Xử lý chất thải rắn y tế bằng công nghệ thân thiện môi trường

TU" N G H I E N C Q U D E N TRIEN KHAI - S A N X U A T<br /> <br /> <br /> <br /> <br /> Kir ly chat thai ran y te<br /> <br /> bang cdng nghe than thien moi trirong<br /> <br /> <br /> NGUYEN MINH TUAN - Vu Trang thiet bi va cong trinh y te<br /> CAO THj VAN DIEM, PHAM MINH QUAN - Vien Trang thiet bj va cong trinh y te<br /> Bo Y te<br /> Viec ap dung cac cdng nghe than thien vdi mdi trddng de xd ly chat thai y te, dac biet la chat<br /> thai r i n y te (CTRYT) ludn phu htfp vdi chu trudng cua Nha ntfdc ta. De gdp phan nang cao hieu<br /> qua cua cdng tac xtf ly CTRYT hien nay, rat can cd nhtfng nghien cud chuyen sau phan tich, danh<br /> gia va so sanh cac cdng nghe, thiet bj xd ly CTRYT, ttf dd Ida chon md hinh va cdng nghe tdi tfu<br /> cd the nhan rdng.<br /> <br /> T r e n the gidi, viec xtf nhiet am thong dung nhat do chi cat, khdng an toan cho ngUdi van<br /> ly CTRYT chu' yeu phi dau tu thap hon va it tao ra hanh va gay phdc tap hon do yeu<br /> van dung cong nghe cac chat d nhiem. Trong sd cdng cau phai ve sinh thie't bi cat rat<br /> Id dot. Tuy nhien, nghe nhiet am, cac nUdc tren the thddng xuyen. Loai thiet bi hop<br /> ben canh mot sd ifu diem, cdng gidi chu yeu sd dung 2 loai cdng khdi ddng nhat nghien cat trong<br /> nghe nay ngay cang trd nen nghe chinh de khd khuan chat thiet bi khd khuan du giai quyet<br /> khdng phu htfp do phat thai thai y te lay nhiem, dd la cdng ddpc van de ngan chan lay benh<br /> cac chat nguy hai tiem an, gia nghe hap bang hoi nddc (dung trong khu vdc xd ly, dam bao an<br /> ca lai ddt do va thieu hieu qua hoi ndng am) hay nhiet ddt va toan ve sinh cho ngddi van hanh<br /> kinh te. Be giai quye't cac van cdng nghe vi sdng (microwave). nhung lai cd nhugc diem la khdng<br /> de nay, cac nha cdng nghe da Cong nghe hdp bdng hoi ntfdc phU hpp cdng suat gida hai loai<br /> nghien cdu va phat trien nhtfng thuan tuy da ddgc ap dung td chdc nang (gay lang phi), khdng<br /> cong nghe khdng ddt phu hop nhdng nam 70 cua the ky trddc dn dinh, chi phi cao do thie't bi<br /> vdi khuyen cao cua cac td chdc nhdng hieu qua khd khuan khdng cat hay bi hong, phai ddng de<br /> mdi trddng qudc te nhu ChUtfng dn dinh va chi phi thie't ke, ldp thay the sda chda. Khi lddi cat<br /> trinh Mdi trudng cua Lien Hup dat, bao dddng rat cao. Vdi the va may cat bi hong hoac khdng<br /> Qudc (UNEP), Quy Mdi trUdng he tien tien nhat, cdng nghe nay dat yeu cau chat ldpng thi bat<br /> toan cau (GEF); Td chdc Y te the thddng ddi hdi phai cat nhd chat budc phai thay the nhanh chdng<br /> gidi (WHO), To chdc ThUc hanh thai trddc khi xd ly khd khuan de bao dam thdc hien nhiem vu<br /> y te khong gay hai (HCWH). Mdt de dam bao hieu qua theo yeu khd khuan ddOc lien tuc (giam<br /> so nude da han che va dan dan cau. Mpt so hang che' tao thie't bi td'i da thdi gian ldu trd chat thai<br /> ngdng sd dung Id dot chat thai y cat dpc lap hoan toan vdi thie't lay nhiem). Bieu nay lam cho chi<br /> te va lua chon nhdng cdng nghe bi ha'p khd khuan, trong khi mdt phi duy tri he thd'ng xd ly tang<br /> mdi than thien mdi trUdng. sd hang khac thie't ke' may cat cao, ddng thdi keo theo nguy co<br /> Theo HCWH, cong nghe gdp chung vdi thie't bi ha'p khd d dpng chat thai y te de khdng<br /> khong dot dUq'c ap dung hien nay khuan thanh mpt he thd'ng. Loai ddgc xd ly khd khuan kip thdi,<br /> bao gdm: Cdng nghe sd dung hda sd dung thie't bi cat hoan toan trd thanh ngudn lay nhiem benh<br /> chat, cdng nghe vi sinh, cdng dpc lap trddc khi khd khuan cd tat va d nhiem mdi trUdng ngay<br /> nghe nhiet khd va cdng nghe nhdgc diem ndi bat la gay nguy tai dd. Ghep ndi hai he thdng<br /> nhiet am. Trong dd, cdng nghe co lay nhiem benh trong khu vUc thie't bi con lam cho tinh linh<br /> o c nuat uuuy , .<br /> d b<br /> KHOA HOC S o t h a n g 7 2 0 1 1<br />  TI/ N G H I E N C L / U D E N TRIEN KHAI - S A N X U A T<br /> <br /> <br /> hoat ve cong suat giam di, thdi chan khdng trong khoang xd ly<br /> gian xd ly tang len. Ngoai ra, chda CTRYT trddc khi cap hoi<br /> viec cat trddc chat thai se khdng nUdc cd tac dung lam hoi nddc<br /> thuan lgi cho cdng tac phan loai tham sau va lam ddt mpi be<br /> de tai che. mat chat thai, ke ca trong long<br /> O cac nirdc phat trien (Anh, khdi chat thai la cac vat the<br /> Phap, My, Ddc...), cdng nghe khil cd cau true phdc tap, nhd, dai<br /> khudn sd dung vi song da ddgc va hep nhd kim tiem. Viec lam<br /> sd dung td khoang 20 nam trd am be mat nay cd tac dung giup<br /> lai day. Cd 2 nhom chinh: Khd nang luong nhiet do vi sdng tao<br /> khuan d dieu kien ap suat thdng ra lam ndng chat thai td ben Xd ly CTRYT bang Id ddt<br /> thddng va d dieu kien ap suat treng, ket hop vdi nhiet dp va<br /> cao (2 va 3 bar). Cac thiet bi ap suat cao se cd tac dung pha thai ra lupng chat thai y te rat<br /> cua cdng nghe nay thddng dat huy ca'u true te bao va tieu diet Idn, trong dd gan 1/10 la loai<br /> cac tieu chuan khat khe ve hieu tat ca cac loai mam benh (vi chat thai nguy hai. Nam 2010,<br /> qua khd khuan, dp an toan, tieu khuan, virus, nha bao, ky sinh lugng chat thai y te phat sinh la<br /> chuan mdi trddng va cac tieu trUng...) cd trong chat thai. Nhd khoang 500 tan/ngay, trong dd<br /> chuan ky thuat bat budc khac, dd, sau khi dupe xd ly, chat thai cd 60-70 tan chat thai nguy hai<br /> dupe chdng nhan va cdng nhan lay nhiem se trd thanh chat can phai xd ly. Ket qua khao sat<br /> bdi cac td chUc cd uy tin va cd thai thdng thudng ma khdng cho thay, 94% so benh vien thdc<br /> gia tri tren toan cau. Ddng thdi, bi pha huy, rat thich hgp cho hien phan loai chat thai ngay<br /> nhdng thiet bi nay thddng cd dp viec tan dung de tai che. Toan tai ngudn, 93% so' benh vien thu<br /> ben cao, giup giam chi phi cho co bp quy trinh hoat dpng cua gom rieng vat sdc nhpn, 85% so<br /> sd sd dung. cdng nghe nay deu khdng tao benh vien sd dung cac phuong<br /> Nguyen ly va mpt sd thdng ra khdi bui, khdng xa ra nUdc tien thu gom, van chuyen (tui,<br /> sd ky thuat cua quy trinh xd thai, cung khong sd dung hoa thung, xe day) theo dung ma<br /> ly CTRYT theo cdng nghe khd chat khd, tiet trung. mau quy dinh (mau vang - chat<br /> khuan sd dung vi sdng ket hop Nude ta hien cd khoang thai lam sang, mau xanh - chat<br /> hoi nude bao hda ap suat cao - 1.050 benh vien vdi tdng so hon thai sinh hoat, mau den - chat<br /> cdng nghe tien tien nhat hien 140.000 giudng benh va hon thai hoa hpc, phdng xa). Nhieu<br /> nay nhu sau: Qua trinh hut 10.000 tram y te xa, hang chuc benh vien da xay ddng khu lUu<br /> khdng khi tao ra mdi trUdng ngan phdng kham tu nhan, co sd gid chat thai tap trung tai benh<br /> nghien cdu, dao tao... hang ngay vien theo dung quy che.<br /> Theo nghien cdu cua Vien<br /> Trang thie't bi va cdng trinh y te,<br /> nUdc ta hien dang sd dung Id ddt<br /> CTRYT chu yeu la Id dot nhap<br /> ngoai va Id ddt san xuat trong<br /> nUdc cua mpt so cdng ty, co sd<br /> nghien cdu ve mdi trUdng. Tuy<br /> nhien, qua khao sat cho thay,<br /> nhieu Id dot hien chua dam bao<br /> thdi gian luu chay cua khdi trong<br /> budng dot thU cap - day la mpt<br /> trong nhdng thdng so quan trpng<br /> nha't dam bao hieu suat ddt chay<br /> rac va phan huy dioxin cua Id<br /> dot. Nhieu cP sd y te khong ddpc<br /> « „,, ,<br /> l h 4 n m Hoat dong -<br /> So thang 7.2011 K H HOC<br /> O A<br /> 3<br />  TLJ N G H I E N C L / U D E N TRIEN KHAI - S A N X U A T<br /> <br /> <br /> <br /> trang bi day du kien thdc va<br /> phdOng tien de cd the kiem soat<br /> chat che viec van hanh Id dot<br /> chat thai. Cac Id dot chat thai<br /> y te' tot nhat cung da cu, xudng<br /> cap va bi hong hoc, nhieu thiet bi<br /> khdng the sda chda dupe.<br /> Ben canh cdng nghe Id dot,<br /> viec xd ly chat thai y te bang<br /> phuong phap khdng dot cung da<br /> dupe ap dung d nude ta, td each<br /> thu cong den cdng nghe xd ly<br /> hien dai. O Benh vien Da khoa<br /> 1 tinh Lao Cai, chat thai y te<br /> lay nhiem sau khi ddpc phan<br /> loai va thu gom dupe chuyen den<br /> nha xd ly trong Benh vien. Tai<br /> Thiet bi xu ly CTRYT bang vi song ket hap hoi nude bao hoa tai Vie<br /> day, rac ddpc dda vao thung de<br /> ngam trong dung dich khd trUng<br /> Cloramin B khoang 1 ngay, sau 1 ngudi, thao tac don gian. He dUng cac tieu chuan, quy trinh<br /> dd dda vao thie't bi khd khuan thdng cdng nghe nay cung dang danh gia thiet bi, cdng nghe su<br /> chuyen dung trong khoang 1 gid. duoc trien khai ap dung d mpt dung vi sdng xd ly CTRYT; do va<br /> Luc nay, rac dupe dUa ra ngoai va sd benh vien khac nhU: Lao va phan tich cac chi tieu ky thuat<br /> xd ly nhU rac thdng thudng (chon benh phdi Trung UOng, C Da mdi trUdng cua thiet bi xd ly<br /> lap tai bai rac). Cong nghe xd ly Ndng, Benh vien 198, 199 Bp CTRYT bang cdng nghe dot; do<br /> chat thai y te bang vi sdng ket Cong An... chi tieu mdi trUdng xung quanh<br /> hpp hoi nude bao hda da dupe sd Tuy nhien, hien nay trong khu vUc xd ly chat thai cua mpt<br /> dung tai Trung tam Y te VietSov nUdc chua cd mdt cdng trinh nao so thiet bi sd dung vi sdng; do<br /> (Ba Ria - Vung Tau) td cuoi nam di sau nghien cdu ve cdng nghe chi tieu ky thuat cua thie't bi sd<br /> 2003. Cdng nghe nay cho thay xd ly chat thai y te bdng vi sdng dung vi sdng. De tai cung nghien<br /> tinh hieu qua cao ve mdi trddng, de cd the' ket luan duoc tinh cdu, danh gia cac chi tieu kinh<br /> kinh te va xa hpi. He thdng Uu viet va kha nang thay the' te - xa hdi ciia hai loai thiet bi<br /> bao gdm 1 thie't bi khd khuan cdng nghe xd ly truyen thdng la xd ly CTRYT bang cdng nghe dot<br /> bdng cong nghe vi sdng ket hpp phuong phap dot. Nham dap dng va khdng ddt; chi phi thu gom,<br /> hoi nddc bao hda, mpt thiet bi yeu cau tim hieu ve van de nay, van hanh, xd ly, quan ly thiet<br /> nghien cat chat thai sau khi khu Vien Trang thie't bi va cdng trinh bi; quy trinh thu gom... De tai se<br /> khuan. Ca hai thiet bi dupe ket y te dang thdc hien de tai cap bp: gdp phan thdc hien chu trdong<br /> ndi ngudn dien don gian. rieng "Nghien cdu danh gia thie't bi xd cua Bp Y te' trong viec giai quye't<br /> thiet bi khd khuan cd ket ndi ly CTRYT dpc hai bang phuong cac van de bat cap cua cdng tac<br /> them dud'ng nddc cap va dng nddc phap vi sdng ket hop hoi nUdc bao xd ly CTRYT, ddng thdi la co sd<br /> thai ra he thdng nude thai chung hoa" do KS Cao Thi Van Diem cho viec xay dUng md hinh va Ida<br /> cua benh vien. Thiet bi nho gon lam chu nhiem. Be tai dang khao chpn cong nghe xd ly CTRYT •<br /> (chiem dien tich hon 1 m-), de di sat cdng nghe xd ly chat thai y<br /> chuyen, sd dung it nang lupng va te bang vi sdng, dac biet la loai<br /> khong can he thdng cap ho'i nude su dung cdng nghe vi sdng ket<br /> ben ngoai. Vat tu tieu hao la tui hop hoi nUdc bao hda tai 5 co<br /> rac chiu nhiet, giay in bao cao so y te d Ha Ndi, Da Ndng va<br /> ket qua tu dpng va nUdc thorn Ba Ria - Vung Tau. Qua dd, xay<br /> Hoatddng<br /> 38khd mui. Viec van hanh chi can<br /> KHOA O CH<br /> S 6 t h a n g 7 2 0 1 1<br />