A Detail Proposal On

BIO-MEDICAL WASTE MANAGEMENT SYSTEM

(Newster-New Age Sterilizer)

Submitted By:

Phone 01-5362654
 Healthcare Waste Management

Waste Scenario of Nepal:

World health organization (WHO) states that 85% of hospital wastes are actually non-hazardous, around 10%
are infectious and around 5% are non-infectious but hazardous wastes.

The solid waste from hospitals consists of bandages, linen and other infectious wastes (30-35%), plastics (7-
10%), disposable syringes (0.3-0.5%), glass (3-5%) and other general wastes including food (40-45%). One
should note that only 15% of biomedical waste is hazardous, not the complete. But when hazardous waste is
not segregated at the source of generation and mixed with non-hazardous waste, then 100% waste becomes
hazardous.

Incineration of heavy metals or materials with high metal contents (lead, mercury and cadmium) can lead to
the spread of heavy metals in the environment. Dioxins, furans and metals are persistent and accumulate in
the environment. Only modern incinerators which are able to work at 800-1000°C with special emission
cleaning equipment can ensure that no dioxins and furans (or only insignificant amounts) are produced.

The first survey on HCW management conducted in 11 hospitals in the Kathmandu Valley (1997) found 0.54
kg/patient/day of HCW whereas health care risk waste (HCRW) was 0.16 kg/patient/day. Another survey was
conducted in 2001 by the Environment & Public Health Organization (ENPHO) for the Kathmandu Valley
Mapping Program, Kathmandu Metropolitan City which demonstrated 1.7 kg/person/day of health care waste
(HCW) and 0.48 kg/person/day of Health Care Risk Waste (HCRW) at an average bed occupancy rate of 65%
whereas in a study done by HECAF (2010) in Bir hospital, Kathmandu found hospital waste of 1.23 kg/bed/day.
Also, a report presented by Ministry of Health in 2003 revealed that HCW generated is 1.7 kg/person/day and
out of which 26% is hazardous

As presented in HCWM guideline, 2014, about 60% big hospitals in different part of country are using municipal
waste disposal system for final disposal of HCW. Also, Study by MoHP and WHO in 2012 shows thatmost of the
HCW from HCF at Kathmandu are collected by municipal vehicles and disposed directly to landfillsite without
pretreatment. Center for Public Health and Environmental Development (CEPHED) in its study in 2012 states
90.32% hospitals do not practice environment sound waste treatment system and 61.29% have poor
separation of waste at source of which 6.45% had no any practice of segregation. Same study also reveals67.42%
hospitals have poor transportation system. Thus, with all these data we can understand very clearly that the
HCW has not been managed to proper norms and thus being great threat to Public Health and Environment.

To be very factual on amount of waste produced in Nepal, as presented in HCWM Guideline, total of 10519.51
tons of HCW per year is generated; of which 29% is HCRW i.e. 3093.98 tons per year. Having this high
production rate, no proper policy and regulations have been made by the government for environment
friendly and safe management of HCW.
From the above mentioned data, one can easily understand the amount of waste generation per patient
per day and also predict a very precarious condition that people are having to go through. It is obvious
that the real data could much higher than what we see as there is no proper waste management policy or
even a proper survey on waste generation. As a result we are lacking an effective policy right from the
government level.
Date Source:
1. Chaudhary N, M. S. (2014). BIOMEDICAL WASTE MANAGEMENT IN NEPAL: A REVIEW. Journal of Universal
College of Medical Sciences Vol.2 No.04 Issue 08, 45-53. Retrieved 09 18, 2018, from
https://www.researchgate.net/publication/272365105
2. Health Care Waste Management Guideline, 2014, Department of health services, Ministry of Health and Population,
Government of Nepal, Page1-3.

Why manage the Hospital waste?

As we know the hospital waste contains potentially infectious and hazardous waste which can cause serious
effects in the human health and environment and improper management and disposal of such waste can be
very dangerous. The most probable risks associated with the hospital waste are as follows:

Risks to Staff

Risk of contracting devastating diseases like:

 Hepatitis  Syphilis
 HIV  Malaria
 Ebola

Some of these diseases can have life-long impacts and even represent a death sentence for the infected.

Risks to Community

Many of the substances have a long half-life, so they take hundreds or even thousands of years to break
down. During this time more waste is added. The potency of the contamination goes up.

Water Supply

Without proper medical waste disposal, medical waste works its way into the watersupply. It soaks through
the soil to enter the groundwater. Medical waste can spread far beyond the original dump site.

Wildlife & Human Population

Medical waste in the water supply exposes wildlife to the toxic effects of medical waste substances which
can, in both wildlife and human, cause:

 Birth defects
 Mutations
 Increased cancer risk
 General health maladies
 Exposure to potentially deadly
 diseases
Patient Perception/Hospital Brand

No one knows whether or not you have proper medical waste disposal practices in place, do they?

Today’s society has an increased focus on protecting the environment and they are constantly into this
and they are always looking for the chances to find you out. With increased choice in the medical
industry, medical providers need their reputation intact to compete in the industry. Patients care about
whether you care about their well-being and safety, as well as the environment. And most importantly
the hospital with proper waste management system always gets praised in every means.

However, most of the hospitals still lack proper waste management system as a result of which the
hospitals and its suburbs pose threats to the safety not only of the patients but of everyone who is
involved. Thus, a waste management system which not only ensures waste disposition but also
provides an all-round health and environmental safety is required. For this, Bio-Medical waste
management system from Newster can be the answer as it offers a true blend of engineering and
quality.
 About the Company

Newster Group was founded in 1996 and is one of the main European leaders in manufacturing and
marketing certified patented systems for:
• Treatment and sterilization of potentially infectious healthcare waste
• Treatment and sterilization of potentially infectious sewage water
• Treatment of laboratory fluids
Newster® is a registered trademark

 OVER 600 Installation & counting

 Available in More than 50 countries & counting

Newster systems are successfully installed worldwide in conformity with the

highest quality standards.

Newster® Group is a European leader in sterilization technologies and the only company in the world
offering a complete and ecological solution for most types of hazardous waste produced in healthcare
facilities. We design and manufacture state-of-the-art equipment for the treatment of solid healthcare
waste, sewage wastewater and medical laboratory fluid waste in a cost-effective and environmentally
friendly way.

Our patented and certified technologies are the result of ongoing investments in research and
development. We work in close collaboration with international organizations, NGOs, universities and
healthcare facilities. Our aim is to prevent the spread of infections and ensure healthy working and living
conditions.
Newster systems are successfully installed worldwide in conformity with the highest quality standards.

Pioneers in ecological waste management solutions

 Newster Sterilization for Solid Health Care Waste

2.1 What is Newster?

Newster is a patented technology for the treatment of health care waste, based on frictional heat
treatment, without burning. The residue obtained is sterilized, finely ground and reduced in volume
and weight. Newster technology is tested, patented certified and referenced by international
governmental institutions. The use of on-site technologies allows the remarkable reduction of costs for
disposal, increases the quality of hygiene, improves personnel’s safety and contributes to reducing the
quantity of medical waste produced by the healthcare facility through targeted training. It also reduces
the environmental impact of green house gas emissions and risks arising from the transport of infectious
waste.

2.2 How does it work?

Newster is a frictional heat treatment technology. In a closed sterilization chamber a powerful rotor
fitted with blades treats the waste by impact and friction, grinding it finely. The energy produced
induces the temperature required for sterilization. For this reason Newster process does not require
pressure steam inside the chamber to reach the temperature of 150 °C. The time of heat exposure and
the cycle parameters are controlled by a PLC. During the cycle, the temperature inside the chamber is
accurately measured in real time by patented sensors. The treatment process is carried out in a single
depression chamber, thereby avoiding any risk for the environment or the operator. The Newster
system finely shreds waste to allow a uniform penetration of the heat. The particles are heated to their
core and not only on the outer surface, for a time lapse long enough to destroy microorganisms and
bacteria. No chemicals are used to achieve sterilization of the waste. Sterilization is proven by
microbiological analyses on the residue and efficacy tests using biological indicator containing
Geobaciullus Stearothermophilus ATCC 7953 spores with a concentration of Log6.

Fig 1.1: Basic layout of Newster Frictional Heat Treatment Technology

2.3 What actually happens?

Fig 1.2: Different phase versus temperature curve

1. Phase-Loading and starting: The operator loads the cell with health care waste, closes the lid and
pressed the start cycle button. A powerful rotor, fitted with stainless steel blades starts rotating slowly
and grinds the material while the temperature increases. When the material is roughly shredded, speed
increases and temperature rises until the evaporation phase starts.

2. Phase Evaporation of liquids: The temperature remains steady until the humidity has evaporated.

3. Phase-Achievement of required sterilization temperature: the temperature increases again to reach

150°C, the exact degree in order to sterilize.

4. Phase-Cooling: the waste is cooled by brief sprays of water until it reaches 95°C.

5. Phase-Unloading: the cycle is complete. The processed waste, now sterilized, is automatically
unloaded. During the whole cycle the temperature of the wastes is measured in real time and with great
accuracy by patented sensors.
Newster’s Frictional Heat Treatment enables hospitals to process hazardous solid waste in a sustainable
and cost-effective way. The patented technology employs the heat generated by the shredding action to
sterilize the waste at the same time without POPs emission into the athmosphere according to the
Stockholm Convention. The final residue is dry, sterile and finely ground.

As well as meeting the public demand for ecological solutions, it offers many other advantages, such as:

 improved levels of hospital hygiene and safety;

 elimination of risks arising from infectious waste transportation;
 lower storage and transport costs due to weight and volume loss;
 lower waste disposal costs;
 use of residue as refuse derived fuel (RDF).

Frictional Heat Treatment Process

The treatment is carried out in a single depression chamber without risks to the environment and the
operator. No chemicals are used. During the cycle, the temperature inside the chamber is accurately
measured in real time by patented sensors. The duration of the exposure to heat and the cycle
parameters are controlled by a PLC. During the cycle, the system automatically generates a printed
report, which the operator attaches to the work sheet at the end of each cycle. Sterilization can be
proven by microbiological analysis on the residue and by efficacy tests using biological indicators
containing Geobaciullus Stearothermophilus spores with a concentration of Log6.

STAGE 1: loading and starting

To begin the process, the operator loads the chamber with healthcare waste, closes the lid and presses
the cycle start button. Inside the closed sterilization chamber, in negative pressure, a powerful rotor
fitted with stainless steel blades finely shreds the waste by impact and friction.
STAGE 2: evaporation of liquids
As the material is roughly shredded, speed and temperature increase to 100°C, the evaporation phase
starts. The temperature remains steady until all the humidity has evaporated.

STAGE 3: reach required sterilization temperature

When the humidity has been eliminated, the temperature starts to rise again reaching a peak of 150°C,
as required for a complete sterilization according to STAATT Level IV. The finely ground waste is heated
to its core and not only on the surface, for the time required to completely destroy microorganisms and
bacteria. Sterilization efficiency can be tested with the help of BIoindicator.

STAGE 4: cooling
The waste is cooled by sprays of water until it reaches a temperature of 95°C necessary for discharge.
STAGE 5: unloading
The cycle is over and the treated waste is automatically unloaded. The sterile, finely ground, dry and
unrecognizable residue is significantly reduced in weight and volume.
What does Newster treat?

Newster technology treats all type of medical waste: plastic, paper, fabric, cotton, cellulose, glass,
small metallic parts, sharps, syringes, drainage boxes, PPE, etc. Specific regulations forbid to process:
radioactive, inflammable and explosive materials, etc. The processed sterilized refuse is: less than 70-
75% of the initial volume, less than 20-30% of the initial weight. Residue is unrecognizable, dry, inert and
odorless.

Fig 1.3: Waste before and after treatment

2.4 After waste discharge:

The sterilized waste downloaded from a Newster machine generally has a minimum Heating
Value/Calorific Value of around 18.0 kJ/kg. This characteristic, together with the low level of
humidity, make it a fuel of good quality, suitable for use in energy production plants. . The
potentially infectious hospital waste treated with Newster® technology, can be brought to energy
production plants and according to its chemical-physical characteristics it can be compared to a
RDF(Refused-Derived Fuel) of normal quality. Thus, the discharged waste can be sent to Brick
industries, cement factories, boiler plants etc. where it can be used as an alternative to traditional
fuel.
 Approved Technology (Frictional Heat Technology)
1. WHO Healthcare waste management approved technology.
2. National Healthcare Waste Management Standards & Operating Procedure- 2020. (MoHS)
3. Health Facility Operation Guideline, 2077 B.S. (MoHS)

Institution where Frictional Heat Technology is at Continuous

Operation in Nepal
1. HAMS hospital, Dhumbarahi, Kathmandu
2. Chitwan Medical College, Bharatpur, Chitwan.
3. Civil Hospital, Minbhawan, Kathmandu.
4. Kanti Children Hospital, Maharajgunj, Kathmandu.
5. Infectious and Communicable Disease Hospital, Pokhara.
6. Karnali Academy of Health Science, Jumla.
7. Municipal Treatment Centre, Nepalgunj Sub-metropolitan city, Banke.
8. Municipal Treatment Centre, Damak Metropolitan city, Jhapa.
9. Municipal Treatment Centre, Dhangadi Sub-metropolitan city, Kailali.
Additional Features:
1. Remote Monitoring and Basic Troubleshooting.

2. Water Recirculation system for less water consumption.

3. No hazardous and chlorine based chemical used as Deodorizer, rather enzymatic agent used.

4. Online Certified training course, level wise.

5. Air and Liquid discharged in the process is treated before discharge.

 SAMPLE TECHNICAL SPECIFICATION OF THE MODEL NW50 FOR TENDER
Bidder’s Deviation Page no/
S
Tender Specification Purposed if catalogue
N
Specification any no.
1 Manufacturer
2 Country of Origin
3 Made In
4 Brand/ Type
5 Model No.
Description of function : An Integrated treatment system.
Breakage, Mixing, shredding, sterlizing to be carried out in same
vessel. The process from the beginnnig of the cycle to discharging
6
must be completely automatic with automatic lift for easy waste
loading. The system must have water recycle system for re-using the
waste water, which should reduce water consumption by 80%-90%.
Waste Processing Method:
7 Frictional Heat Technology (By moist heat at high temperature
(140°C-150°C) without positive pressure.
Must meet requirement of STAAT IV level or higher (6log10), final
resideu should be tested up & reported by third party registered
8 laboratory. Upto 28 days no growth bacterias test report should be
provided after the sterilization cycle from the same
model/technology.
9 Method of heating : Impact and friction of the waste.
10 Load Capacity/Processing Potential (Weight) : 90- 110 Kg per hour.
11 Load Capacity/Processing Potential (Volume) : >800 ltr/hrs.
Loading Chamber (Material of Construction): Stainless Steel &
12 high resistant metal alloys, load should be done at once .

Types of Medical Waste that can be processed: Plastic

Materials,Glass Materials, Single use surgical instruments and
13 materials,Contaminated Sharps, PPE Material, paper, cotton, rubber
disposals, Blood Bags, Urine Bags etc..

14 Waste Volume Reduction : 70%-80%

15 Waste Weight Reduction : 20%-30%
Output should be dry waste suitable for direct disposal as non-
16 infectious municipal waste
The system renders the waste unreusable and safe to dispose of as
17 ordinary municipal waste.
18 Odour Control : Enzymatic agent without chlorine based chemical
Treatment Chamber (Material of Construction) : Vertical chamber,
19 Stainless Steel equiped with high resistant material
Waste Shredder (Material of Construction) : Shredder should have
20 single shaft high speed with multiple blades and auto reverse system
to avoid jams made out of special wear resistant alloys
Equipped with system controls and alarms for overloading,
21 overheating and/or other critical operating
parameters. Bidder to indicate list of control and alarm systems.
22 Power consumption : Average 60 kw/h
 Cycle Traceability (through computerized
data and printout) : Integrated in the System; Printed ticket or SD
card for collecting data recommended should have provision of
23 50000 data storage or more. Machine should be equiped with remote
connection and access with software which should allow
maintenance & process checking.
The air/ liquid going out of the unit should also be sterilized and
24 safe to drain directly to normal drain line. Evidence should be
provided.
25 Electricity : 400 V, 50 Hz, 3 Phase
26 Water supply : Max pipe size 3/4 inch
27 Must submit ISO 9001:2015
28 Must Submit European CE Certification.
29 Must submit Machinery Directive- 2006/42/EC
30 Must submit Manufacturing authorization letter.

31 At least 3 installation within Nepal for similar technology with

successful operation till date
32 The supplier must submit the original brochure or e-copy.
The supplier must be able to show the worldwide installation of the
33 machine references list
34 Minimum of 10 years of experience in the field of the manufacturer
35 Presence in at least 35-40 countries
36 The supplier must have atleast two factory trained engineers.
The local agent should be available instantly within hours of call for
37 the after sales services. Must station a factory trained engineer at
supplier own expenses.
Warranty should be 2 years from the date of installation of the
machine. Must quote rate of frozen rate of Comprehensive
38 Maintenance Contract ( CMC ) for a period of 3 years after warranty
which should not exceed 5 % of equipment cost and should cover all
spare, consumables and labor.
Four preventive maintenance should be performed annually through
39 out warranty period.
During the warranty period supplier must ensure planned preventive
40 maintenance (PPM) along with corrective / breakdown maintenance
whenever required.
Must provide a user training to enable operators to use the equipment
properly. The training shall include the use of all operational
41
functions of the equipment, as well as routine checks and
maintenance expected by users.
Must provide service training (installation, assembling,
42 disassembling, trouble shooting) to at least two Biomedical
maintenance staff by trained company engineer.
Hard copy and soft copy of both user manual and service manual in
43 English shall be provided at the time of installation.
Certificate of calibration and inspection from factory during
44 installation