Tiu lun Qun l cht thi rn

TRNG I HC M - A CHT KHOA MI TRNG

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GVHD: Trn Th Thanh Thu

TIU LUN

QUN L CHT THI RN

Tn ti: Cht thi rn y t

GV hng dn: Trn Th Thanh Thu Sinh vin thc hin: Tun Anh Phm Vn Chng L Duy Khnh Trn Quang Dng Lp: a Sinh Thi K53

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M U
Chng ta ang sng trong thi i vi s pht trin khng ngng ca nn kinh t th trng. Khi trnh kinh t x hi v dn tr ca con ngi ngy cng pht trin th nhu cu ca con ngi v vic chm sc sc khe ca mnh ngy cng c ch trng mt cch chu o hn. Cng vi tc th ho nhanh, vn qun l cht thi rn ni chung, bao gm cht thi rn th, cng nghip v cht thi bnh vin, ang l nhng vn nan gii trong cng tc bo v mi trng v sc kho ca nhn dn. C nc c 605 th, chim 0,35% din tch t t nhin, tp trung ch yu cc vng ng bng v ven bin. Dn s th l 19 triu ngi, chim hn 23% dn s c nc. T l tng dn s th l 4,2% nm, vi mc tng tuyt i l 0,5 triu ngi nm. Trong tng lng pht sinh cht thi rn, cht thi rn cng nghip chim t trng ln nht (54,8%). Tt c cc loi cht thi sinh hot, cng nghip v y t thu gom c, u chn lp ln ln ti cc bi chn cha hp v sinh. Nng lc thu gom cht thi tnh trung bnh trong c nc ch t 20-30% v lng cht thi khng c thu gom ang l cc yu t gy nhim mi trng tim tng, nh hng nghim trng n sc kho ca ngi dn. Bn cnh , hng ngy cc bnh vin v c s y t khm v cha bnh thi ra mt lng cht thi y t kh ln v xu th s dng cc sn phm ch dng mt ln. Trong cht thi rn c rt nhiu loi nguy him i vi mi trng v con ngi. Do , vn x l cht thi rn y t ti cc bnh vin lun l vn quan tm ca ton x hi. Cht thi y t l mt trong nhng cht thi nguy hi vo bc nht, vic x l cc loi cht thi ny rt phc tp v gp rt nhiu kh khn. y thc s l mi quan tm, lo lng khng ch vi ngnh Y t m c vi ngi dn sng quanh khu vc bnh vin. Nu khng c cc bin php qun l hp l, x l khng tt th y s l ngun ly lan cc mm
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bnh, nh hng n sc khe ca con ngi, gy ra nhng vn nhim mi trng mt cch nghim trng. Xut pht t c s l lun v thc tin trn, chng ta cn gim thiu lng cht thi rn v a ra cc bin php hay h thng qun l cht thi y t sao cho chi ph v hiu qu v bo v c mi trng, hng ti mt nn kinh t bn vng v mt mi trng trn c s mt nn sn xut sch v mt x hi tiu dng xanh.

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CHNG 1 TNG QUAN TI LIU

1.1. Cc khi nim v nh ngha cht thi rn y t:
1.1.1. Cc khi nim v qun l cht thi rn nguy hi Vit Nam: Ngy 27 thng 8 nm 1999, B trng B Y t ra quyt nh s 2575/1999/Q-BYT v vic ban hnh Quy ch qun l cht thi y t, trong quy nh v nh ngha cht thi y t nh sau: Cht thi rn (solid waste) Y t l cht thi pht sinh trong cc c s y t, t cc hot ng khm cha bnh, chm sc, xt nghim, phng bnh, nghin cu, o to. Cht thi y t c th dng rn, lng v dng kh. Cht thi nguy hi l cht thi c cha cc cht hoc hp cht c mt trong cc c tnh gy nguy hi trc tip (d chy, d n, lm ng c, d n mn, d ly nhim, v cc c tnh nguy hi khc), hoc tng tc vi cc cht khc gy nguy hi ti mi trng v sc kho con ngi. Cht thi y t nguy hi l cht thi c mt trong nhng thnh phn nh sau: mu, dch c th, cht bi tit, cc b phn v c quan ca ngi, ng vt; bm kim tim v cc vt sc nhn, dc phm, ho cht v cc cht phng x dng trong y t. Nu nhng cht thi ny khng c tiu hu s gy nguy hi cho mi trng v sc kho con ngi. 1.1.2. Cc khi nim v qun l cht thi rn nguy hi trn Th Gii: Cht thi rn: c Quc hi M nh ngha l "mt cht thi rn hay kt hp cc cht thi rn, c s lng, nng , hay cc c tnh l, ho hay ly nhim c th gy ra hoc gp phn ng k lm tng kh nng t vong, hay lm tng bnh tt nghim trng khng c kh nng cha ni; gy nguy c tim tng v ln n sc kho con ngi hay mi trng, khi c x l, lu gi, chuyn ch, hay tiu hu hoc qun l khng ng quy cch" v thut ng cht thi rn
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c Quc hi M quy nh ch tt c cc loi cht thi th rn, lng v kh. Cht thi ly nhim, nm 1976, Quc hi M a vo p dng t "ly nhim" c trng ho loi cht thi nguy him tim tng. Cho n 1988, M vn s dng t ny hng dn "loi cht thi c kh nng to ra cc bnh truyn nhim". Cho n nay, thut ng "cht thi y t", bao gm nhiu loi cht thi chnh thc c lit vo cc cht thi ly nhim nguy him.

1.2. Tnh hnh pht sinh cht thi rn y t Vit Nam v th gii:
1.2.1. Tnh hnh pht sinh cht thi rn Y t Vit Nam: Theo thng k, c nc c 12.526 c s khm cha bnh, trong c 847 bnh vin vi cc quy m khc nhau (theo cc cp qun l hnh chnh nh trung ng, tnh v huyn). Bng 1.1. Lng cht thi pht sinh Vit Nam Tuyn bnh vin Tng lng cht thi Y t (kg/ging bnh/ngy) Trung ng Tnh Huyn Chung 0,97 0,88 0,73 0,86 Cht thi Y t nguy hi (kg/ging bnh/ngy) 0,16 0,14 0,11 0,14

( Ngun: BVMT trong cc c s Y t, 2004) Qua bng 1.1chng ta nhn thy rng nhng ni tp trung nhiu dn c th lng cht thi Y t thi ra l nhiu nht do , cn tm ra nhng bin php nhm qun l hp l lng rc thi thi ra hng ngy mt cch c hiu qu nht.

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Trung bnh mi ngy cc bnh vin trn khp c nc thi ra mt s lng cc cht thi Y t khong 240 tn (Theo bo co tng kt 2006 ca S Ti Nguyn Mi Trng). Lng cht thi t cc bnh vin chim 1,76% tng s cht thi ca ton thnh ph (iu tra 36 bnh vin trn a bn H Ni). Mi ngy trung bnh mt ging bnh thi ra khong 2,27kg rc, trong c ti 25% l rc thi nguy hi.

Hnh 1: Cht thi y t Cc cht thi y t c sn sinh ra t: cc bnh vin, cc phng khm a khoa, cc phng xt nghim v th nghim, cc khu iu dng, ngn hng mu, nh xc, trung tm khm nghim t thi, cc c s sn xut dc phm, Cc cht thi bnh vin gm: cht thi nhim khun, nhng phn c th b ct b v xc cht ng vt, cc vt sc nhn, ha cht, dc phm ht hn, khng dng n v b nhim bn, vt liu c hot tnh phng x, kim loi nng, 1.2.2. Tnh hnh pht sinh cht thi rn trn Th gii:

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Theo bo co ca U ban nghin cu v bo v mi trng Lin hp quc, ngy nay lng cht thi ngy cng gia tng v s lng v tnh cht c hi, c bit ti cc khu vc nng thn ngy cng gia tng v s lng v tnh cht c hi, c bit, ti cc khu vc ng c dn c, rc thi khng c thu gom v y l mt trong cc dch gy bnh nghim trng. Bng 1: Lng pht sinh trn Th gii Vng Bc M Ty u Vit Nam ng ng u Kuwait Sawdi Kbabia Iran Turkey Nht Bn n Thi Lan Bangldesd Php Cht thi pht sinh hng ngy (kg/ging) 11,4 - 17 5,2 7,3 1,2 2,5 3 4,8 1,8 4,2 3,87 7,44 1,7 2,4 6,4 11,3 3,42 4,2 2,3 3,9 1,2 2,7 0,89 1,26 1,6 2,3 3,8 4,6

Qua bng 1.2 cho chng ta thy nhng vng c nn kinh t pht trin, mc sng ca ngi dn cao do thc bo v sc khe ca mnh nn thng c lng cht thi pht sinh cao. Ty tng iu kin kinh t - x hi v mc pht trin khoa hc cng ngh k thut ca tng nc m mi nc c lng cht thi pht sinh ring.

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1.3. Thnh phn v tnh cht ca cht thi rn y t:

Theo phn loi v xc nh cht thi (Quy ch qun l cht thi Y t, B Y t, 1999), phn thnh 5 loi cht thi trong cc c s Y t nh sau: - Cht thi lm sng - Cht thi phng x - Cht thi ha hc - Cc bnh cha kh c p sut - Cht thi sinh hot Nhm cht thi lm sng: c B Y t phn thnh 5 nhm loi cht thi, trong : - Nhm A: tt c cc cht thi nhim khun, bao gm: nhng vt liu thm mu, thm dch, cc cht bi tit ca ngi nh: bng, gc, bng, dy truyn mu, cc ng thng, dy v ti dung dch dn lu, - Nhm B: tt c cc vt sc nhn, bao gm: bm tim, kim tim, li v cn dao m, inh m, ca, cc ng tim, mnh thu tinh v v mi vt liu c th gy ra cc vt ct hoc chc thng, cho d chng c th b nhim khun hoc khng nhim khun. - Nhm C: l cht thi c nguy c ly nhim cao, pht sinh t cc phng xt nghim, bao gm gng tay, lam knh, ng nghim, bnh phm sau khi sinh thit/ xt nghim/nui cy, ti ng mu, v.v.. - Nhm D:l cht thi dc phm, bao gm: dc phm qu hn, dc phm b nhim khun, dc phm b , doc phm khng cn nhu cu s dng; thuc gy c t bo. - Nhm E: l cc m v c quan ngi- ng vt, bao gm tt c cc m c th (d nhim khun hoc khng nhim khun), cc c quan, chn tay, rau thai, bo thai, xc sc vt.

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Nhm cht thi phng x: ti cc c s Y t, cht thi phng x pht sinh t cc hot ng chun on, ha tr liu v nghin cu. Cht thi phng x bao gm: cht thi rn, lng, kh. - Cht thi phng x rn gm cc vt liu s dng trong cc xt nghim, chn on, iu tr nh ng tim, bm tim, kim tim, knh bo h, giy thm, gc st khun, ng nghim, chai l ng cht phng x, v.v.. - Cht thi phng x lng gm: dung dch c cha nhn phng x, pht sinh trong qu trnh chn on, iu tr nh nc tiu ca ngi bnh, cc cht bi tit, nc xc ra cc dng c c cha phng x, v.v... - Cht thi phng x kh gm: cc cht kh dng trong lm sng nh: cc kh thot ra t cc kho cha cht phng x,v.v... Nhm cht thi ha hc: bao gm cc cht thi rn, lng v kh. Cht thi ho hc trong cc c s y t c phn thnh 2 loi: - Cht thi ho hc khng gy nguy hi, nh ng, a-xt bo, mt s mui v c v hu c. - Cht thi ho hc nguy hi bao gm: + Formaldehyde: c s dng trong khoa gii phu bnh, lc mu, p xc v dng bo qun cc mu xt nghim mt s khoa khc. + Cc ho cht quang ho hc: c trong cc dung dch dng c nh v trng phim. + Cc dung mi. Cc dung mi dng trong c s y t bao gm: cc hp cht halogen, nh methylene chloride, chlorofom, fron, trichloroethylene, cc thuc m bc hi nh halothane, cc hp cht khng c halogen, nh xylene, acetone, isopropanol, toluen, ethyl acetate v acetonitrile.

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+ Oxit ethylene- oxit ethylene c s dng tit khun cc thit b y t, phng phu thut nn c ng thnh bnh v gn vi thit b tit khun. Loi kh ny c th gy ra nhiu c tnh v c th gy ra ung th ngi. + Cc cht ha hc hn hp, bao gm: cc dung dch lm sch v kh khun, nh phenol, du m v cc dung mi lm v sinh, v.v... Nhm cc bnh cha kh c p sut: nh bnh ng oxy, CO2, bnh ga, bnh kh dung v cc bnh ng kh dng mt ln. Cc bnh ny d gy chy, n khi thiu t v vy phi thu gom ring. Nhm cht thi sinh hot: bao gm: - Cht thi khng b nhim cc yu t nguy hi, pht sinh t cc bung bnh, phng lm vic, hnh lang, cc b phn cung ng, nh kho, nh git, nh n, ....bao gm: giy bo, ti liu, vt liu ng gi, thng ct tng, ti nilon, ti ng phim, vt liu gi thc phm, thc n d tha ca ngi bnh, hoa v rc qut dn t cc sn nh. - Cht thi ngoi cnh: l cy v rc t cc khu vc ngoi cnh... Tnh cht ca cc cht thi Y t nguy hi l: rt c, d n mn, d chy, d n, gy c ti gen, ly nhim (HIV/ASD, vim gan,),

1.4. Nhng nh hng ca cht thi rn y t n mi trng v sc kho:

Do thnh phn v tnh cht ca cc cht thi rn Y t rt phc tp nn vic ly nhim cc loi bnh l khng th trnh khi nu khng c cc bin php qun l ng n v hp l th kh nng ly nhim s rt cao. Trong rc thi bnh vin nhng cht nguy him c nguy c ly nhim, truyn bnh v c hi,... nc ta do c kh hu nng m nn kh nng pht sinh ra nhng dch bnh li cng cc k nguy him hn. V d nh bnh t, kit l, st xut huyt,

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Nhng nhm ngi: + Bc s. + Nha s. + iu dng. + Cc nh tr liu. + Y t. + H l + Nhn vin xt nghim. + Cn b k thut (v d nh nhn vin Xquang,) + Nhn vin thu gom cht thi ( trong bnh vin, cc c s Y t, nhn vin vn chuyn, nhn vin x l khu cui,). + Nhng ngi bi rc. + Mi trng. Do nhng nhm ngi ny thng xuyn tip xc vi cc dng c y t, cc cht thi nhim khun, cht thi dc phm, cht thi phng x pht sinh t cc hot ng chun on, ha tr liu v nghin cu, .nn h c nguy c mc cc bnh v vim nhim ng rut, cc bnh vim nhim v ng h hp, vim nhim qua truyn mu, vim nhim da do b xc, t tay chn hay b tn thng, nh hng phng xa,l cao nht. Trc y, c mt thi ngi dn quanh vng bnh vin Vit c (H Ni) phi chu ng nhng th mi rt kinh khng, kht lt mi khi bnh vin t rc. Nhng bi rc bnh vin thng xuyn to mi hi thi, thu ht rui nhng,gy nhim cho khng kh, nc ngm, nc mt,nh hng khng nh n cuc sng ca nhn dn quanh vng.

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Theo bo An ninh th gii mi trng xung quanh ca bnh vin Lao ca thnh ph Thi Nguyn b nhim nng ti mcby d ca vin chn th y cng b nhim lao nh ngi, chng ho s s, gy g, khng ln c v cht dn. Vn bc xc v rc thi bnh vin cng i hi Nh nc v cc bnh vin phi c cc bin php gii quyt ngay, khng chm tr.

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CHNG 2 M HNH QUN L, THU GOM, X L CHT THI RN Y T

2.1. Nhng vn chung:
Ty tng iu kin kinh t x hi v mc pht trin khoa hc k thut cng vi nhn thc v qun l cht thi m mi nc c nhng cch x l cht thi ca ring mnh. Lng cht thi rn Y t pht sinh trn phm vi ton quc theo c tnh ca B Y t nm 2001 l khong 12.500 tn/ nm. S liu iu tra ca B Y cho thy, hin nay c khong 61 l t cht thi Y t c lp t trn ton quc. Tnh n thng 6/2002, tng cng sut x l ca cc l t cht thi y t t khong 30 tn/ngy. Tuy nhin, do cha phi hp tt trong cc khu thu gom, vn chuyn, x l, nn mt s cc l t ny khng vn hnh ht cng sut v thi gian trong ngy. Trong khi , cc c s y t khc li cha c trang b l t cht thi y t, v vy gy nn s lng ph do khng tn dng ht cng sut ca l t cht thi y t hin c. Ti nhiu c s y t, cht thi y t vn ln vi cc loi cht thi khc v c chn lp n gin ti cc bi chn lp cht thi sinh hot. Hin ti, vi s ti tr ca chnh ph Php, B y t ang xy dng mt n quy hoch tng th v qun l cht thi y t. Qua s liu thng k v tnh hnh x l cht thi rn ca mt s nc trn th gii cho thy rng, Nht Bn l nc s dng phng php thu hi cht thi rn vi hiu qu cao nht (38%), sau n Thy S (33%), trong Php s dng phng php x l vi sinh nhiu nht (30%),cc nc s dng phng php chn lp hp v sinh nhiu nht trong vic qun l cht thi rn l Phn Lan (84%), Thi Lan (84%), Anh (83%),Di y l nhng m t tng quan v tnh hnh qun l cht thi rn nguy hi Vit Nam v mt s nc trn Th gii.
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2.2. Tnh hnh qun l, thu gom, x l cht thi rn Y t Vit Nam v Th Gii
2.2.1 Tnh hnh qun l, thu gom, x l cht thi rn Vit Nam Qun l cht thi Y t nguy hi (Quy ch qun l cht thi rn Y t, B Y t) c nh ngha nh sau: l cc hot ng kim sot cht thi nguy hi trong sut qu trnh t khi cht thi pht sinh n x l ban u, thu gom, vn chuyn, lu gi v tiu hy cht thi Y t nguy hi. Vic qun l cc cht thi nguy hi c ngha cc k quan trng. Mi cng on u c th xy ra cc ri ro v u i hi kinh ph hot ng. Do , cng tc qun l i hi phi phn tch v kim sot mt cch ch ng t khu pht sinh cht thi cho n khu tiu hu cui cng. Cc cht thi nguy hi thng pht sinh t cc ngun thi khc nhau, do cn phi x l v thi b theo mt trnh t nht nh. Vic thu gom cht thi rn nguy hi t cc ngun khc nhau ty thuc vo iu kin, kh nng c th ca ngun thi. Rc thi nguy hi trc khi x l phi c phn loi gim chi ph cho vn x l tip theo.

Hnh 2: Cn phn loi cht thi y t ngay ti ngun pht sinh

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Cng tc phn loi cht thi rn Y t ti ngun cha c thc hin hoc thc hin cha tt. Trong , c 81,25% bnh vin thc hin phn loi cht thi nhng cn phin din, cha theo chun mc v km hiu qu do nhn vin cha c o to; 45% bnh vin cha tch ring cc vt sc nhn ra khi cht thi rn Y t; 11,4% bnh vin c vt sc nhn cha c thu gom vo cc hp ng theo ng tiu chun quy nh. V lu tr cht thi trong bnh vin: hu ht cc cht thi trong bnh vin c tp trung trong cc khu t trong bnh vin, khng c mi che, khng c hng ro bo v, vic thiu hy cn rt s si, Phn ln hn 310 phng khm t nhn trong thnh ph cha chu trch nhim i vi rc thi ca mnh, cha thc hin ng quy trnh thu gom, chuyn giao rc y t cho cng nhn vn chuyn rc (s liu theo B Ti nguyn Mi Trng, Bo co tng kt 2006). nhng ni c iu kin, cht thi nguy him cn c x l trc khi em tiu hu cui cng, nhm gim thiu hoc trit tiu nguy c ca cht thi nguy him. Do c tnh khc nhau gia cc loi cht thi, cho nn khng th x l nh nhau. Tnh hnh thu gom rc thi trong bnh vin hin nay l khng hon ton. 85% rc thi y t l cht thi sinh hot, tng t nh cht thi sinh hot ca h gia nh khng cn phi x l c bit. Cn li 25% l rc thi nguy hi cn c x l. Lng cht thi y t do h thng bnh vin thi ra mi ngy ln n 200.000 tn rc sinh hot v 30.000 tn rc thi nguy hi. Quy ch qun l cht thi y t hin hnh khng cp n vic cho php hay cm bn cht thi. Gn y, khi ti mt s bnh vin ln b pht hin c mt s c nhn ng ra bn cht thi y t, B Y t c vn bn yu cu cm mua bn, cho tng cht thi y t nguy hi. Cht thi ti ch khi nhit cao th thnh phm khng gy hi cho sc khe. iu nguy him l, nu cht thi cha c x l an ton th ngi tip xc trc tip (trong qu trnh vn chuyn, sc ra) s chu nh
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hng. V vy, yu cu hng u l cht thi bnh vin phi c phn loi v x l nghim ngt. 2.2.2.Tnh hnh qun l, thu gom, x l cht thi rn Y t trn Th gii: - Php: cc cht thi nguy hi ch c thiu hy khong 40%, s cn li cha c x l hp v sinh. Hin nay hng nm c khong 20 triu tn cht thi khng c x l cht ng nhng ni hoang vu v khng ngi khai thc. Ngoi ra do ph lu gi cht thi Php kh r nn cc nc lng ging khng do d mang cht thi ca quc gia mnh sang cc bi cht thi ti Php. - H Lan: vic x l cht thi ca H Lan c s tham gia tng lc ca chnh quyn , x hi cng nh cc c quan chuyn ngnh. Cht thi nguy hi c x l bng nhiu cch khc nhau, trong phn ln c thiu hy, mt phn c ti ch. Trc y, H Lan tin hnh thiu hy cht thi nguy hi ngoi bin. Hng nm, H Lan c ti hn 20 triu tn cht thi, 60% trong s ny c cc bi cha, phn cn li c a vo cc l thiu hy hoc ti ch. bo v Mi Trng, chnh ph H Lan ra mc tiu gim cht thi hng nm gim chi ph x l. Cng ngh x l cht thi nguy hi ch yu c p dng l thiu hy, nhit nng do cc l thiu hy sinh ra s c ha nhp vo mng li nng lng chung ca t nc. Vic thiu hy cht thi nguy hi c tin hnh nhng l t hin i vi k thut mi nht, hoc vic t chc sn xut c ng dng nhng quy trnh c bit nhm to ra ngun nguyn liu mi, thun li cho cng vic ch bin. - Hng Kng: c s x l cht thi nguy hi tp trung c xy dng t nm 1987 n nm 1993. Vi h thng thu gom vn chuyn v thit b x l hin i, cng ngh ch yu l x l nhit v x l ha/ l x l c hu ht lng cht thi nguy hi ti Hng Kng. Ti y ngi ta cng tin hnh nghin cu v xut quy ch chung v s tiu hy cht thi, c bit l cht thi ha hc. nh h thng nghin nh chn lp, h thng kim sot vic

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chn lp, kim sot ni thu gom, vn chuyn x l v tiu hy cht thi, nht l cht thi rn nguy hi gp phn nng cao cht lng qun l Hng Kng.

2.3. Cc phng php x l cht thi rn:

Pht sinh cht thi

Thu gom, phn loi v lu gi ti ngun

Tp trung

Truyn ti v vn chuyn

Tch, x l v ti ch

Tiu hy S : Nguyn tc chung ca cng ngh x l cht thi nguy hi Hin nay, v c bn c 3 phng php x l cht thi rn: - Phng php chn lp. - Phng php thiu hy. - Phng php x l bng cng ngh sinh hc.
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2.3.1. Phng php chn lp: Cht thi nguy hi trc khi chn lp phi c x l nhm gim ti a kh nng r r cc cht nhim vo mi trng hoc khi h thng bo m an ton ca bi chn lp b trc trc. Cc gii php qun l v k thut ny bao gm: - gim khi lng cht thi ti ngun. - X l cc hp cht hu c d b phn hy bng phng php sinh hc. - X l bng nhit ph hy cht thi hu c.

Hnh 3: chn lp cht thi Phng php chn lp hon ton i vi cc loi rc thi sinh hot, cng ngh t c hi thng c thu gom, vn chuyn, chuyn n cc bi cha sau c chn lp i. y l phng php n gin nht, r tin nhng khng v sinh d gy nhim cc

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ngun nc ngm v tn din tch t cha bi rc. Phng php ny ch ph hp vi nhng nc km pht trin, kinh t cn kh khn. i vi cc cht thi c hi th y bi chn lp phi c x l m nn hoc tri tm lt polymer c bit, sao cho cht thi c chn lp hon ton cch ly vi mi trng bn ngoi. Vi cch ny kh tn km. Phng php chn lp c x l Rc thi thu gom v c phn ra lm 2 loi: rc v c v rc hu c. i vi rc v c c em i chn lp, cn rc hu c c nghin lm phn bn. 2.3.2. Phng php thiu hy: Cht thi rn nguy hi c x l bng qu trnh t thng qua s nhit phn. t l mt qu trnh oxy ha cht thi rn nguy hi nhit rt cao. qu trnh phn hy bng nhit t hiu qu cao th ngoi yu t oxi t nhin cn cn thi gian lu kh thi sinh ra c duy tr cho qu trnh chy hon ton, nhit phi cao, qu trnh xoy trn ln tt. y l quy trnh x l cui cng ng dng cho mt s cht thi khng th ti ch, ti s dng hay d tr an ton trong bi chn lp. Phn tro sau khi t c chn lp.

Hnh 4: L t cht thi rn y t

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t cht thi nguy hi c s dng nh mt bin php x l gim tnh c, thu hi nng lng v c th x l mt khi lng ln cht thi. Nhn chung dng l thiu hy l phng php sch nhng chi ph cao. Phng php thiu t ch s dng khi cht thi l cht c sinh hc, khng b phn hy sinh hc v bn vng trong mi trng. Cc cng ngh hin nay thng c s dng t cht thi nguy hi l: Bng 2: Tng hp cc cng ngh thng s dng t cht thi nguy hi Loi cng ngh L t thng quay Nguyn l qu trnh Cht thi nguy hi c t trong ng tr gch chu nhit L t mt bung ng quay. Cht thi nguy hi c phn nh bng kh nn hoc hi p sut cao v b chy L t nhiu tng trng thi l lng. Cht thi nguy hi c t ch nhit tng dn. Khu vc p dng t bt c loi cht thi nguy hi no. Cht thi nguy hi dng bn c th bm c. Bn v cc cht thi nguy hi dng L t tng si Cht thi nguy hi c phun vo trong lp si c t nng. vin. Cht thi nguy hi rn dng vin. 760 1100 Vi pht 760 980 Vi gi 700 1650 0,1 1 giy Nhit t (0C) 650 1370 Thi gian lu Vi gi

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Qua bng 2.1 cho chng ta thy, thi gian lu ca cc cht thi trong l t chy i vi pha kh t nht l 2 giy, cn vi pha rn th phi trong mt vi gi ty theo kch thc cht thi. C 3 phng php thiu t: - Thiu t ti l t tp trung. u im: lm gim ti a nhng tc ng nguy hi ca rc thi i vi mi trng v sc khe cng ng. Nhc im: gp kh khn v vic la chn v tr, thit b vn chuyn v kho tm cha cht thi nguy hi. - Thiu t tai ch. u im: gim chi ph vn chuyn. Nhc im: cc c s c l t thng nm ln vi cc khu dn c nn vic xy dng s gy nhim khng kh trong khu vc. Bn cnh nu t khng ng theo quy nh k thut rt d gy ra cc tc ng xu. - Thiu t trong l xi mng. u im: thiu t trong l xi mng l cht cn sau thiu t c s dng lm nguyn liu cho xi mng, tit kim c ngun ti nguyn. Nhc im: phi tn mt khon tin cho vic x l trc khi a cht thi vo t. 2.3.3. Phng php sinh hc: - Nui giun t (nui t nhin v nui cng nghip). Nui t nhin: ri mt lp bn cng ln vng t cn ci to v th giun xung. Di tc dng ca giun t s to ra mt lp t ti xp giu cht hu c. Nui cng nghip: lm gin nui giun trong c nhiu gin. Th ging giun trn nn ph thi hu c, to iu kin mi trng (pH, m, nhit , khng kh,)thch hp, b sung thm thc n cho giun.

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- Phng php phn hy vi sinh: c nhiu loi vi sinh vt c kh nng phn hy cc cht hu c phc tp thnh cc hp cht n gin thng qua vic ho kh vi men vi sinh cng nghip.

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KT LUN
Trong giai on pht trin hin nay lng rc thi ngy cng thi ra nhiu lm cho mi trng b nhim trm trng. Cng tc lp bo co nh gi tc ng mi trng cc bnh vin cha c quan tm ng mc. H s k thut, quy trnh vn hnh cc h thng, thit b x l cht thi cha c chuyn giao, hun luyn i vi cc bnh vin xy mi hoc nng cp. Cng tc kim tra vic qun l cht thi y t, bo v mi trng ti cc bnh vin, c s y t cn b bung lng, thiu quan tm. Vic x l cht thi y t, bo v mi trng ti cc bnh vin cn nhiu kh khn, bt cp. c bit tnh trng x l cht thi lng nguy hi hin nay cc bnh vin l ng bo ng, nguy c ly nhim, nh hng mi trng sng rt cao.Vic phn loi cht thi rn y t cn cha ng quy nh, cn ln vo cht thi sinh hot. Phng tin thu gom nh ti, thng ng cht thi cn thiu v cha ng b, hu ht cha t tiu chun, vt sc nhn cha c c lp an ton. Khng c phng tin vn chuyn ring bit, chuyn dng, ni lu gi khng bo m v sinh, c nhiu nguy c gy ri ro do vt sc nhn ri vi, nhiu cn trng xm nhp. Ni tp trung cht thi khng c mi che, ro bo v. Rc thi sinh hot ti cc bnh vin huyn cng cha c x l mt cch trit . Kinh ph u t cho cc h thng x l cht thi y t ni ring, cng tc qun l cht thi y t, bo v mi trng ni chung ti bnh vin, c s y t cn thiu nhiu, cha tng xng vi nhim v qun l cht thi y t, bo v mi trng theo quy nh ca php lut. Dch v thu gom, vn chuyn, x l rc thi y t, rc thi sinh hot ti nhiu huyn cn nhiu kh khn.

Kin ngh:
- Cn tng cng thc hin cc hot ng thu gom, x l cht thi, c bit l vic thu gom v x l cc cht thi nguy hi. Bn cnh , cng tc qun
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l v bo v mi trng phi hng n cc mc tiu c th nh: khng ngng ci thin v bo v mi trng, nhm nng cao cht lng v sc khe ca nhn dn, m bo s pht trin bn vng ca t nc, - Ban hnh quy ch qun l cht thi Y t, thnh lp cc i gim st v phn cng tng ngi trong i gim st, gim st cc khoa, cc phng trong vic thu gom, vn chuyn v x l cht thi. - Quan tm cng tc o to, bi dng, hun luyn cho cn b, nhn vin ph trch qun l cht thi y t, bo v mi trng trong cc bnh vin, c s y t. Xem xt vic phn b v s dng kinh ph x l cht thi y t ti cc bnh vin, bo m cn i v ph hp vi thc t ti tng bnh vin ngoi nh mc khon kinh ph hng nm. Phi hp tt vi S Ti nguyn v Mi trng trong vic lp k hoch, phn b, s dng kinh ph s nghip mi trng; thanh tra, kim tra vic qun l cht thi y t, bo v mi trng trong cc bnh vin, c s y t. Cn ch o cng tc kim tra, thanh tra, x l vi phm php lut v bo v mi trng.

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