Options for the Management of Healthcare Waste in Developing Countries

摘要

Healthcare waste (HCW) is often treated by thermal conversion methods, including gasification, pyrolysis, incineration and refuse-derived fuel (RDF). These methods divert HCW from landfills while allowing energy recovery. However, thermal technologies are considered challenging in several developing countries due to high cost and lack of technical expertise. As a result, many healthcare institutions adopt disinfection methods, followed by landfilling with regular municipal solid waste. This project addresses HCW management in developing countries, taking Lebanon as a case study. In Lebanon, annual HCW generation reaches about 2,950 Mg of which 70 to 80% resembles regular MSW while the remaining consists of infectious and hazardous waste. In the absence of local standards and specialized regulations, healthcare institutions send their waste to landfills or open-dumps, as deems convenient (mainly depending on the proximity to landfills). About 85% of the generated HCW is being sterilized prior to disposal. Disinfection is managed by one NGO who collects and autoclave all the waste across the country. This project examines the characteristics and energy potential of HCW in Lebanon with the aim of providing guidelines to diversify the processing methods and strengthen the HCW management sector, which depends currently on one major NGO only. The technologies considered in this study are: pyrolysis, gasification, incineration, and RDF in comparison with the adopted management method, which is landfilling. A Multi-Criteria Decision Analysis (MCDA) was performed covering major decision making components, including cost, technical expertise, practicality, energy yield, impact on the environment, safety, land use, efficiency, and maintenance. The MCDA data was being collected via literature and interviews with project managers, engineers, municipality board members, technical experts, and governmental parties with previous experience in HCW management and are familiar with the technologies being evaluated. The results indicate that although pyrolysis and gasification have the capacity of generating more net energy, RDF seems to be more attractive to stakeholders in Lebanon for three main reasons: no need for high-tech equipment, lower cost, and practicality.