Development and Application of Integrated Indicators for Assessing Healthcare Waste Management Systems in Kenyan Hospitals

Healthcare waste management (HCWM) is an important aspect of healthcare delivery globally because of its hazardous and infectious components that have potential for adverse health and environmental impacts. The paper introduces a set of indicators for assessing HCWM systems in hospitals. These indicators are: HCWM policies and standard operating procedures, management and oversight, logistics and budget support, training and occupational health and safety, and treatment, disposal and waste treatment equipment housing. By plotting a mark on a continuum which is defined as good and poor on the extremes and is connected with all other marks in a spoke arrangement, it’s possible to describe a baseline for HCWM in any specific hospital. This baseline can be used to improve awareness of the actors and policy-makers, compare the same hospital at a different point in time, to compare observations by different evaluators and to track improvements. Results suggest that in Kenya, the application of such indicators is useful for evaluating which priorities should be addressed to improve outcomes in HCWM systems. Systematic sampling technique was used to identify and collect data by use of observational checklist, interviews, visual verification and review of documents and a HCWM assessment tool. The objective is to suggest an integrated management tool as a method to identify prevailing problems with a HCWM system. The method can be replicated in other contexts worldwide, with a focus on the developing world. The integrated indicators focus on management of HCW and not its potential impact on human health and environment, an area recognized to be critical for future research.

Kinetics and Process Studies of the Potential for Transformation of Biogas to Biomethane and Liquefaction using Cryogenic Liquid for Domestic Applications

The present work dealt with the generation, purifying and liquefaction of biomethane to improve energy density using local materials for domestic applications. Cow dung was sourced at JKUAT dairy farm and experiments were conducted at JKUAT Bioenergy laboratory using biogas generated in laboratory scale 1 m3 bioreactors. Experiments were done in triplicates and repeated under different conditions to get the optimal conditions. The results showed that enhanced cow dung substrate displayed an improved fermentation process with increased biogas yields. Purified biogas optimized methane content from 56% ± 0.18% for raw biogas to 95% ± 0.98% for biomethane which was ideal for liquefaction.

Experimental Investigations of the Effects of Secondary Air Injection on Gaseous Emission Profiles (NOx, NO, NO2, CO) and Hydrocarbons (CxHx) in Cookstoves Using Charcoal from Eucalyptus glandis

Use of biomass in domestic cookstoves leads to the release of oxides of nitrogen (NOx), nitric oxide (NO), nitrogen dioxide (NO2), carbon monoxide (CO) and hydrocarbons CxHx that can be detrimental to health of the public and the environment. Attainment of complete combustion is the best strategy for mitigating the release of these emissions. This study sought to experimentally determine the effects of secondary air injection on the emission profiles of NOx (NO & NO2), CO and CxHx in a charcoal operated cookstove. Charcoal from Eucalyptus glandis was bought from Kakuzi PLC. Composites from three batches were analyzed for chemical composition and the stoichiometric air equivalent. Proximate analysis data show that the charcoal composed 58.72% ± 3.3% C, 15.95% ± 1.2% Volatile Matter, 4.69% ± 0.55% Moisture, 20.7% ± 0.8% Ash, High heat value (HHV) of 30.5 ± 1.1 and 29.3 ± 1.3 Low heat value (LHV) (MJ/kg) with a chemical formula of C18H2O and a stoichiometric air requirement of 5.28 ± 0.6 with a fuel flow rate of 1 kg fuel/hr. Emission profiles for CO and CxHx reduced significantly by 70% and 80% respectively with secondary air injection whereas those of NOx increased by between 15% and 20% for NO2 and NO. The study reveals that secondary air injection has potential to mitigate on emission release, however other measures are required to mitigate NOx emissions.

Economic Assessment of Selected Regulatory Ecosystem Services (RES) in the Elgeyo and Nyambene Watersheds Ecosystems in Kenya

Evidence of increased valuation of ecosystem services (ES) globally is significant. However, most of these studies focus on marketed subsets of ES at national and international levels. Ecosystems differ in spatial scale, biophysical and ecological structure, and functionality. This requires conducting studies at the local level to understand how, for example, the watershed ecosystem contributes to humanity locally and nationally. This study focuses on selected regulatory ecosystem services (RES) in Kenya’s catchment area ecosystems (Elgeyo and Nyambene). Field-based sampling and Landsat imagery with secondary information were used to generate biophysical and ecological data. The study used market price-based, cost-based, and unit transfer methods for RES valuation. The study estimates the total value of the six selected regulatory ecosystem services (RES) at KES 41.4 billion (US$386.7 million) and KES 14.73 billion (US$137.71 million) for Elgeyo and Nyambene, respectively. This equates to KES 1.64 million (US$15,331.19) and KES 2.72 million (US$25,375) per hectare per year. Extrapolating the study estimates to the national level, the country’s regulatory ecosystem services would range from US$18.4 billion to US$30.45 billion annually. This equates to between 16.7% and 27.7% of Kenya’s GDP in 2021, underscoring the importance of watersheds to the national economy.

Levels of Polycyclic Aromatic Hydrocarbons (PAHs) in Healthcare Waste Incinerators’ Bottom Ash from Five County Hospitals in Kenya

Health-care waste contains potentially harmful microorganisms and compounds which can infect and affect hospital patients, healthcare workers, the general public and environment. Therefore, management of health care waste requires safe handling, treatment and disposal procedures. While incineration reduces the volume and quantity of waste for final disposal, it leads to the production of fly and bottom ashes laden with toxic incomplete combustion products such as Polycyclic Aromatic Hydrocarbons (PAHs), dioxins, furans and heavy metals. This exposes workers who handle and dispose the bottom ashes, hospital patients, the general public and environment. The goal of this study was to determine the total and individual levels of 16 most prevalent and toxic PAHs. Bottom ash samples were collected from incinerators in five county hospitals in Kenya, namely;Moi-Voi, Narok, Kitale, Makindu and Isiolo. Bottom ash samples were collected over a period of six months from the five hospitals. The samples were then sieved, homogenised and stored at 4°C in amber coloured glass containers. The PAHs were extracted using 30 ml of a hexane-acetone solvent (1:1) mixture by ultrasonication at room temperature (23°C) for 45 minutes. The PAHs were then analyzed with a GC-MS spectrophotometer model (Shimadzu GCMS-QP2010 SE) connected to a computer work station was used for the PAHs analysis. The GC-MS was equipped with an SGE BPX5 GC capillary column (30 m × 0.25 mm × 0.25 μm) for the separation of compounds. Helium was used as the carrier gas at a flow rate of 15.5 ml/minute and 14.5 psi. 1 μl of the sample was injected at 280°C, split mode (10:1). The oven programming was set for a total runtime of 40 minutes, which included: 100°C (2-minute hold);10°C /min rise to 200°C;7°C /min rise to 249°C;3°C /min rise to 300°C (2-minute hold). The interface temperature was set at 290°C. Analysis was done in Selected Ion Monitoring (SIM) mode and the peak areas of each of the PAHs were collected from the chromatograph and used for quantification of the 16 PAHs listed by the U.S. Environmental Protection Agency (EPA) which included, BaA (benz[a]anthracene: 4 rings), BaP (benzo[a]pyrene: 5 rings), BbF (benzo [b]fluoranthene: 5 rings), BkF (benzo[k]fluoranthene: 5 rings), Chr (chrysene: 4 rings), DbA (dibenz[a,h]anthracene: 5 rings), InP (indeno[1,2,3 - cd] pyrene: 6 rings) and Acp (acenaphthene: 3 rings), Acpy (acenaphthylene: 3 rings), Ant (anthracene: 3 rings), BghiP (benzo[g,h,i]perylene: 6 rings), Flu (fluorene: 3 rings), FluA (fluoranthene: 4 rings), Nap (naphthalene: 2 rings), PhA (phenanthrene: 3 rings) and Pyr (pyrene: 4 rings). Ion source-interface temperature was set at 200°C - 250°C. Internal standards from Sigma Aldrich were used in the analysis and the acquired mass spectra data were then matched against the NIST 2014 library [1] [2]. The mean PAHs concentration in the bottom ashes of each hospital varied broadly from 0.001 mg/kg to 0.4845 mg/kg, and the mean total concentration levels of individual PAHs ranged from 0.0072 mg/kg to 1.171 mg/kg. Low molecular weight PAHs (Phenanthrene, Naphthalene and Fluorene) were predominant in all the hospital wastes whereas Kitale and Narok presented the lowest PAHs concentrations and the lowest number of individual PAHs. Moi/Voi recorded the highest total PAHs concentration at 1.3129 ± 0.0023 mg/kg from a total of 11 PAHs being detected from the bottom ash samples. Narok had only three PAHs being detected at very low concentrations of 0.0041 ± 0.00 mg/kg, 0.0076 ± 0.00 mg/kg and 0.012 ± 0.00 mg/kg for phenanthrene, anthracene and chrysene respectively. This study presents hospital incinerator bottom ash as containing detectable levels of both carcinogenic and non-carcinogenic PAHs. Continued unprotected exposure of hospital workers (waste handlers) to the bottom ash PAHs could be hazardous to their health because of their cumulative effect. Preventive measures e.g. the use of Personal protective equipment (PPE) should be prioritised to minimise direct contact with the bottom ash. The study recommends an upgrade on incinerator technology for efficient combustion processes thus for better pollution control.

Distribution and Concentrations of Heavy Metals in Tropospheric Suspended Particulate Matter (PM10) In Nairobi City, Kenya

Air pollution present the greatest threat to human health and welfare in urban environments. Population growth, industrial activities, expanded transport system, vehicular traffic, poor road planning, poor land use and traffic congestion contribute to the problem. Particulate matter (PM2.5 and PM10) has become the principal pollutants due to increased material use, energy demand and use as a result of global economic growth. This study assessed the levels of PM10 in ambient air and heavy metal composition in Nairobi city. Sampling sites were classified into three categories namely;controlled areas, industrial and residential areas as proscribed in the EMCA Air Quality Regulations, 2014. Portable Mini-Vol ambient air samplers were used for fine particulate monitoring. The concentrations of manganese, lead, and cadmium was determined in PM10 samples from all sampling sites. The lead concentration mean was 0.07 ± 0.06 μg/m3, 0.34 ± 0.35 μg/m3 and 1.10 ± 0.59 μg/m3 for residential, controlled and industrial areas respectively. Generally, all afternoons had high particulate matter while the lowest concentration levels of PM10 were recorded at night.

Mesophilic Process and Kinetics Studies of Selected Biomolecules as Potential Enhancers of Biomethanization of Cow Dung in an Anaerobic Tubular Batch Reactor

Mesophilic biogas production and substrate decomposition is one of the significant limiting steps in biogas generation. The rate of generation and quality often affect the viability of biogas systems. This study assessed the potential for biogas process catalysis using powdered Sorghum bicolor L., Zea mays, and Pennisetum glaucum. The kinetics and biogas generation processes were studied. Experiments were conducted in 1 m3 tubular batch reactors, where batches were dosed with various organic biomolecules. Results show that the use of P. glaucum L. and S. bicolor L. reduced the biogas retention times significantly. Biogas generation commenced after the first day for digesters fed with S. bicolor L. and P. glaucum L. while one with Z. mays and control occurred on day two. The rate of biomethanation and methane content were enhanced. S. bicolor L. led to the highest methane content. Findings reveal that locally available organic biomolecules improved biogas quality and quantity.

Performance Assessment of Heat Exchangers for Process Heat Integration

Pinch Analysis is an attractive solution for reduction of thermal energy costs in thermo-chemical industries.In this approach,maximum internally recoverable heat is determined and a heat exchange network is designed to meet the recovery targets.The thermal performance of a heat exchanger over its lifetime is however a concern to industries.Thermal performance of a heat exchanger is affected by many factors which include the physical prop-erties of the shell and tube materials,and the chemical properties of the heat transferfluid.In this study,thermal performance of shell and tube heat exchangers designed to meet heat recovery targets in a Pinch Analysis study is simulated.The aim of this paper is to present predictions of thermal performances of shell and tube heat exchan-gers with different heat transferfluids and geometries as they undergo fouling degradation.Engineering approaches based on thermodynamic analysis,heat balance and Kern Design equations,as well as what-if simu-lation modeling are used in this work.Shell and tube heat exchangers were designed to meet internal heat recov-ery targets for three process plants,A,B and C.These targets were published in a separate paper.The effects of degradation of the tubes-due to incremental growth of fouling resistance-on thermal performance of the exchan-ger were simulated using Visual Basic Analysis(VBA).Overall,it was found that growth in fouling reduces ther-mal efficiency of shell and tube heat exchangers with an exponential relationship.An increase of 100%of fouling resistance leads to an average reduction of 0.37%heat transfer.Higher values of logarithmic mean temperature difference(LMTD)and higher ratios of external diameter to internal diameter of the exchanger tubes amplify the effect of fouling growth on thermal performance of the exchangers.The results of this work can be applied in pinch analysis,during design of heat exchangers to meet the internal heat recovery targets,especially in predicting how fouling growth can affect these targets.This can also be useful in helping operators of shell and tube heat exchangers to determine cleaning intervals of the exchangers to avoid heat transfer loss.

Performance of a Modified Trickling Filter Packed with Different Substrates in Polishing Aquaculture Wastewater

Sustainable use of natural resources is one of the most critical aspects in today’s world,water monument being one of them.There is a high demand for water in domestic,agricultural and industrial sector.As a result of these there is an increased rate of wastewater generation.To ensure sustainable use of the resource,there is need for wastewater management that will ensure reuse and reduce pollution to the water resource.The aim of the study was to evaluate the performance of different locally available substrate materials in polishing aquaculture wastewater before it is discharged to the receiving bodies and to determine the substrates’optimal treatment conditions in a modified trickling filter system.The wastewater was characterized with high levels of nitrates,nitrites and phosphates which are nutrients responsible for the degradation of water resources through eutrophication.A modified trickling filter system was fabricated and woodchips,maize cobs and sugarcane bagasse were each packed in three different reactor tanks.These substrates were subjected to similar operating conditions of substrate column heights of 14 cm,18 cm and 22 cm,varied HRT(Hydraulic Retention Time)at 12 h,24 h,48 h and 60 h respectively.Wastewater was collected from a fish pond and passed through the modified trickling filter system for a specified period of time.Samples of the effluent were collected and tested for nitrates,nitrites and phosphates using a UV VIS(Ultraviolet-visible)spectrometer.The results obtained showed that the contaminant with the highest concentration was nitrates.Nitrites was converted into nitrates during the treatment process hence it was not a suitable parameter to be used to make conclusions.Phosphate was present in lower concentrations compared to nitrates hence the desired level was achieved.The most suitable substrate in the removal of all the contaminants was the woodchips with an efficiency of 94%at an operating condition of 18 cm and 22 cm substrate column height for the small and large woodchip particles at 48 and 60 h HRT respectively.Maize cobs and sugarcane bagasse both yielded an efficiency of 92%at 22 cm substrate column height and 60 h HRT.

Thermal Gasification of Rice Husks from Rice Growing Areas in Mwea, Embu County, Kenya

Thermal gasification of biomass provides a potential renewable energy resource in rural areas in Kenya. Rice husks are a key byproduct of rice production that are not considered of economic value to millers. Rice husks obtained from Mwea, Embu County, Kenya were converted into syngas using a locally assembled modified updraft gasifier. The syngas production was produced at temperatures between 450°C and 750°C with injection of limited supply of air and purified using series of gas cleaning and cooling devices. Proximate analysis shows that rice husks have a mean content of 21.9% ± 0.3% ash, 9.5% ± 3.3% moisture, 78.8% ± 0.3% volatiles and 91.8% ± 1.3% total solids. Carbonized rice husks have mean contents of 37.8% ± 1.2% ash, 3.1% ± 0.4% moisture, 62.3% ± 1.2% volatiles and 96.5% ± 0.4% total solids. The study shows that feedstock is consumed at a rate of 25 - 32 Kg/Hr with gas generation rate of 7.76 - 7.78 m3/hr;this translates to a gas yield of 0.31 - 0.35 m3/Kg. Process water was re-circulated at a rate of 2.2 m3/hr within the plant. The total electricity consumption per hour was 1.1 - 1.3 kWh. Carbon monoxide (CO) and temperature were monitored in the working area to assess the safety of the workers and were found to be in the range of 35 - 50 ppm and 24°C - 29.5°C respectively. The two were found to be within safe limits;however, the CO concentrations increased when leakages occurred. Syngas was found to be composed of 16.5% - 17.55% CO, 14.5% - 16.1% CO2, 4.1% - 4.5% H2, 6.8% - 7.2% CH4 and 17.9% - 45.7% N2 among others. The gas was used for direct heating applications and to run modified petrol engines. Carbonized husks were used to make energy briquettes and partly applied to the rice growing pads to improve soil properties. The technology provides energy solutions and aids in the abatement of climate change mitigation and abatement since it provides a permanent carbon sink. The technology provides a value addition chain for rice growers.

Wet Coffee Processing Discharges Affecting Quality of River Water at Kayanza Ecological Zone, Burundi

Wet coffee processing leads to the generation of large volumes of wastewater, whose discharge to the environment leads to pollution of freshwater bodies. Kayanza is a major coffee growing area in Burundi with more than 40 wet coffee processing factories (WCPF) that discharge effluents directly to receiving water bodies without treatment. This study was carried out to assess the effect of coffee wastewater on the physicochemical properties of receiving waterbodies in Kayanza coffee growing ecological zone. Currently, no study has been done to analyze the effluent from the WCPF and assess the level of pollution. This study will therefore provide valuable data on the water pollution from coffee processing plants. Ten (10) rivers in the Kayanza coffee growing zone were studied during the months of April and June, 2020. Water samples were collected upstream (U) and downstream (D) of the effluent discharge points in triplicate. Samples were analyzed for pH, Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD5), Temperature, Salinity, Electrical Conductivity (EC), Total Dissolved Solids (TDS), Dissolved Oxygen (DO), Total Suspended Solids (TSS), Nitrates, Nitrites, Lead (Pb), Copper (Cu), Chlorides and Ammonium ions using standard methods. Physical parameters were analyzed in situ whereas chemical parameters were analyzed in the laboratories in Burundi Institute of Agricultural Sciences (ISABU) and University of Burundi. Data were analyzed using R-studio-1.0.153, GenStat 64-bit Release 14.1 and SSPS. Results on the physicochemical parameters indicated that coffee factory effluent has a polluting potential during coffee processing peak. The concentrations of the physicochemical parameters were significantly (p < 0.05) higher downstream (D) compared to upstream (U) of the river water sampling points. All downstream sites had COD, BOD5, TSS and pH values above allowable limits set by WHO and Burundi. The polluting impact of public wet coffee processing factories was significantly higher than that of private and cooperatives owned factories (p < 0.05). Measures should be taken in order to protect water bodies.

Association between Respirable Dust Exposure and Respiratory Health Concerns among Workers in Apparel Processing Companies in Export Processing Zone (EPZ) in Machakos County, Kenya

Apparel processing is an essential industry in providing clothing needs for the population. The Export Processing Zone (EPZ) in Kenya employs many employees. Garment processing releases respirable dust particles, thus exposing workers to risks to the respiratory system. The study determined the respirable dust health concerns among workers in Apparel Processing Companies (APCs) in EPZ in Machakos County, Kenya. A cross-sectional descriptive design was employed where four companies were studied. Three hundred and sixty-seven participants were selected through systematic random sampling. Data was collected using questionnaires and Interview guides. The study established that workers were exposed to respirable dust PM2.5 ranging from 40.89 ± 24.0 μg·m−3 to 87.49 ± 45.2 μg·m−3 with a mean of 65.61 ± 31.5 μg·m−3. While PM2.5 ranged from 63.59 ± 21.2 μg·m−3 to 313.41 ± 468.0 μg·m−3. With a mean of 104.02 ± 26.0 μg·m−3. Workers complained of different respirable dust-related diseases. The most prevalent conditions were sneezing and coughing (86.4%), chest pains (41.1%), blocked chests (36.8%), and allergic reactions to dust (18.3%). The APC should develop an OSH management system that includes;a dust management policy, dust monitoring, Risk Assessments, Engineering controls installations, medical examination, Training on dust management, PPE provision, and use enforcement.

Biogas Production Using Water Hyacinth (Eicchornia crassipes) for Electricity Generation in Kenya

Water hyacinth, E. crassipes, an invasive water weed thrives in fresh water bodies causing serious environmental problems. In Kenya the weed has invaded Lake Victoria and poses great socioeconomic and environmental challenges. Currently the weed is harvested from the Lake and left in the open to rot and decay leading to loss of aesthetics, land and air pollution. There is therefore need for development of value addition and economic exploitation strategies. The aim of the study is to assess the potential for utilization of the weed as a renewable energy resource for biogas production. Samples were collected from Lake Victoria, pulped and blend with cow dung at a ratio of 3:1 as inoculum. The resultant mixture was mixed with water at a ratio of 1:1 and fed into a 6 m3 tubular digester. The digester was recharged with 20 kg after every three days. The temperature, pH variations, gas compositions, upgrading and gas yields were studied. The temperature ranged between 22.8°C - 36.6°C and pH 7.4 - 8.5. Biogas was found to contain 49% - 53% methane (CH4 ), 30% - 33% carbon dioxide (CO2 ), 5% - 6% nitrogen (N2 ) and traces of hydrogen sulphide (H2S). The biogas was upgraded using solid adsorbents and wet scrubbers increasing the methane content by up to 70% - 76%. The upgraded gas was used to power internal combustion engines coupled with an electricity generator and direct heat applications. The study concludes that E. crassipes is a potential feedstock for biogas production especially in areas where it is abundant.