Initiatives to broaden safety concerns in anaesthetic practice: The green operating room.

The health sector is a major contributor to climate change through its large carbon footprint. Hospitals are highly energy and resource intensive. Operating rooms (ORs) contribute to a major part of these emissions because of anaesthetic gases, energy-intensive equipment and waste. Besides initiatives aimed to mitigate hospitals' climate footprints, health care professionals need to be involved in this process by changing their professional and personal behaviours without compromising the quality of care. Education on metrics (greenhouse gases), concepts (life cycle) and strategies to reduce the health care footprint would help professionals to commit themselves to the issue. The 5R's rule (reduce, reuse, recycle, rethink and research) used to promote an environmentally friendly way of life can be applied to the medical field and especially to the operating room and anaesthesia. When applied in the ORs, these strategies help question the use of disposable devices, attires and packaging, as well as our professional and personal behaviour. Greening the ORs requires the engagement of all professionals as well as other departments (pharmacy, hygiene) and management. Economic and social co-benefits are expected from this process.

Safety evaluation of recycling process used to produce recycled pulp for adult paper diapers.

Eight contaminants were used to perform a surrogate contamination test to evaluate safety of the process for producing recycled pulp for adult paper diapers. We performed a safety evaluation of the recycling process for producing recycled pulp following the European Food Safety Authority safety assessment for polyethylene terephthalate (PET) bottles using recycled PET. We also compared the first tier safety limit established on the basis of TTC (Climit) in the pulp that contained recycled pulp with residual contaminant concentrations (Cres). If Climit > Cres, there is no concern regarding safety of the recycling process. Climit was determined to be 0.46 mg/kg-pulp based on the human exposure threshold of 0.15 µg/person/day using the scenario in which a bedridden senior citizen uses four adult paper diapers manufactured with pulp containing 10% recycled pulp per day. Cres was derived from the initial concentration in used pulp (0.17 mg/kg-pulp), and decontamination rate was obtained from the surrogate contamination test. The Cres of the eight contaminants were between 0.0017 and 0.10 mg/kg-pulp, which were all below the Climit of 0.46 mg/kg-pulp. These results indicated there was no safety problem regarding this process for producing recycled pulp for adult paper diapers.

Use of Tyre-Derived Aggregate as Backfill Material for Wave Barriers to Mitigate Railway-Induced Ground Vibrations.

The use of piles as barriers to mitigate vibrations from rail traffic has been increasing in theoretical and practical engineering during the last years. Tyre-derived aggregate (TDA) is a recycled material with some interesting applications in civil engineering, including those related to railway engineering. As a novelty, this paper combines the concept of pile wave barriers and TDA material and investigates the mitigation effect of pile barriers made of TDA on the vibrations transmitted by rail traffic. This solution has a dual purpose: the reduction of railway vibrations and the recycling of a highly polluting material. The mitigation potential of this material when used as backfill for piles is analysed using a numerical scheme based on a 3D finite-difference numerical model formulated in the space/time domain, which is also experimentally validated in this paper in a real case without pile barriers. The numerical results show insertion loss (IL) values of up to 11 dB for a depth closed to the wavelength of Rayleigh wave. Finally, this solution is compared with more common backfills, such as concrete and steel tubular piles, showing that the TDA pile is a less effective measure although from an environmental and engineering point of view it is a very competitive solution.

Characteristics of Canteens at Elementary Schools, Upper Secondary Schools and Workplaces that Comply with Food Service Guidelines and Have a Greater Focus on Food Waste.

Policy actions to improve the nutritional environment include the provision of official food service guidelines. This study aimed to examine compliance with food service guidelines for hot meals as well as self-evaluated focus on food waste reduction across settings, i.e., elementary schools, upper secondary schools and workplaces, and different canteen characteristics. The same five criteria for hot meals were applied for all settings with regard to serving of fruit and vegetables, fish, wholegrain product and high fat meat and dairy products. A self-administered questionnaire survey was conducted as a cross-sectional study among 680 Danish canteens. Canteens having a high degree of organic food procurement were more likely to comply with the five criteria for hot meals combined (OR 2.00 (Cl 1.13,3.53)). Also, the use of organic food together with having a meal policy was associated with reported focus on food waste reduction (OR 1.91 (CI 1.12,3.25) and 1.84 (Cl 1.31,2.59), respectively). Compliance with individual criteria varied across settings with elementary schools being more likely to comply with criteria on, e.g., maximum serving of non-wholegrain products, whereas workplaces were more likely to comply with criteria on, e.g., minimum fruit and vegetable content and serving of fish. In addition, specific characteristics, e.g., serving system, were found to predict compliance with some of the criteria. These findings highlight the need to address differences in canteen characteristics when planning implementation support for both guideline and food waste reduction initiatives.

Agent-Based Modelling for Simulation-Based Design of Sustainable Faecal Sludge Management Systems.

Re-using faecal sludge (FS) to generate value has the potential to contribute towards solving the issue of long term sanitation solutions in growing urban areas across sub-Saharan Africa; however, hitherto, no design tools have been available that are capable of simulating a system involving economic factors, complex social issues and environmental circumstances. We hypothesized that Agent-Based Modelling (ABM), when deployed with appropriate rigour, can provide such a tool. Extensive field work was carried out in a Malawian city, investigating the adoption of Skyloo above-ground composting toilets by households, and the operation of the municipal FS site. 65 semi-structured interviews and 148 household interviews, together with observations, were carried out to characterize these processes, with the data acquired being used to construct two separate ABMs. The Skyloo ABM was run for various scenarios of start-up capital for business and payback of loans against the toilet cost to households. The municipal FS Site ABM was run for different patterns of dumping fee and enforcement structure. The field work demonstrated that there is potential for further expansion of FS reuse, with a market for agricultural application. The Skyloo ABM identified the significance of start-up capital for a business installing the toilet technology; the municipal FS Site ABM showed that existing fees, fines and regulatory structure were insufficient to reduce illegal dumping of FS to any useful degree, but that a monthly permit system would provide enhanced revenue to the city council compared with per-visit charging of disposal companies at the municipal FS site. Whilst each ABM ideally requires some additional data before full application, we have, for the first time, shown that ABM provides a basis for the simulation-based design of FS management systems, including complex social, economic and environmental factors.

Review of water quality criteria for water reuse and risk-based implications for irrigated produce under the FDA Food Safety Modernization Act, produce safety rule.

Questions related to the safety of alternative water sources, such as recycled water or reclaimed water (including grey water, produced water, return flows, and recycled wastewater), for produce production have been largely un-explored at the detail warranted for protection of public health. Additionally, recent outbreaks of Escherichia coli (E. coli) in fresh produce, in which agricultural water was suspected as the source, coupled with heightened media coverage, have elevated fruit and vegetable safety into the forefront of public attention. Exacerbating these concerns, new Federal regulations released by the U.S. Food and Drug Administration (FDA) as part of implementation of the FDA Food Safety Modernization Act (FSMA), require testing of agricultural water quality for generic E. coli. Here, we present a review of water quality criteria - including surface water, groundwater recreational water, and water reuse - in an attempt to better understand implications of new FDA regulations on irrigated produce. In addition, a Quantitative Microbial Risk Assessment (QMRA) was conducted to estimate risks from pathogen contamination of food crops eaten fresh under the context of FDA regulations to provide perspective on current water reuse regulations across the country. Results indicate that irrigation water containing 126 CFU/100 mL of E. coli correspond to a risk of GI illness (diarrhea) of 9 cases in 100,000,000 persons (a 0.000009% risk) for subsurface irrigation, 1.1 cases in 100,000 persons (a 0.0011% risk) for furrow irrigation, and 1.1 cases in 1000 persons (a 0.11% risk) for sprinkler irrigation of lettuce. In comparison to metrics in states that currently regulate the use of recycled water for irrigation of food crops eaten fresh, the FDA FSMA water quality metrics are less stringent and therefore the use of recycled water presents a reduced risk to consumers than the FDA regulations. These findings, while limited to a one-time exposure event of lettuce irrigated with water meeting FSMA water quality regulations, highlight the need for additional assessments to determine if the scientific-basis of the regulation is protective of public health.

Public Health Bacteriology of Commercially Composted Domestic Food and Garden Waste by the 11 Councils in Northern Ireland - Persistence Of Clostridium perfringens and Implications for Local Food Safety.

BACKGROUND: New legislation has been introduced in Northern Ireland from April 2017, requiring domestic households to recycle all domestic food waste items. The purpose of this study was to examine the bacteriology of compost derived from this source which is supplied free-of-charge to the public for horticultural use. METHODS: Municipal compost samples were compared microbiologically with commercial garden compost samples, examining total viable count and diversity of bacteria cultivated. RESULTS: The municipal compost had a mean Total Viable Count (TVC) of 1.53 × 108 colony forming units (cfu)/ g compost, whereas the commercial garden compost had a mean TVC of 4.5 × 107 cfu/g compost. Campylobacter, Salmonella and Listeria were not isolated from any compost. Twenty-three bacterial genera were represented amongst the 46 organisms recovered. Of these, Pseudomonas aeruginosa and Clostridium perfringens were the most clinically significant. DISCUSSION: The application of municipal compost to cultivate non-food plants, such as roses and flowers presents minimal risk, provided safe handling practices are adopted and hands are thoroughly washed and dried afterwards. However, if applied to soil growing food produce, it is important that municipal compost does not enter the food chain without an effective critical control point which would prevent germination of spores of Clostridium perfringens. Risk may be increased in products such as marinades, home canning, home bottling and associated products. These methods of food preparation are common in ethnic Eastern European populations in Northern Ireland, where awareness of risk needs to be increased.

Decision-Making and Environmental Implications under Cap-and-Trade and Take-Back Regulations.

To reduce carbon emissions during production and realize the recycling of resources, the government has promulgated carbon cap-and-trade regulation and take-back regulation separately. This paper firstly analyses the manufacturing, remanufacturing and collection decisions of a monopoly manufacturer under cap-and-trade regulation and take-back regulation conditions, and then explores the environmental impact (i.e., carbon emissions) of both carbon regulation and more stringent take-back regulation. Finally, numerical examples are provided to illustrate the theoretical results. The results indicate that it will do good for the environment once the cap-and-trade regulation is carried out. We also conclude that government’s supervision of carbon trading price plays an important role in reducing the environmental impact. Furthermore, unexpectedly, we prove that if emissions intensity of a remanufactured (vis-á-vis new) product is sufficiently high, the improvement of collection and remanufacturing targets might lead to the deterioration of environment.

Environmental impact assessment of municipal solid waste management options using life cycle assessment: a case study.

The goal of this study is to use life cycle assessment (LCA) tool to assess possible environmental impacts of different municipal solid waste management (MSWM) scenarios on various impact categories for the study area Dhanbad City, India. The scenarios included in the present study are collection and transportation (denoted as S1); baseline scenario consisting of recycling, open burning, open dumping, and finally unsanitary landfilling without energy recovery (denoted by S2); composting and landfilling (denoted by S3); and recycling and composting followed by landfilling of inert waste without energy recovery (denoted by S4). One ton of municipal solid waste (MSW) was selected as the functional unit. The primary data were collected through sampling, surveys, and literatures. Background data were obtained from Eco-invent data of SimaPro 8.1 libraries. The scenarios were compared using the CML 2 baseline 2000 method, and the results indicated that the scenario S1 had the highest impact on marine aquatic ecotoxicity (1.86E + 04 kg 1,4-DB eq.) and abiotic depletion (2.09E + 02 kg Sb eq.). S2 had the highest impact on global warming potential (9.42E + 03 kg CO2 eq.), acidification (1.15E + 01 kg SO2 eq.), eutrophication (2.63E + 00 kg PO43- eq.), photochemical oxidation (2.12E + 00 kg C2H4 eq.), and human toxicity (2.25E + 01 kg 1,4-DB eq.). However, S3 had the highest impact on abiotic depletion (fossil fuels) (2.71E + 02 MJ), fresh water aquatic ecotoxicity (6.54E + 00 kg 1,4-DB eq.), terrestrial ecotoxicity (3.36E - 02 kg 1,4-DB eq.), and ozone layer depletion (2.73E - 06 kg CFC-11 eq.). But S4 did not have the highest impact on any of the environmental impact categories due to recycling of packaging waste and landfilling of inert waste. Landfilling without energy recovery of mixed solid waste was found as the worst disposal alternative. The scenario S4 was found as the most environmentally suitable technology for the study area and recommended that S4 should be considered for strategic planning of MSWM for the study area.

An interpretive structural modeling (ISM) and decision-making trail and evaluation laboratory (DEMATEL) method approach for the analysis of barriers of waste recycling in India.

Increasing amount of wastes is posing great difficulties for all countries across the world. The problem of waste management is more severe in developing countries such as India where the rates of economic growth and urbanization are increasing at a fast pace. The governments in these countries are often constrained by limited technical and financial capabilities, which prevent them from effectively addressing these problems. There is a limited participation from the private players too in terms of setting up of waste recycling units. The present study aims at identifying various barriers that challenge the establishment of these units, specific to India. Further, it attempts to identify the most influential barriers by utilizing multicriterion decision-making tools of interpretive structural modeling (ISM) and decision-making trail and evaluation laboratory (DEMATEL). The findings of the study suggest that the lack of funds, input material, and subsidy are the most influential barriers that are needed to be addressed for the development of waste recycling infrastructure in India. IMPLICATIONS: This work has been carried out to address the problem of proper waste management in India. To deal with this problem, the method of waste recycling has been felt appropriate by the government of various countries, including India. Therefore, the barriers that play vital role in waste recycling for private players have been identified and their importance has been established with the help of ISM and DEMATEL methods. Doing so will assist the government to take appropriate steps for the betterment of waste recycling infrastructure in India and enhance waste management.

Utilization of waste cooking oil as an alternative fuel for Turkey.

This study is based on three essential considerations concerning biodiesel obtained from waste cooking oil: diesel engine emissions of biodiesel produced from waste cooking oil, its potential in Turkey, and policies of the Turkish government about environmentally friendly alternative fuels. Emission tests have been realized with 35.8 kW, four-cylinder, four-stroke, direct injection diesel tractor engine. Test results are compared with Euro non-road emission standards for diesel fuel and five different blends of biodiesel production from waste cooking oil. The results of the experimental study show that the best blends are B10 and B20 as they show the lowest emission level. The other dimensions of the study include potential analysis of waste cooking oil as diesel fuels, referring to fuel price policies applied in the past, and proposed future policies about the same issues. It was also outlined some conclusions and recommendations in connection with recycling of waste oils as alternative fuels.

Los pediatras y el sostenimiento del medioambiente / Pediatricians and the sustainability of the environment

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Satisfaction and dissatisfaction in the work of recyclable solid waste segregators: convergent-care research.

OBJECTIVES: describe elements that promote satisfaction and dissatisfaction in the work of recyclable solid waste segregators and conduct a nursing action focused on these elements. METHOD: qualitative research, convergent-care, conducted with members of the cooperative. Data production occurred during 2015 through participation observation, semi-structured interviews, and a convergence group. Analysis comprised the phases Apprehension, Synthesis, Theorization, and Transference. RESULTS: four categories emerged. They showed satisfaction and dissatisfaction related to identification with tasks and work content, material and personal gains obtained from solid waste segregation, prejudice, lack of appreciation, and difficulties in interpersonal relationships. This last item, due to its importance, received a nursing action. CONCLUSION: the study contributed to the advancement of knowledge and the association of possibilities between the research performance and nursing care for workers.

Satisfaction and dissatisfaction in the work of recyclable solid waste segregators: convergent-care research / Satisfacción e insatisfacción en el trabajo de recuperadoras de materiales reciclables: estudio convergente asistencial / Satisfação e insatisfação no trabalho de catadoras de materiais recicláveis: estudo convergente-assistencial

ABSTRACT Objectives: describe elements that promote satisfaction and dissatisfaction in the work of recyclable solid waste segregators and conduct a nursing action focused on these elements. Method: qualitative research, convergent-care, conducted with members of the cooperative. Data production occurred during 2015 through participation observation, semi-structured interviews, and a convergence group. Analysis comprised the phases Apprehension, Synthesis, Theorization, and Transference. Results: four categories emerged. They showed satisfaction and dissatisfaction related to identification with tasks and work content, material and personal gains obtained from solid waste segregation, prejudice, lack of appreciation, and difficulties in interpersonal relationships. This last item, due to its importance, received a nursing action. Conclusion: the study contributed to the advancement of knowledge and the association of possibilities between the research performance and nursing care for workers.

RESUMEN Objetivos: describir los elementos promotores de satisfacción e insatisfacción en el trabajo de recuperadoras de materiales reciclables y realizar acción de enfermería enfocada en tales elementos. Métodos: estudio cualitativo, convergente asistencial, realizado con recuperadoras trabajando en cooperativa. Datos obtenidos en 2015 mediante observación participante, entrevistas semiestructuradas y grupo de convergencia. El análisis contempló las fases Aprendizaje, Síntesis, Teorización y Transferencia. Resultados: emergieron cuatro categorías que ilustran experiencias de satisfacción e insatisfacción relativas a la identificación con las tareas y el contenido del trabajo, ganancias materiales y personales obtenidas con la recuperación, el prejuicio, la desvalorización y dificultades con las relaciones interpersonales. Esta última, por su significatividad, fue objeto de una acción de enfermería. Conclusión: el estudio contribuyó a mejorar conocimientos y posibilidades de asociación entre la realización de la investigación y la atención de enfermería a trabajadores.

RESUMO Objetivos: descrever os elementos promotores de satisfação e insatisfação no trabalho de catadoras de materiais recicláveis e realizar uma ação de enfermagem focada nesses elementos. Método: pesquisa qualitativa, convergente-assistencial, realizada com catadoras cooperativadas. A produção de dados ocorreu em 2015 por meio de observação participante, entrevistas semiestruturadas e grupo de convergência. A análise contemplou as fases Apreensão, Síntese, Teorização e Transferência. Resultados: emergiram quatro categorias que ilustram vivências de satisfação e insatisfação relacionadas à identificação com as tarefas e com o conteúdo do trabalho, ganhos materiais e pessoais obtidos com a catação, o preconceito, a desvalorização e dificuldades nas relações interpessoais. Esta última, devido ao seu destaque, foi objeto de uma ação de enfermagem. Conclusão: o estudo contribuiu para o avanço de conhecimentos e possibilidades de associação entre a realização da pesquisa e do cuidado de enfermagem com trabalhadores.

Evaluation of concrete recycling system efficiency for ready-mix concrete plants.

The volume of waste generated annually in concrete plants is quite large and has important environmental and economic consequences. The use of fresh concrete recyclers is an interesting way for the reuse of aggregates and water in new concrete production. This paper presents a study carried out for over one year by one of the largest ready-mix concrete producers in Brazil. This study focused on the evaluation of two recyclers with distinct material separation systems, herein referred to as drum-type and rotary sieve-type equipment. They were evaluated through characterization and monitoring test programs to verify the behaviour of recovered materials (aggregates, water, and slurry). The applicability of the recovered materials (water and aggregates) was also evaluated in the laboratory and at an industrial scale. The results obtained with the two types of recyclers used were equivalent and showed no significant differences. The only exception was in terms of workability. The drum-type recycler generated fewer cases that required increased pumping pressure. The analysis concluded that the use of untreated slurry is unfeasible because of its intense negative effects on the strength and workability of concrete. The reclaimed water, pre-treated to ensure that its density is less than 1.03g/cm(3), can be used on an industrial scale without causing any harm to the concrete. The use of recovered aggregates consequently induces an increase in water demand and cement consumption to ensure the workability conditions of concrete that is proportional to the concrete strength level. Therefore, the viability of their use is restricted to concretes with characteristic strengths lower than 25MPa.

Assessing the environmental performance of construction materials testing using EMS: An Australian study.

This paper reports the audit findings of the waste management practices at 30 construction materials testing (CMT) laboratories (constituting 4.6% of total accredited CMT laboratories at the time of the audit) that operate in four Australian jurisdictions and assesses the organisation's Environmental Management System (EMS) for indicators of progress towards sustainable development (SD). In Australia, waste indicators are 'priority indicators' of environmental performance yet the quality and availability of waste data is poor. National construction and demolition waste (CDW) data estimates are not fully disaggregated and the contribution of CMT waste (classified as CDW) to the national total CDW landfill burden is difficult to quantify. The environmental and human impacts of anthropogenic release of hazardous substances contained in CMT waste into the ecosphere can be measured by construing waste indicators from the EMS. An analytical framework for evaluating the EMS is developed to elucidate CMT waste indicators and assess these indicators against the principle of proportionality. Assessing against this principle allows for: objective evaluations of whether the environmental measures prescribed in the EMS are 'proportionate' to the 'desired' (subjective) level of protection chosen by decision-makers; and benchmarking CMT waste indicators against aspirational CDW targets set by each Australian jurisdiction included in the audit. Construed together, the EMS derived waste indicators and benchmark data provide a composite indicator of environmental performance and progress towards SD. The key audit findings indicate: CMT laboratories have a 'poor' environmental performance (and overall progress towards SD) when EMS waste data are converted into indicator scores and assessed against the principle of proportionality; CMT waste recycling targets are lower when benchmarked against jurisdictional CDW waste recovery targets; and no significant difference in the average quantity of waste diversion away from landfill was observed for laboratories with ISO14001 EMS certification compared to non-ISO14001 certified laboratories.

Leaching of chloride, sulphate, heavy metals, dissolved organic carbon and phenolic organic pesticides from contaminated concrete.

Concrete samples from demolition waste of a former pesticide plant in Sweden were analysed for total contents and leachate concentrations of potentially hazardous inorganic substances, TOC, phenols, as well as for pesticide compounds such as phenoxy acids, chlorophenols and chlorocresols. Leachates were produced by means of modified standard column leaching tests and pH-stat batch tests. Due to elevated contents of chromium and lead, as well as due to high chloride concentrations in the first leachate from column tests at L/S 0.1, recycling of the concrete as a construction material in groundworks is likely to be restricted according to Swedish guidelines. The studied pesticide compounds appear to be relatively mobile at the materials own pH>12, 12, 9 and 7. Potential leaching of pesticide residues from recycled concrete to ground water and surface water might exceed water quality guidelines for the remediation site and the EU Water Framework Directive. Results of this study stress the necessity to systematically study the mechanism behind mobility of organic contaminants from alkaline construction and demolition wastes rather than rely on total content limit values.