ ٔاألدٌٔخ يُزٍٓخ انظالدٍخ‪ .‬رزؼًٍ إعبدح رذٌٔش‬
‫انُفبٌبد انطجٍخ سهسهخ يٍ انخطٕاد انزً رؼًٍ يعبنجخ انُفبٌبد ثشكم طذٍخ ٔانزخهض يُٓب ثطشٌمخ طذٌمخ‬
‫نهجٍئخ‪ .‬انخطٕح األٔنى فً عًهٍخ إعبدح رذٌٔش انُفبٌبد انطجٍخ ًْ جًع يٕاد انُفبٌبد ٔفشصْب إنى فئبد يخزهفخ‪،‬‬
‫يثم األدٔاد انذبدح ٔغٍش انذبدح ٔانُفبٌبد انظٍذالٍَخ‪ْٔ .‬زا ٌسبعذ عهى ػًبٌ فظم انُفبٌبد ثشكم طذٍخ‬
‫ٔيعبنجزٓب ٔفمًب نزنك‪ٌ .‬زى ثعذ رنك َمم انُفبٌبد إنى يُشأح إعبدح انزذٌٔش‪ ،‬دٍث ٌزى ٔصَٓب ٔرسجٍهٓب‪ .‬انزبنً‬

‫رزى يعبنجخ انُفبٌبد انطجٍخ ثطشق يخزهفخ‪ ،‬يثم انزعمٍى‪ .‬انذشق‪ ،‬أٔ انًعبنجخ انكًٍٍبئٍخ‪ٌ .‬زؼًٍ انزعمٍى رعشٌغ‬
‫انُفبٌبد نذسجبد دشاسح عبنٍخ ٔػغؾ نزعمًٍٓب‪ ،‬فً دٍٍ ٌزؼًٍ انذشق دشق انُفبٌبد فً دسجبد دشاسح‬
‫عبنٍخ نزذيٍش أي يسججبد األيشاع‪ .‬رزؼًٍ انًعبنجخ انكًٍٍبئٍخ اسزخذاو يٕاد كًٍٍبئٍخ نزذٍٍذ انُفبٌبد ٔجعهٓب‬
‫يكت انُفبٌبد أٔ يٕلع آيُخ نهزخهض يُٓب‪ .‬ثًجشد يعبنجخ انُفبٌبد انطجٍخ‪ٌ ،‬زى رعجئزٓب َٔمهٓب إنى يكبٌ آخش‬
‫انزً رى رظًًٍٓب نًُع انزسشة أٔ االَسكبثبد‪ .‬انزخهض اَخش‪ٔ .‬عبدح يب ٌزى ٔػع انُفبٌبد فً دبٌٔبد خبص‬
‫ٌزى اخزٍبس يٕلع انزخهض ثعُبٌخ نهزأكذ يٍ أَٓب رهجً جًٍع انًزطهجبد انزُظًٍٍخ ٔرمع ثعٍذا عٍ انًُبؽك انسكٍُخ‬
‫ٔغٍشْب يٍ انًٕالع انذسبسخ‪ .‬فً انخزبو‪ ،‬إعبدح انزذٌٔش رعزجش انُفبٌبد انطجٍخ عًهٍخ يًٓخ رسبعذ عهى دًبٌخ‬
‫انظذخ انعبيخ ٔانجٍئخ‪ٔ .‬يٍ خالل جًع انُفبٌبد انطجٍخ ٔفشصْب ٔيعبنجزٓب ثشكم طذٍخ‪ًٌ ،‬كُُب رذمٍك رنك‬

‫ٔأٌ ٌزى انزخهض يُٓب ثطشٌمخ رمهٍم كًٍخ انُفبٌبد انزً رُزًٓ فً يذافٍ انُفبٌبد ٔانًذبسق‪ٔ ،‬انزأكذ يٍ رنك‬
‫آيُخ ٔ يسؤٔنخ ‪.‬‬

‫‪43‬‬
 ‫كلٍت الوٌصىر الجاهعت‬
‫قسن هٌذست تقٌٍاث االجهسة الطبٍت‬

‫تقٍٍن الولىثاث الصلبت والسائلت فً هستشفى الشٍخ زاٌذ‬

‫هشروع هقذم لقسن هٌذست تقٌٍاث االجهسة الطبٍت فً كلٍت الوٌصىر الجاهعت كجسء‬
‫هي هتطلباث ًٍل شهادة البكالىرٌىش فً هٌذست تقٌٍاث االجهسة الطبٍت‬

‫اعذاد‬
‫زٌٌب رضىاى وفٍق عبذ الرحوي‬
‫حىراء سعذ جاسن حسي‬
‫داود سلواى‬
‫علً عباش ّ‬
‫علً حسٍي لفتت عٍسى‬
‫اشراف‬
‫ا‪.‬د‪ .‬حاهذ حسٍي رجب الجبىري‬
‫‪0202‬‬ ‫‪1445‬‬

‫‪Web Site:WWW.muc.edu‬‬

‫‪44‬‬