4th  DIMENSION ENERGY
                      MEDICAL WASTE TO ENERGY PLATFORM

        Statistics:

      The total annual volume of medical waste generated in the United States is currently estimated to be approximately 465,000 tons
    (1998 estimation)  Solid waste generated per person per day in hospital facilities has been estimated to range from 10 to 25 pounds, of
    which approximately 10-15% is classified as “infectious” under Environmental Protection Agency (EPA) guidelines The annual rate of
    growth in the volume of medical waste generated is estimated to be 7-10%.

        Estimated that the costs associated with removal of the 465,000 tons of medical waste generated annually in the United States are
    approximately $1 billion (1998 report) EPA estimates that the costs for a comprehensive medical waste tracking system are an
    additional 8 cents per pound. A figure disputed by the American Hospital Association, which estimates such costs at an additional 28 to
    58 cents per pound



    Existing Methods for Disposal:

    Most common methods of treating medical waste are incineration, and autoclaving.
    Costs approximately 10 to 15 cents per pound of medical waste – 1998 estimation - (does not include costs associated with new
    environmental clean act measures)


    Incineration is not Feasible:

    Incineration is expensive and prices are going up

    Vendor consolidation  

    Closure the country’s commercial medical waste incinerators by EPA and Department of Justice is under way.  Increased federal
    regulation, and public pressure will pave the way for more environmental friendly technologies.  

    Skyrocketing fuel costs, and class action lawsuits associated with incineration process will ensure that the prices will continue to rise.



    Incinerators Emit Dioxins and Mercury:

        Medical waste incinerators are one of the nation’s leading emissions sources of persistent, toxic, bioaccumulative pollutants like
    dioxins and mercury Dioxins are a family of complex, but related molecules with similar chemical structures. These highly toxic
    substances persist for long periods in the environment, where they bioaccumulate in living tissues. The dioxins can weaken the immune
    system and interfere with the endocrine system, which is responsible for making hormones needed to regulate bodily functions. Medical
    waste incinerators must meet the emission limit set at 0.1 ng TEQ/m3 for dioxins and furans. U.S. EPA’s 1995 dioxins emissions
    inventory estimated that medical waste incineration was the nation’s third largest dioxins source  emitting 15% of all the dioxins on the
    national inventory.

         The prevalence of chlorine-containing polyvinyl chloride (PVC) plastic products in medical waste is one contributor to dioxins
    formation—studies show that increasing the amount of chlorine or chlorine-containing PVC in a particular combustor (like a specific
    medical waste incinerator) increases its dioxins emissions


     Autoclaves Literally a Smoke Screen Technology:

         The autoclave emissions for a normal medical waste load from a hospital during cooling cycle produces the following volatile
    organic compounds: xylenes, ethyl benzene, toluence, carbon disulfide, acetone, and styrene. The autoclave technology has had its
    number of issues that prevent proper sterilization proceeds; condensate issues (wet loads) in their chamber post-sterilization impeding
    satisfactory processing results. The water from the autoclave during the process is a cesspool of endotoxins that contaminate the
    surrounding area. Key members of the FDA and the autoclave industry serve on a joint committee called the ANSI/AAMI ST55.


        Endotoxins have been a growing concern and discussed heavily in recent years, primarily because the human immune system does
    not know how to get rid of them. “Think of an amoeba. When that amoeba dies, not only its carcass, but its excretions are left behind as
    endotoxins." states Chuck Fishelson of Alfa Medical. Endotoxin is invariably associated with Gram-negative bacteria, regardless of
    whether the organisms are pathogenic. Although the term is occasionally used to refer to any cell-associated bacterial toxin, in
    bacteriology it is properly reserved to refer to this lipopolysaccharide complex. Gram-negative bacteria containing these endotoxins
    include Escherichia coli, Salmonella, Shigella, Pseudomonas, Neisseria, Haemophilus influenzae, Bordetella pertussis, and Vibrio
    cholerae

    Boiling for 30 minutes does not destabilize endotoxins.  



     How to Recoup Cost Associated with Medical Waste:


             Many times State Laws define the regulations for how a hospital must handle and dispose of their regulated medical waste and
    hazardous waste. A hospital can typically generate up to 10-12 separate waste streams, which require multiple lines of vendors to
    handle each waste stream, will add to the various types of containers/equipment required to dispose of the waste, and will require
    hospitals to train their medical staff on proper handling of these waste streams. The financial savings start with a consolidation of all
    vendors to one - 4th Generation Energy for all waste disposal and streamline the process to a local facility. Transporting and disposing
    hazardous waste out of state is not cost prohibitive; especially when all waste can be processed locally. Formulating a
    purchasing/supplemental (clean renewable energy) electricity agreement with 4th Generation Energy is cost reduction strategy  instead
    of paying the going rate with local power company


          4th Generation Energy has the resources and technology to implement a significant financial savings on medical waste upon a
    formal contract agreement
    The sum of all medical waste plus any that where not mentioned utilizing the 4th Generation Energy program as sole waste
    management organization will reduce expenditures from 15 to 40%
    A viable solution for all waste venues handled by one entity!


     Average National Cost Figures for Medical Waste:



    MEDICAL SOLID WASTE (MSW)

    The average cost to dispose of MSW in a hospital is approximately $250 – $300 per bed  Example >  (661 bed facility) MSW cost of
    $198,300 @ $300 per bed per year expenditure.


       Plastics Waste


    The plastics that are most common in hospitals are listed below:
    Tyvek plastic wrap – this generally makes up 50% of the plastic waste from pre-patient operating rooms.
    IVbags – many times these items are discarded in the MSW waste containers.
    If the average 600-bed hospital could focus on the blue wrap and polypropylene plastics in just the OR Departments that would
    average 14,000 – 17,000 lbs. per month (6.5 to 8.7 tons). This would equate to approximately $280 – $400 per month.


      Regulated Medical Waste

    The national average is approximately $350-$500 per bed.
    Example > (661 bed) at $500 per bed = $330,500 per year based on national average.
    Example #2 - Actual waste output 240 cubic yards per week or 64.8 tons per week  64.8 tons x $684 (minimum rate) per ton x 52
    weeks= $2,304,806.40 a year expenditure * Does not factor for hauling, and shredding fees if they apply.  Biohazard waste contributes
    to 15% of an average hospitals waste stream and the average cost is about 20% higher than regular solid waste.


       General Waste

    This waste is comprised of food waste, paper trash, anything that environmental / housekeeping services collects
    throughout the hospital.  

    Example :  160 cubic yards per week or 43.2 tons per week
    43.2 tons x $60 per ton x 52 week = $134,784 expenditure per year


      Universal Waste


    Universal waste is the largest growing need in hospitals based on the volumes they generate and the regulatory requirements to
    properly dispose of them. These types of waste cannot be disposed of in your solid waste stream or placed in landfills. Your hospital
    runs the potential risk of hefty fines imposed by the EPA if you are caught placing these items in a landfill
    The typical cost range for this waste is  $ 0.75 - $1.00 per pound.