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MedicShred Technologies GmbH(Salzburg, Austria)Germany September, 2007
MedicShredMedicShred GmbHGmbHmedical waste shredding & disinfection
Infectious Treatment System TransformsBiohazardous Waste into Ordinary Municipal Waste
FISSORE AgencyExclusive Agentwww.fissoreagency.com
Stockholm Convention TreatyStockholm Convention Treaty
Most Countries signed the Stockholm Convention Treaty on Persistent Organic Pollutants (POPs).
Treaty compliance is required by January 2007.
Medical waste incineration is one of (if not) the largest sourceof the POPs.
Replacement of medical waste incinerators with non-thermal infectious waste disinfection systems will greatly help The Countries achieve Stockholm Convention Treaty requirements.
Healthcare Waste Healthcare Waste Incinerators Incinerators ---- Trending to ZeroTrending to Zero
US - 1995 US - 2003
Incinerators create dangerous air emissions and hazardous end waste forms.
Healthcare waste is some of the worst to burn, due to the dioxins, furans, mercury and other pollutants that are generated or released.
Incinerators have all but vanished in the US due to strong regulatory and public pressure.
EU and worldwide countries are following the US’s lead to improve public health & safety by shutting down medical waste incinerators.
US HealthcareWaste Incinerators
Yr No
1995 5,000+
1997 2,373
2003 115
2006 59
Dangerous Healthcare Wastes Dangerous Healthcare Wastes (Statistical(Statistical Ratios)Ratios)
Infectious Waste (95%)
Hazardous Wastes (5%):• Chemical • Cytotoxic• Expired Pharmaceuticals
Radioactive Wastes (< 1%)
Waste Treatment Waste Treatment Engineering ProjectEngineering Project
Waste Characterization
Requirements Waste Throughputs Facilities (by Waste Stream) Test Protocols Demonstration Project
Engineering Systems Design and 3-D Model: Infectious Waste Treatment Facility Hazardous Waste Treatment Facility Radioactive Waste Treatment Facility
Facility Location Options Assessment
Budgetary Cost & Implementation Schedules
Program & Procedure Recommendations, Schedules and Estimates:
Propose Government Regulations Changes Needed to Comply with Stockholm Convention.
Regulatory Compliance Training & Procedures Needed for Dangerous Healthcare Waste Generators.
Procedures for Standardization of Waste and Sharps Containers, Handling, Storage, Transportation and Disposal.
MedicShredMedicShred’’ss Turnkey, Integrated Project EngineeringTurnkey, Integrated Project Engineering
MedicShredMedicShred NonNon--ThermalThermalInfectious Waste TreatmentInfectious Waste Treatment
World’s Best-In-Class Technology
Offering:• Non-Polluting Advanced Process• Stockholm Convention Compliance • Safest Operations• Less Cost• Least Risk (Long and Short Term)
Infectious Waste ProcessorInfectious Waste Processor
Boxed Waste Conveyor
Feed Hopper
Automated Liquid Chemical DisinfectantSystem
Extruder/Compactor
Waste Cart Tripper
AdvancedWaste
Shredder
Chemical Trough
WasteScrew Auger
Ready Spare Hopper/Shredder
Roll-OffWaste Container
High Efficiency Particulate Air (HEPA) Filtration System
System Shreds Waste to Desired Particle Size and then Disinfects Waste with Concentrated
Sodium Hypochlorite Solution
Operator Booth
FACILITY FACILITY VIEWSVIEWS
US EPA - FIFRA TESTING FIFRA sets the world’s highest standards for microb ial
inactivation of infectious waste. (STAATT Conference Level III)
“Inactivation of vegetative bacteria, fungi, lipophilic/hydrophilic viruses, mycobacteria at a 6 Log 10 reduction or gre ater; and inactivation of GeoBacillus stearothemophillus spores and Bacillus subtillis spores at a 4 Log 10 reduction or greater.”
Autoclaves cannot met equivalent efficacy standards without <50mm pre-shredding.
Shredding and sodium hypochlorite chemical disinfection is the only non-incineration technology that has ever achieved FIFRA testing requirements for medical waste applications.
SODIUM HYPOCHLORITESODIUM HYPOCHLORITEThe Safe Chemical ApproachThe Safe Chemical Approach
Disinfection properties recognized since ancient times. Used in hospitals for 150 year s. #1 disinfectant used in the US. Used in common household laund ry and kitchen bleach. Used to disinfect foods (and safely edible in small quantiti es). Used to disinfect municipal dr inking water, well water, municipal sewer
and sanitary water, as well as swimming pools. Disinfectant recommended by US Centers for Disease Control ( CDC)
and National Institute of Heal th (NIH). Safe for the environment in typical concentrations according to the US
Environmental Protection Agenc y.
SODIUM HYPOCHLORITESODIUM HYPOCHLORITEThe Safe Chemical Approach The Safe Chemical Approach (continued)
Recommended for disinfection o f needles and syringes by the US National Institute of Drug Abu se, the US Center for Substanc e Abuse Treatment of the Substance Abu se and Mental Health Services Administration, and the US Cen ters for Disease Control (CDC) .
Recommended by the US Centers for Disease Control for treatm ent of hospital water systems that may be contaminated by Legionella spp.(Legionnaires disease).
Recommended by the CDC and the US Occupational Health and Sa fetyAdministration (OSHA) for the disinfection of blood spills.
Recommended by the American De ntal Association for the disin fection of dental prosthesis and appli ances.
NonNon--Incineration Technology for Incineration Technology for 95% of Healthcare Waste95% of Healthcare Waste
MedicShredMedicShred System ShredSystem Shred
The Untha medical waste shredder’s design (developed and owned exclusively by MedicShredprovides the highest throughput and the best particle size of any medical waste shredder in the world.
Our shred renders sharps unusable and patient information unrecognizable.
Remaining 5% of Healthcare Difficult-To-Treat W astes
Idaho National Laboratory (INL) is the US’s premier organization for advanced waste destruction technologies and management techniques and they helped def ine the US Environmental Prote ction Agency’s medical waste regulations.
INL’s world’s-best-in-class solutions are key option al elements of GrowthNet’s Center of Excellence for Healt hcare Waste Treatment.
INL subcontracts to MedicShred and delivers zero emissions wa ste destruction technologies for t reating Hazardous (Chemical, CytotoxicExpired Pharmaceuticals) and Radioactive wastes.
www.inl.gov
Wastes Treated: Chemical, Cyctoxic, Expired Pharmaceuticals, Controlled Substances
Process: Thermal Destruction (molten bath, electrically heated, zero oxygen)Advanced Off-gas System (collects mercury and heavy metals)
Byproducts: Harmless Gases/SolidsSmall Quantities of Mercury and Heavy Metals (collected, solidified)
Steam Reforming for Steam Reforming for Hazardous Waste TreatmentHazardous Waste Treatment
Steam Reforming Process isScaleable to Any Requirement
Key Advantage
Destroys hazardous materialsso they do not have to be buried(landfills are a stop-gap measurethat must ultimately be dealt with at much, much greater costs).
Wastes Treated: Radioactive Substances
Process: Electrical, Radio-Frequency Melter with Advanced Off-gas System
Byproducts: Radioactive Materials are Enscapulated in a Glassy Matrix that Does Not Leach
Cold Crucible Cold Crucible MelterMelter for for Radioactive Waste TreatmentRadioactive Waste Treatment
Key Advantage
Radioactive wastes can easily contaminate air, soil and water forthousands of years (huge cleanupcosts). The Cold Crucible Melterprocess traps radioactivity in a glassy form that will not pollute for up to 10,000 years.
MedicShredMedicShred Strategic PartnerStrategic Partner
MedicShred Strategic Alliance Partner, UN THA, is an Austrian-based, globally-recognized, premier manufacturer of advanced indus trial shredding equipment.
Since 1980, Untha has manufactured over 1,000 medical waste shredders, over 20,000 total shredder systems and turnkey m edical waste systems.
UNTHA exclusively turnkey manufactures Shredder/ Disinfection Systems to MedicShred’s specifications.
MedicShred provides its expertise in syst ems engineering, waste treatment and automated chemic al disinfection process to each proprietary System application.
www.untha.com
Infectious W aste Treatment Technologies
TechnologyTechnology TrendTrend CharacteristicsCharacteristics
Incineration Rapid Decline • Large Amounts of Deadly Air Pollution• Shortens Peoples Lives• Very Strong Public Rejection• Hazardous Residual Materials (flyash)• Flyash Often Hazardous Waste • Windborne Flyash is Dangerous• 30% - 50% Volume Reduction• Filters Do Not Trap Fine Particles• Filters Do Capture Trap Mercury• Costly Air Pollution Systems Do Not
Eliminate Risks• Increasingly Stricter Air Limitations
Infectious W aste Treatment Technologies
TechnologyTechnology TrendTrend CharacteristicsCharacteristics
Autoclaves Hospitals Want Out • Never Proven for Medical Waste(Not Core Business) (previously assumed proven based on
sterilization of surgical instruments).
Scientists Now • Experts Now Believe Shredding Must Say Must Pre-Shred Occur Prior to Autoclaving (since Prior to Autoclaving steam often does not disinfect inside (i.e., Must Add a suction canisters, needles, organs, Front-End Shredder) animal carcasses and other items).
• Releases Harmful Vapors.
• Slow Process with High Energy Requirements (Requires a Separate Steam Plant).
• Does not Shred Materials (sharps and confidential patent data left intact).
Infectious W aste Treatment Technologies
TechnologyTechnology TrendTrend CharacteristicsCharacteristics
Microwave Hospitals Want Out • Low (95-99oC) Temperatures will not(Not Core Business) Kill Hard-to-Kill Spores
• Very High Maintenance & Energy Requirements.
• Never Scientifically Proven.
• Potential High Employee Exposure Risks.
Other Combinations • Twice the capital cost, 1/3-1/2 the Systems (examples: throughput and 4X the floor spaceRotoclave, Hydoclave) • Too Expensive for Regional Operations.
• Requires a Separate Steam Plant.
TechnologyTechnology TrendTrend CharacteristicsCharacteristics
Shredding & Rapid Expansion • Only Non-Incineration Technology to Sodium Achieve US Environmental ProtectionHypochlorite Public Acceptance Federal Insecticide, Fungicide &Disinfection Agency’s Rodenticide Act (“FIFRA”)
Efficacy Requirements
• Eco- and Public-Friendly
• Very High Throughputs and Lower Operating Costs
• Renders Sharps, Waste and Confidential Patient Data Unrecognizable.
Accepted Infectious W aste Treatment Technology
Harmful IncinerationHarmful Incineration
Incineration takes a containerized solid or liquid waste problem and converts it into w ide-spread, much greater airborne, soil and water contamination environmental release , problem, proven to significantly shorten people’s lives.
The smallest particles released -- the ones that cannot be filtered or monitored -- are the incineration particles that do the most harm.
Until, recently medical waste incineration was the single largest source of cancer-causing dioxin air pollution in the US.
Incinerator Air PollutionIncinerator Air Pollution
MERCURY - Powerful Neurotoxin - Healthcare incineration is 4th largest source of mercury air emissions in US with 1 in 10 women already having enough mercury in their bodies to cause fetus brain, spinal cord, liver and kidney damage. Mercury cannot be removed by filters.
OTHER TOXIC METALS - Emissions and ash from incinerators contain over 35 metals, such as nickel, beryllium, chromium, cadmium and arsenic, which cause lung cancer, heart disease, lower intelligence, and other serious health problems.
DIOXINS & FURANS - Caused by burning plastics and similar substances. Substances accumulate in fatty tissue and remain active in living organisms and the environment for many years. Causes early puberty, endometriosis, breast cancer, reduced sperm count, male reproductive tissue disorders and testicular cancer. Recognized endocrine and thyroid disrupters.
NITROGENS & OZONE - Pollutants produced by incineration that effects the lungs, spleen, liver, and blood. Children are the worst effected.
200 ORGANIC CHEMICALS - including known carcinogens, mutagens and hormone disrupters.
The Health Effects of Waste Incinerators, 4th Report of the British Society for Ecological Medicine, December 2005
“Incinerators presently contravene basic human rights as stated by the United Nations Commission on Human Rights, in particular the Right to Life under the European Human Rights Convention, but also the Stockholm Convention and the Environmental Protection Act of 1990.”
“The fetus, infant and child are most at risk from incinerator emissions: their rights are therefore being ignored and violated, which is not in keeping with the concept of a just society. Nor is the present policy of locating incinerators in deprived areas where their health effects will be maximal: this needs urgent rev iew.”
2005 Report: British Society 2005 Report: British Society for Ecological Medicinefor Ecological Medicine
Autoclaves
Never proven for medical waste applications.
Always assumed to work due to sterilization of medical instr uments.
Recently evaluated by world experts in 2005 study and 2006 r eport.
Findings: Autoclaves require p re-shredding to <50mm under negative pressure and HEPA filtration ( as well as other requirements) .
These requirements were adopted by IStAAT in 2006. IStAATT (formerly known as STAATT) guidance has been incorporated into the reg ulations of the majority of the US States and many other countries, s uch as the
United Kingdom, Japan, Chile, and Hong Kong.
No autoclaves currently meet t hese requirements.
Autoclaves
Require a boiler, pre-shredding and containment.
Not proven to sterilize inside suction canisters, needles an d containers.
Slow loading and (typical) one-hour “cook” time.
Releases potentially hazardous gases (operator exposures).
Costs hospitals space, utiliti es and non-core business staffing.
Roughly same capital cost with higher operating cost & lower throughput (~ 3000 lb/hr vs. GrowthNet’s 5,000 - 14,000 lb/hr).
Autoclaves do not provide < 50mm shredding, therefore, no assurance of waste treatment, needles ar e not rendered unusable, conf idential information is not destroyed a nd there is no volume-reduction.
Autoclaves
New Facility Construction and Business Start-ups often require Front -End Development and Planning. MedicShred can support your effort with t he following Consulting Services:
Market Assessments and Facilit y Sizing Cost, Investment and Employmen t Estimates Preliminary Engineering Designs Business Plans Capital Investment Plan Full Business and infrastructure Implementation
MedicShredMedicShred ConsultingConsulting
MedicShred Offers Engineering and Regulat ory Consulting and is Experienced in Strategic Planning, Process Design & Manufact uring, Start-ups, Operations, Training, Auditing and Turnarounds for foll owing types of Waste Treatment Facilities and Businesses:
Healthcare Wastes Hazardous Wastes Municipal Wastes Contaminated Soil Materials Buried Wastes
FISSORE AgencyExclusive Agent
www.fissoreagency.com
MedicShredMedicShred OffersOffers
Defense Wastes Low Level Radioactive Wastes Transuranic Wastes Mixed Hazardous/Radioactive Special Nuclear Materials
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