Paper 2 survey of hospital's wastewater quality in alexandria the main hazardous pollutants
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Paper 2 survey of hospital's wastewater quality in alexandria the main hazardous pollutants

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SURVEY OF HOSPITAL'S WASTEWATER QUALITY IN ALEXANDRIA: THE ...

SURVEY OF HOSPITAL'S WASTEWATER QUALITY IN ALEXANDRIA: THE
MAIN HAZARDOUS POLLUTANTS
Dr. Helaley Abdel Hady Helaley, Chief of Industrial Drainage, Sludge and Reuse Device; Dr.
Samaa Maher Zaki Abdel Aziz, Manager of Industrial Wastewater Research Dept.; Chemist.
Mohammed Refaat Zaghloul, Manager of Industrial Relationships Dept.,Alexandria Sanitary
Drainage Company, Alexandria, Egypt
Alexandria city has a large number of Hospitals which almost reaches 74 hospitals. All
Sanitary drainage companies are not aware of monitoring the quality of wastewater produced
from this kind of activity which is very hazardous in nature. In addition, all of the sanitary
wastewater drainage companies don't have specialized laboratories to analyze hospital
hazardous effluents.
It severely affects the health of sanitary workers along the sewer lines and the pumping
stations and those working in the wastewater treatment plants and also on the quality of the
influent entering the treatment plants itself. This effect is more obvious for hospitals located
near these plants.
Nevertheless, most hospitals use the public sewer system in the disposal of some of their
hazardous solid waste. Therefore, it is important to manage hospital effluent quality to
minimize the impacts on the workers and the sewerage system.
Alexandria Sanitary Drainage Company was the unique company to establish a Management
system to monitor this kind of specific activity which included field survey for each hospital
to identify sources of hazardous pollution, sampling and analyzing the final effluent from
Alexandria hospitals, and provide technical assistant services to minimize the hazardous
pollutant effects of the hospital activities.
The most irritating problem was the high content of some hazard pollutants especially
phenols, which was found to be above the permitted levels of the Law 93 year 1962 and its
presidential Decree 44 for year 2000.

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Paper 2 survey of hospital's wastewater quality in alexandria the main hazardous pollutants Paper 2 survey of hospital's wastewater quality in alexandria the main hazardous pollutants Document Transcript

  • SURVEY OF HOSPITAL'S WASTEWATER QUALITY IN ALEXANDRIA: THE MAIN HAZARDOUS POLLUTANTS Dr. Helaley Abdel Hady Helaley, Chief of Industrial Drainage, Sludge and Reuse Device; Dr. Samaa Maher Zaki Abdel Aziz, Manager of Industrial Wastewater Research Dept.; Chemist. Mohammed Refaat Zaghloul, Manager of Industrial Relationships Dept.,Alexandria Sanitary Drainage Company, Alexandria, Egypt Alexandria city has a large number of Hospitals which almost reaches 74 hospitals. All Sanitary drainage companies are not aware of monitoring the quality of wastewater produced from this kind of activity which is very hazardous in nature. In addition, all of the sanitary wastewater drainage companies don't have specialized laboratories to analyze hospital hazardous effluents. It severely affects the health of sanitary workers along the sewer lines and the pumping stations and those working in the wastewater treatment plants and also on the quality of the influent entering the treatment plants itself. This effect is more obvious for hospitals located near these plants. Nevertheless, most hospitals use the public sewer system in the disposal of some of their hazardous solid waste. Therefore, it is important to manage hospital effluent quality to minimize the impacts on the workers and the sewerage system. Alexandria Sanitary Drainage Company was the unique company to establish a Management system to monitor this kind of specific activity which included field survey for each hospital to identify sources of hazardous pollution, sampling and analyzing the final effluent from Alexandria hospitals, and provide technical assistant services to minimize the hazardous pollutant effects of the hospital activities. The most irritating problem was the high content of some hazard pollutants especially phenols, which was found to be above the permitted levels of the Law 93 year 1962 and its presidential Decree 44 for year 2000. INTRODUCTION: Wastewater is referred to any water, whose quality has been adversely being abused by anthropogenic influence. This includes liquid waste discharged from domestic home, industries, agricultural and commercial sectors. Medical wastes consist of both organic and inorganic substances including pathogenic microorganisms. Hospital waste possess serious health hazard to the health workers, public and air flora on the area. (1) Dr. SamaMZ 1/10
  • The consumed water in daily life is recycled to primary source in some ways, but it is in the form of liquid containing the consumed water and different contaminants that are entered during consumption. One of the important environmental problems which are increased by population growth is the spread of wastewater contaminants, for example hospital wastewater which results in surface and underground water contaminants. Specifications of hospital wastewaters have made these kinds of wastewaters special in environmental contaminations control issue. (2) Quality and quantity of wastewater produced in every hospital depends on different factors. Some of these factors are: bed number, accessibility to water, kind of services, number of units, climate situation, people's culture and geographical situation which result in variety of hospital wastewater production and defines that necessary treatments should be carried out on them before their entrance into urban wastewater network. (2) Hazardous medical waste consists primarily of chemicals and discarded cytotoxic drugs, which find their ways into the environment due to improper usage and indiscriminate disposal. Their presence in the environment posses serious environmental health risk due to their carcinogenic nature. (1) It is very necessary to understand the sources of waste that contribute pollutant to the individual waste streams and the shortcomings that will be encountered in an attempt to treat the waste. (1) Medical waste consists of solid, liquid and gaseous wastes contaminated with organic and inorganic substances including pathogenic microorganisms. Main groups include: general waste which composed largely of non-hazardous particles such as kitchen waste, paper and plastics; parts of human, foetus, blood and body fluid, which are hazardous; infectious wastes which include culture and stock of infective agents from laboratory waste, waste from surgery, etc; shape waste, waste material that could cause damages to the handling persons (knife, needle, broken glasses, scalps); pharmaceutical wastes, this includes pharmaceutical products (drugs and chemicals) that have been returned from wards, contaminated or expired products; chemical waste which comprises of discarded solid, liquid and gaseous chemicals and radioactive waste, which include solid, liquid and gaseous wastes contaminated with radionuclide generated from in vitro analysis of body tissues and fluid.(3) Because of potentially dangerous materials contained in hospital and care-center wastewaters, it is necessary to be investigated. (2) Dr. SamaMZ 2/10
  • Connection of hospital waste to the municipal sewage network may create problems such as public health risks and imbalance of the microbial community in the sewage systems, which in turn affect the biological treatment process. (1) For This reason Alexandria Sanitary Drainage Company was the unique company to establish a Management system to monitor this kind of specific activity. Management included field survey for each medical facility to identify sources of hazardous pollution, sampling and analyzing the final effluent from Alexandria hospitals, and provide technical assistant services to minimize the hazardous pollutant effects of the medical facilities. This work was done by the Department of Monitoring medical facilities and hazardous waste under the umbrella of Industrial Wastewater, Sludge and Reuse sector. MATERIALS AND METHODS: A survey was carried out to determine the distribution of all medical facilities in Alexandria and their distribution within the city. Then a plan was established to take random samples from different medical categories to determine the pollution quality and quantity arising from each facility and the pollution loads received into the public sewer system. Wastewater was collected prior to the final disposal point from the hospitals. It was collected for 5 years in the duration from January 2007 to July 2011. The samples were taken during the maximal hospital activity period (8:00 am to3:00 pm). The wastewater was collected into sterile glass bottles from the major discharge point of the hospital (containing all the wastewater generated from all arms of the hospital) into the surrounding environment. This was kept at 4°C throughout the period of this study. The wastewater samples were analyzed for a number of standard physico-chemical properties, including chemical oxygen demand (COD), total suspended solids (TSS) and biochemical oxygen demand (BOD). Three heavy metals namely cadmium (Cd), Lead (Pb) and mercury (Hg) were analyzed in the effluent samples. In addition, the concentration of phenols was determined in the final effluent. All experiments were carried out on the basis of "standard methods for water and wastewater tests" (APHA, 1998). (4) Because Alexandria Sanitary Drainage company has no specific laboratories to analyze medical wastes samples, which is the case in all the wastewater companies in Egypt, a contract was Dr. SamaMZ 3/10
  • signed with the Institution of Public Health were they carried out all the analysis work. This contract is within the frame work of the newly formed Management system. RESULTS AND DISCUSSION: 1. Survey results The survey showed that there were a total of 4935 Medical facilities distributed in Alexandria. These were categorized as shown in Figure (1). The results show that the majority of the Medical facilities are the private clinics; this reached around 3039 private clinic. Clinic centers and dentists were around 600, followed by the Medical Analysis laboratories around 357, followed by the Radiology centers 71, the least numbers were those of the private hospitals and the Dialysis centers. Samples taken from Alexandria's hospitals during the five years of the study were analyzed and represented in Figure (2). The bars show the percentage of the total number of samples to the number of the non-complying samples. The ratio of total number of samples to non-complying samples during the years 2007, 2008, 2009, 2010, 2011 were 68%, 18%, 13%, 50% and 66% respectively. 1.1 Physico-chemical Analysis The results of the physico-chemical parameters determined in the Medical wastewater samples taken during the period 2007-2011 are shown in Figure (3). For BOD analysis it was found that during the years 2007, 2008, 2009 and 2011 all samples were complying to the permitted levels of BOD except for year 2010 where the average total load received to the wastewater system reached 828 mg/L. Results of COD analysis showed the same trend with an average level of COD 1279 mg/L received to the wastewater system. During the five years of monitoring it was found that the levels of the TSS were within the permitted levels. 1.2 Heavy Metals Analysis The results of the heavy metals analysis in the medical wastewater samples taken during the same mentioned period are shown in Figure (4). The three tested heavy metals showed no increase in levels according to the permitted levels during the years 2007-2011, except for Mercury which showed very high levels far beyond the permitted levels it reached 0.5 mg/L while the permitted levels are 0.2 mg/L. Dr. SamaMZ 4/10
  • Figure (1): Distribution of Medical facilities within Alexandria. Figure (2): Ratio of Total number of samples to non-complying samples. Dr. SamaMZ 5/10
  • Figure (3):Physio-chemical Analysis for Medical Wastewater samples. Figure (4): Heavy Metals Analysis for Medical Wastewater samples. 1.3 Phenols Analysis Finally, the results of phenol analysis represented in Figure (5), showed significant increase in its levels during the years 2007, 2008, 2010 which reached 1.8, 0.13, 0.48 mg/L respectively. Dr. SamaMZ 6/10
  • Figure (5): Phenols Analysis for Medical Wastewater samples. 2. Survey Data Analysis 2.1 Organic Load It was found from the investigation that the organic load during the year 2010 was very high, Figure (6), especially in levels of BOD and COD. During this year 6 medical facilities were monitored and it was found that this high load was coming from one hospital. This hospital was given special care as we have advised that they should apply a preliminary treatment unit for their wastewater before the final discharge to the sewer system. They were advised to make a sedimentation chamber; the dimensions were given according to the flow. Figure (6):Physio-chemical Analysis for Medical Wastewater samples during 2010. Dr. SamaMZ 7/10
  • 2.2 Heavy metals It was found from the investigation that the heavy metals levels during the year 2011 were very high, Figure (7), especially in the levels of Mercury (Hg). During this year 6 medical facilities were monitored and it was found that this high load was coming from four hospitals. They were advised to separate the units producing Mercury from the rest of the hospital's wastewater and to be collected in special containers where they should be incinerated or given special treatment methods. Figure (7): Heavy Metals Analysis from Medical Wastewater samples during 2011. 2.3 Phenols From the investigation it was found that the phenol levels during the years 2007, 2008, 2010 were very high in comparison with the permitted levels as shown in Figures (8-10). During 2007, eight medical facilities were found to cause these high levels. While during year 2008, only three facilities produced these high levels. During year 2010, only two facilities caused these high levels. It was found that it was a repetitive trend the increase in the levels of phenols as the majority of the hospitals use phenol-based detergents in cleaning and disinfection. They were advised to use chlorine-based detergents or even environmentally friendly detergents which cause no harm to the sewer system. Dr. SamaMZ 8/10
  • Figure (8): Heavy Metals Analysis for Medical Wastewater samples during 2007. Figure (9): Heavy Metals Analysis for Medical Wastewater samples during 2008. Dr. SamaMZ 9/10
  • Figure (10): Heavy Metals Analysis for Medical Wastewater samples during 2010. CONCLUSION: Medical waste poses a significant impact on health and environment. Since hospitals are one of the sources of injections of genotoxic compounds in wastewater, efforts must be undertaken by hospitals in order to integrate the knowledge of the control of their wastewaters, and thus the environment management, in their environmental control programs. Proper waste management strategy is needed to ensure health and environmental safety. REFERENCES: 1. Influence of Hospital Wastewater Discharged from University of Benin Teaching Hospital (UBTH), Benin City on its Receiving Environment. F.O. Ekhaise and B.P. Omavwoya. American-Eurasian J. Agric. & Environ. Sci., Sci, 4(4): 484-488,2008. 2. Quality and Quantity survey of hospital wastewaters in Hormozgan province, Iran. J. Environ. Health. Sci. Eng., 2007, Vol.4, No.1, pp. 43-50. 3. Toxicological effects of hospital wastewater using animal bioassays. Annuals of Biological Research, 2011,2(2):265-275. 4. APHA., (1998). Standard methods for the examination of water and wastewater. 20th Ed., APHA-AWWA-WEF,. Washington DC, USA. Dr. SamaMZ 10/10