Medical Waste Incineration

The use of medical waste incinerators appears to be rapidly expanding in developing countries at the same time as it is being phased out in many industrialized countries for health and environmental reasons. A related trend is the increase in the amount of waste generated by healthcare facilities in developing countries due to the expansion of healthcare systems and services. This development, combined with increased use of disposable (single-use) items and poor waste segregation practices, leads to increasingly large quantities of waste being burned.

In response to immediate and pressing concerns about the spread of diseases caused by exposure to healthcare wastes, many developing countries have opted for the combustion or incineration of healthcare waste as a disposal method. Some facilities use open burning, while others have installed combustion devices ranging from "drum incinerators" to locally-constructed incinerators with no pollution controls. Imported small-size or mid-size incinerators that have minimal pollution controls and inadequately-controlled large incinerators for central facilities are also increasing in number.

Meanwhile, international donors and agencies - reflecting the same concerns about the spread of infectious diseases - contribute to the construction or importation of large numbers of small- or mid-sized medical waste incinerators in developing countries, and they often support the construction or modification of large incinerators for central facilities. However, in many cases these new or upgraded facilities may still generate and release unintentional persistent organic pollutants (POPs) at levels considerably higher than would be permitted in most donor countries.

The Stockholm Convention lists medical waste incinerators as having the potential for comparatively high formation and release of unintentional POPs. It additionally lists the open burning of waste and the burning of landfill sites as sources that can unintentionally form and release POPs to the environment. Under the Stockholm Convention, countries are obliged to require the use of best available techniques for new waste treatment facilities and are obliged to promote best available techniques and environmental practices for all new and existing sources of POPs.

Annex C of the Convention states that when Parties are considering proposals to construct new facilities using processes that release unintentional POPs (e.g., incineration), "priority consideration should be given to alternative processes, techniques or practices that have similar usefulness but which avoid the formation and release of such chemicals."

In most cases, the incinerators used in developing countries release significant quantities of unintentional POPs and other hazardous pollutants to the environment through gaseous emissions and ash and occasionally through wastewater. A medical waste incinerator releases such pollutants as particulate matter, heavy metals (arsenic, cadmium, mercury, lead, etc.), acid gases like hydrogen chloride and nitrogen oxides, carbon monoxide and toxic organic compounds like benzene, chlorophenols, polycyclic aromatic hydrocarbons and dioxins.

Often, imported incinerators have a limited or nonexistent market in their countries of origin because they cannot satisfy domestic regulations related to air pollution (including the release of unintentional POPs). Many developing countries have little or no capacity to measure and monitor these POPs releases. Furthermore, due to the absence of expertise to maintain and service these incinerators, the facilities do not meet recommended operating practices that are already unacceptably low. Rising concern over the fate of healthcare wastes, along with the lack of strong regulatory and enforcement mechanisms, increases the possibility that small incinerators with poor designs and inadequate pollution controls will be used. However, the trend of transferring obsolete technologies is no longer an acceptable framework for developing countries.

The goal of this project is to protect public health and the global environment from the impacts of unintentional releases of POPs and mercury that are the result of the burning of healthcare waste. Learn more about how we are achieving this by demonstrating the effectiveness of non-burn waste treatment technologies and an alternative systems approach to healthcare waste management.