ABSTRACT
The study was carried out by collecting soil samples, water samples and medical waste incinerator ash samples from the surroundings of Federal Medical Centre, Umuahia. These samples were analyzed in the laboratory for heavy metal concentration in it.Data collected were subjected to ANOVA, and mean values separated with FLSD at P<0.05. Principal component analysis (PCA) was used for data interpretation, grouping of the soil parameters and heavy metals of the soil, groundwater, incinerator ash and open burning sites. Soil samples were collected at different intervals within the incinerator site at (50, 100, 150 meters) apart and 1000 meters away to serve as control point. The pollution load index and Geo-accumulation index levels of the heavy metals in the soil, water, incinerator ash and open dump in Federal Medical Centre Umuahia were determined. The statistical result obtained from the soil, water, incinerator ash and open burning were compared to the NESREA permissible limit for heavy metals. Results of the study revealed that the physical parameters of the soil were over 70% for example sand percentage was between 67.450-75.450%, Silt was low and was between 6.00-8.00% and clay concentrations was between 16.600-25.550%.The chemical properties of the soil revealed that pH value where near neutral at (5.150 ± 0.00 – 5.900 ± 0.07) for R1 and (5.250 ± 0.00 – 6.400 ± 0.07) for R2. The organic manure (OM) was between (0.6950 ± 0.01 – 1.8500 ± 0.07) for R1 and (0.4150 ± 0.01 – 13.850 ± 0.01) for R2. Heavy metals concentration in soil, ground water and incenerator ash were determined. In groundwater, copper, zinc, manganese, chromium, cadmium, lead was all above the permissible limits of drinking water quality of standard organization of Nigeria. For the incinerator ash, the study revealed zinc (Zn) and manganese were above NESREA permissible limit and is between 11.520 ± 0.05 for R1 and 11.900 ± 1.20 R2 for zinc and 4.300 ± 5.43 R1 and 4.100 ± 0.50 R2 for manganese. While in the open dump site zinc and manganese were above the permissible limit of NESREA for zinc is between 7.0150 ± 0.01 for R1 and 9.0021 ± 0.00 for R2 and 6.0805 ± 0.01 for R3 while (Mg) is between 1.4050 ± 0.01 for R1, 3.0700 ± 0.00 R2 and 2.5050 ± 0.01 R3. For the principle component analysis it recorded cumulative percentage of 72.011% for soil physical properties and 86.134% for soil chemical properties, 79.26% for borehole water, 83.69% for hospital incinerator ash, 81.84% for soil at graded distance and 97.29% for open burning. From the result the soil of the studied areas are at high risk of more contamination from heavy metals. This is given in low medium values of organic matter, clay and pH values that encourage the mobility of heavy metal in the soils. The management of Federal Medical Centre Umuahia should take advantage of the new method of medical waste treatment to advert the effect of medical waste flue-gas on soil, groundwater, from incinerator bottom ash and fly ash contamination.
TABLE OF CONTENTS
Title Page i
Declaration ii
Certification iii
Dedication iv
Acknowledgements v
Table of Contents vi
List of Tables xi
List of Figures xiii
Abstract xiv
CHAPTER 1: INTRODUCTION 1
1.1 Background of the Study 1
1.2 Statement of the Research Problem 3
1.3 Aim and Objectives of the Study 4
1.4 Significance of the Study 5
1.5 Justification of the Study 6
1.6 Scope of the Study 7
CHAPTER 2:
LITERATURE REVIEW 8
2.1
Medical Waste 8
2.1.1 Infectious waste 8
2.2 Wastes
with High Contents of Heavy Metal 9
2.3 Heavy Metals 9
2.4 Selected Heavy Metals
Found in Incinerator Bottom Ash 10
2.4.1 Zinc (Zn) 10
2.4.2 Chromium (Cr) 11
2.4.3 Copper (Cu) 12
2.4.4 Cadmium (Cd) 12
2.4.5 Lead (Pb) 13
2.4.6 Manganese (Mn) 14
2.5 Properties of Heavy Metals in Environment 15
2.6 Environmental implications of
incineration 15
2.6.1 Effects on soil 15
2.6.2 Effect of heavy metal on human health 17
2.6.3 Effects on water 18
2.7 The Effect of Soil pH on the Mobility of
Heavy Metals 18
2.8 Sources of Heavy Metals in Contaminated
Soil and Water 19
2.9 Incineration
of Medical Waste 21
2.9.1 Advantage of incineration 22
2.9.2 Disadvantage
of incineration 22
2.10 The Ash of Medical Waste Incinerators 24
2.11 Generation, Processing and Handling of
Incinerator Ash 25
2.12 Methods
of Biomedical Waste Incinerator Ash Treatment 26
2.12.1 Solidification/stabilization 26
2.12.2 Verification process 26
2.12.3 Stabilization of medical waste incineration
ash 28
2.13 Treatment and Disposal of Hospital Waste 29
2.13.1 Autoclaving 29
2.13.2 Chemical treatment 30
2.13.3
Microwave treatment 30
2.14 Theoretical Framework 31
2.14.1 Standard for treatment and disposal of
biomedical wastes 35
2.14.2 Application of medical waste ashes 36
CHAPTER 3: MATERIALS AND METHODS 37
3.1 The
Study Area 37
3.1.1 Location 37
3.1.2 Climate 39
3.1.3 Vegetation 39
3.1.4 Soil 39
3.1.5 Geology 39
3.1.6 Economy 40
3.2 Sampling Design 40
3.3 Sample Collection 41
3.3.1 Incinerator bottom ash sampling 41
3.3.1.2 Soil sampling 41
3.3.1.3 Water sampling 42
3.3.1.4 Soil, incinerator ash and water samples laboratory
preparation 42
3.3.2 Bore hole water laboratory preparation 43
3.3.3 Assessment of the contribution of hospital incinerator gas flue
on soil
quality dynamics of an environment 44
3.3.4 Vulnerability assessment of borehole water
quality status within the
hospital and its environs 44
3.3.5 Quality control 45
3.3.6 Determination of the soil physical
properties 45
3.3.7 Determination of the soil chemical
properties 46
3.3.8 Available phosphorus 46
3.3.9 Exchangeable bases: 46
3.3.10 Soil exchangeable activity 46
3.3.11 Total nitrogen 46
3.3.12 Cation exchange capacity 46
3.3.13 Exchangeable sodium percentage 47
3.3.14 Exchangeable sodium percentage 47
3.3.15 Base saturation 47
3.3.16 Determination
of heavy metal 47
3.3.17 The index of geo accumulation (Igeo) 47
3.3.18 Contamination /pollution index 48
3.3.19 Statistical analysis 49
CHAPTER 4: RESULTS AND DISCUSSION 50
4.1 Results 51
4.2 Discussion 90
4.2.1 Soil physiochemical characteristics in
Federal Medical Centre Umuahia 90
4.2.2 Soil fractions in Federal Medical Centre
Umuahia 91
4.2.3 pH values of soil in Federal Medical Centre
Umuahia 92
4.2.4 Organic matter and organic carbon in Federal
Medical Centre, Umuahia 93
4.2.5 Exchangeable
bases (Ca, Mg, K, and Na) in Federal Medical Centre,
Umuahia 94
4.2.6 Phosphorus and nitrogenin Federal Medical
Centre, Umuahia 95
4.2.7 Heavy metal of bore-hole water in Federal
Medical Centre, Umuahia 96
4.2.8 Heavy
metal of incinerator bottom ash (IBA) in Federal Medical Centre Umuahia 97
4.2.9 Heavy
metals present in Federal medical Centre, Umuahia 98
4.2.10 Heavy
metal of open dump incinerator in Federal Medical Centre,
Umuahia 100
4.2.11 Contamination / pollution index and
geo-accumulation index 101
4.2.12 Varimax rotated component bar graph for soil
physicochemical
properties and heavy metals 102
CHAPTER 5: CONCLUSION AND RECOMMENDATIONS 104
5.1 Conclusions 104
5.2 Recommendations 105
References 107
Appendix 125
LIST OF TABLES
2.1: Heavy
metals found in medical waste fly ash (FA) (mg/kg) 33
2.2: Heavy
metals found in medical waste bottom ash (BA) (mg/kg) 34
2.3: Applications
of medical waste ashes 36
3.3.1: Incinerator bottom ash sampling
points and coordinates 41
3.3.1.2: Incinerator flue gas soil sampling
point, at graded distance and
coordinates 42
3.3.1.3: Incinerator flue gas / groundwater
sampling point and coordinates 42
3.3.17: Showing categorization of geo
accumulation(Igeo) 48
3.3.19: Showing the significance of
intervals of contamination/pollution
index (C/PI) 49
3.3: Showing target values for
heavy metals (mg kg-1) 49
4.1: Statistical summary of
incinerator flue gas on soil physical
parameters at graded distances in Federal
Medical Centre,
Umuahia 50
4.2: Eigen vector values for
principle component using surrounding
soil and its physical properties 51
4.3: Statistical summary of soil
physical parameters present in the soil
from agricultural land as control 52
4.4: Varimax rotated component of
soil physical properties from
agricultural land as control 53
4.5: Statistical summary of the
incinerator flue gas on soil chemical
properties at graded distances in Federal
Medical Centre, Umuahia 54
4.6: Varimax rotated component
matrix of soil chemical properties
affected by hospital incinerator flue gas. 56
4.7: Statistical summary of soil
chemical parameters present in the soil
from agricultural land as control 58
4.8: Varimax rotated component
matrix of soil chemical properties of
Agricultural land as control. 60
4.9: Statistical summary of
incinerator flue gas on heavy metal
concentration in soil atgraded distance in
Federal Medical
Centre, Umuahia. 61
4.10: Varimax rotated component matrix
of heavy metal of soil at
graded distance in Federal Medical Centre,
Umuahia. 63
4.11: Comparison of the statistical
summary of heavy metal in
agricultural land with NESREA permissible limits. 64
4.12: Varimax rotated component matrix
of heavy metal in agricultural
land as control. 65
4.13: Statistical summary of medical
waste incinerator on bore-hole
water quality in Federal Medical Centre,
Umuahia 66
4.14: Varimax rotated component matrix
of heavy metal in borehole
water at hospitalincinerator location. 68
4.15: Statistical summary of heavy
metal concentrations in incinerator
bottom ash in Federal Medical Centre,
Umuahia 69
4.16: Varimax rotated component matrix
of heavy metal in hospital
incinerator bottom ash in Federal Medical
Centre, Umuahia. 71
4.17: Statistical summary of open dump
incinerator for heavy metal
concentration in soil in Federal Medical
Centre, Umuahia 73
4.18: Varimax rotated component matrix
of heavy metal in hospital
open dumpsite in Federal Medical Centre,
Umuahia. 75
4.19: Contamination/pollution Index of
heavy metals in incinerator
bottomash 78
4.20: Contamination/pollution Index of
heavy metals in open dump
incinerator 79
4.21: Contamination/Pollution Index of
heavy metals in bore hole water 80
4.22: Contamination/Pollution Index of
heavy metals in soil sample at
degraded distances 81
4.23 Contamination/Pollution Index
of heavy metals in in agricultural
land as control 82
4.24 Contamination/geo-accumulation
index of heavy metals in
incinerator bottom ash 83
4.25: Contamination/geo-accumulation
index of heavy metals in open
dump incinerator ash 84
4.26: Contamination/geo-accumulation
index of heavy metals in
borehole water 85
4.27: Contamination/geo-accumulation
index of heavy metals in the soil
at various distances 86
4.28: Contamination/geo-accumulation
index of heavy metals in the soil
for control sample 87
LIST OF FIGURES
3.1: Map of Umuahia showing the
study area (FMC Umuahia) 38
4.1: Soil physicochemical result 88
4.2 Heavy metals in samples 88
CHAPTER 1
INTRODUCTION
1.1
BACKGROUND OF THE STUDY
About
ten (10) to twenty five (25) percent of medical waste forms healthcare wastes
which are considered as hazardous and may be toxic or radioactive (Patcharin,
2002). Poor management of medical wastes may pose a high health risk which may
likely cause environmental contamination through the emission of smoke and non- proper disposal of
incinerator ash (Ford et al., 2004). Hazardous waste
incinerator as a treatment option is dangerous (Ridlington and Heavner, 2004). If
not properly treated could lead to a remarkable inconvenience and result to
public health risk (WHO, 2004). During the incinerating of waste from
medical sources, waste that may contain heavy metals should be separated and
excluded from other wastes for alternative treatment. This will ensure that the pollution of the
environment is not enhanced by the emissions of the gas flaring of the heavy
metal residues present in the incinerator ash (Howard, 2002, UNEP, 2009). Heavy
metals that are contained in health care wastes for example mercury,
incinerated without adequate precautions measures will release mercury vapor
into the environment that pollutes the air. This may be toxic if inhaled by
humans, and could be fatal or can lead to injuries that are life threatening in
some parts of the body e.g. the neurological systems and lungs (Howard, 2002; UNEP,
2009). It is observed that Health-care wastes have more concentration of heavy metals than domestic or municipal
solid waste (Takeuchi et al., 2005).
Wastes like broken thermometers which are mistaken as sharps from dental clinics
contain mercury gas when incinerated, will concentrate mercury particles in the
incinerator ash while the remaining ones are released as gaseous emission in
the surrounding environment causing a significant risk to public health (EPA,
2011). Heavy metals from incinerator ash leak into drinking water in
various types and quantities can cause cancer e.g. inorganic arsenic and non-cancer
causing agents like mercury (Hg) can lead to high risks in humans (USEPA, 2015).
Among the heavy metals such as arsenic
(As), cadmium (Cd), lead (Pb), chromium
(Cr), copper (Cu), mercury (Hg) and nickel
(Ni) are of major concern, due to their presence at relative concentration that
is high mainly in drinking water and its human health effect (ATSDR, 2015).
Such heavy metal like Arsenic (As), Cadmium (Cd) and Lead (Pb) has extensively
been researched for their public effects on health (USEPA, 2015; ATSDR, 2015).
Drinking water with the presence of Arsenic (As) of 50µg/l is reported to lead
to cancer of the liver, lungs, kidney or bladder in 13 to 100 persons (Smith et al., 2006). Its effect on soil from
past studies showed that heavy metals showed major significant role due to their non-degradable nature
over an extended period of time (Gallego et
al. 2002; Wu and Zhang, 2010).Metal ions concentration in soil
environment clearly creates major risk to the quality of soils, plants, natural
water and human health (Adraino, 2001). Heavy metal in soil could be a double
edged sword ranging from the role in normal plant growth and living organisms
that associated with the toxicity presence of certain metals like lead (Pb), cadmium(Cd)
and mercury (Hg) etc. (Adraino, 2001).
The presence or bioaccumulation of metal ions in the soil is determined by
the temperature, pH, , redox potential, cat ion exchange capacity, organic
matter, present in the soil, the soil
quality and the composition of metal ions, in the soil (Moon et al., 2000; Manchester et al.,2005; Skorda and Kelepertists,
2005;Manchester et al.,2010). Studies
about contamination of heavy metal of soil within Nigeria environments are many
(Bamgbose et al., 2000; Onianwa and
Fakayode, 2000; Onianwa, 2001; Ana and Sridhar, 2004; Umoren and Onianwa, 2005,
Iwegbe, et al., 2006; Iwegbue, 2007).
Incineration
of hospital wastes is known for not completely destroying the metallic
components from the waste stream but concentrate heavy metals founds in the
incinerator ash (Iqbal, 2001). However, many researchers had done work on
Hospital waste incinerator ash outside Nigeria like Tanjim et al., (2012) in Sylhet, China, Adama et al., (2016) in Ghana, Bakkali et al., (2013) in Morocco, Nkonge et al., (2012) in Kenya and Batterman, (2004) in Geneva,
Switzerland but there is no much attention given to hospital waste incinerator
ash in Nigeria especially Abia State. Estimate shows that about 5.2 million
people (including 4 million children) die each year from diseases that are
sourced from waste. Globally, the amount of waste generated from municipal
source will double by the year 2000 and quadruple by year 2025” (Akteret.
al. 1999; Akter, 2000). Worried
by this situation, Agenda 21, as adopted in the United Nations Conference on
Environment and Development (UNCED) in Rio de Janerio in June, 1992, set goals
and targets with regard to waste management in cities: All countries should develop a criteria for waste
treatment to be able to monitor the environmental impacts of waste by the year
2000. By 2025, all nation shall dispose their waste according to international
quality guidelines (Akter, 2000).Unfortunately, there is scare
information on the analysis of soil and ground water in the proximity of
hospital waste incinerator at Federal Medical Centre (FMC) Umuahia. This study
was conducted in Federal Medical Centre, to analyze the soil and ground water quality
in the proximity of hospital waste incinerator at Federal Medical Centre (FMC)
Umuahia, together with the composition of the selected heavy metal in the
incinerator bottom ash (IBA). Such as, copper, zinc, manganese, chromium,
cadmium and lead.
1.2 STATEMENT OF THE RESEARCH PROBLEM
In the past, the quantity
of medical waste produced in Federal Medical Centre, Umuahia was barely managed
without a major call for concern. However, hospital waste pose a significant
impact on health and the environment at which it is found. Nigeria as a
developing country, healthcare waste has received less attention and the main
priority that supposed to be given to it (Abah and Thiamin, 2010). The rapid
increase in population of Nigeria in recent years represents an increasing
number of patients (Ikonne, 2011). Without an adequate increase in
technological development for medical waste management, this will lead to
problems of improper medical waste management. If patients are to receive
healthcare and recovery in safe surrounding, medical waste, incinerator ash and
its disposal must be safe (WHO, 2012). The problem here is that the healthcare
delivery system, which are being built to provide treatment and safeguard the
health of the people against illness, has turned to become source of infection
and means of diseases spreading in the process of healthcare delivery. It is
generally known that management of healthcare waste is a tedious, foul,
difficult, expensive and complicated exercise. However, proper handling of
waste during storage, transportation, treatment, and disposal is therefore
important (Ubuoh et al., 2012).
Improper management of healthcare waste can cause significant inconveniences
and become a risk to the population (Zhoa et
al., 2010). To demonstrate the effect of this medical waste incinerator ash
on ecosystem and bring to attention the needs for sustainable management of
hospital wastes, this study was conducted in Federal Medical Centre, Umuahia to
assess the soil and ground water pollution levels of surroundings within the
incinerator site.
1.3 AIM
AND OBJECTIVES
OF THE STUDY
The
aim of the study is to analyze soil and groundwater in the proximity of
hospital waste incinerator at Federal Medical Centre Umuahia with a view to
creating healthy hospital environment. This
was accomplished through the following objectives:
i.
To
assess the effects of incinerator flue gas on soil characteristics in Federal
Medical Centre, Umuahia.
ii.
To
assess the effects of incinerator flue gas on ground water quality in Federal
Medical Centre, Umuahia.
iii.
To
determine the composition of selected heavy metals such as copper, zinc, manganese,
chromium, cadmium, lead in incinerator ash in Federal Medical Centre, Umuahia.
1.4 SIGNIFICANCE
OF THE STUDY
This
study will contribute to the background knowledge on medical waste management
at Federal Medical Centre, Umuahia and will spur up further research on the
impact of current waste management practices (methods and technological
managements effects) on natural resources as well as human health within the
study/related areas. E.g. Federal Medical Centre, Umuahia.
By
understanding the significant impact of improper management of hospital wastes
incinerator ash, in healthcare institutions and clinical facilities. Policy
makers may formulate or introduce better policies to improve on the current
situation and this will serve as a base for those who are in charge of formulating,
managing of natural resources and legislative policies that are being practiced
in Nigeria. However, this will also serve as a guide to help in various
remedial activities and also to create awareness concerning the exposure of
incinerator flue gas to human health and its environment. It will also help the
management of Federal Medical Centre, Umuahia, to know the best management and
disposal method for incinerator ash in order to reduce the dangers of its harm
and the amount of pollutions emitted from the medical waste incinerator plant.
1.5 JUSTIFICATION
OF THE STUDY
Nigeria
as a developing country, where there are many health concerns and competing for
limited resources, it is not a surprise that the management of health care
wastes has received less attention and the main priority that supposed to be
given to it (Abah and Thiamin, 2010). Unfortunately, the practice and the
formation of the important aspect of management of health is inadequate and
research on the public health implication of improper management of waste from
health care are few and limited in scope (Abah and Ohimain, 2010). Similarly in
the management of waste practices in two general hospitals, that is
characterized by improper plan for hospital waste minimization or strategies
for waste reduction, poor waste segregation practices, lack of waste
segregation, general waste disposal and posters on waste segregation and
disposal of hospital waste with general waste (Olubukola, 2009). This
mismanagement of health care wastes poses health risks to the environmental
contamination via air, soil and water resources. Health care hospitals and
units are supposed to safeguard the health of the community where they are
found. However, waste from healthcare that is not properly managed can pose
more threat than the original diseases themselves (Path, 2009). Therefore,
treatment of health care waste is very important and one of the medical waste
treatments used worldwide is medical waste incinerator at a very high
temperature by dry oxidation process (Patchain, 2002; Shams et al., 2011).
However,
incineration of hospital waste bottom ash has more heavy metals as much as
organic components polychlorinated biphenyls (PCBS), which if not well disposed
can cause environmental pollution and pose public health problems such as acute respiratory,
syndrome gastrointestinal abnormalities and various cancers (Zhao et al., 2010; Mohajer et al., 2013). Because of this
environmental problem, incinerator bottom ash management is under continuous and
monitoring for proper control (Gidarakos et
al., 2009). This will serve as a guide to help in various remedial
activities and also to create awareness concerning its exposure to humans.
1.6 SCOPE
OF THE STUDY
The
study was limited to the hospital waste incinerator (HWI) located in Federal
Medical Centre (FMC) Umuahia of Abia state Nigeria. Controls were taken within
Federal Medical Centre, Umuahia but far from the incinerator for comparison and
inference between the month of June to August, 2017.
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