Experiences on Regulated Medical Waste Management in Hungary

1. Experiences on Regulated Medical Waste Management in Hungary UNIDO Conference Kazan, Tatarstan 14-15 May. 2009. Dr. Kovács László

2. Data of Hungary • Population of Hungary: 10 million • Number of active hospital beds : appr. 60.000 • Average waste generation: 0,35 kg/bed/day • RMW in the hospitals: 7.600 t/year • In the outpatient services: 800 t/year • At the private doctors practices: 400 t/year • Total: 8.800 t/year

3. Legal background (EU harmonised) • 12/2006/EC Directive for general waste management in the EU • 98/2008/EC Directive will regulate the EU waste management from 12th December 2010. All EU member states waste legislation has to comply to this directive until 12th December 2010. • A 2000/532/EC Directive regulates the wastes by EWC codes, the hazardous wastes are marked by asterisk. The Hungarian equivalent is 16/2001 (VII. 18) KöM. decree. • 2000/76/EC directive regulates the waste incineration, the Hungarian equivalent is 16/2001 (VII. 18) KöM. decree. • The trans-boundary movement of wastes are regulated by 1013/2006/EC decree. The execution isregulated by the 1418/2007/EC decree .

4. Other harmonised Hungarian regulations • 2000. year XLII. Law on Waste management Hungary. • 98/2001. (VI.15.) Governmental decree on the conditions to deal with hazardous wastes. •  1/2002. (I.11.) Ministry of Health decree on the conditions to deal with hazardous medical wastes. • 2/2002. (I.11.) Governmental decree on the safety of hazardous waste transport. • 28/2002 (XII.9.) Governmental and 46/2005 (VI.28) Ministerial decree on the transboundary movement of hazardous wastes • The only allowed activity to import hazardous wastes, is recycling (utilisation)

5. RMW management in the health care institutions The regulated medical wastes are collected selectively in the Hungarian hospitals, out-patients institutes and private doctors. Most of the wastes are handled over to specialised companies having permit for transport/disposal of hazardous wastes. • According to the EU requirements the non complying incinerators have been stopped in Hungary at 2005. • There was an invitation for governmental support to upgrade the incinerators to comply with EU standards from 2004. One application was given only and that has been approved, because to upgrade the small hospital incinerators were not economic. According to our calculations the minimum economic capacity is around 2-3,000 t/y.

6. Main data of the SEPTOX Ltd. • The yearly amount of waste managed: 5.300 t/y • Number of active transporting vehicles: 26 pc • The capacity of the applied equipment for treatment/disposal (operated by Septox Ltd.): • Waste incinerator 3,000 t/y • Steam sterilizer (built in shredder type, „Lajtos”) 1,000 t/y • Steam sterilizer (pre-vacuum type, „Tuttnauer”) 2,000 t/y

7. Main data of the Zöld Zóna Ltd. • The yearly amount of waste managed: 1,600 t/y • Number of active transporting vehicles: 7 pc • The capacity of the applied equipment for treatment/disposal: • Steam sterilizer („Lajtos”) own operation 1,000 t/y • Incinerator (hired capacity) 600 t/y

8. Waste collecting sacks bins and boxes

9. Collection of wastes

10. Waste containers, built in scale

11. Containers and sacks

12. Lifting the container to the transporting truck

13. Steam sterilizer (Lajtos)

14. Steam sterilizer (Tuttnauer) with shredder

15. Comparison of counter-current and co-current rotary kilns counter-current rotary kiln is short, with biggerØ. co-current rotary kiln is longer, with small Ø.

16. Comparison of rotary kiln ashes counter-current rotary kiln ash counter-current rotary kiln ash

17. Rotary kiln

18. Afterburner

19. Heat utilising steam boiler

20. NaHCO3 activated carbon feeding

21. Bag filter

22. I.D.fan

23. Stack

24. Expenses of incineration + = 813.300 USD/2250t= 361 USD/t Scale advantage, in case of 15,000 t/y 195 USD/t

25. The estimated investment cost of RMW system for 2,250 t/y.