Page 618 - Materials Chemistry, Second Edition

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Medical and Infectious Wastes 589
A. Training on the following subjects:

● Environmental concerns, including pathogen destruction and types of emissions
● Basic combustion principles including products of combustion
● Operation of the type of incinerator to be used by the operator, including proper startup,
waste charging, and shutdown procedures
● Combustion controls and monitoring
● Operation of air pollution control equipment
● Methods to monitor pollutants and equipment calibration procedures
● Inspection and maintenance of the incinerator, air pollution control devices, and emission
monitoring systems
● Actions to correct malfunctions or conditions that may lead to malfunction
● Bottom and fly ash characteristics and handling procedures
● Applicable federal, state, and local regulations
● Safety procedures
● Pre-startup inspections
● Record keeping requirements

B. Completion of an examination.
Qualification for incinerator operation is obtained by completion of a training course combined
with experience as an operator or direct supervisor of an operator. To maintain qualification, the
qualified operator must pass an annual refresher course covering the following at a minimum:

● An update of relevant regulations
● Incinerator operation, including startup and shutdown procedures
● Inspection and maintenance
● Responses to malfunctions or conditions that may lead to malfunction
● Discussion of operating problems encountered

20.5 FACILITY OPERATIONS
20.5.1 WASTE MANAGEMENT PLAN

There are many documented cases in which toxic materials such as nickel–cadmium batteries have
been collected and commingled with combustibles and disposed in a hospital incinerator. In order
to prevent such contamination episodes, the incineration facility must prepare a waste management
plan. The purpose of the plan is to identify the means of separating certain components of solid
waste from the healthcare waste stream in order to reduce the amount of toxic emissions from incin-
erated waste. A waste management plan may include aspects such as paper, plastics, glass, battery,
and metal recycling; or the purchase of recycled or recyclable products. A waste management plan
may include different goals or methods for different departments at the facility. The plan should
identify additional waste management measures, taking into account the costs of the additional
measures, the emission reductions expected to be achieved, and any other environmental or energy
impacts they might cause. The American Hospital Association publication, An Ounce of Prevention:
Waste Reduction Strategies for Health Care Facilities (AHA, 1993) should be considered in the
development of the waste management plan.

20.5.2 COMPLIANCE AND PERFORMANCE TESTING
The facility must conduct an initial performance test (40 CFR Part 60.8) to determine compliance
with emission limits (see below). All performance tests consist of a minimum of three test runs con-
ducted under representative operating conditions. The minimum sample time is 1 h per test run.