Eco-responsibility in the operating theater: An urgent need for organizational transformation.

Factors associating environmental degradation with human health have shown that air pollution is a source of morbi-mortality throughout the world. Unfortunately, hospitals are themselves "silent polluters". As healthcare professionals, we are the guarantors not only of quality of patient care, but also of proper hospital conduct. The aim of this attempt at clarification is to outline what can be done in the operating theater to reduce the environmental impact of the treatments we administer. Our recommendations will go above and beyond regulatory frameworks and draw upon daily practice concerning waste management, energy consumption, utilization of anesthetic agents and multiple forms of waste. A number of French and international pilot experimentations have been carried out and could strongly contribute to the modification of clinical practices with a societal impact, at a time when ecology has become one of the main preoccupations of our fellow citizens.

Electricity generation from landfill gas in Turkey.

Landfill gas (LFG)-to-energy plants in Turkey were investigated, and the LFG-to-energy plant of a metropolitan municipal landfill was monitored for 3 years. Installed capacities and actual gas engine working hours were determined. An equation was developed to estimate the power capacity for LFG-to-energy plants for a given amount of landfilled waste. Monitoring the actual gas generation rates enabled determination of LFG generation factors for Turkish municipal waste. A significant relationship (R = 0.524, p < 0.01, two-tailed) was found between the amounts of landfilled waste and the ambient temperature, which can be attributed to food consumption and kitchen waste generation behaviors influenced by the ambient temperature. However, no significant correlation was found between the ambient temperature and the generated LFG. A temperature buffering capacity was inferred to exist within the landfill, which enables the anaerobic reactions to continue functioning even during cold seasons. The average LFG and energy generation rates were 45 m3 LFG/ton waste landfilled and 0.08 MWhr/ton waste landfilled, respectively. The mean specific LFG consumption for electricity generation was 529 ± 28 m3/MWhr. IMPLICATIONS: The paper will be useful for local authorities who need to manage municipal waste by using landfills. The paper will also be useful for investors who want to evaluate the energy production potential of municipal wastes and the factors affecting the energy generation process mostly for economical purposes. Landfills can be regarded as energy sources and their potentials need to be investigated. The paper will also be useful for policymakers dealing with energy issues. The paper contains information on real practical data such as engine working hours, equation to estimate the necessary power for a given amount of landfilled waste, and son on.

Saneamiento ambiental y mortalidad en niños menores de 5 años por enfermedades de transmisión hídrica en Brasil / Environmental sanitation and mortality associated with waterborne diseases in children under 5 years of age in Brazil

OBJETIVO: Determinar y evaluar las asociaciones entre las variables que reflejan las condiciones del agua y el saneamiento ambiental y la mortalidad en niños menores de 5 años por un grupo de enfermedades de transmisión hídrica. MÉTODOS: Se realizó un estudio ecológico y exploratorio a partir de datos obtenidos del Censo Demográfico Nacional de 2000 y del Sistema Único de Salud para las 558 micro-regiones de Brasil. El modelo aplicó la técnica de regresión lineal múltiple y consideró como variable de respuesta la mortalidad por enfermedades de transmisión hídrica en menores de 5 años y, como variables explicativas, las condiciones del agua y el saneamiento y el nivel de escolaridad. RESULTADOS: Se observó una relación directa entre saneamiento inadecuado en la vivienda -incluidos desagües por canaletas y fosas rudimentarias, y disposición de la basura en terrenos baldíos o áreas públicas- y mortalidad en menores de 5 años por enfermedades de transmisión hídrica. También se encontró una relación inversa entre el nivel de escolaridad y la mortalidad de esos menores por dichas causas. CONCLUSIONES: Los mayores riesgos para la salud derivados del saneamiento inapropiado se registraron en las micro-regiones con gran concentración de poblaciones que, además de su condición económica humilde, tenían bajo nivel de escolaridad. Se destacan, como determinantes de la mortalidad, las condiciones generales de saneamiento y también otros factores asociados a la calidad y la infraestructura de las viviendas. La cobertura de abastecimiento de agua -que en Brasil alcanza a 90 por ciento de los hogares- no se mostró por sí sola como factor importante en la reducción de la mortalidad estudiada.

ABSTRACT OBJECTIVE: Determine and evaluate the relationship between the variables for water conditions, environmental sanitation, and mortality in children under 5 years of age associated with a group of waterborne diseases. METHODS: An exploratory ecological study was conducted based on data obtained from the 2000 national demographic census and the Unified Health System for the 558 microregions of Brazil. The model used multiple linear regression analysis. Mortality associated with waterborne diseases in children under 5 years of age was considered to be the response variable. Water conditions, sanitation, and level of education were considered to be explanatory variables. RESULTS: A direct relationship was observed between inadequate sanitation in the dwelling (e.g., sewerage disposal via rudimentary gutters and pits, the disposal of waste in uncultivated land or public areas) and mortality in children under 5 years of age associated with waterborne diseases. An inverse relationship was found between level of education and mortality associated with waterborne diseases in these children. CONCLUSIONS: The greatest health hazards related to poor sanitation were found in the microregions with a high concentration of low-income population with limited education. The general sanitation conditions and other factors related to dwelling quality and infrastructure are major determinants of mortality. Coverage of the water services, which reach 90 percent of households in Brazil, was not in itself found to be an important factor in the reduction of the mortality studied.

Occurrence of Cryptosporidium and Giardia in sewage sludge and solid waste landfill leachate and quantitative comparative analysis of sanitization treatments on pathogen inactivation.

Circulation of Cryptosporidum and Giardia in the environment can be facilitated by spreading of sewage sludge on agricultural or livestock grazing lands or depositing in landfills. Solid waste landfill leachate and sewage sludge samples were quantitatively tested for C. parvum and C. hominis oocysts, and G. lamblia cysts by the combined multiplexed fluorescence in situ hybridization (FISH) and immunofluorescent antibody (IFA) method. Subsequently, the effects of four sanitization treatments (i.e., ultrasound and microwave energy disintegrations, and quicklime and top-soil stabilization) on inactivation of these pathogens were determined. The landfill leachate samples were positive for Giardia, and sewage sludge samples for both Cryptosporididium and Giardia. The overall concentration of G. lamblia cysts (mean; 24.2/g) was significantly higher (P<0.01) than the concentration of C. parvum and C. hominis oocysts (mean; 14.0/g). Sonication reduced the load of G. lamblia cysts to non-detectable levels in 12 of 21 samples (57.1%), and in 5 of 6 samples (83.3%) for C. parvum and C. hominis. Quicklime stabilization treatment was 100% effective in inactivation of Cryptosporidium and Giardia, and microwave energy disintegration lacked the efficacy. Top-soil stabilization treatment reduced gradually the load of both pathogens which was consistent with the serial dilution of sewage sludge with the soil substrate. This study demonstrated that sewage sludge and landfill leachate contained high numbers of potentially viable, human-virulent species of Cryptosporidium and Giardia, and that sonication and quicklime stabilization were the most effective treatments for sanitization of sewage sludge and solid waste landfill leachates.

Absorption of odourous substances using selective gas-liquid separation processes.

Absorption is one of the most widely used techniques for treating odourous waste gases. An improvement of the effectiveness of gas scrubbers can be achieved by using adapted washing liquids. A screening test is proposed as a low cost tool for testing washing liquids on industrial waste gases. The odour index is used to identify the main cause of the specific smell and to simplify the analysis of absorptive performances of washing liquids. The method is verified by experiments at a chocolate factory and a fat and oil refinery.

Development of a basic procedure to design sorption processes.

The intention of this work is to offer, within the shortest time, an appropriate sorption separation process for almost any odour problem. The development is based on the preparation and characterisation of new adsorbents, the strategy for the selection of the best adsorbent, the process engineering and the choice of a suitable regeneration procedure. In this context a new method for the characterisation of the adsorbents - the adsorption profile analysis - was developed. The classification of the adsorbents was carried out by means of a cluster analysis, which simplifies the selection of the most suitable adsorbent for a particular problem. The physical and chemical behaviour of silica-adsorbents could be tailored by silanisation of the surfaces. Methods for the determination of process engineering parameters were developed, established and used. Adsorption kinetics and isotherms were determined with a magnetic adsorption balance. In a laboratory-scale fixed bed adsorber, breakthrough curves of different support materials were investigated and compared. For the investigations of different regeneration procedures, four innovative methods were employed: microwave desorption, ultrasonic desorption, ultrasonic-water desorption and extraction with water. Of the four desorption methods examined, microwave desorption and ultrasonic-water desorption demonstrated the best results.

Biological agent inactivation in a flowing air stream by photocatalysis.

The first decontamination of a flowing air stream polluted by bacteria, via room temperature non-germicidal UV photocatalysis on titania, leads to a simple and 99.1-99.8% efficient process.

Hygienization of municipal sludge in automatically operated chamber filter presses with thermal vacuum drying.

This paper presents the state of the art of thermal vacuum drying in chamber filter presses for unattended automatic operation. The achieved results are exemplified by the treatment of the two stage digested combined primary, chemical and biological sludge created by the VEAS concept for nutrient removal from municipal wastewater at VEAS. The water removal rate in each stage of the drying process is described, with comments on the low energy needs. The advantages of one-sided heating, the capacity and the drying potential are discussed. The hygienization potential of the process is demonstrated by the effect on thermostable coliform bacteria, Escherichia coli, salmonella, the spores of sulfite reducing anaerobic bacteria, f-specific bacteriophages, the seeds of the weed, wild oat, Avena fatua, and the parasite eggs of the potato cyst nematode, Globodera rostochiensis. A more complete paper with the VEAS-concept is found on the VEAS homepage (www.veas.nu).

Esgotamento sanitário condominial: as experiências de Natal e Petrolina / Sewage treatment: Natal and Petrolina experiences

Discorre sobre a atuaçäo do Banco Nacional de Desenvolvimento Econômico e social (BNDES) na área de saúde e saneamento no Brasil. Analisa o cenário de saúde e saneamento do país: déficit no atendimento das necessidades de saneamento básico das populaçöes de baixa renda, alta mortalidade infantil e incidência de doenças pela falta de serviços de infra-estrutura adequada nos bolsöes de pobreza das periferias urbanas. Apresenta as dificuldades para a implantaçäo de serviços de esgotamento sanitário nessas áreas: as redes convencionais de esgoto näo se adequam a traçados urbanos näo convencionais (favelas e loteamentos de geometria irregular). Relata que avaliaçoes preliminares de experiências executadas através de um sistema alternativo de saneamento - o sistema condominial - indicavam resultados positivos, com elevado índice de adesäo dos moradores ao sistema e baixo custo de investimento o que levou o BNDES/FINSOCIAL a apoiar alguns projetos que pudessem produzir uma avaliaçäo das vantagens daquela tecnologia. Apresenta a descriçäo técnica dos princípios do sistema condominial de esgotamento sanitário e um resumo dos resultados observados em dois projetos apoiados pelo BNDES, nos municípios de Natal e Petrolina. (NMPM)

[Intensive methods of sewage treatment]. / Intensivnye metody ochistki stochnykh vod.

The results of the study on intensive treatment of sewage are presented and the general approach to it is proposed. Formation of oxygen active forms in biological systems, their generation during physico-chemical treatment under definite conditions and interaction with organic substances provide higher purity levels in treatment of sewage.

[Hydrobotanical after-purification of effluents from a medical drug plant in winter]. / Gidrobotanicheskaia doochistka stochnykh vod zavoda meditsinskikh preparatov v zimnikh usloviiakh.

The parameters of additional treatment of biologically pure antibiotic production sewage in winter were studied on a pilot model of a 3.72 m3 biopond with higher aquatic plants (Phragmites communis). Sufficiently high efficiency of the process of possible provision of the required sewage quality were shown. A mathematical model of the process based on the first order reaction equation was developed. Its application was estimated and the values of the equation constants were measured.

[The dynamics of the microorganism count of active sludge during the aerobic treatment of sewage]. / Dinamika chislennosti mikroorganizmov aktivnogo ila pri aérobnoi ochistke stochnykh vod.

Dynamics of the active sludge microorganism quantity is studied under different cultivation regimes. It is shown that quantity of microorganisms in different physiological groups depends on the specific growth rate, micro, determined by the dilution rate and biomass recirculation level. The results may be used for selecting optimal regime of the sewage treatment system functioning.