Comparative assessment of the carcinogenic risk arising from the release of products of high-temperature and low-temperature neutralization of medical waste into the air

Introduction. The problem of neutralization/decontamination of medical waste generated in medical institutions occupies a significant place among the existing epidemiological and environmental problems. Domestic and foreign colleagues consider the use of thermal methods for the disposal of medical waste to be a priority. Despite technological advances in the system of purification of «exhaust» gases, the work of enterprises for the disposal of medical waste is still of concern to the population of the territories in which they operate.

The objective of the study. The assessment of the impact of low-temperature and high-temperature thermal treatment of medical waste on the atmospheric air and public health in the zone of their influence to substantiate the laboratory control program using these technologies.

Materials and methods. The work used sanitary-chemical methods for studying emissions from installations for the thermal treatment of medical waste, modelling the dispersion of emissions with the calculation of ground-level concentrations, and the methodology for assessing the risk to public health based on «Guidelines for assessing the risk to public health from exposure to chemicals polluting the environment».

Results. The results of the calculation of the carcinogenic risk to public health from high-temperature neutralization technologies are assessed as the maximum allowable and acceptable, from the low-temperature method as acceptable.

Limitations. Emissions from the main technologies for the disposal of medical waste included substances with a carcinogenic effect, but the carcinogenic risk was calculated only for those substances that had a carcinogenic potential factor.

Conclusion. Based on the results of the study, when managing production laboratory control programs and monitoring atmospheric air in the impact zone of medical waste incineration enterprises, it is necessary to include the such components in the mandatory list of monitored indicators as sulfur dioxide, nitrogen dioxide, suspended solids, cadmium oxide, nitrogen oxide, dioxins, and benz/a/pyrene; in the operating area of installations for low-temperature thermal treatment of medical waste (autoclaving), it is necessary to control chemical components as follows: benzene, dimethylbenzene, methylbenzene, ethylbenzene, 2-butoxyethanol, butan-1-ol, propan-1-ol.

Compliance with ethical standards. The study does not require the submission of the opinion of the biomedical ethics committee.

Contribution:
Khurtsilava O.G. — hygienic technology assessment, editing;
Mironenko O.V. — scientific leadership, concept and design of the study, editing, approval of the final version of the article, responsibility for the integrity of all parts of the article;
Noskov S.N. — calculation of gross emissions, maximum single surface concentrations, editing;
Magomedov Kh.K. — research concept and design of the study, proofreading and editing;
Pankin A.V. — statistical processing, calculation of carcinogenic risk;
Fedorova E.A. — collection and statistical processing of material, writing the text;
Obukhov D.A. — statistical processing;
Suvorova O.K. — research concept and design of the study.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: June 05, 2023 / Accepted: August 15, 2023 / Published: October 9, 2023