Incineration is a thermal process that transforms medical wastes into inorganic, incombustible matter thus leading to significant reduction in waste volume and weight. The main purpose of any medical waste incinerator is to eliminate pathogens from waste and reduce the waste to ashes. However, certain types of medical wastes, such as pharmaceutical or chemical wastes, require higher temperatures for complete destruction.
Medical waste incinerators typically operate at high temperatures between 900 and 1200°C. Developing countries of Asia and Africa usually use low-cost, high-temperature incinerators of simple design for stabilization of healthcare wastes. The most reliable and predominant medical waste incineration technology is pyrolytic incineration, also known as controlled air incineration or double-chamber incineration. The pyrolytic incinerator comprises a pyrolytic chamber and a post-combustion chamber.
Medical waste is thermally decomposed in the pyrolytic chamber through an oxygen-deficient, medium-temperature combustion process (800– 900°C), producing solid ashes and gases. The gases produced in the pyrolytic chamber are burned at high temperature (900– 1200°C) by a fuel burner in the post-combustion chamber, using an excess of air to minimize smoke and odours.
Small-scale decentralized incinerators used in hospitals, of capacity 200–1000kg/day, are operated on demand in developing countries, such as India. On the other hand, off-site regional facilities have large-scale incinerators of capacity 1–8 tonnes/day, operating continuously and equipped with automatic loading and de-ashing devices. In recent years, mobile incinerators are getting attraction in developing world as such units permit on-site waste treatment in hospitals and clinics, thus avoiding the need to transport infectious waste across the city.
However, the WHO policy paper of 2004 and the Stockholm Convention, has stressed the need to consider the risks associated with the incineration of healthcare waste in the form of particulate matter, heavy metals, acid gases, carbon monoxide, organic compounds, pathogens etc. In addition, leachable organic compounds, like dioxins and heavy metals, are usually present in bottom ash residues. Due to these factors, many industrialized countries are phasing out healthcare waste incinerators and exploring technologies that do not produce any dioxins. Countries like United States, Ireland, Portugal, Canada and Germany have completely shut down or put a moratorium on medical waste incinerators.