FIGURE 2.18 Nursing home inspection form. Use federal or state form where available.

FIGURE 2.18 (continued)

low-level radioactive wastes, disposable needles, syringes, scalpels, and other sharp items. These are in addition to food service, laboratory, bandage, cleaning, and miscellaneous wastes. Proper handling, segregation, packaging, marking, storage, transport, treatment, and disposal of all hospital wastes are necessary to minimize the potential risks to the health of the patient, health care worker, visitor, refuse handler, and community.84 85 Only about 15 percent of all hospital wastes are infectious. Although of public health and aesthetic concerns, they do not pose a health risk for the general public.

Infectious and pathological wastes, including packaging, disposable needles, syringes, and scalpels, are best disposed of by incineration providing proper temperature, oxygen, and residence time and by autoclaving followed by compaction or shredding. Chemotherapy and pathological wastes are incinerated. Autoclaved wastes are disposed of in a landfill or incinerator. Older hospital incinerator emissions can be expected to be high in participates, chlorinated toxins, hydrochloric acid, and chlorine (in view of the burning of large quantities of plastic wastes), if the waste is not well mixed and if proper design and operation, including air pollution control devices, are not provided. Most, if not all, old hospital incinerators require upgrading.

Recommendations to equal or exceed air quality standards include temperature of 2,000oF (1,093oC) with 2 seconds residence time and secondary chamber exit temperature of 1,800oF (982oC); 97 percent acid gas removal or 30ppm; particulates 0.010 gram/ft3; CO emissions 100ppm hourly average; and opacity less than 10 percent.86 A controlled starved air incinerator with flue gas scrubbers has been found satisfactory to control emissions.87

General hospital and kitchen wastes can usually be disposed of through the community waste collection system. Centralized regional incinerators and auto-claving with compaction or shredding for hospital wastes are usually recommended over individual plants. Other alternatives include chemical disinfection of macerated wastes with discharge to the sewer system (if permitted by the regulatory agency) and microwave disinfection of shredded wastes. Liquid infectious wastes may be carefully poured to a drain connected to a sanitary sewer.88

The usual method for the disposal of low-level radioactive solid waste is by storage until decayed, followed by disposal with the general waste. Low-level liquid waste, including body wastes, can be diluted and disposed of to the sanitary sewer. Gaseous radioactive wastes are dispersed directly to the outside air, away from any indoor air intakes or occupied areas. The entire process requires responsible regulatory and institutional surveillance.

The EPA regulates the handling of hazardous wastes and OSHA has jurisdiction over chemical carcinogens and other hazardous chemicals in work areas. Hospital wastes are also controlled by the Nuclear Regulatory Commission, the Toxic Substances Control Act, and the Resource Conservation and Recovery Act. State and local regulations must also be followed. It is incumbent upon hospitals and other generators, including clinics, medical laboratories, nursing homes, doctors, dentists, and veterinarians, to identify infectious and hazardous materials. They must protect workers, patients, and visitors from any hazard within the institution, clinic, or office and the community from any discharges or releases to the air, water, and land.89

Schools, Colleges, and Universities

Schools, colleges, and universities may incorporate a full spectrum of facilities and services not unlike a community. Involved—in addition to basic facilities such as water supply, sewage, and other wastewater disposal, plumbing, solid waste management, and air quality—are control of food preparation and service, on-site and off-site housing, hospital or dispensary, swimming pool, radiation installations and radioisotopes, insect and rodent infestations, and safety and occupational health in structures, laboratories, and work areas, including fire safety, electrical hazards, noise, and hazardous materials. In view of their complexity and their effect on life and health, all institutions should have a professionally trained environmental health and safety officer and staff responsible for the enforcement of standards, such as in a sanitary code, encompassing the areas of concern already noted. Such personnel can work closely with federal, state, and local health and safety regulatory officials and thus provide maximum protection for the student population and teaching, research, and custodial staffs.90 Figures 2.19 and 2.20 suggest the broad areas to be considered when making an inspection. Guidance as to what is considered satisfactory compliance can be found in this text under the appropriate headings and also in federal, state, and local publications.

Correctional Institutions

Correctional institutions include short-term jails, long-term prisons, and various types of detention facilities. The health care services may include primary health care services, secondary care services, health care services for women offenders, mental health care, dental care, environmental concerns, nutrition and food

Renewable Energy 101

Renewable Energy 101

Renewable energy is energy that is generated from sunlight, rain, tides, geothermal heat and wind. These sources are naturally and constantly replenished, which is why they are deemed as renewable. The usage of renewable energy sources is very important when considering the sustainability of the existing energy usage of the world. While there is currently an abundance of non-renewable energy sources, such as nuclear fuels, these energy sources are depleting. In addition to being a non-renewable supply, the non-renewable energy sources release emissions into the air, which has an adverse effect on the environment.

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