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Thit k l t rc thi y t nguy hi cho bnh vin a Khoa Trung ng Thi Nguyn Phm Vn Kin CNMT K48

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MC LC

MC LC .............................................................................................................................1MU ...............................................................................................................................3CHNG I............................................................................................................................4TNG QUAN V CHT THI Y T V PHNG PHP XL CHT THI Y T 4

I.1. nh ngha v cc c trng ca cht thi y t ............................................................4I.1.1. nh ngha cht thi y t.......................................................................................4I.1.2. Phn loi cht thi y t: ........................................................................................4I.1.3. Ngun pht sinh....................................................................................................6I.1.4. Thnh phn cht thi y t......................................................................................7

I.2.Tc hi ca cht thi rn y t ........................................................................................7I.2.1. i vi sc khe...................................................................................................7I.2.2. i vi mi trng...............................................................................................9

I.3. Phng php qun l v x l cht thi y t .............................................................10I.3.1. Qun l cht thi y t..........................................................................................10I.3.2. X l cht thi y t ............................................................................................12

I.4. Hin trng qun l v x l cht thi y t..................................................................15I.4.1. Hin trng qun l v x l cht thi y t trn th gii ......................................15I.4.2. Hin trng qun l v x l cht thi y t ti Vit Nam.....................................16I.4.3. Hin trng qun l v x l cht thi y t ti Thi Nguyn................................18

CHNG II ........................................................................................................................20HIN TRNG THU GOM V XL CHT THI RN Y T CA BNH VIN AKHOA TRUNG NG THI NGUYN..........................................................................20

II.1. Gii thiu v bnh vin............................................................................................20

II.2. Chc nng ca bnh vin .........................................................................................20II.3. Quy m cv ccu t chc ca bnh vin............................................................21II.4. Tnh hnh hot ng y t ca bnh vin trong nhng nm gn y.........................22II.5 Hin trng thu gom v x l cht thi rn y t ca bnh vin...................................23

II.5.1. Ngun pht sinh ................................................................................................23II.5.2. Lng thi.........................................................................................................24II.5.3. Thnh phn rc thi ca bnh vin....................................................................24

II.6. Hin trng thu gom v x l ....................................................................................25II.7. D bo v pht sinh cht thi rn ca bnh vin a Khoa Trung ng Tnh Thi

Nguyn.............................................................................................................................26CHNG III .......................................................................................................................27

C S L THUYT QU TRNH T RC THI Y T .............................................27III.1. L thuyt qu trnh t............................................................................................27

III.1.1. L thuyt qu trnh chy ca cht rn..............................................................27III.1.2. ng hc qu trnh t cht thi......................................................................28

III.2. L thuyt qu trnh x l khi thi .........................................................................31III.2.1. S hnh thnh cc cht thi..............................................................................31III.2.2. X l khi thi .................................................................................................32

CHNG IV.......................................................................................................................36LA CHN CNG NGH XL CHT THI Y T NGUY HI..............................36

IV.1. La chn phng php x l rc thi bnh vin ....................................................36IV.2. Cc loi l t cht thi y t ...................................................................................37IV.3. So snh v la chn cng nght ........................................................................39


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IV.4. Cng ngh thiu t cht thi rn y t ...................................................................40CHNG V ........................................................................................................................42TNH TON THIT K L T CHT THI Y T NGUY HI CHO BNH VINA KHOA TRUNG NG THI NGUYN ...................................................................42

V.1. Cng sut v thnh phn cht thi y t nguy hi cn x l......................................42V.2. Thit k l t cht thi y t nguy hi......................................................................43

V.2.1. Cn bng vt cht..............................................................................................43V.2.2. Cn bng nhit lng........................................................................................49V.2.3. Tnh lng vt cht ra khi l t.....................................................................54V.2.4. Kch thc l t ..............................................................................................54V.2.6. Th xy l .........................................................................................................63

CHNG VI.......................................................................................................................65XL NHIM KH .......................................................................................................65

VI.1. Thnh phn v nng cc cht nhim trong khi thi......................................65VI.2. Thit b trao i nhit .............................................................................................66VI.3. H thng x l bi Xyclon ..................................................................................72VI.4. Thp hp th ...........................................................................................................75VI.5. ng khi .................................................................................................................77VI.6. Qut cp khng kh vo l......................................................................................77VI.7. Bm dung dch Ca(OH)2 5%..................................................................................79VI.8. Qut ht ..................................................................................................................82VI.9. D ton chi ph cho cng trnh ...............................................................................87

KT LUN..........................................................................................................................89TI LIU THAM KHO ...................................................................................................90


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MUTrong nhng nm gn y, tc th ho, cng nghip ho ti cc thnh

ph v cc khu th Vit Nam gia tng mnh m v ang c xu hng tip tc

tng mnh m trong nhng nm ti. Cng vi s pht trin ca cng nghip ho v

th ho, nhiu loi cht thi khc nhau sinh t cc hot ng ca con ngi c xuhng tng ln v s lng, t nc cng, rc sinh hot, phn, cht thi cng

nghip n cc cht thi c hi nh rc y t. Nu ta khng c phng php ng

n phn hu lng cht thi ny th s gy nhim mi trng do vt qu kh

nng phn hu ca t nhin.

Cht thi rn y t (CTRYT) l loi cht thi nguy hi. Trong thnh phn

CTRYT c cc loi cht thi nguy hi nh: cht thi lm sng nhm A,B,C,D,E.

Cc loi cht thi ny c bit l cht thi nhim khun nhm A, cht thi phuthut nhm E c cha nhiu mm bnh, vi khun gy bnh c th thm nhp vo c

th con ngi bng nhiu con ng v nhiu cch khc nhau. Cc vt sc nhn

nh kim tim d lm try xc da, gy nhim khun. ng thi, trong thnh

phn cht thi y t cn c cc loi ho cht v dc phm c tnh c hi nh: c

tnh di truyn, tnh n mn da, gy phn ng, gy n. Nguy him hn cc loi trn

l cht thi phng x pht sinh t vic chun bnh bng hnh nh nh: chiu chp

X-quang, tr liu

Cho n nay, chn lp vn l bin php x l cht thi rn ph bin nht ivi nhiu nc trn th gii trong c Vit Nam. u im chnh ca cng ngh

chn lp t tn km v c th x l nhiu loi cht thi rn khc nhau so vi cng

ngh khc. Tuy nhin hnh thc chn lp li gy ra nhng hnh thc nhim khc

nh nhim nc, mi hi, rui nhng, cn trngHn na, cng ngh chn lp

khng th p dng x l trit cc loi cht thi y t, c hi. Ngoi ra trong

qu trnh th ho nh hin nay, qut ngy cng thu h p, dn n kh khn

trong vic la chn v tr lm bi chn lp rc.

V vy, p dng mt s bin php x l rc khc song song vi chn lp l

mt nhu cu rt thit thc. Cng nght cht thi rn, mt trong nhng cng ngh

thay th, ngy cng trnn ph bin v c ng dng rng ri c bit vi loi

hnh cht thi rn y t v c hi. Cng nght cht thi rn s t tn km hn nu

i km vi bin php khai thc tn dng nng lng pht sinh trong qu trnh.


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CHNG I

TNG QUAN V CHT THI Y T V PHNG PHP X

L CHT THI Y T

I.1. nh ngha v cc c trng ca cht thi y t

I.1.1. nh ngha cht thi y t

Cht thi y t (CTYT) l cht thi t cc hot ng khm cha bnh, chm

sc, xt nghim, nghin cuCTYT nguy hi l cht thi c cc thnh phn nh:

mu, dch cth, cht bi tit, cc b phn, cquan; bm, kim tim, vt sc nhn,

dc phm, ha cht, cht phng xthng dng rn, lng, kh. CTYT c

xp l cht thi nguy hi, cn c phng thc lu gi, x l, thi bc bit, c quy

nh ring; gy nguy hi sc khe, an ton mi trng hay gy cm gic thiu thm

m.

Rc sinh hot y t l cht thi khng xp vo cht thi nguy hi, khng c

kh nng gy c, khng cn lu gi, x l c bit; l cht thi pht sinh t cc

khu vc bnh vin: giy, plastic, thc phm, chai l

Rc y t (RYT) l phn cht thi y tdng rn, khng tnh cht thi dng

lng v kh, c thu gom v x l ring.

I.1.2. Phn loi cht thi y t:

I.1.2.1. Cht thi lm sng

Nhm A: cht thi nhim khun, cha mm bnh vi s lng, mt

gy bnh, b nhim khun bi vi khun, virus, k sinh trng, nmbao gm cc vt

liu b thm mu, thm dch, cht bi tit ca ngi bnh nh gc, bng, gng tay,

bt b gy xng, dy truyn mu

Nhm B:l cc vt sc nhn: bm tim, li, cn dao m, mnh thy tinh v

v mi vt liu c th gy ra cc vt ct hoc chc thng, d chng c c s dng

hay khng s dng.

Nhm C: cht thi nguy c ly nhim pht sinh t phng xt nghim: gng

tay, lam knh, ng nghim, bnh phm sau khi xt nghim, ti ng mu

Nhm D:cht thi dc phm, dc phm qu hn, b nhim khun, dc

phm b, khng cn nhu cu s dng v thuc gy c t bo.


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Nhm E:l cc m cquan ngi ng vt, cquan ngi bnh, ng vt,

m cth (nhim khun hay khng nhim khun), chn tay, nhau thai, bo thai

I.1.2.2. Cht thi phng x

Ti cc c sy t, cht thi phng x pht sinh t cc hot ng chun on

ho, ho tr liu, v nghin cu. Cht thi phng x gm: dng rn, lng v kh.

Cht thi phng x rn bao gm: Cc vt liu s dng trong cc xt nghim,

chun on, iu tr nhng tim, bm tim, kim tim, knh bo h, giy thm, gc

st khun, ng nghim, chai lng cht phng x

Cht thi phng x lng bao gm: Dung dch c cha cht phng x pht

sinh trong qu trnh chun on, iu tr nh nc tiu ca ngi bnh, cc cht bi

tit, nc sc ra cc dng c c cht phng x

Cht thi phng x kh bao gm: Cc cht kh thot ra t kho cha chtphng x

I.1.2.3.Cht thi ho hc

Cht thi ho hc bao gm cc ho cht c th khng gy nguy hi nh

ng, axit bo, axit amin, mt s loi mui v ho cht nguy hi nh

Formaldehit, ho cht quang hc, cc dung mi, ho cht dng tit khun y t v

dung dch lm sch, kh khun, cc ho cht dng trong ty u, thanh trng

Cht thi ho hc nguy hi gm: Formaldehit: y l ho cht thng c s dng trong bnh vin, n c

s dng lm v sinh, kh khun dng c, bo qun bnh phm hoc kh khun

cc cht thi lng nhim khun. N c s dng trong cc khoa gii phu bnh,

lc mu, p xc

Cc cht quang ho: Cc dung dch dng c nh phim trong khoa

Xquang.

Cc dung mi:Cc dung mi dng trong csy t gm cc hp cht cahalogen nh metyl clorit, chloroform, cc thuc m bc hi nh halothane; Cc hp

cht khng cha halogen nh xylene, axeton, etyl axetat

Cc cht ho hc hn hp: Bao gm cc dung dch lm sch v kh khun

nh phenol, du mv cc dung mi lm v sinh


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I.1.2.4. Cc bnh cha kh nn c p sut

Nhm ny bao gm cc bnh cha kh nn c p sut nh bnh ng oxy,

CO2, bnh gas, bnh kh dung, cc bnh cha kh s dng mt ln a s cc bnh

cha kh nn ny thng d n, d chy nguy c tai nn cao nu khng c tiu

hy ng cch.I.1.2.5.Cht thi sinh hot

Nhm cht thi ny c c im chung nh cht thi sinh hot thng thng

t h gia nh gm giy loi, vi loi, vt liu ng gi thc n cn tha, thc phm

thi b v cht thi ngoi cnh nh l, hoa qu rng

I.1.3. Ngun pht sinh

Xc nh ngun pht sinh cht thi c quan h cht ch ti vic qun l

chung v trong nhiu trng hp nu x l ngay u ngun hiu qu s cao hn.

Cn c vo s phn loi trn c th thy cht thi bnh vin gm 2 phn

chnh: Phn khng c hi (chim khong 85%) tng s cht thi bnh vin) loi

cht thi ny ch cn x l nh nhng cht thi cng cng v sinh hot khc. Phn

cn li (chim 15%) l nhng cht thi c hi nguy him, cn c bin php x l

thch hp.

Hnh 1.1. Ngun pht sinh cht thi bnh vin


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I.1.4. Thnh phn cht thi y t

Thnh phn vt l:

Bng vi si: Gm bng bng, gc, qun o, khn lau, vi tri

Giy: Hp ng dng c, giy gi, giy thi t nh v sinh.

Nha: Hp ng, bm tim, dy chuyn mu, ti ng hng.

Thy tinh: Chai l, ng tim, bm tim thy tinh, ng nghim.

Nha: Hp ng, bm tim, dy truyn mu, ti ng.

Kim loi: Dao ko m, kim tim.

Thnh phn tch ra t cth: Mu m t bng gc, b phn cth b ct b.

Thnh phn ha hc:

V c: Ha cht, thuc th Hu c: vi si, phn cth, thuc.

Thnh phn sinh hc:

Mu, bnh phm, b phn cth b ct b

I.2.Tc hi ca cht thi rn y t

I.2.1. i vi sc khe

Cc loi hnh ri ro:Vic tip xc vi cc cht thi y t c th gy nn bnh tt hoc tn thng.

Kh nng gy ri ro t cht thi y t c th do mt hoc nhiu c trng cbn sau:

Cht thi y t cha ng cc yu t truyn nhim, l tc nhn nguy hi c

trong rc thi y t.

Cc loi ha cht dc phm c thnh phn c, t bo nguy him.

Cc cht cha ng v phng x.

Vt sc nhn c th gy tn thng. Cht thi c yu tnh hng tm l x hi.

Nhng i tng c th tip xc vi nguy c:

Tt c mi c nhn tip xc vi cht thi y t nguy hi l nhng ngi c

nguy ctim tng, bao gm nhng ngi lm trong cc csy t, nhng ngi lm

nhim v vn chuyn cc cht thi y t v nhng ngi trong cng ng b phi

nhim vi cht thi do hu qu ca s bt cn v tc trch trong khu qun l v

kim sot cht thi.


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Nguy ct cht thi truyn nhim v cc vt sc nhn:

Cc vt th trong thnh phn cht thi y t cha ng mt lng ln cc tc

nhn vi sinh vt gy bnh truyn nhim nh t cu, HIV, vim gan B. Cc tc nhn

ny c th thm nhp vo cth ngi thng qua cc cch thc sau:

Qua da, qua mt vt thng, try xc hoc vt cn trn da do vt sc nhngy tn thng.

Qua nim mc, mng nhy.

Qua ng h hp do ht phi.

Qua ng tiu ha do nut, n phi.

Nguy ct cc cht thi gy c t bo:

i vi nhn vin y t do nhu cu cng vic phi tip xc v x l loi cht

thi gy c t bo m mc nh hng v chu tc ng t cc ri ro tim tng

s ph thuc vo cc yu t nh tnh cht, liu lng gy c ca cht c v

khong thi gian tip xc. Qu trnh tip xc vi cc cht c c trong cng tc y t

c th xy ra trong lc chun b hoc trong qu trnh iu tr bng cc thuc c bit

hoc bng phng php ha tr liu. Nhng phng thc tip xc chnh l ht phi

ha cht c tnh nhim c dng bi hoc hi qua ng h hp, b hp th qua

da do tip xc trc tip, qua ng tiu ha do n phi thc phm nhim thuc.

c tnh i vi t bo ca nhiu loi thuc chng ung th l tc ng ncc chu kc bit ca t bo, nhm vo cc qu trnh tng h p AND hoc qu

trnh phn bo nguyn phn. Nhiu loi thuc c c tnh cao v gy nn hu qu

hy hoi cc b sau khi tip xc trc tip vi da hoc mt. Chng cng c th gy

ra chng mt bun nn, au u hoc vim da.

Nguy ct cht thi phng x:

Loi bnh v hi chng gy ra do cht thi phng xc xc nh bi loi

cht thi i tng v phm vi tip xc. N c th l hi chng au u, hoa mt,

chng mt v nn nhiu mt cch bt thng. Cht thi phng x, cng nh cht

thi dc phm, l mt loi c hi ti t bo, gen. Tip xc vi cc ngun phng

x c hot tnh cao v d nh ngun phng x ca cc thit b chun on nh my

Xquang, my chp ct lp c th gy ra mt lot cc tn thng chng hn nh

ph hy cc m, nhiu khi gy ra bng cp tnh.

Cc nguy ct nhng loi cht thi c cha cc ng v c hot tnh thp c

th pht sinh do vic nhim x trn b mt ca cc vt cha, do phng thc hoc

khong thi gian lu gi ca loi cht thi ny. Cc nhn vin y t hoc nhng


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ngi lm nhim v thu gom v vn chuyn rc khi phi tip xc vi cht thi c

cha cc loi ng v phng x ny l nhng ngi c nguy ccao.

Tnh nhy cm x hi:

Bn cnh vic lo ngi i vi nhng mi nguy cgy bnh ca cht thi rn

y t tc ng ln sc khe, cng ng thng cng rt nhy cm vi nhng ntng tm l, gh sc bit l khi nhn thy loi cht thi thuc v gii phu, cc

b phn cth b ct b trong phu thut nh chi, d dy, cc loi khi u, rau thai,

bo thai, mu

I.2.2. i vi mi trng

i vi mi trng t:

Khi cht thi y tc chn l p khng ng cch th cc vi sinh vt gy

bnh, ha cht c hi c th ngm vo t gy nhim c t lm cho vic ti s

dng bi chn lp gp kh khn

i vi mi trng khng kh:

Cht thi bnh vin t khi pht sinh n khu x l cui cng u gy ra

nhng tc ng xu n mi trng khng kh. Khi phn loi ti ngun, thu gom,

vn chuyn chng pht tn bi rc, bo t vi sinh vt gy bnh, hi dung mi, ha

cht vo khng kh. khu x l (t, chn lp) pht sinh ra cc kh c hi HX,

NOX, ioxin, furan t l t v CH4, NH3, H2S t bi chn lp. Cc kh nynu khng c thu hi v x l s gy nh hng xu ti sc khe ca cng ng

dn c xung quanh.

i vi mi trng nc:

Nc thi bnh vin cha nhiu ha cht c hi, phng x, tc nhn gy

bnh cc kh ly nhim cao nh Samonella, coliform, t cu, lin cu Nu khng

c x l trc khi thi b vo h thng thot nc chung ca thnh ph th c th

gy ra tnh trng nhim nghim trng ngun nc.Khi chn lp cht thi y t khng ng k thut v khng hp v sinh. c

bit l cht thi y tc chn lp chung vi cht thi sinh hot c th gy nhim

ngun nc ngm.


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I.3. Phng php qun l v xl cht thi y t

I.3.1. Qun l cht thi y t

I.3.1.1. Gim thiu ti ngun

Chn nh cung cp hu cn cho bnh vin m sn phm ca h t ph thihay gim lng cht thi rn y t nguy hi phi x l c bit.

S dng cc bin php kh trng ty u c l hc nhiu hn cc bin php

ha hc s gim thiu cht thi nguy hi.

Gim thiu cht thi, nht l trong cng tc h l v kh trng ty u.

I.3.1.2. Qun l v kim sot bnh vin

Tp trung qun l thng nht cc loi thuc, ha cht nguy hi

Gim st s lun chuyn lu hnh ha cht, dc cht ngay t khu nhn,nhp kho, s dng v tiu hy thi b.

I.3.1.3. Qun l kho ha cht, dc cht

Thng xuyn nhp hng tng lng nh hn l nhp qu nhiu mt t d

dn ti tha hay qu hn.

S dng cc l hng c trc, hng mi dng sau

S dng ton b thuc, dc cht vt t trong kin ri mi chuyn sang kin

mi. Thng xuyn kim tra hn s dng ca cc loi thuc, dc cht, vt t tiu

hao ngay t khi nhp hng cng nh trong qu trnh s dng.

I.3.1.4. Thu gom, phn loi v vn chuyn

Tch Phn loi:

im mu cht ca bin php ny l phn loi v tch ngay tu mt cch

chnh xc cht thi y t nguy hi v cht thi rn thng thng. Vic tch v phn

loi chnh xc cht thi y t to iu kin thun li cho cc qu trnh tip theo nhqu trnh vn chuyn v lu ti trm hay ni trung chuyn v qu trnh vn chuyn

ti ni tiu hy v qu trnh tiu hy.

Vic tch v phn loi cht thi rn y ti hi phi c thng cha, ti lt

thng cha dy tht ti, hp nht vt sc nhn. Yu cu mu sc phi thng nht

d qun l cht thi y t c phn loi thu gom trong sut qu trnh lu thng.


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Bng 1.1. Yu cu mu sc, nh du nhn thng v ti ng cht thi y t

Loi cht thi Mu v nh du nhn Loi thng,ti

Cht thi ly nhim cao Vng, k hiu nhimkhun cao

Thng nha, ti nha bnchc chn

Cht thi ly nhim, bnh

phm, gii phu

Vng, c logo nhim

khun

Thng nha, ti nha bn

Vt sc nhn Vng, ch vt sc

nhn

Ti nha bn, hoc hp

giy, chai nha

Cht thi y t c ng v

phng x

Vng nu, logo c bc x

theo quy inh

H p ch, kim loi c dn

nhn bc x

Cht thi y t thng

thng

en, nh ti ng rc

sinh hot

Ti nilon, thng nha,

kim loi

Thu gom ti phng khoa

H l v nhn vin y t phn loi, tch cht thi y t ngay trong qu trnh

thc hnh nghip vu chuyn mn k thut nh thay bng, tim truyn. Hot ng

ny phi duy tr thng xuyn lin tc.

Nhn vin chuyn trch thu gom cht thi y t t cc bung chuyn mn tp

trung v thng lu cha trung chuyn, vn chuyn v khu lu trung chuyn cht

thi y t nguy hi bnh vin. Cn ch :

Cht thi phi c thu gom hng ngy v chuyn v ni lu, trung chuyn

cht thi ca bnh vin.

Thng ti cha y cht thi, khi vn chuyn i phi c nhn ghi r cht

thi t khoa, bnh vin, ngy gi.

Phi c ngay thng, ti cha rc t ngay vo v tr khi chuyn thng ci.

Lu cha:

Khu trung chuyn lu cha cht thi y t c th xy dng ring hoc c th

kt hp vi nh xng lp t l t nu c trang b tiu hy ti ch. Nh

xng l t v lu cht chi rn y t nguy hi, x l thng thu gom c din tch

bao che (i vi tuyn tnh) t 40 50 m2.

Tng dy 110 mm, c ca li thp


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Ct thp ch I 200

Phn trn tng bao quanh lp li B40 khung thp cao 2200 mm

Mi lp tn ausman. Nn lt gch chng trn, d ra.

Thi gian lu cha nhsau:

Tt nht l vn chuyn cht thi rn y t nguy hi i x l ngay trong ngy.

Vn chuyn cht thi i x l trong vng 48 h i vi ma ng

Vn chuyn cht thi i x l trong vng 24 h i vi ma h.

I.3.2. Xl cht thi y t

I.3.2.1. Cc phng php chnh xl cht thi y t

Thiu t nhit cao

Kh trng

Chn lp hp v sinh

ng rn

X l bng phng php thiu t nhit cao:

Thiu t nhit cao l phng php thnh cng nht m bo ph hy

cc c tnh c hi ca cht thi y t, gim thiu th tch rc n 95% v tiu dit

hon ton vi khun gy bnh nhit (1050 1100oC). Phng php ny p ng

tt c cc tiu ch v tiu hy an ton ngoi tr vic pht thi cc kh thi cn cx l.

X l cht thi y t bng phng php kh trng:

Theo phng php ny, cc cht thi c kh nng ly nhim trc khi thi ra

mi trng nh cht thi sinh hot thng thng phi em i kh trng. cc nc

pht trin, vic kh trng cn c coi l cng on u ca vic thu gom cht thi

y t nhm hn ch kh nng gy tai nn ca cht thi.

Kh trng bng ha cht: Ha cht thng dng l Clo, hypoclorit. y lphng php n gin v r tin, nhng c nhc im l khng tiu dit c ht

lng vi khun trong rc nu thi gian tip xc ngn. Ngoi ra, mt s vi khun c

kh nng bn vng vi ha cht x l, hoc clo ch l cht kh trng hu hiu khi

khng c cc cht hu c Do vy, hiu qu ca phng php kh trng khng

cao.

Kh trng bng nhit v p sut cao: y l phng php kh trng hiu qu

cao nhng thit b x l t tin v i hi ch vn hnh, bo dng cao


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13

X l bng phng php chn lp:

y l phng php ph bin c dng nhiu ni nht l cc nc ang

pht trin. Cht thi sau khi c chuyn n bi chn lp thnh tng c lp ph,

lp lt trn v di chn lp ngn nga cht thi pht tn theo gi hoc ngmvo lng t.

X l bng phng php ng rn:

Qu trnh ng rn cht thi cng vi cht c nh xi mng, vi. Thng

thng ngi ta trn hn hp rc y t nguy hi 65%, vi 15%, xi mng 15%, nc

5%. Hn hp ny c nn thnh khi, trong mt s trng hp n c dng lm

vt liu xy dng.

Trong thc hnh ti bnh vin, i vi mt s cht thi y t c dng sc nhnnh kim tim, li dao m, kim khu Ngi ta cng thng p dng phng

php thu gom v nht chx l.

I.3.2.2. Xl mt s loi rc thi y t

X l cht thi lm sng:

Cht thi nhm A : p dng 1 trong cc phng php sau:

- Thiu t l phng php tt nht cho cht thi ly nhim nhng kh thi

phi t tiu chun mi trng.- Chn lp hp v sinh: phi chn ti bi chn lp ring, c h thng chng

thm tt v che ph tc thi.

- Kh trng cht thi ly nhim: Bng x l nhit, vi sng, ha cht

Cht thi nhm B:

- Khng c t trong l

- Nn dng phng php chn lp

- C th thu hi cc phn kim loi

- ng rn

Cht thi nhm C:

- C th x l ging nh cht thi nhm A

Cht thi nhm D:

- Thiu t cng vi cht thi nhim khun nu c l t

- Chn lp: trc khi em chn lp phi ng rn cht thi


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14

Cht thi nhm E:

- Thiu t cng vi cht thi nhim khun nu c l t

- Chn lp ngha a hoc ni quy nh. Ti mt sa phng, theo tp tc

vn ha, ngi nh bnh nhn c c th t mang rau thai, bo thai, chi v cc phn

ct b ca cth ngi i chn, vi iu kin cc csy t phi m bo cc chtthi c ng trong cc ti nilon mu vng v ng gi, bao bc cn thn trc

khi giao cho ngi nh bnh nhn.

X l cht thi phng x:

Tt c cc cng on ca quy trnh qun l phi tun theo hng dn v x

l cht thi phng x. Thc hin theo cc quy nh ca php lnh an ton v kim

sot bc x ngy 25/6/1996, ngh nh s 50/c p nh nc ngy 16/7/1998 ca

chnh ph quy nh v vic thi hnh Php ln an ton v kim sot bc x v ccquy nh hin hnh ca nh nc.

X l cht thi ha cht:

Ha cht ha hc khngc hi: c th p dng 1 trong 2 phng php sau

- Ti s dng

- Tiu hy nh cht thi sinh hot

Ha cht ha hc nguy hi:

- Nguyn tc:

+ Nhng ha cht ha hc nguy hi c tnh cht khc nhau khng c trn

ln vi nhau tiu hy

+ Khng c t cht thi c cha halogen v s gy nhim kh

+ Khng c chn lp vi khi lng ln v s gy nhim ti nc ngm

- Phng php tiu hy:

+ Tr li ni sn xut

+ Thiu t

+ Chn lp: trc khi chn lp phi trha ng rn

X l cc bnh c p sut

Khng ln bnh cha kh c p sut vo cht thi lm sng thiu t v

c nguy cgy n. p dng 1 trong cc phng php sau x l:

- Tr li ni sn xut

- Ti s dng


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15

I.4. Hin trng qun l v xl cht thi y t

I.4.1. Hin trng qun l v xl cht thi y t trn th gii

Trn th gii, qun l rc thi bnh vin c nhiu quc gia quan tm v

tin hnh mt cch trit t rt lu. V qun l, mt lot nhng chnh sch quy

nh, c ban hnh nhm kim sot cht ch loi cht thi ny. Cc hip c

quc t, cc nguyn tc, php lut v quy nh v cht thi nguy hi, trong c c

cht thi bnh vin cng c cng nhn v thc hin trn hu ht cc quc gia

trn th gii.

Cngc Basel:c k kt bi hn 100 quc gia, quy nh v s vn chuyn

cc cht c hi qua bin gii, ng thi p dng, c vi cht thi y t. Cng c

ny a ra nguyn tc ch vn chuyn hp php cht thi nguy hi t cc quc gia

khng c iu kin v cng ngh thch hp sang cc quc gia c iu kin vt chtk thut x l an ton mt s cht thi c bit.

Nguyn tc pollutor pay: Nu r mi ngi, mi cquan lm pht sinh cht thi

phi chi trch nhim v php lut v ti chnh trong vic m bo an ton v gi

cho mi trng trong sch.

Nguyn tc proximitry: Quy nh rng vic x l cht thi nguy hi cn c

tin hnh ngay ti ni pht sinh cng sm cng tt. Trnh tnh trng cht thi b lu

gi trong thi gian di gy nhim mi trng.

X l cht thi bnh vin, tu thuc vo iu kin kinh t v khoa hc cngngh, nhiu nc trn th gii c nhng bin php khc nhau x l loi rc

thi nguy hi ny.

Cc nc pht trin

Hin ti trn th gii hu ht cc quc gia pht trin, trong cc bnh vin,

cschm sc sc khe, hay nhng cng ty c bit x l ph thi u c thit lp

h thng x l loi ph thi y t. l cc loi l t nhit cao ty theo loi

ph thi t 1000

o

C n trn 4000

o

C. Tuy nhin phng php ny hin nay vn cnang tranh ci v vic x l kh bi sau khi t c thi hi vo khng kh.

Cc ph thi y t trong khi t, thi hi vo khng kh c nhiu ht bi li ti

v cc ha cht c hi pht sinh trong qu trnh thiu t nh axit clohidric,

ioxin/furan, v mt s kim loi c hi nh thy ngn, ch hoc asen, cadmi. Do

, ti Hoa k vo nm 1996, bt u c cc iu lut v kh thi ca l t v

yu cu kh thi phi c gim thiu bng h thng lc ha hc v chc ty theo

loi ph thi.


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16

Ngoi ra cn c phng php khc gii quyt vn ny c cc

quc gia lu tm n v phng php t gy ra nhiu bt li do lng kh c

hi pht sinh thi vo khng kh, do cc nh khoa hc hin ang p dng mt

phng php mi. l phng php nghin nt ph thi v x l di nhit v

p sut cao trnh vic phng thch kh thi.Da theo phng php ny rc thi y t nguy hi c chuyn qua mt my

nghin nt. Ph thi c nghin xong sc chuyn qua mt phng hi c

nhit 138oC v p sut 3,8 bar. iu kin nhit v p sut trn l iu kin

ti u cho hi nc bo ha. Ph thi c x l trong vng 40 60 pht. Sau cng

ph thi rn c x l sc chuyn n cc bi rc thng thng v t

c tiu chun tit trng. Phng php ny cn c u im l lm gim c khi

lng ph thi v c nghin nt, chi ph t tn km hn l t, cng nh khng

to ra kh thi vo khng kh.

Ti cc nc ang pht trin

i vi cc nc ang pht trin, vic qun l mi trng ni chung vn cn

rt l l, nht l i vi ph thi bnh vin. Tuy nhin trong khong 5 nm tr li

y, cc quc gia nhn , Trung Quc bt u ch n vic bo v mi

trng, v c nhiu tin b trong vic xy dng cc l t bnh vin. c bit

n t nm 1998, chnh ph ban hnh lut v Ph thi y t: Lp th tc v

Qun l. Trong b lut ny c ghi r rang phng php tip nhn ph thi, phnloi ph thi, cng vic x l v di di n cc bi rc Do , vn ph thi y t

c hi ca quc gia ny c ci thin rt nhiu.

I.4.2. Hin trng qun l v xl cht thi y t ti Vit Nam

Hin nay, ngnh y t c 11657 c skhm cha bnh vi 136542 ging

bnh, trong 843 bnh vin t tuyn huyn trln, khi y t t nhn c 17701 c

sy t t phng khm ti bnh vin t hot ng. S lng v mng li y t nh

vy l ln so vi cc nc trong khu vc, song vn m bo v sinh mi trng,x l cht thi ti cc cst trung ng ti a phng cn qu yu, hu ht cha

c h thng x l cht thi hoc rc thi, mt vi ni tuy c hot ng nhng cha

t yu cu k thut.

Vi mng li y t nh vy, lng rc thi rn y t pht sinh trn ton quc

l 11800 tn/ngy. Trong c khong 900 tn cht thi y t nguy hi.


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17

Bng 1.2. Khi lng cht thi rn y tnguy hi cc bnh vin ca mt stnh

thnh ph

Tnh, thnh ph Khi lng rc

YTNH (T/nm)

Tnh, thnh ph Khi lng rc

YTNH (T/nm)

Hi Phng 547 Tp H Ch Minh 4730Ph Th 70 ng Nai 180

Cn Th 110 Bnh Dng 368

H Ni 410 B Ra Vng Tu 288

Qung Ninh 190 Thi Nguyn 215

Hng yn 73 Hi Dng 132

Ngun: Bo co hin trng mi trng, 2003 ca cc tnh thnh trn c

nc

Qun l rc:

92,5% s bnh vin c thu gom rc thng k, 14% s bnh vin c phn

loi rc y t x l. Tuy nhin phn loi rc t khoa phng khm v iu tr bnh

nhn cha trthnh ph bin.

Hu ht cht thi rn cc bnh vin khng c x l trc khi chn lp

hoc t. Mt s t bnh vin c l t rc y t song qu c, hoc t l thin gy

nhim mi trng.

Phn loi cht thi y t:

a s cc bnh vin thc hin phn loi cht thi ngay t ngun nhng vic

phn loi cn phin din v km hiu qu do nhn vin cha c o to.

Thu gom cht thi y t:

Theo quy nh, cht thi y t v cht thi sinh hot u c cc h l v y

cng thu gom hng ngy ngay ti khoa phng. Cc i tng khc nh bc s, y t

cn cha c hun luyn tham gia vo hot ng qun l cht thi y t. Tnh

trng chung l cc bnh vin khng c o bo h v cc phng tin bo h khc

cho nhn vin trc tip tham gia vo thu gom, vn chuyn v tiu hy cht thi.

Lu tr cht thi y t:

Hu ht cc im tp trung rc u nm trong khun vin bnh vin, v sinh

khng m bo, c nhiu nguy cgy ri do vt sc nhn ri vi, nhiu cn trng

xm nhp nh hng n mi trng bnh vin. Mt sim tp trung rc khng

c mi che, khng c ro bo v, v tr gn ni i li, nhng ngi khng c nhim

v d xm nhp.


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18

Vn chuyn cht thi ngoi csy t:

Nhn vin ca cng ty mi trng thn thu gom cc ti cht thi ca bnh

vin, hin cha c xe chuyn dng chuyn chcht thi bnh vin. C nhn vin

bnh vin ln nhn vin cng ty mi trng thu cha c o to, hng

dn v nguy cc lin quan n thu gom, vn chuyn v tiu hy cht thi.

I.4.3. Hin trng qun l v xl cht thi y t ti Thi Nguyn

Thi Nguyn c 19 bnh vin, 13 phng khm a khoa, 1 trung tm iu

dng, 1 tri phong, 2 nh h sinh, 177 trm y t x phng, vi tng s 3882

ging bnh. Vi lng cskhm cha bnh trn, nm 2006 lng rc thi pht

sinh trn ton thnh ph l 9846 kg/ngy m.

Bng 1.3. Lng cht thi pht sinh tcc bnh vin thnh phThi Nguyn

Lng cht thi rn pht sinhTT Loi bnh vin Tng s bnh

vin Tng lng

(T/nm)

T l nguy hi

(%)

1 a khoa c p TW 1 BV: 550

ging

182 23,0

2 Bnh vin ca tnh 9 BV: 1190

ging

466 28,5

3 Bnh vin ca

huyn

9 BV: 485

ging

441 12,0

Tng s 19 bnh vin: 2225 ging 1089 21,2

(Ngun: D n QLMT tnh Thi Nguyn, hp phn cht thi y t DANIDA)

Trong thi gian gn y, tnh hnh qun l v x l rc thi y tthnh ph

c quan tm u t ng mc. Phn ln cc bnh vin u c trang b

thng rc phn loi cht thi. Tuy nhin, phn ln rc thi y t vn c tp

trung trong khun vin bnh vin. Do khu vc ny cht thi lu tr lu ngy, khng

c v sinh thng xuyn, nn mi hi thi bc ln to iu kin cho vi sinh vt

gy bnh pht tn.

Hin nay, hu ht lng rc thi trn thnh ph Thi Nguyn u c thu

gom bi cng ty mi trng th. Cht thi bnh vin sau khi c thu gom ti

khu t p trung sc cng ty Mi trng th thu gom ti p trong khong thi

gian 1 2 ngy mt ln v c vn chuyn n bi rc ca thnh ph x l. Ti


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19

y rc thi sinh hot c chn lp, cht thi rn y t sc thiu t ti l t

t bi rc.

Hin c 1 l t cht thi y tt ti bnh vin Gang thp, cng sut ca l

t l 50 kg/h. Tuy nhin, l t ny chc thit k hot ng gin on, khng

c h thng gt tro tng, tn sut 2 ln 1 tun.Mi y, thnh ph c trang b thm 1 l t Hoval t ti khu x l

rc Tn Cng, cng sut thc t l 20 40 kg/ngy (cng sut thit k l 400

kg/ngy), tn sut hot ng 2 ngy/ln.


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20

CHNG II

HIN TRNG THU GOM V XL CHT THI RN Y T CA

BNH VIN A KHOA TRUNG NG THI NGUYN

II.1. Gii thiu v bnh vin

Bnh vin a Khoa Trung ng Thi Nguyn c thnh lp t nm 1953,

l bnh vin trc thuc b y t. y l mt bnh vin c k tha v pht trin t

bnh vin khu t tr Vit Bc.

Trong hn nm thp k qua, trong qu trnh pht trin ca mnh, c

iu kin lm tt cng tc khm cha bnh, nghin cu khoa hc, o to khu

vc c nhiu khu cng nghip tp trung v ng dn c ca cc dn tc min ni

pha bc, c s quan tm ca b y t v cc v c lin quan, bnh vin tngbc c u t xy dng v ci to. T nhng nh tm cp 4 mi tranh vch na

n nay bnh vin c c kt cu cng trnh mi bng khung ct b tong ct

thp, quy m ngy cng c mrng khang trang.

II.2. Chc nng ca bnh vin

Bnh vin a Khoa Trung ng Thi Nguyn trc thuc b y t c chc

nng nhim v:

Khm v iu tr cho cn b, nhn dn cc dn tc Thi Nguyn, cc huynca cc tnh ln cn (Tuyn Quang, Lng Sn, Bc Giang, Cao Bng).

L Tuyn cui tip nhn cc bnh nhn nng ca cc bnh vin trong tnh v

cc bnh vin ngnh ng trong khu vc.

Bi dng nghip v cho cc cn b y t thuc cc tnh Lo Cai, Yn

Bi,Tuyn Quang, Lng Sn, H Giang, Cao Bng.

L csthc hnh chnh ca Trng i Hc Y Khoa Thi Nguyn.

o to bc schuyn khoa cp I.

Nghin cu khoa hc: M hnh bnh tt, sc khe mi trng khu vc min

ni pha bc.

Tuyn Truyn Gio dc sc khe y t cho cc tnh min ni pha bc.

Thc hin cc chng trnh y t: ARI (nhim trng h hp), SDD (suy dinh

dng), chng m la, tiu chy, st rt, bu c.

Thc hin kinh t y t.


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21

II.3. Quy m cv ccu t chc ca bnh vin

Bnh vin a Khoa Trung ng Thi Nguyn hot ng vi quy m hin ti

l 560 ging bnh, l bnh vin khu vc phc v cho cn b v nhn dn tnh Thi

Nguyn v cc tnh min ni pha bc t nc. Bnh vin c nhiu cn b, y bc s

c nng lc v chuyn mn. Vi quy hoch pht trin mng li bnh vin giaion 2005 -2010 c ph duyt theo quyt nh s 1047/Q BYT, bnh vin

s c quy m trn 700 ging bnh vo nm 210 v mt s chuyn khoa mi: n

v thn nhn to, khoa ni tit, phu thut thn kinh, dinh dng cha bnh.

Vi tng s cng nhn vin chc l 517 ngi, trong n c 477 ngi vi

ccu t chc b my bnh vin nh sau:

ng y Gim c Cng on, onthanh nin

Cc khoa cn lm sng:- Khoa huyt hc TM- Khoa sinh ha- Khoa vi sinh- Khoa gii phu bnh- Khoa thm d chc

nng- Khoa Xquang- Khoa chng nhimkhun- Khoa dc- Khoa dinh dng

Cc khoa cn lm sng:- Khoa khm bnh- Khoa hi sc cp cu- Khoa ni- Khoa truyn nhim- Khoa da liu- Khoa thn kinh- Khoa tm thn- Khoa ng y- Khoa nhi- Khoa ngoi- Khoa gy m hi sc- Khoa chn thng- Khoa sn- Khoa tai mi hng- Khoa rng hm mt- Khoa mt

- Khoa vt l tr liu- Khoa y hc ht nhn- Khoa u bu

Cc phng chcnng:

- Phng k hoch- Phng hnhchnh qun tr- Phng ti chnhk ton- Phng vt tTBYT- Phng y t iudng- Phng t chccn b - bo v


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II.4. Tnh hnh hot ng y t ca bnh vin trong nhng nm gn y

Thng k s liu c bn v tnh hnh hot ng ca bnh vin a Khoa

Trung ng Thi Nguyn c th hin trong bng 2.1:

Bng 2.1. Sliu cbn vhotng chuyn mn ca bnh vina Khoa

Trungng Thi Nguyn:STT Thc hin 2000 2001 2002 2003 2004

1 Ging bnh k hoch 560 560 560 560 560

2 Tng s ln khm bnh 189701 170193 191108 192048 167484

3 TS bnh nhn T

ngoi tr

889 630 821 981 648

4 TS Bnh nhn T ni

tr

20830 20060 22660 23450 22085

5 Tng s ngy iu tr 22095 220547 225769 227338 224998

6 Ngy iu tr trung

bnh

11 10,09 10 9,7 9,6

7 Ngy s dng

ging/thng

34,2 32,8 33,6 33,8 31,5

8 T l t vong (%) 1,4 1,3 1,2 1,2 1,2

9 Tng s phu thut 4458 4273 4373 4487 5085

10 Phu thut cp cu 2610 2515 2596 2735 235011 Mnh sn 37 29 28 36 63

12 No ph thai 813 667 648 632 476

13 t vng 214 85 74 205 152

14 S lng mu (lt) 314 410 430 709 403

15 Tng s xt nghim 299532 293762 359706 378354 422819

S ln chiu 16251 14012 1073016 Xquang

S ln ch p 53712 52036 57110 54347 52494ng v

phng x

42 64 88 9417 Tng

s ln

thm

d

Siu m 6272 15457 13966 12474 13928

Trc trng 1491 2035 1397 1348

Bang quang 2 6 29 34

18 Tng

s ln

soi

D dy 1630 6780 4928 4230

4921


23/92



23

II.5 Hin trng thu gom v xl cht thi rn y t ca bnh vin

II.5.1. Ngun pht sinh

Rc thi ti bnh vin c pht sinh t cc hot ng khm cha bnh, sinh

hot hng ngy ca bnh nhn, ngi thn phc v, cn b y t. Nhn chung, rc

thi bnh vin thng pht sinh t nhng hot ng ch yu sau:

Cc cht thi pht sinh t cc hot ng chuyn mn, t cc qu trnh khm

cha bnh:

- Cc cht nhim khun bao gm: nhng vt liu thm mu, thm dch v cc

cht bi tit ca ngi bnh, nh bng, gc, bng, gng tay, tp d, o chong, bt

b, vi, cc ti hu mn nhn to, dy truyn mu, cc ng thng, dy v ti

dung dch dn lu.

- Tt c cc vt sc nhn bao gm bm tim, kim tim, li dao cn m, ca,cc mnh thy tinh vv mi vt liu c th gy ra vt ct hoc chc thng, cho d

chng c th b nhim khun hay khng.

- Cc cht thi c nguy cly nhim cao, pht sinh t cc phng th nghim,

bao gm: Gng tay, lam knh, ng nghim, bnh phm sau khi sinh thit, xt

nghim, nui cy, ti PE ng mu

- Cht thi dc phm, bao gm: Dc phm qu hn, dc phm b nhim

khun, dc phm b, dc phm khng cn nhu cu s dng, thuc gy c t

bo.- Cc m v c quan ngi ng vt, bao gm tt c cc m c th (d

nhim khun hay khng), cc cquan, chn tay, rau thai, bo thai, xc sc vt

- Cht thi phng x pht sinh t cc hot ng chn on, ha tr liu v

nghin cu bao gm cc th loi trn nhng vi mc nhim phng x khc nhau.

- Cc cht ha hc nguy hi: Formaldehyde (c s dng trong khoa gii

phu bnh, lc mu, p xc v bo qun cc mu xt nghim), cc ha cht ha

hc hn hp (cc dung dch lm sch v kh khun nh phenol, du m, cc dungdch lm v sinh).

Cc cht thi sinh hot ca bnh nhn, thn nhn, cn b nhn vin y t ti

bnh vin: Giy vn, v hp, thc n tha, rau, v tri cy.

Cht thi t hot ng chung ca bnh vin nh l cy, giy loi

Trong s cc loi cht thi rn trn th cht thi pht sinh t cc hot ng

chuyn mn c coi l cht thi y t c hi thng chim khong 10% tng

lng rc thi bnh vin.


24/92



24

II.5.2. Lng thi

Lng rc thi pht sinh trong bnh vin t l thun vi s ging bnh

trong bnh vin v c thc tnh theo kt qu kho st thc t, kinh nghim v

cng thc thc nghim. S ging bnh l N th lng ngi trong bnh vin l 4N,

vi trung bnh mi ngi thi ra khong 0,75 kg/ngy m th lng rc thi hngngy l 3N kg/ngy m.

Vi tng s ging bnh l 560 ging th lng rc thi ca bnh vin a

Khoa Trung ng Thi Nguyn l:

560 ging x 3 kg/ging.ngy m = 1680 kg/ngy m

Trong lng rc thi y t chim 10% lng rc thi bnh vin tc l 168

kg/ngy m.

II.5.3. Thnh phn rc thi ca bnh vin Thnh phn ca rc thi bnh thng (cht thi sinh hot ca bnh

nhn, thn nhn, cc cn b nhn vin y t ti bnh vin.).

Bng 2.2. Thnh phn rc thi sinh hot bnh thng ca bnh vin

TT Thnh phn T l khi lng (%)

1 Rc hu c 70

2 Nha cht do 3

3 Cc cht khc 104 Rc v c 17

5 m 65 69

Thnh phn ca rc thi y t (Cc cht thi pht sinh t cc hot ng chuyn

mn, t cc qu trnh khm cha bnh).

Bng 2.3. Thnh phn rc thi y t

TT Thnh phn T l khi lng (%)

1 Cc cht hu ccc loi 53,22 Giy cc loi 3

3 Thy tinh 3,2

4 Kim loi 0,7

5 Bng bng, thch cao 8,8

6 Plastic 10,1

7 Cht rn khc 21


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25

II.6. Hin trng thu gom v xl

Vi lng rc thi c tnh 1680 kg/ngy m, trong lng rc thi y t

c hi chim 10% (168 kg). Nu lng rc thi ny khng c thu gom v x l

trit th s tc ng nghim trng n mi trng.

Bnh vin a Khoa Trung ng Thi Nguyn vi quy m 560 ging bnhlng pht sinh rc hng ngy kh ln, c bit l lng rc thi y tc hi.

m bo v sinh mi trng trong bnh vin cng nh mi trng xung quanh,

trong bnh vin c mt t cng nhn v sinh chuyn trch vic qut dn, thu gom

rc thi. Tt c cc loi rc thi ca bnh vin c phn loi ngay ti phng bnh

theo ng quy cch ca b y t. S phn loi v thu gom rc thi ca bnh vin

c th hin trn hnh sau:

Hnh 2.1. S thu gom cht thi ca bnh vin

Quy trnh phn loi, thu gom v x l cht thi rn ti bnh vin a Khoa

Trung ng Thi Nguyn: Qu trnh phn loi cht thi sinh hot v cht thi y t

c thc hin ngay ti phng bnh vi quy nh rc thi sinh hot cho vo cc ti

mu xanh, rc thi y tc hi c phn lm 2 loi, i vi rc thi mm cho vo

Cht thi sinh hot

Ti mu xanh

Xe gom cht thisinh hot

Vn chuyn nnh cha rc

Chn lp ti birc ca thnh ph

Cht thi y t

Vt cng: B tronghp cng

Mm: Timu vng

Thng ng cht thic hi (mu en)

Vn chuyn n nhcha rc

t ti l t chtthi rn y t


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26

ti mu vng, vt cng c b vo trong hp cng. Sau , cc thnh phn rc thi

ny c nhn vin v sinh ti cc khoa vn chuyn n xe gom cht thi c t

ti u mi khoa. Ti y, lng rc thi c nhn vin v sinh bnh vin vn

chuyn n nh cha rc ri sau thu cng ty mi trng th vn chuyn i.

Rc thi sinh hot c chn lp ti bi chn lp rc ca thnh ph, rc thi y tc t ti l t rc t ti bi rc thnh ph.

Phng thc vn chuyn, bo qun ha cht theo ng quy nh v vn

chuyn bo qun ha cht. V x l ha cht qu hn (y chnh l cht thi thuc

nhm D theo phn loi ca b y t l cht thi dc phm bao gm dc phm qu

hn, dc phm b nhim khun, dc phm b, dc phm khng c nhu cu s

dng v thuc gy c t bo, y bnh vin a Khoa Trung ng Thi Nguyn

thc hin theo ng quy nh v quy ch qun l cht thi y t (Quyt nh s

2575/1999/Q BYT ngy 27 thng 8 nm 1999 ca b trng b y t) loi ha

cht ny c em i thiu hy cng vi cht thi y tc hi khc nhit cao,

m bo kh nng tiu hy ca thuc.

Hin nay, lng xe thu gom rc thi cn thiu, nh cha rc chn gin l

nh cha rc thng thng, c xy cao, h thng cp thot nc v sinh m bo.

Tuy nhin, m bo nh cha hp v sinh, trnh nhim mi trng phi ci to

li nh cha rc: ci to trn nh, b tr ng thot kh, h thng n c pht tia cc

tm kh trng, xy ngn phng lnh trong c lp iu ha my lnh boqun cht thi y t (bnh phm, ph tng) trong khi cha kp vn chuyn x l.

II.7. Dbo v pht sinh cht thi rn ca bnh vin a Khoa Trung ng

Tnh Thi Nguyn

Bnh vin a Khoa Trung ng Thi Nguyn hot ng vi quy m hin ti

l 560 ging bnh, l bnh vin khu vc phc v cho cn b v nhn dn tnh Thi

Nguyn v cc tnh min ni pha Bc t nc. Bnh vin c nhiu cn b, y bc s

c nng lc v chuyn mn. Vi quy hoch pht trin mng li bnh vin giaion 2005 -2010 c ph duyt theo quyt nh s 1047/Q BYT, bnh vin

s c quy m trn 700 ging bnh vo nm 2010 v mt s chuyn khoa mi: n

v thn nhn to, khoa ni tit, phu thut thn kinh, dinh dng cha bnh.

Theo qui hoch pht trin mng li y t ca tnh Thi Nguyn trong

khong 10 nm na vi tnh hnh cng nghip v dch v trn a bn pht trin th

nhu cu khm cha bnh ca ngi dn cng s tng ln. c tnh s ging bnh

ca bnh vin s tng ln hn 800 ging bnh tng ng vi lng rc thi l

khong 250 kg/ngy m.


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27

CHNG III

CSL THUYT QU TRNH T RC THI Y T

Qu trnh x l cht thi rn bnh vin bng phng php t gm 2 giaion chnh:

t cht thi: giai on ny cht thi c t chy to thnh tro v khi

l. Mt phn tro nm di dng x sc tho ra y l, mt phn di dng bi

sc cun theo khi l.

X l khi l: Khi sinh ra trong l t c nhit cao 1100oc cha bi,

nhng kh nhim nh SO2, NOx, CO2, CO trc khi thi vo kh quyn, khi

cn c x l h nhit , loi bt bi v kh c. m bo nhng yu cu ti

thiu ca khi khi thi vo mi trng.

III.1. L thuyt qu trnh t

Qu trnh t cht thi bnh vin xy ra trong l t thc cht l qu trnh

chy ca 3 loi cht: Rn, lng, kh.

Cht rn l bn thn cht thi

Cht lng gm nhin liu ph c cung cp t ngoi vo l du FO v

nhng thnh lng c tch ra t cht thi trong qu trnh nhit phn.

Cht kh l nhng sn phm ca qa trnh t v kh ha cht thi nh CO,

H2, mt s hydrocacbon, mt s hp cht hu cth kh, nhng kh c tnh cao

nh Dioxin, Furan.

III.1.1. L thuyt qu trnh chy ca cht rn

Cht thi rn t kh n p vo l ti khi chy c c th tri qua cc giai

on:

Sy: l qa trnh nng nhit cht thi t nhit ban u ti khong

200oc, trong khong nhit ny m vt l trong cht thi c thot ra, sau l

m ha hc. Tc sy ph thuc vo kch thc, b mt tip xc, xp vt rn,

v nhit bung t.

Thc t cht thi rn l hn h p nhiu cht c thnh phn v kch thc

khng ng u. y l mt vn cn ch t chc qu trnh t c hiu

qu cao.


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28

Nhit phn: t khong nhit 200oc ti nhit bt u chy, xy ra nhng

qa trnh phn hy cht rn bng nhit. Nhng cht hu c c th b nhit phn

thnh nhng hp cht phn t lng nh hn th lng nh axit, axeton, metanol,

mt s hydrocacbon th lng. Mt s cht kh cng c sinh ra trong qu trnh

nhit phn nh CH4, H2, CO, CO2Thnh phn ca sn phm nhit phn ph thuc vo bn cht ca cht thi,

nhit v tc nng nhit .

Qu trnh chy: l phn ng ho hc gia oxy trong khng kh, cht thi rn

v thnh phn chy c, sinh ra lng nhit ln v to ra nh sng. Tc chy

ph thuc vo nhit v nng cht chy c trong nhin liu v cht thi rn.

mt nhit nht nh, tc chy ph thuc ch yu vo nng cht

chy c trong hn hp nhin liu, cht thi rn v khng kh. Khi nng ny thp

tc chy chm v ngc li. i vi mt nng nht nh, tc chy ph

thuc vo nhit . nh hng ca nhit i vi qu trnh chy ln hn nhiu

nh hng ca nng . Khi nhin liu v cht thi rn c sy n nhit bt

la th qu trnh chy xy ra. Sauk hi bt la, qu trnh chy xy ra mnh lit, nng

cht chy trong nhin liu v cht thi gim dn, nhit bung t tng cao.

Trong qu trnh chy nhin liu v cht thi rn, mt vn quan trng l chy cht

bc, tc l chy cc kh chy nh hydro, cacbon oxyt v giai on chy to cc.

Qu trnh to x: Sau khi chy ht cc cht chy c th nhng cht rnkhng chy c s to thnh tro x. S to thnh tro x ph thuc vo nhit

bung t. Mi loi cht thi rn khng chy c nhit nng chy khc nhau. Cc

cht khng chy c v khng b nng chy to thnh tro, cn x l tro b nng

chy to thnh. Thng ngi ta la chn nhit thi x l 850oC.

III.1.2. ng hc qu trnh t cht thi

III.1.2.1. Cc bc xy ra trong qu trnh t cht thi rn Khuych tn i lu xy nhn c t nhn ti b mt lp bin chy dng

bao quanh ht rn.

Khuych tn oxy qua chiu dy lp bin chy dng bng khuych tn phn

t.

Khuych tn oxy vo ng mao dn.

Hp th oxy vo b mt trong ca cht thi rn.

Phn ng ho hc:


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29

C+O2 = CO2

2C+O2 = 2CO

CO2+C = 2CO

S+O2 = SO2

SO2+1/2O2 = SO32H+1/2O2 = H2O

N2kk+O2 = 2NO

N (nhin liu+CTR)+1/2O2 = NO

NO+1/2O2 = NO2

Cl2+H2O = 2HCl+1/2O2

Qu trnh nh khuych tn: Khuych tn sn phm ngc li ng mao dn,

khuych tn phn t, khuych tn i lu sn phm vo pha kh.

III.2.1.2. Kho st vi ht rn dng hnh cu,chy trong khng kh d

Coi ht rn l hnh cu c bn knh R, m t bi hnh di y:

R

Ct

Cm Co

C0: Nng oxy pha kh

Cm: Nng oxy lp bin ngoi

Ct : Nng oxy tm ht rn

: Chiu dy lp bin chy dng

Khi qu trnh chy xy ra nhit thp:Tc phn ng ho hc th p so vi qu trnh khuch tn phn t v

khuych tn i lu. Phn ng ho hc quyt nh qu trnh phn ng. Qu trnh

ng hc thun tu din ra nh sau:

Khuych tn i lu oxy t tm dng chy ti mt ngoi lp bin chy dng

1 0 1( )g C C = : h s khuych tn

Khuych tn phn t oxy qua lp bin chy dng

2 1( )mD

g C C =

D: h s khuych tn phn t


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30

Tiu tn oxy cho phn ng chy/

3 0 . .E RT

m mg K e C K C = =

/E RT oK K e

= , K: hng s phn ng

Nu qu trnh n nh:

1 2 3

0

1 1

g g g g

Cg

K D

= = =

=+ +

Cc yu tnh hng:

- Nhit tng, vn tc qu trnh tng.

- Kch thc ht hu nh khng gy nh hng.

- Tc gi khng gy nh hng nhiu.

Nhit tng dn, ln hn nhit ng hc thun tu Vn tc phn ng tng:

o mC C C= > , 0,1t oC C>

Min phn ng l min khuch tn trong (min chuyn tip ni). Phn ng

ho hc xy ra trong ton ht rn.

Yu tnh hng:

- Kch thc ht rn: Kch thc nh, tng kh nng khuych tn O2 vo trong

ht, nng oxy cao, tc phn ng tng.- Vn tc gi khng nh hng nhiu.

Nhit tng dn, ln hn nhit khuych tn ni:

Vn tc phn ng tng:

o mC C , 0tC , AR < 1/3R

(AR: chiu su thm kh)

Min phn ng l min ging hc.

Yu tnh hng:

- Kch thc ht cng nh, b mt ht rn tng, vn tc tng.- Nhit vn l thng s khng gy nh hng mnh.

- Tc gi khong gy nh hng nhiu do Co Cm.

Nhit tng dn, ln hn nhit min ging hc

Min phn ng l min khuych tn.

o mC C> , 0 0,1m oC C , 0tC >

Yu tnh hng:

- ng knh ht nh, vn tc gi tng.


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- Tc phn ng tng.

- Bn cht ht rn khng gy nh hng qu trnh.

III.2. L thuyt qu trnh xl khi thi

III.2.1. Shnh thnh cc cht thi

Tro, x bay theo khi bi

Tro x l nhng cht khng chy c c trong cht thi. Bi bao gm tro

bay theo khi v mt s cht cha chy ht do s chy khng hon ton nhin liu

cng nh cht thi. Bi t bung t ch yu l bi v ckch cnh, d < 100 m

chim 90%.

Kh CO, CO2

Kh t chy cc cht hu cc cacbon, tu theo lng oxy s dng m c

th sinh ra CO hoc CO2. Khi cung cp thiu oxy, qu trnh chy khng hon ton :

2C + O2 = 2CO

Khi cung cp oxy, qu trnh chy hon ton sn phm l:

C + O2 = CO2

Kh NOx

Hai kh quan trng nht ca NOx l NO v NO2. Kh ny c hnh thnh do

2 nguyn nhn:

- Phn ng ca oxy v nittrong khng kh cp vo bung t.- Phn ng ca oxy v nitc trong nhin liu.

NOx d dng to ra khi d tha oxy trong qu trnh chy. nhit trn

650oC th NO to ra l ch yu.

Kh SO2

Kh ny c to ra khi t cht thi v nhin liu cha lu hunh:

CS2 + O2 = CO2 + SO2 + Q

Hi axit

Khi t cht thi c cha Cl, Br th s to ra kh HCl, HBr:CHCl3 + O2 = CO2 + HCl + Cl2 + Q

t cht thi cha lu hunh v nitcng to hi axit tng t.

Dioxin v Furan

Dioxin v furan l nhng hp cht c tnh c cao pht thi cc l t rc

thi y t nguy hi. Dioxin v furan l tn chung ch cc hp cht ho hc c cng

thc tng qut l Polyclorua dibenzoxin (PCCD) (C6H2)2Cl4O2 v Polyclorua

dibezofuran (PCDF) (C6H2)2Cl4O2. l ba dy vng thm, trong 2 vng c

kt ni vi nhau bng mt cp nguyn t oxy hay mt nguyn t oxy.


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thi gian ri xung xung chm y di tc dng ca trng lc v b gi li

.

u im: Cu to n gin, u t thp, c th xy dng bng cc vt liu

sn c, chi ph nng lng, vn hnh, bo qun v sa cha thp, tn tht p sut

thp, c th lm vic cc nhit v p sut khc nhau.Nhc im: Cng knh, ch tch c bi th [7]

Phm vi p dng: Thng c dng tch bi sb khi bi c nng

cao, kch thc ln. Ch yu p dng cho bi c d > 50 m .

Xyclon:

Cch: Tch bi bng lc ly tm.

Nguyn l hotng:

Dng kh c a vo theo phng tip tuyn vi thn hnh tr ca thit b

nn s chuyn ng xoy c bn trong thit b t trn xung. Do chuyn ng xoy,

cc ht bi chu tc dng ca lc ly tm lm cho chng b vng v pha hnh thnh

hnh tr ca xyclon ri chm vo c tch ra khi dng kh. Di tc dng ca

trng lc, cc ht bi ny s ri xung y phu thu bi pha di ca xyclon. Khi

chm vo y hnh nn, dng kh di ngc tr li nhng vn gi nguyn c

chuyn ng xoy c t di ln v thot ra ngoi.

u im: Gi thnh u t thp, cu to n gin, d vn hnh, chi ph sa

cha, bo hnh thp, c kh nng lm vic lin tc, c thc ch to bng cc vtliu khc nhau ty theo yu cu v nhit , p sut, mc n mn.

Nhc im: Hiu sut tch thp i vi bi c d < 5 m , d b mi mn nu

ht bi c cng cao, hiu sut gim nu bi c dnh cao.

Phm vi p dng: C th dng tch bi c d > 5 m , thng dng cho cc

lnh vc nh ximng, m, bt git, giy, l t

Thit b tch bi in (lng tnh in ESP)

Cch: Tch bi bng lc tnh in.

Nguyn l hotng:

Thit b gm 2 tm t song song vi nhau c ni vi t (tc in p =

0). y chnh l in cc lng ca ESP (v bi sc lng trn in cc ny).

Gia 2 tm ca in cc lng l dy in c ni vi cc m ca mt ngun in

cao th (thng l -40kV n -60kV) mt chiu. Cc dy ny c gi l in cc

qung. Dng kh bi c thi vo khng gian gia 2 in cc lng. Ti y ht bi

c ion ha nh trnh by trn v c tch in m. Di tc dng ca in

trng mnh, cc ht bi s chuyn ng v pha in cc lng. Trn b mt incc lng, cc ht bi ny s mt in tch dnh vo nhau to thnh cc bnh bi.


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Cn kh sch thot ra ngoi. Sau mt thi gian nht nh cc bnh bi trn b mt

in cc sc tch ra bng cch rung lc hoc ra. [7]

u im: Hiu sut tch bi rt cao, tch c bi c kch thc nh

(0,1 m ), c kh nng lm vic trong di nhit , p sut rng, lm vic c vi

c bi kh v t, tn tht p sut nh.Nhc im: Khng thch hp cho vic x l kh chy n, chi ph u t cho

thit b rt ln, thit b cng knh, cu to phc tp, khng thch hp vi x nghip

quy m va v nh.

Phm vi p dng: Cho bi c d > 0,1 m , dng rng ri trong cc nh my

nh nhit in, ximng, vt liu xydng, phn bn, luyn kim, gm s, du m

Phng php t:

Cchchung:: To ra s tip xc gia dng kh bi vi cht lng (thng l

nc), bi trong dng kh b cht lng gi li v c thi ra ngoi di dng bn

cn.

Cc thit b tch bi t:

Thp ra rng:

Nc c phun thnh nhng dng nh ngc chiu hoc vung gc vi dng

kh bi. Do tip xc, cc ht bi s dnh kt vi cc git nc v s b lng xung

y. Khi sch si ra khi thit b. Xyclon t:

C cu to hnh tr, tn dng c lc ly tm do dng kh c dn vo thit

b theo phng tip tuyn gy ra. Dng kh bi c a vo phn di ca thn

hnh tr ca thit b. Nc c phun ra t rt nhiu du phun nht trn mt trc

quay tm ca hnh tr. Nh nc c phun thnh tia t tm ra ngoi i qua

dng kh ang chuyn ng xoy. Cc git nc s bt cc ht bi. Tip cc git

nc cha bi, dc tc dng ca lc ly tm s vng ra pha ngoi v chm vo

thnh t ca xyclon. Sau nhng git nc cha bi ny s theo thnh xyclonchy xung di y v s b loi b.

Thit b Ventury:

Dng kh i t trn xung. Ti ch tht tc ca n s tng ln t ngt,

t n 50 80 m/s. Cng ti ch tht c mt dy cc l phun nc vo. Nc c

phun vo khi g p dng kh c tc cao, s b dng kh x thnh git mn. Bi

trong dng kh s va p vi cc git nc v s b cc git nc bt. Khi qua khi

ch tht, do thit din tng dn nn tc dng kh gim dn. Cc git nc s lng

xung pha di y thit b, to thnh bn v s tch ra ngoi.


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u im: Gi thnh u t ban u thp, c th x l ng thi c kh v bi,

c hiu sut tch cao i vi bi c kch thc nh, c th vn hnh nhit

tng i cao, khng c hin tng bi quay li.

Nhc im: Tiu th nng lng ln, chi ph bo dng cao v d b n

mn, mi mn in ha, tn tht p sut ln i vi thit b c hiu sut tch bicao, sinh ra bn thi.

Phm vi p dng: Dng tch bi c kch thc nh kt hp vi tch mt

s kh cng nghip v lm ngui kh.

III.2.2.3. Xl kh nhim

X l kh SO2: c cc phng php sau:

Hp th bng nc

Hp th bng dch sa vi

Hp th bng dung dch ca MgO (Mg(OH)2)

X l NOx:

Phng php kh:

Kh xc tc c chn lc

Kh chn lc khng xc tc

Phng php hp th:

Hp th bng nc v dung dch HNO3

Hp th km phn ng xi haPhng php hp ph:

S dng than hot tnh, Zeolite

X l hi axit HCl v HF:

S dng thit b lc t s dng dung mi l nc hoc sa vi. C th x l

ng thi vi SO2.

X l Dioxin v Furan:

Khng ch nhit l t khong 1100 1200oc v thi gian lu kh chy

trong l t khong 1 2 giy m bo khng pht sinh kh c hi nh Dioxinv Furan. Ngoi ra c th s dng phng php hp ph loi b cc kh ny. Vt

liu hp ph thng dng l than hot tnh.


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IV.2. Cc loi l t cht thi y t

IV.2.1. L quay

H thng l quay dng trong x l cht thi nguy hi bao gm b phn np

liu, b phn phn cp kh, l quay, bung t th cp v thit b gom tro. Kh i ra

t bung t th cp c dn qua h thng x l v c qut a ln ng khi.L quay bao gm mt bung t hnh tr, bn trong c lt gch chu la t

trn cc bnh rng rng truyn ng v quay vi tc 3 5 vng/pht theo trc

dc ca n. nghing ca l t khong 3o 5o theo chiu tu nhp liu n

u tho tro v do vy cht thi c th chuyn ng song phng theo phng ngang

v theo phng bn knh ca l. Trong lc di chuyn, cht thi cng ng thi c

t chy. Ti phn cui ca l, tro c tho ra v ng thi kh thi tip tc i vo

bung

t th

cp

ng

c duy tr

nhi

t

cao h

n

hon thnh qu trnh tiu

hy cht thi.

Do cu to, h thng l quay thng xy ra r r kh thi v nhit lng trong

lc vn hnh. Cc im c kh nng gy ra r r gm: ca nhp liu, ca tho tro,

im chuyn tip gia l quay v bung th cp khng chiu ny, phi b

tr mt qut ht nhm to s cn bng p sut gia mi trng bn trong v bn

ngoi l. Thc t, vic duy tr p sut cn bng ny i hi cc k thut iu khin

tng hin i v tn km.

IV.2.2. L ng 2 cpL ng 2 cp bao gm mt bung t scp v mt bung t th cp. Hai

bung scp v th cp c th b tr theo chiu ngang hoc chiu dc. Nu b tr

theo chiu dc, th bung t th cp pha trn v thng thng l loi l t

c kim sot khng kh.

i vi cc l t c cng sut nh, cht np tng m vo bung scp, cn

tro xc tho ra khi tch ly vi s lng ln gy nh hng n ch hot

ng ca l. i vi cc l t c cng sut ln, cht thi c np vo v tro c

ly ra lin tc nhcc h ckh. Bung t th cp c nhim vt tip tiu

hy hon ton cc thnh phn hu chin din trong kh thi t bung scp.

IV.2.3. L tng si

L tng si c cu to hnh tr, tng bng gch chu la, bn trong c s

dng mt tng vt liu ang si ca ct hoc nhm, vi, vt liu gm m ti

qu trnh t chy din ra. Thit b ngoi vi quan trng nht ca l l qut thi

kh, va c chc nng to tng si va c nhim v c p kh chy cho l. Trong

trng hp cn x l kh thi ca l, phi trang b thm qut li tm.


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Cht thi c np trc tip vo bn trn hoc bn trong ca tng si, ty

thuc vo m ca bn. Vi cht thi c m cao, cn phi np liu cch xa v

pha trn so vi tng si m bo thi gian v hiu qu tch m, v trng hp

ny cn din tch b mt tng si, dn n yu cu v din tch tit din l phi ln.

Ngc li, tit din l c th nh hn nu cht thi c np vo bn trong tng si.Do c im cu to cu to, cht thi sau khi np vo l tng si t c

s tip xc mnh lit vi khng kh thc hin qu trnh thiu t hiu qu cc

thnh phn chy c v tch ht m. Nhit tng si thng dao ng trong

khong 1300oKn 1500oK, ty thuc vo trng thi vt l ca cht thi c t.

Thi gian lu ca khng kh trong l kh ln, trong khong 3 6 giy.

Tro cn li sau khi t s ln ln vi vt liu tng si, mt phn theo dng

kh thi ra ngoi. Vi cht thi cha cc mui kim loi, lng tro sau khi t thng

gy ra hin tng kt t tng si. Hin tng kt t tng si l s tng kch thc

ca cc ht vt liu tng si, ko theo s kt hp ca chng thnh cc ht rn ln, v

d dng lng t, dn n gim hiu qu s dng ca tng si v hiu sut lm vic

ca l.

IV.2.4. L hng ngoi

L hng ngoi (l in/l bc xin) l mt h thng gm mt bng ti

cha cht thi di chuyn bn trong mt bung t scp di, c duy tr p sut

m nhqut ht. Kh i ra khi bung nung c tip tc qua bung t th cp,cn cht thi sau khi nung c bng ti vn chuyn ra ngoi, dn n b phn cha

tro.

Bng ti c cu to di dng li lin tc c lm bng h p kim chu

nhit cao (1300 1600oF). L p chu nhit ca h thng l hng ngoi c lm

bng vt liu gm thay v gch chu la nhm hn ch mc tn nhit ca l.

Cht thi c np vo bung t scp t ming np xung bng ti, to

thnh mt lp bn dy khong 2,5 cm trn mt bng ti. Tc ca bng ti c

la chn sao cho cht thi c thiu hy m khng phi o trn. Chnh iuny lm gim nng bi trong kh thi u ra. Khng kh c cp vo l theo

chiu ngc vi chiu ca bng ti tn dng nhit ca cht thi.

Nhit lng c cung cp cho l qua cc tm gia nhit hng ngoi b tr

pha bn trn ca bng ti, duy tr nhit trong l 1600oF. Do s dng nng lng

in, nn trong kh thi khng c thm cc sn phm chy nh khi s dng nhin

liu ha thch.


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IV.2.5. L kim sot khng kh (L nhit phn)

Nguyn l hot ng ca l ch yu l qu trnh kim sot khng kh cp vo

l. Trong bung t scp lng khng kh chc cp bng 70 80% nhu cu

cn thit theo tnh ton l thuyt. Kh sinh ra t phn ng ny gm c cc kh chy

v hi nc sc dn n bung th cp v kh chy sc tip tc t tiptrong bung th cp. bung th cp lng khng kh cp vo vt 110 200%

lng khng kh cn thit.

IV.3. So snh v la chn cng nght

Bng 4.1. Tng ktu nhc im ca cc cng ngh thiu t cht thi y t

Cng ngh u im Nhc im

L quay - Cng sut x l rt cao- C th x l ng thi c

nhiu loi cht thi khc nhau

- Nhit hot ng cao

- xo trn cao v tip xc tt

lm tng hiu qu chy

- Chi ph u t v vn hnhcao

- Yu cu bo n tt i vi

l p lt chu la ca l v tnh

hn kn ca l

- Cc trc trc c bit thng

sinh ra khi trn ln rc thi

- Kh thi c hm lng bi

cao

- iu kin chy dc theo chiu

di ca l rt kh khng ch

- Nhit tn tht ln do tro

L ng 2

cp

- Chi ph u t v vn hnh thp

- Nng bi trong kh thi

khng cao

- Hiu qu chy tt

- Cht thi rn cn phi x l

sb

- Thi gian t trong l hai

ngn cnh lu hn l quay- Hiu qu xo trn cht thi

khi t khng cao

L tng si - Thit kn gin

- Hiu qu chy cao

- C th thay i t l nh p liu

v thnh phn ca cht thi cn

t trong khong kh rng

- Chi ph vn hnh tng i

cao

- iu kin vn hnh kh kim

sot v khng n nh

- Nng bi trong kh thi rt

ln


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L hng

ngoi

- Kh thi t l hng ngoi t

nhim

- Kh nng tng ha cao

- Thit k phc tp

- Chi ph u t v vn hnh

cao

- Ch s dng c nng lng

inL iu

khin lung

kh

- Yu cu nhin liu thp

- Qu trnh din ra nhit thp

do vy tng tui th ca vt liu

chu la, gim chi ph bo tr

- Bi ko theo trong khi t gim

do gim bt thit b thu bi

- Th tch cht thi b gim ng

k

- Cng sut b gii hn bi h

thng cp v trn rc

- Khng nn t cht thi c

phn ng thu nhit

- Thi gian t lu hn so vi

cng ngh l quay

Vi mc tiu x l c tnh nguy hi ca cht thi y t v chi ph xy dng,

vn hnh thp ta la chn cng nght bng l ng 2 cp.

IV.4. Cng ngh thiu t cht thi rn y t

Cng ngh thiu t l t cht thi mt cch c kim sot trong mt vng

kn, mang nhiu hiu qu. Qu trnh t c thc hin hon ton, ph hy hon

ton cht thi c hi bng cch ph vcc lin kt ha hc, gim thiu hay loi b

hon ton c tnh. Hn ch t p trung cht thi cn loi b vo mi trng bng

cch bin i cht rn, lng thnh tro. So vi CTYT cha x l, tro thi vo mi

trng an ton hn.

Vic qun l kim loi, tro v cc sn phm ca qu trnh t l khu quan

trng. Tro l mt dng vt liu rn, trgm C, mui, kim loi. Trong qu trnh t,

tro tp trung bung t (tro y), lp tro ny xem nh cht thi nguy hi. Cc httro c kch thc nh c th b cun ln cao (tro bay). Tn tro cn chn lp an ton

v thnh phn nguy hi s trc tip gy hi.

Thnh phn kh thi ch yu l CO2, hi nc, NOx, hydrigen cloride v cc

kh khc. Cc kh vn tim n kh nng gy hi cho con ngi v mi trng, v

vy cn c h thng x l khi thi t l t.

L t c chia lm 2 bung:

Bung t chnh: Gm 2 giai on


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CHNG V

TNH TON THIT K L T CHT THI Y T NGUY HI CHO

BNH VIN A KHOA TRUNG NG THI NGUYN

V.1. Cng sut v thnh phn cht thi y t nguy hi cn xl

c tnh theo quy m pht trin ca bnh vin th trong khong hn 10 nm

na s ging bnh ca bnh vin c th tng ln khong 800 ging bnh tc l

lng rc thi rn cn x l l khong 250 kg/ ngy m.

Ta thit k l t vi chu k 2 ngy 1 ln tc l lng cht thi rn ln

500kg. thc hin t trong 5 ting. Mi gist 100 kg. Cht thi c np vo

l theo phng thc gin on. Chu k np rc l 20 pht, nh vy 1 ginp 3 ln,

mi ln 33 kg. Sau mi gis tho x mt ln.

Bng 5.1. Thnh phn vt l ca cht thi rn y tnguy hi theo khi lng:[8]

Thnh phn T l phn trm (%)

Polyetylen 34,2

PVC 1,8

Bng gc 41

Bnh phm 8

Gng tay cao su 5

Thu tinh 9,5

Kim loi 0,5

Bng5.2 Thnh phn ho hc ca cht thi rn y ttheo khi lng:[8]

Thnh phn Phn trm khi lng (%)

C 29,016H 3,45

O 12,79

N

S 1,064

Cl 1,284

Tro 10,03

m 42


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V.2. Thit k l t cht thi y t nguy hi

V.2.1. Cn bng vt cht

Theo nh lut bo ton khi lng: tng lng vt cht i vo l bng tng

lng vt cht ra khi l.

Thnh phn vt cht vo l: Cht thi rn y t, nhin liu t (du DO),

khng kh.

Thnh phn vt cht ra khi l: Tro x, kh thi.

Hnh 5.1. S khi cn bng vt cht ca qu trnh chy cht thi y t

V.2.1.1.Lng vt cht cp vo lK hiu:

Lng vt cht np vo l l : GV (kg/h)

Lng cht thi np vo l l GCT (kg/h)

Lng cht t np vo l l GD (kg/h)

Lng khng kh np vo l l GKK(kg/h)

Ta c: Gv = GCT + GKK+ GDLng cht thi rn y t cp vo l:

Cng sut ca l t l 100 kg/h vy lng, kt hp vi bng 3.2 ta c:

L t

Cht thi rn y t

Nhin liu b sung

Khng kh

Khi thi

Tro, x


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Bng5.3. Thnh phn ho hc ca 100 kg cht thi rn bnh vin:

Thnh phn khi lng (kg)

C 29,016

H 3,45

O 12,79 N

S 1,064

Cl 1,284

Tro 10,03

m 42

Lng nhin liu b xung:

qu trnh chy ca cht thi c trit v m bo nhit phn hu

cn phi cung cp thm mt lng cht t t bn ngoi vo l. Nhng cht t

thng s dng l than, ci, kh gas, du. Trong trng hp ny ta chn du DO

lm nhin liu do c tnh c nhit tr cao, gi thnh va phi, v cha lng lu

hunh thp.

Bng 5.4. Thnh phn du DO v khi lng cc cht c trong x kg du DO [5]

Thnh phn Lng cht c trong 1kg du

DO

Lng cht c trong x kg du

DO

C O,865 0,865xH 0,125 0,125x

O 0,002 0,002x

N 0,004 0,004x

S 0,004 0,004x

Bng 5.5. Khi lng mi cht tham ra qu trnh chy

Thnh phn khi lng

C 29,016 + 0,865x

H 3,45 + 0,125x

O 12,79 + 0,002x

N 0,366 + 0,004x

S 1,064 + 0,004x

Cl 1,284

Tro 10,03

m 42


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Khi nhit tng th qu trnh phn hu NO2 thnh NO v O2 s tng ln.

nhit trn 650oC th hu nh NO2 phn hu ht. Vy nu nhit chy ca

bung t c th coi lng NO2 bng 0.

Lng oxi dng phn ng (1):

1 32 (29,016 0,865x)12G = + =77,376 + 2,307x (kg/h)

Trong phn ng (3): 232

(3,45 0,125x)4

G = + = 27,6 + x (kg/h)

Trong phn ng (7): 3 (1,064 0,004x)G = + (kg/h)

Gi lng N2 tham gia phn ng (4) l y (kmol)

phn ng (4), 4 32.G y= (kg)

phn ng (5), 58

(0,366 0,004x)7G x= +

= 0,418 + 4,57.10

-3

x (kg/h)Gi z l phn mol ca Cl tham gia phn ng (8). Lng O2 to ra l:

6

16. .1,284

71G z=

Lng oxi c sn trong cht thi v nhin liu l

7 12,79 0,002xG = + (kg/h)

Lng oxi l thuyt cn cung cp t ngoi vo t chy 100 kg cht thi bnh

vin trong 1 h l:

2 1 2 3 4 5 6 7O LTG G G G G G G G= + + + +

= 93,668 + 3,314x + 32y - 0,289z (kg/h)

qu trnh chy xy ra hon ton lng oxy cn cung cp cn d so vi l

thuyt. H s d oxy cung cp t chy du DO nm trong khong 1,10 1,20;

Theo mt s ti liu v l t rc y t h s ny i vi rc thi y t thng ln hn

1,5 mt cht. Do lng Oxi cn cung cp vo l c nhim v duy tr qu trnh chy

cho c du v cht thi y t v tng quan gia khi lng du DO vi khi lng

cht thi ta chn h s d oxi = 1,5.

2 21,5O TT O LT G xG= = 140,502 + 4,971x + 48y -0,4335z (kg/h)

Khng kh c p vo l c KK =1,29 (kg/m3). Khi lng ring ca O2 l

2O =1,4289(kg/m3).[9]

Ly nhit trung bnh ca khng kh l 24oC v m tng i trung bnh l

80%. Vy khng kh cha 15g hi nc/1kg khng kh kh.

2 2

,

0,21

0,2326

O TT O

KK TT KK

G x

G

= =


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Lng khng kh thc t cp vo l:

2

, 0,2326O TT

KK TT

GG = = 604,049 + 21,371x + 206,363y 1,864z

Lng N2 c trong lng khng kh trn:

2 2, ,N KK TT O TT G G G= = 463,547 + 16,4x + 158,363y 1,4304zLng m khng kh l: , ,0,015AM KK KK TT G xG= = 9,061+0,321x+3,095y-0,028z

Lng khng kh m thc t:

, , ,KKAm TT KK TT Am KK G G G= + = 613,11 + 21,692x +209,458y 1,892z

Tng lng vt cht vo l l:

,V CT KKam TT DG G G G= + + = 100 + x + 613,11 + 21,692x +209,458y 1,892z

= 713,11 + 22,692x + 209,458y 1,892z

V.2.1.2. Lng vt cht ra khi l

- Lng kh ra khi l: Gkh (kg/h)

- Lng hi nc ra theo khi l : Ghoinuoc (kg/h)

- Lng tro hnh thnh: Gtro (kg/h)Kh ra khi l:Gm CO2, NO, SO2, HCl, Cl2, N2, O2 , hi nc.

2

44(29,016 0,865 )

12COG x= + = 106,392 + 3,172x

22(1,064 0,004 )SOG x= + = 2,128 + 0,008x

30(4) (5) 2. .30 (0,366 0,004 )

14NO NO NOG G G y x= + = + + = 0.7843 + 8,57.10-3.x + 60y

Lng HCl sinh ra trong qu trnh t:

73. .1,284

71HClG z= =1,32z

Lng Cl2 d khng tham gia phn ng l:

2

(1 ).1, 284Cl

G z=

Lng N2 cn trong khi thi:

2 2 2(4)N N N G khoithai G G= = 463,547 + 16,4x + 130,363y 1,4304z

Lng oxi d:

2 2 2O O TT O LT G G G= = 46,834 + 1,657x + 16y 0,145z

Lng hi nc ra theo khi l:

2 2, ,(3) (8)

hoinuoc am CT am KK H O H OG G G G G= + + =82,111 + 1,446x + 3,095y 0,326z


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Lng tro hnh thnh trong qu trnh t:

Gtro = 10,03 (kg/h)

Tng lng vt cht ra khi l l:

r a kh hoinuoc troG G G G= + +

= 713,11 +22,692x + 209,458y -1,865z

Theo phn ng (4):2

2NO

PN O

PK

P P= , t bng 4.6 bng phng php ni suy ta c:

PK = 2,78.10-6

( )

2

23

2,

0.7843 8,57.10 .x 60y

30 .(0,7674. / 32).(0,5. / 32)KK TT O LT G G

+ += 2,78.10-6

( )2

2

2

3

2

0.7843 8,57.10 .x 60y .28.321,5.

30 .0,7674. .0.50,2326

O LTO LT

GG

+ + = 2,78.10-6

( )

2

30.7843 8,57.10 .x 60y

O LTG

+ += 0,00263

y = -0,00897 + 2,437.10-6x - 1,27.10-5z

Thay gi tr ca y vo tnh:

GNO = 0,2461 + 8,716.10

-3

x - 7,62.10

-4

z2N khoithai

G = 462,378 +16,4x 1,432z

2OG = 46,691 + 1,657 x 0,145z

,KK TTG = 602,198 +21,372x 1,867z

,KKAM TTG = 611,231 + 21,693x 1,895z

Lng vt cht cp vo l:

GV = 711,231 + 22,693x 1,895z

Lng vt cht ra khi l:GR= 711,231 + 22,693x 1,868z


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Bng5.7. Cn bng vt cht cc thnh phn trong dng ra v dng vo:

Dng vo Dng ra

Cht Lng (kg/h) Cht Lng (kg/h)

CTNH bnhvin

Du DO

Khng kh m

100x

611,231 + 21,693x

1,895z

TroCO2

SO2HCl

Cl2NO

O 2d

N2Hi

nc

10,03106,392 + 3,172x

2,128 + 0,008x

1,32z

1,284 1,284z

0,2461+8,716.10-3x-7,62.10-4z

46,691 + 1,657 x 0,145z

462,378 +16,4x 1,432z

82,083+1,446x 0,326z

Gvo 711,231 + 22,693x

1,895z

Gra 711,231 + 22,693x 1,868z

V.2.2. Cn bng nhit lng

Lng nhit a vo l:

Nhit do cht thi a vo CTQ

Nhit do nhin liu mang vo: dQ

Nhit do khng kh a vo: KKQ

Nhit do m khng kh mang vo: amQ

Nhit do cht thi chy: CCTQ

Nhit do nhin liu chy: CdQ

Lng nhit mang ra khi l

Nhit do khi mang i: khoiQ

Nhit a ra qua tro x: TroQ

Nhit tn a ra do hi nc: HoiQ

Nhit mt mt do mca l t: oQ

Nhit mt mt do tng l: TQ


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V.2.2.1. Nhit lng a vo l tC C

V CT d KK am d CT Q Q Q Q Q Q Q= + + + + +

Nhit lng do cht thi y t mang vo:

Bng 5.8. Thnh phn cht thi rn v nhit dung ring tngng[8] :Thnh phn CTBV Khi lng (kg) Nhit dung ring

C(kcal/kg )

Cht thi khng chy 10,03 Ckchay =0,18

m trong cht thi 42 Cam =1

Cht thi chy c 47,97 Cchay=0,26

Cng thc tng qut tnh nhit lng cht thi:

. .CT CT CT CT Q G C t =

[10]Trong :

CTG : Khi lng (kg/h)

CTC : Nhit dung ring (kcal/kgoC)

CTt : Nhit

CTQ = (10,03.0,18 + 42.1 + 47,97.0,26).24 = 1350,662 (kcal)

Nhit lng do du DO mang vo:

. .d d d d Q G C t = Trong :

dG : Lng du dng t 100 kg cht thi (kg/h)

dC : Nhit dung ring ca du = 0,44(kcal/kgoC) [9]

dQ = x.0,44.24 =10,56x (kcal/kg)

Nhit lng do khng kh v m khng kh mang vo:

( . ) . .KK am KK KK hn KK Q Q G C C d t G r d + = + +

KKC : Nhit dung ring ca khng kh, KKC = 0,24 (kcal/kgoC) [9]

hnC : Nhit dung ring ca hi nc, hnC = 0,487 (kcal/kgoC) [9]

d: m ca khng kh, d = 0,015 (kg hi nc/kg KK)

r: n nhit ho hi ca hi nc, r = 540,5 (kcal/kg) [9]

KKG : lng khng kh thc t cp vo l t

KK amQ Q+ = ( )[ ]602,198 21,372x 1,867z (0,24 0,487.0,015).24 540,5.0,015+ + +

= 8456,667 + 300,127x 26,218z


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. .CT i iQ G C t = [10]

Trong :

iG Khi lng cht kh i

iC Nhit dung ring ca tng cu t (kcal/kgoC)

Bng 5.9. Nhit dung ring ca cc kh nhit 1100oC [8]

Kh CO2 SO2 NO N2 HCl Cl2 O2 Hi

nc

C

(kcal/kgoC)

0,45 0,22 0,3 0,3 0,22 0,31 0,27 0,6

2COQ = 0,45.(106,392 + 3,172x).1100 = 52664,04 + 1570,14x

2SOQ = 0,22(2,128 + 0,008x).1100 = 514,976 + 1,936x

NOQ = 0,3(0,2461+8,716.10-3x - 7,62.10-4z).1100 = 81,213 + 2,876x - 0,2515z

2NQ = 0,3(462,378 + 16,4x 1,432z).1100 = 152584,74 + 5412x 472,56z

HClQ = 0,22.1,32z.1100 = 319,44z

2ClQ = 0,31.(1,284 1,284z).1100 = 437,844 437,844z

2OQ = 0,27.( 46,691 + 1,657 x 0,145z).1100 = 13867,227 + 492,129x 43,065z

hoinuocQ = 0,6.( 82,083+1,446x 0,326z).1100 = 54174,78+ 954,36x 215,16zKhoiQ = 274324,82 + 8433,441x 849,441z

Tn tht nhit do tng l v do ml t

Theo mt s ti liu thit k l t cht thi th tn tht nhit do tng l c

tnh bng 5% lng nhit chy ca du v cht thi, cn tn tht nhit do mca l

t bng 10% nhit mt mt qua tng l.

0,05.( )C CT CT d Q Q Q= + = 0,05.( 264212 + 10275.x)

= 13210,6 + 513,75x

0,1.0,05.(264212 10275.x)MoQ = + = 1321,06 + 51,375x

T MoQ Q+ = 14531,66 + 565,125x

Nhit lng ra khi l t:

Ra Tro Khoi Mo T Q Q Q Q Q= + + +

= 274324,82 +8433,441x 849,441z + 14531,66 + 565,125x + 3309,9

= 292166,38 + 8998,566x 849,441z


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Bng 5.10. Cn bng nhit lng cc dng vo v dng ra

Nhit lng vo Nhit lng ra

Thnh

phn

Nhit lng (kcal/h) Thnh

phn

Lng nhit (kcal/h)

CTQ 1350,662 TroQ 3309,9

dQ 10,56x

KK AmQ v Q 8456,667 + 300,127x

26,218z

KhoiQ 274324,82 + 8433,441x

849,441z

CCTQ 264212

CdQ 10275.x

o TQ Q+ 14531,66 + 565,125x

VaoQ 274019,329 + 10585,687x

26,218zRaQ 292166,38 + 8998,566x

849,441z

Theo nh lut bo ton nng lng: VaoQ = RaQ

274019,329 + 10585,687x 26,218z = 292166,38 + 8998,566x 849,441z

18147,051 1587,121x 823,223z = 0

Gii phng trnh vi x (kg) l lng du cn thit t 100 kg rc thi y t, z (0

z 1)l phn trm s mol Cl tham gia phn ng (8) trong 1 gi.

Nu z = 0 tng ng vi Cl trong rc thi khng tham gia phn ng chy

x = 11,434 (kg)

Nu z = 1 tng ng vi ton b Cl trong cht thi tham gia phn ng chy

x = 10,915 (kg)

Sai s ca hai gi tr du cn b sung trn l:

= (11,434 10,915)/11,434 = 0,045

Do nh nn ta c th chn x trong c 2 trng hp u c, nhng nhit L t l 1100oC nn Clo trong cht thi c tham gia phn ng. Vy ta chn gi tr

gn ng l z = 1 tng ng x = 10,915 (kg)

Lng du cn s dng t 100 kg rc thi l 10,915 kg.

Ta c lng khng kh cn cp cho t lng rc thi trng 1 h l:

GKK= 611,231 + 21,693x 1,895z, thay x = 10,915, z = 1 vo ta c:

GKK= 846,115 (kg/h)

KK = 1,29 (kg/m3

)


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Vy lu lng khng kh vo l l:

3600.KK

KK

GQ

= = 0,182 (m3/s)

V.2.3. Tnh lng vt cht ra khi l t

Bng5.11. lng vt cht ra khi l t trong 1 gi

Cht Khi lng (kg) Lng mol (kmol)

CO2 141,014 3,205

SO2 2,215 0,035

NO 0,341 0,011

N2 639,952 22,855

O2 64,632 2,02

HCl 1,32 0,036H2O 97,54 5,419

Tro 10,03

Tng 957,057 33,581

Lng bi to thnh thng chim 25% tng lng tro x [8]. Vy khi lng

bi l:

0,25bui troG G= = 2,508 (kg/h)

V.2.4. Kch thc l t

V.2.4.1. Th tch bung t scp

Th tch l thuyt ca bung t scp:

SLT CSC

v

QV

q= [3]

Trong :LTSCV l th tch bung t scp theo l thuyt (m

3

)SCQ l lng nhit sinh ra trong bung t scp (kcal)

vq l mt nhit th tch ca bung t (kcal/m3h)

bung t scp, thng th lng nhit sinh ra trong qu trnh t Qrac phn phi vo 2 bung t. bung s c p, qu trnh t cn lng nhit

nhiu hn chuyn cht thi rn v m thnh dng kh. Gi thit lng nhit

bung t scp s chim 80% Qra. [5]

raQ = ( 292166,38 + 8998,566x 849,441z), thay x = 10,915, z = 1 ta c:

8/6/2019 Do

Do an Tot Nghiep Cua Kien

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