Pharmafilter Results of the demonstration project at Reinier de Graaf Hospital, Delft, the Netherlands, in April 2012
Pharmafilter A CLEANER HOSPITAL, A CLEANER ENVIRONMENT Shredder Tonto Tonto shreds the hospital waste Existing sewerage Existing sewerage transports the shredded waste together with the sanitary water Purification installation Purification installation reduces the solid waste and purifies the water Removal of waste through the sewer system, for a cleaner hospital; removal of medicinal residues from waste water for a cleaner environment that is the promise of the Pharmafilter system in a nutshell. Shredders (Tonto ) are installed in the hospital, to replace the conventional bedpan washers as well as in places where waste is generated. Almost all types of waste are shredded and flushed by the existing sewer system with the Tonto. An installation is set up outside the hospital which ferments and decontaminates the solid waste, thereby producing biogas. All waste water is purified and cleaned of medicinal residues. Pharmafilter makes it economically and environmentally feasible to innovate processes in the hospital with the introduction of biodegradable, disposable products instead of products that need to be sterilised after each use, such as bedpans, urinals and cutlery. 2 3
We hereby present the results of the Pharmafilter demonstration project at the Reinier de Graaf Hospital in Delft, where the first pile was driven on 25 January 2010. System tests began on 7 June 2010. Since late 2010, the hospital s waste water has been undergoing a full purification. The first series of Tontos were tested and developed in the wards of H Building from the start of 2011 onwards. The fermentation and decontamination of the waste from the wards, the biodegradable bedpan (Olla ), the disposable urinals and measuring cups have been fully operational since October 2011. From December 1, 2011 tests have been carried out with the processing of particular kinds of hospital waste. This booklet summarises the most important results achieved so far. Bert Palsma, Chairman of the Steering Committee 4 5
TONTO AND OLLA The new Olla disposable bedpan, made from organic plastic, is shredded in the Tonto after use. This makes the work of nurses cleaner and more efficient. Patients appreciate the Olla for its ergonomic, comfortable seat. Approximately 60 Ollas are used per 200 beds per day. Each Olla saves approx. 2 minutes compared to the current method. This method replaces the conventional steel bedpan, which must be sterilised in a bedpan rinser with plenty of hot water after use. The Tonto fits the site of the bedpan rinser. Per 200 beds, this method saves approx. 547,500 litres of hot water per year. The Olla is the first in a series of disposable products. The replacement of the urinal, the Botta, a 24-hour system, will soon enter production. This process will save at least another 4 minutes per day per patient. (During the trial, disposable urinals and measuring cups of conventional plastic were used.) Olla and Botta together can, per 200 beds per year, make around 43,800 hand disinfections redundant. 6 7
TONTO AND WASTE The Tonto shredder is the shortest way out of the hospital for waste. Almost all the waste from a hospital can be processed in the Tonto. Some exceptions are office paper (as it is worth money), glass (which goes in the bottle bank) and small chemical waste such as batteries. Specific hospital waste can be fully processed. Up to 100% savings are made on logistics costs of waste and waste processing from the wards. With Tonto, no transport and lift movements are needed for the transportation of waste, saving time for logistics employees, who also have less contact with infected waste. Collecting waste instead of processing it separately ultimately affords greater control over dangerous hospital waste. 8 9
internal sewer system The Tonto shredder is connected to the hospital s existing internal sewer system, which connects to the treatment plant on the hospital grounds. The sewer system, dating from 1967, whose construction was altered to meet the current building code with regard to fall and angles, has turned out to function well for the transport of solid waste. The method has not been causing any additional blockages. 10 11
fermentation All the waste from Tonto ends up in the shredder. The organic waste, including faeces, and the bioplastic products, are almost completely converted into biogas, which is used for the energy and heating of the purification plant. The fermentation process takes about 30 days at around 60 C. This process strips the waste that is not fermented of viruses and bacteria that are harmful to humans. Periodically, the non-fermentable residual fraction is decontaminated at 100 C and removed for incineration. Research is being carried out into recycling this waste stream. The waste volume and the number of road transports has been reduced by 20-50%. 12 13
Water Purification The effluent from the hospital is fully purified in four steps and cleansed of all harmful substances such as medicinal residues, cytostatics, contrast liquids, endocrine substances, bacteria and viruses. Samples show that all medicinal residues found in the waste water are eliminated to below the detection limit. Medicinal waste in the water is no longer detectable. 99.9% savings on the waste water charge. The purified water is suitable for flushing the Tonto, toilets, cooling towers and other process applications. Up to 40% reuse of water is achievable. 14 15
Platform for innovation Pharmafilter is a platform for innovation The concept allows employees to work faster and cleaner with new products, to increase patient satisfaction and safety and further reduce the waste stream by using biodegradable disposables. New products by Pharmafilter include the Olla de Luxe, a replacement of the shower chair, the Olla on the Move mobile toilet for at home, designed for patients who use cytostatics. A Megatonto for processing waste from the company canteen is being developed. 16 17
Stakeholders Clients are Reinier de Graaf Hospital, Delfland Water Board, and the Stichting Toegepast Onderzoek Waterbeheer (Foundation for Applied Water Research). With support from: The European Environment and Nature Policy Programme Life+, and the innovation programme Water Framework Directive of the Ministry of Infrastructure and Environment. The Pharmafilter is internationally patented as a method and system by Pharmafilter BV. Pharmafilter, Tonto, Olla, Botta are registered trademarks of Pharmafilter BV. Disclaimer: No rights can be derived from the information provided in this booklet. 18 19
Design and printing: Ecodrukkers Nieuwkoop, The Netherlands This book has been made with: Chemical-free CTP Solvent-free 20