CHAPTER 1: BRIEF DESCRIPTION OF THE PROJECT
SUBPROJECT: BUILDING OF NEUROSURGERY INTERNATIONAL HOSPITAL
ENVIRONMENTAL DOCUMENT:
PART 1: ENVIRONMENT IMPACT ASSESSMENT (P 02)
PART 2: ENVIROMENT REPORT (P 66)
PART 3: RISK MANAGEMENT PLAN (P 88)
PART 1: ENVIRONMENT IMPACT ASSESSMENT
CHAPTER 1: BRIEF DESCRIPTION OF THE PROJECT
1. NAME OF PROJECT
2. INVESTOR:
3. LOCATION OF PROJECT LAND
4. MAIN CONTENTS OF PROJECT
1. Structure of planning
2. Hospital architect space design
3. Land arrangement plan
5. TECHNICAL INFRASTRUCTURE NETWORK
1. Transportation network
2. Electricity network
3. Water supply network
4. Fire prevention network
5. Communication network
CHAPTER 2. NATURAL – ECONOMIC – SOCIAL CONDITION AT PROJECT LAND
2.1. NATURAL AND ENVIRONMENTAL CONDITIONS
2.1.1. Geographical and geological conditions
2.1.1.1. Geographical location
2.1.1.2. Ground and geomorphology features
2.1.1.3. Geology
2.1.2. Meteoric and hydrographical conditions
2.1.2.1. Temperature
2.1.2.2. Humidity
2.1.2.3. Wind
2.1.2.4. Pluvial index
2.1.3. Status of natural environmental conditions
2.1.3.1. Status of air quality
2.1.3.2. Status of underground water quality
2.2. SOCIAL AND ECONOMICAL CONDITIONS
2.2.1. Economical conditions
2.2.2. Social conditions
2.2.2.1. Population
2.2.2.2. Medicine
CHAPTER 3. ENVIRONMENT IMPACT ASSESSMENT
3.1. DEFINE THE POLLUTION SOURCES
3.1.1. Impact sources relating to the waste
3.1.2. Impact sources not relating to the waste
3.1.3. Prediction of the environmental risks from the project
3.1.3.1. The environmental risks in the construction stage
3.1.3.2. The environmental risks in the operation stage
3.2. IMPACT ENTITY AND SCALE
3.2.1. The entity impacted in the stage of construction and equipment installation
3.2.1.1. Dust and waste gas
3.2.1.2. Wastewater
3.2.1.3. Waste solid
3.2.1.4. Noise
3.2.1.5. Accident, fire and explosion
3.2.2. The entity impacted in the stage of operation
3.2.2.1. Air polluted waste
3.2.2.2. Wastewater
3.2.2.3. Waste solid
3.2.2.4. Noise
3.3. IMPACT ASSESSMENT
3.3.1. Environmental impact assessment in the stage of construction and equipment installation
3.3.1.1. Impact of the source of air polluted waste
3.3.1.2. Impact of waste water
3.3.1.3. Impact of waste solid
3.3.1.4. Other impacts
3.3.2. Environmental impact assessment in the stage of operation
3.3.2.1. Impact of the source of air polluted waste
3.3.2.2. Impact of waste water
3.3.2.3. Impact of waste solid
3.3.2.4. Social impact
CHAPTER 4. MINIMIZATION MEASURES OF NUISANCE, PREVENTION AND COUNTERMEASURES OF ENVIRONMENTAL ACCIDENT.
4.1. BAD IMPACT MINIMIZATION MEASURES, PREVENTION AND COUNTERMEASURE OF ENVIRONMENTAL RISK IN CONSTRUCTION STAGE
4.1.1. The impact minimization measures on the water
4.1.2. The impact minimization measures on the air
4.1.3. The impact minimization measures from site hut
4.1.4. The measures to ensure the labor safety
4.1.4.1. The use of vehicles and construction machines
4.1.4.2. The safety in site hut installation and dismantling
4.1.4.3. The labor safety land work
4.1.4.4. The labor safety in masonry work
4.2. BAD IMPACT MINIMIZATION MEASURES, PREVENTION AND COUNTERMEASURE OF ENVIRONMENTAL RISK IN OPERATION STAGE
4.2.1. The measures to control the air pollution
4.2.1.1. Control the impact from the traffic
4.2.1.2. Control the air pollution from the operation of wastewater treatment system and solid waste collection
4.2.1.3. Control the impact from the waste gas from the generator
4.2.1.4. The measures to control the noise and vibration
4.2.2. The measures to minimize the bad impact from wastewater
4.2.2.1. Classification of waste water
4.2.2.2. Drainage construction
4.2.2.3. Preliminary domestic wastewater
4.2.2.4. The wastewater treatment system
4.2.2.5. The measures to prevent the water pollution
4.2.3. The measures to manage and treat the solid waste
4.2.3.1. Collection and classification stage
4.2.3.2. Treatment stage
4.2.4. The measure to prevent the environmental risks
4.2.4.1. The measures to prevent the fire and explosion
4.2.4.2. The accident relating to electricity
4.2.4.3. The accident relating to radiation
4.2.4.4. The accident from labor and occupational diseases
CHAPTER 5. COMMITMENT TO IMPLEMENT THE ENVIRONMENTAL PROTECTION MEASURES.
CHAPTER 6. ENVIRONMENTAL TREATMENT BUILDING, ENVIRONMENTAL MANAGEMENT AND MONITORING
6.1. THE LIST OF ENVIRONMENT TREATMENT BUILKDINGS
6.2. MANAGEMENT PROGRAM
6.2.1. Environment management program during the construction stage
6.2.2. Environment management program during the operation stage
6.3. ENVIRONMENT MONITORING PROGRAM
6.3.1. Air quality monitoring
6.3.1.1. Surrounding atmosphere quality monitoring
6.3.1.2. Hospital atmosphere quality monitoring
6.3.2. Water quality monitoring
6.3.2.1. Wastewater quality monitoring
6.3.2.2. Monitoring of solid waste management
CHAPTER 7. COST ESTIMATION FOR ENVIRONEMNTAL BUILDING
7.1. COST ESTIMATION OF WASTE TREATMENT BUILDINGS
7.1.1. Building
7.1.2. Equipments – Installation – Operation - Acceptance
7.2. COST ESTIMATION OF ENVIRONMENTAL QUALITY MONITORING
CHAPTER 8. COMMUNITY CONSULTING
8.1. OPINIONS OF TAN THOI HOA WARD’S PEOPLE COMMITTEE
8.2. OPINIONS OF TAN THOI HOA WARD’S FATHERLAND COMMITTEE
CHAPTER 9. DATA SOURCE AND EVALUATION METHOD
CONCLUSION AND PROPOSAL
9.1. DATA SOURCE
9.1.1. Data source for reference
9.1.2. Data source created by the investor
9.2. APPLIED METHOD IN EIA
9.3. REMARK ON THE DETAILED, RELIABLE EVALUATION METHOD
I. CONCLUSION
II. PROPOSAL
PREFACE
I. THE ORIGIN OF PROJECT
In the industrialization time, stresses and demands of life have made many people infectious with diseases of nerves and spine. But at present the number of patients under the neurosurgery is very large (disk buffer to release the spine, neck, spine, waist). In Ho Chi Minh City, the overload of faculty of neurosurgery in the public hospitals is increasing, affecting the quality of treatment and service of public health, not to meet the needs of health care quality for patients having the high economic condition.
Treatment at the specialized hospitals in Singapore, Thailand have the cost much more many times than in Vietnam and is not always convenient for patients and their families
While the provincial hospitals, although having the neurosurgery faculty but only solve the cases of brain injury (such as blood from surgery ..) and almost not be able to resolve the common diseases in neurosurgery field (brain and spine)
The southern provinces in general and HCMC in particular there are no neuro specialized hospital (currently, only Cho Ray hospital with specialized in neurosurgery is the only treatment only in the South and may be for all the country).
In Ho Chi Minh City it has a number of private specialized hospitals as the eye hospital in Saigon, ITO Hospital (trauma specialized in Orthopedics), international puerperal hospital, their success have proven to require the beneficiaries to high health care quality by patients is real and the formation of the specialized hospital is right in the selective development of health branch today.
II. THE LEGAL AND TECHNICAL BACKGROUND
II.1. Legal Documents
The EIA of the project “Investment of the International Neurosurgery Hospital” is based on the following legal documents:
- The Environment Protection Law 2005 approved by National Assembly dated 29 November 2005 and signed to issue by State President dated 12 December 2005.
- Decree No 80/2006/ND-CP of the Government issued on 9 August 2006 to stipulate in details and direct the implementation of some articles of The Environment Protection Law.
- Circular 08/2006/TT-BTNMT dated 08 September 2006 of Ministry of Natural Resource and Environment on “The direction of Strategic Environment Assessment, Environment Impact Assessment, Environment Protection Commitment”
- Decree 21/2008/NĐ-CP dated 28 February 2008 on the modification, supplementation some articles of Decree No 80/2006/ND-CP of the Government issued on 9 August 2006 to stipulate in details and direct the implementation of some articles of The Environment Protection Law.
- Ordinance 07/2003/PL-UBTVQH dated 25 February 2003 on Private Medicine and Pharmacy Professional Practice.
- Decree 103/2003/NĐ-CP dated 12 September 2003 of the Government to stipulate in details and direct the implementation of Private Medicine and Pharmacy Professional Practice
- Circular 12/2006/TT-BTNMT dated 26 December 2006 of Ministry of Natural Resource and Environment on “The direction of practice conditions and the formality to form the documents, registration, professional practice issue code for management of the hazardous wastes.
- Decision 22/2006/QD-BTNMT dated 18 December 2006 of Ministry of Natural Resource and Environment on being compulsory to apply Environment Vietnam standards.
- Decision 23/2006/QD-BTNMT dated 26 December 2006 of Ministry of Natural Resource and Environment on issuing the list of the hazardous wastes.
- Decision 43/2007/QD-BYT on issuing the regulation of medical waste management.
The environment standards
- The allowable maximum limits of the noise in the public and people regions (equivalent sound level TCVN 5949 – 1998)
- TCVN 6772 – 2000. The standards of water quality – domestic wastewater – The allowable pollution limit (Level I)
- TCVN 5937 – 2005: The air quality – surrounding air quality
- TCVN 5938 – 2005: The air quality – The allowable maximum concentration of some hazardous substances in the surrounding air.
II.2. Technical Documents
- The data and documents on the status of natural, environmental, and socio – economical conditions of Tan Thoi Hoa ward, Tan Phu District, HCMC.
- Documents of the technical design of The INH project implemented by construction company.
- WHO’s Documents for fast evaluation to estimate the pollution load from the project activities.
- The EIA implemented in VN during the past years, especially the projects similar to the INH project.
III. EIA IMPLEMENTATION ORGANIZATION
The EIA of “INH investment project” is consulted by AQC (Water and Environment Technology Development Company)
Director: Mr. Ho Xuan Nham, MS
Address: 80/125B Tran Quang Dieu St, Ward 14, District 3, HCM city
Office: 27/41 Hau Giang St, Ward 4, Tan Binh District, HCM city
Phone: 08 – 39484383 Fax: 08 – 39484183
Group of EIA implementation
MS Ho Xuan Nham, Director of AQC Company
Eng. Do Van, Environment Engineer, AQC Company
Eng. Nguyen Ngoc Anh, Environment Engineer, AQC Company
Bac. Do Tran Mong Thuy, Environment Bachelor, AQC Company
Eng. Nguyen Dang Quynh Nhu, Environment Engineer, AQC Company
CHAPTER 1: BRIEF DESCRIPTION OF THE PROJECT
1. INVESTOR:
INTERNATIONAL NEURISURGERY HOSPITAL JOINT STOCK COMPANY
Address: 203 Dong Khoi Street, District 1, Ho Chi Minh city
Phone: 08.38277308
Representative: Tran Ngoc Lan Trang
Position: Chairman of BOM
2. LOCATION OF PROJECT LAND
The investment project of building The International Neurosurgery Hospital is located at 65A Luy Ban Bich St, Tan Thoi Hoa Ward, Tan Phu District, HCMC which area is 1,257.1 m2 with their directions are:
• North East is Luy Ban Bich street;
• South East is inhabitants;
• South West is inhabitants;
• North West is inhabitants and school.
Total land area: 1,257.1 m2
Year 1 of the section factor 3 to map number 32 (Peta) and belongs to Tan Thoi Hoa Ward, Tan Phu District, HCMC. There is a state hospital old can improve, repair, use the right
3. MAIN CONTENTS OF PROJECT
The project of building and improving The International Neurosurgery Hospital mobilizes 100% of capital contribution by Enterprises law with the scale of 100 patient beds and has achievable planning target
• Total land area: 1,257.1 m2
• Construction site area: 715.5 m2
• Construction density: 57%
• Land for trees: 514.5 m2
• Level of construction: 5 stories
• Coefficient of land use: 3,28
• Total site area: 4,125.5 m
Table 1.1 : Item need be improved, built
|No. |Item |Flooring height (m) |Construction area (m2) |
|1 |Newly-built technical operating room in terrace : brick walling, |4.4 |144.00 |
| |reinforced concrete column, tole roof | | |
|2 |Roofing stair |3 |- |
Items improvement, repair and new construction on the present reflected in the following table
1. Structure of planning
According to plan of building hospital, international neurosurgery hospital is built and improved on the foundation of old hospital with land using structure.
Land for main building
Land for planting trees
Land for internal transportation
2. Hospital architect space design
The project of building new international neurosurgery hospital consists of 5 floored block. Main block is rectangular shape, has green space middle isolated with the outer space.
options on architecture outline and the beautiful block, durable and environmental friendly materials nature and the environment, creating maximum sense of healthy, consistent, safety and ventilation.
3. Land arrangement plan
Ground floor: 715.5 m2 is reception, patient receiving, emergency aid, and professional support …
1st floor: 756.0 m2; ultrasonic test, cardio electricity, XR interference, rooms for patient, nurses, doctors…
2nd floor: 756.0 m2; rooms for patient, kitchen, canteen…
3rd floor: 756.0 m2; rooms for patient, rooms for VIP patient, administration
4th floor: 756.0 m2; rooms for patient, anaesthetizing room …
Terrace: 756.0m2 ; surgery technique, washing room, drying ground…
Transportation design for disables is followed the international standards.
|Floor |Name of rooms |Area, m2 |
|Ground | |715.5 |
| |Examination |203.1 |
| |Emergency |174.2 |
| |Support |202.7 |
|1st | |733.52 |
| |X ray |34 |
| |Blood test sample |10 |
| |Test |16 |
| |Cardio Ultrasonic |13.5 |
| |Treatment |335.7 |
| |Administration |324.32 |
|2nd | |733.02 |
| |Treatment |337.7 |
| |Administration |79.72 |
| |Support |315.6 |
|3rd | |721.75 |
| |Treatment |349.4 |
| |Administration |372.35 |
|4th | |800.42 |
| |Treatment |100 |
| |Surgery |700.42 |
Treatment area: patient rooms
Administration area: meeting room, dean room, storage, attendant room, accounting room, hygiene room, nurse room, lobby stair
Surgery area: surgery room, interval room, session room, receiving and anaesthetizing room, sterilizing room.
Examination and emergency area is placed at ground floor with convenient waiting space for patient. The 1st, 2nd, 3rd floor are designed for patient room, separately the 3rd floor for VIP room with full facilities to serve patients having high demands on service of examination and treatment in hospital. Surgery area is place at the 4th floor with full of functional room for operation and postoperative.
4. TECHNICAL INFRASTRUCTURE NETWORK
1. Transportation network:
The International Neurosurgery Hospital is located in Luy Ban Bich St which belongs to Tan Binh District and Tan Phu District, so the transportation is quite convenient.
Internal transportation of hospital with internal road even the road for disable people according to the design meeting the international standard.
2. Electricity network:
Power supply of hospital is connected to the electricity network running along Luy Ban Bich by underground cable to the transformer station. Total load distribution throughout the hospital is estimated about 450 KVA. Conductors inside hospital are kind of copper core with PVC cover, invocatory layout, automat automatically disconnect for each room to ensure safety.
3. Water supply network
Pure water for hospital is supplied continuously throughout the day for activities, treatment and fire fighting. Water supply is ensured hygiene in accordance with the request of activities, treatment and from the city water supply system located along Luy Ban Bich street.
Water supply demand for patient beds in hospital, averagely 500 l/day for each patient bed. Plus water for watering plants, fire fighting, estimating the amount of water supply for hospital’s activities is 100 m3/day.
4. Drainage network:
Hospital’s drainage network is divided into 2 network completely separating from the beginning:
Drainage network of rainwater
Rainwater from roofs, garden and internal road is collected into drain system B200 with cover to reinforced concrete culvert Ф300, then is released directly to city drainage network running along Luy Ban Bich street.
Drainage network of waste water
Wastewater of hospital is preliminary processed, then following PVC pipe system D200 leading to concentrating wastewater treatment station before released to city drainage network.
5. Fire prevention network:
Sufficient amount of Water for fire fighting inside and outside hospital as described in the resolution of water supplying, the layout of exit nearest, corridor, doors all meet the stipulated level in TCVN 2622-1995.
Fire fighting alarm system is arranged in each room, running continuously 24 /24 hours of all day. The design of system is based on TCVN 2622-1995 about general requirements of equipments, installment that reach highest safety when hospital is in operation.
6. Communication network:
Modern system in order to meet the demand of administration, meeting, training such as:
Camera observing system connected surgery rooms, meeting hall.
Network System of staff management as well as connected to other relevant hospitals’ network system outside the area.
System of fire alarm, exit, fire fighting
Bell calling nurse system
CHAPTER 2. NATURAL – SOCIO-ECONOMIC –CONDITIONS AT PROJECT LAND
2.1. NATURAL AND ENVIRONMENTAL CONDITIONS
2.1.1. Geographical and geological conditions
2.1.1.1. Geographical location:
The investment project of building The International Neurosurgery Hospital is located at 65A Luy Ban Bich St, Tan Thoi Hoa Ward, Tan Phu District, HCMC which area is 1,257.1 m2 with their directions are:
• North East is Luy Ban Bich street;
• South East is inhabitants;
• South West is inhabitants;
• North West is inhabitants and school.
2.1.1.2. Ground and geomorphology features:
Land of building and improving hospital is quite flat, having existing structure of old hospital. The neurosurgery hospital‘s construction bases on the existing structure of old hospital
2.1.1.3. Geology:
2.1.2. Meteoric and hydrographical conditions
2.1.2.1. Temperature:
Average temperature: 27oC
Highest temperature is 28.8oC in April. Lowest temperature is 25.7oC between December and January. There are about 330 days having the average temperature of 25-28oC. Such conditions will accelerate the decomposition process of organic substances contained in waste, contributing to reduce urban environmental pollution.
2.1.2.2. Humidity:
Air humidity is fairly high, averagely annually 79.5% and 80% in rain season against absolute humidity of 100%, averagely 54.5% in dry season and even 20% of lowest rate.
2.1.2.3. Wind:
2 main wind directions: West-Southwest, North-Northwest
West-Southwest wind comes from Indian Ocean in rain season about June to October, average wind speed of 3.6 m/s with fastest in August about 4.5 m/s.
North-Northwest comes from East Sea in dry season about November to May, average wind speed of 2.4 m/s
Besides, other wind direction is South-Southeast wind about March to June, average wind speed of 3.7 m/s
2.1.2.4. Pluvial index:
High rainfall, annually averagely 1,949 mm. average rain day/year is 159 days. About 90% annual rainfall is in rain month
2.1.3. Status of natural environmental conditions
2.1.3.1. Status of air quality:
In order to access environmental actuality of project area and surroundings, the consultant has conducted sampling and analysis of environmental quality in some locations featured in the project area and inhabitant area on assessing exactly harmful level, diffusion of polluted substances in the environment at the time of this report. Environmental quality is accessed through specific feature as following:
Polluted air: Dust, NO2, SO2
Non climate: Noise
The result of air environment and non climate survey at project area are done with the collaboration of HCMC chromatography training and development center in 14January2008.
Sampling and analyzing method of figures following technical regulations of ministry of Health 1993 and Standard Method For Examination (USA).
Table 2.1: Result of measuring air quality of project area
|No. |Parameters |Unit |Result |TCVN 5937-2005 |
| | | |1st position |2nd position | |
|1 |NO2, |mg/m3 |0.025 |0.020 |0.2 |
|2 |SO2 |mg/m3 |0.123 |0.070 |0.35 |
|3 |Dust |mg/m3 |0.28 |0.27 |0.3 |
|4 |Noise |dBA |65 – 68 |63 – 65 |75 (*) |
Source: HCMC chromatography training and development center
Note:
TCVN 5937 – 2005 : air quality – surrounding air quality standard
(*) TCVN 5949 – 1998 : acoustics – noise of public and inhabitant area- allowed maximum level of noise
1st position: hospital gate
2nd position: project under construction
Assessment:
Measurement result show that air environment quality in project area is quite clean, concentration of polluted substance (Dust, NO2, SO2) and noise are both under permitted standard.
2.1.3.2. Status of underground water quality:
In order to assess the water environment quality of project area and surroundings, survey group has conducted sampling for these figures: pH, Fe, Cl-, N-NO3-, SO42-
Table 2.2: Result of measuring ground water quality of project area
|No. |Figure |Unit |Result |TCVN 5944-2005 |
|1 |pH |mg/l |5.34 |6.5 – 8.5 |
|2 |Fe |mg/l |7.952 |200 – 600 |
|3 |Cl- |mg/l |KPH |1 – 5 |
| | | |(LOD = 0.01) | |
|4 |N-NO3- |mg/l |0.013 |45 |
|5 |SO42- |mg/l |KPH |200 - 400 |
| | | |(LOD = 0.1) | |
Source: HCMC chromatography training and development center
Note:
KPH
LOD
Assessment:
In general, ground water of project has not been polluted, the result are under the limit of Viet Nam Standard, only pH has not met the standard.
2.2. SOCIAL AND ECONOMICAL CONDITIONS
2.2.1. Economical conditions:
GDP in 2007 of HCM city increases 12.6% - highest in recent decades. Income per capital is about 2,180 USD, the most against the whole country (only 900 USD per capita).
2.2.2. Social conditions
2.2.2.1. Population
Tan Phu District was established on November 2003 with its area 16,06 km2. Its population is 376,855 inhabitants in 2006. The percentage of unemployment is 6.3%. The percentage of immigrants is 48.09%, most of them are unstable life, popular workers.
Tan Thoi Hoa Ward has the area of 114.6 ha and its population is 24,614 inhabitants at 31 December 2004.
2.2.2.2. Health care
at the end of 2006, HCM city has 289 medical facilities, in which there are 36 hospitals, 29 regional examination stations, 1 sanatorium rehabilitation hospital, 317 stations at wards, companies.
In 2005 – 2010, Tan Phu District concentrates to implement the community health care, raise the quality to serve people, intensify the food hygiene and safety, epidemic prevention, management the private medical facilities on the area.
CHAPTER 3. ENVIRONMENT IMPACT ASSESSMENT
3.1. DEFINE THE POLLUTION SOURCES
3.1.1. Impact sources relating to the waste
3.1.1.1 Construction, innovation, equipment installation
The INH is mainly innovated and constructed more items based on the old structure of pregnancy hospital. The wastewater treatment station and inside streets are upgraded and building more the fifth floor. Therefore the pollution is minimized compared to newly constructed and the affect to environment and surrounding people area is also reduced significantly.
In this stage, the pollution sources which may impact to the regional environment quality as well as the people life are mostly from the construction and equipment installation stage.
a. Source of air pollution
The source of air pollution in this stage is mainly dust. Dust created from wall drilling, floor damming to construct new items as water supply, wastewater treatment stations, inside streets.
b. Source of waste water:
❖ Waste water of construction workers
The source of wastewater in this construction and equipment installation stage is the wastewater of workers. If the construction is concentrated, the number of workers is about 40 workers. With the rate of the worker is 45 li1tre/day and night, the wastewater flow rate from the worker hut is 2 m3/ day and night. It is not great but its properties and the excretion waste containing many infectious microorganisms that it must be collected and treated reasonably.
❖ Rain water overflow
The overflow is depended on the regional climate. If there is no good management plan it can be contaminated with grease and oil, broken building materials during the construction time.
At the collection site of building materials and machine, the water environment can be impacted especially in the gathering of materials for machine operation.
The rain water overflows this site will pollute the environment because of entraining soil, rock, waste solid, grease and oil,…
c. Source of solid waste
In the construction stage, 2 main kinds of waste solid are created:
❖ Solid waste from construction worker activities
The index of waste solid per worker is about 0.3 kg/man. day and night. If the number of workers is about 40 workers, the waste garbage of workers is about 12 kg/day and night. Although it is not much but it is necessary collected and treated as regulations.
The garbage can be classified into 2 kinds:
a. Inorganic: can, paper packaging, plastic, glass…
b. Organic: food residue, fruit cover…
❖ Construction waste
During the innovation time, some old wall must be broken and newly constructed and created the waste as broken brick, wood, metal (aluminum skeleton, iron, nail…), carton, electric wire, plastic pipe… The land digging to strengthen the floor as well as wastewater digestion tank construction will create the surplus soil in the site and it will be used for leveling the floor.
3.1.1.2 Hospital in operation
When the international neurosurgery hospital goes into the operation, the interaction between the hospital operation and the environment aspects is mainly the one way impact. The wastes created during its operation into the environment under three forms: gas, liquid and solid. In any form which has the risk to pollute and affect to the people health because of the infectious agents in the wastes.
The possible sources of environment pollution and risks may create during its operation are defined aas follows:
- All kinds of wastewater (including dosmetic wastewater from the examination, treatment, the auxiliary facilities…)
- All kind of waste solids (including the domestic waste solids and medical wastes, injection needles, dressing…
- The waste from the generator, traffic in the hospital campus.
- The noise from the generator, traffic in and out of the hospital campus, the people activities.
- The radioactive substances, electromagnetic spark emmit during X ray operation, ultrasonography, scanner and radioactive room…
a. Source of air pollution:
❖ Waste gas from generator’s operation
The waste gas from the generator has the high content of dust, SO2, NOX, CO may pollute the regional atmosphere. Moreover CO, CO2 in this waste gas are also the agents that make the greenhouse effects.
❖ Pollution from the outside traffic
When the project goes into operation, it is definitely the traffic intensity raising on Luy Ban Bich street and with the great number of cars whch will create the great quantiy of waste gas and dust polluting the hospital atmosphere.
These vehicles use mainly gasoline and diesel oil which will emmit the waste gas containing the polluting the air. The content of the waste gas is mainly dust, NOx, SO2, CO, CO2, VOC…. These substances will impact differently on the environment and the people health depending on their properties. Besides these vehicles also make noise in operation which affect locally in the region.
❖ Air pollution by the other sources
b. Source of waste water:
In the hospital operation, the wastewater created all over the hospital campus includes many kinds with the following sources:
- The wastewater is the rain water collected all over the campus.
- The domestic wastewater from the hospital staff, patients and their relatives stay to care the patients.
- The wastewater from the examination and treatment rooms.
- The wastewater from the auxiliary facilities (cooling the stand-by generator, cooling the air conditioners…)
❖ Rain water
The rain water drops on the hospital campus. Its quality depends on the purity of the air at the region and the surface area. Following to the land layout of INH, the yards and the internal streets are asphalt spreading, tiling or concrete boards. Do not let the waste, goods accumulate on the yard, therefore the water overflowing through this region is not polluted and considered “clean” wastewater. Along with the rain water collected from the roof, all of them drains to the drainage system and to the city one, not necessary to be treated.
The polluted potential rain water that flows through some special area as: the outsside garbage basket, , hospital garbage store house, diesel tank for the stand – by generator and parking area. The contents of the rain water in this case may contain contaminants and oil film. However the hospital concerns to this problem and plan reasonably the location for these equipments that are not affected by the rain water and in this case the rain water is considered “clean” wastewater which flows directly to the hospital drainage system, not necessary to be treated.
❖ Domestic wastewater
The domestic wastewater is the one discharge after use for the operations in the hospital such as eating, drinking, showering, cleaning form the activities of the functional rooms, offices, restrooms, canteen…
❖ The wastewater from the activities of examination and treatment
This wastewater is most organic polluted and contains many kind of the infectious microorganisms. It may created from many different sources: patient cloth washing, towel, drap and blanket, medical instrument cleaning, examination, surgery, patient rooms and office cleaning… Their properties and pollution level are different depending on the specific operations.
❖ The report does not analyze deeply their contents and properties for every unit but it concentrates to define the percentage of the mixed wastewater. It is the base for impact assessment and suggestion for the reasonal treatment measures. This also corresponds with the pollution reduction plan from the hospital wastewater that only build the wastewater treatment station for all the hospital wastewater because the separate wastewater treatment will cost very much. wastewater
❖ Cooling water of stand-by generator
The wastewater from the generator cooling has the similar percentage of input water. There is only the higher temperature compared to the input but it may control the allowable limits (< 450C) by adjusting the reasonal flow rate. Because of the irregular operation o the generator and the time of power off is not long that it is unecessary to install the circulation system of cooling water due to its high cost.
Besides the above wastewater, the hospital operation may create the irregular wastewater for fire extinguisher. This wastewater may be contaminated by the fire product. However this waste source is irregularly and it may be considered as rain water and flows freely to the receiver without treatmnet.
c. Source of solid waste
Besides the pollution from the wastewater, the other environment problem that is very important in the hospital operation is the waste solid.
3.1.2. Impact sources not relating to the waste
3.1.2.1 Construction, improvement, equipment installation
Because the project is only innovation, supplementation some small items that the construction stage does not create the noise from digging of the machines.
3.1.2.2. Hospital in operation
The hospital is the place which requires the most quiet atmosphere, therefore the inside activities must reduce the noise to the possible lowest, in communication between doctors and patients, patient relatives. This requires not only the good organization but also the right regconization of people in the hospital. However some activities make the noise at the different levels. The typical sources of noise are:
- The generator operation in the case of the national electricity power off,
- The allowed traffic operation in the hospital but only at the restricted areas (ambulance, trucks, motorcycles…),
- The collision of medical instruments on the specialized trolleys in the treatment room and lobbies.
- The operation of fans, air ventilators, air conditioners, specialized machines in treatment.
- The operation of machines in the auxiliary facilities (pumps,air compressors in the wastewater treatment station…),
- The people activities in the hospital,
- The outside noise spreading into the hospital.
3.1.3. Prediction of the environmental risks from the project
3.1.3.1. The environmental risks in the construction stage:
a. Accident at work
Generally, the labor accidents may happen in any construction stage of the project. Their reasons at the construction site are mainly defined;
- The environment pollution during construction affects negatively to the workers’ health. On the time and level some acute pollutions make the woerkers tired, dizzy during working.
- The installation and transportation with the dense traffic, the noise… may make the labor and traffic accidents.
- The workers’s carelessness in working, lack of protection instruments, no awareness to obey the labor safety regulations.
The pollution impact assessment from dust, waste gas during the construction presented below affects negatively highly to the workers’ health in the hot and windless climate. Therefore the investor must implement the measurements to ensure the labor safety and in the necessary case it may stop the construction or let the workers have a long rest.
b. Firing, explosion
During the construction it may create fire and explosion from many reasons:
- The fuels (DO, FO) contains in the construction site is the important source especially it stays next to heat source or much traffic and people go through,
- The electricity breakdown.
3.1.3.2. The environmental risks in the operation stage
a. Firing, explosion
The hospital operations require to use and store some the air, solvents, and fuels as: oxygen (specialized containers), medical alcohol, ether, fuels (DO in vessel or drum), gasoline.
These are very inflamable and make fire and explosion. In addition the hospital also stores the other inflamable things as blanket, dressing, paper and wood packaging.
The nature of fire may classifed into 4 main groups:
- Group 1: fire from the inflamable solid as: blankets, cotton, dressing, paper, woods…
- Group 2: fire from the gases, solvents and liquid fuel: gasolin, oil, oxygen, alcohol, ether in contacting with fire.
- Group 3: fire from electricity equipments.
- Group 4: Lighting strike
The causes of fire
- Transportation of inflamable materials as gasolin, alcohol… through the heat and spark place.
- The oygen and compressed air in the treatment, surgery rooms may be leakage or the bad containers, drums.
- The sterilization equipments, gas cookers may be breakdown if there are the carelessness in management, control, maintenance.
- The unregulated store of the solvents, oxygen drums.
- Drop the fire cigarette or fire source to the oxygen drum area, blanket, dressing, file store area.
- keep the garbage, paper, plastic packaging in the fire area.
- The electricity equipment breakdown: wires, motors, fans… are overloaded in operation, heat generation or short circuit in heavy rain.
- Lighting strike may create fire and explosion
There are many above causes that the hospital need to be aware to the good fire prevention and extinguishing to ensure the safety for people and limit the possible lost.
b. Leakage of radioactive substances
The radioactive substances may created mainly from the radioactive treatment, X ray, scanner… may make harmful to people’s health and surrounding environment if there is no reasonable protection measures
c. Other breakdowns
- The electricity transformer explosion,
- The pump is burnt or the water pipe broken.
- Water supply from the city source is off for a long time, but this risk is seldom.
3.2. IMPACT ENTITY AND SCALE
3.2.1. The subjects impacted in the stage of construction and equipment installation
As presented above, INH is reconstructed more new items on the old foundation of the pregnant hospital, not fully new project. Therefore the impact of the project to the natural, economical and social conditions during the construction and installation is not high, mainly on the workers.
3.2.1.1. Dust and waste gas
The dust will affect:
• The worker’s health: the dust suspends in the air will impact to workers;
• The surrounding habitants: mainly on the people in the end direction of wind;
• Plant system: The dust attached to leaf will reduce the photosynthesis
The waste gas contains mainly dust, CO, SO2, NO2. The polluting agents may impact directly on workers as respiratory inflame, lung and cardiovascular disease. However the affection level is only concentrate during transportation time and interruptedly.
3.2.1.2. Wastewater
If the polluted rainwater and domestic wastewater created during the construction stage is not drained well, they will make stagnant locally, arise the bad odor. This will affect to the construction worker’s health, land sight as well as the land and surface water.
3.2.1.3. Waste solid
If the waste solid created during the construction stage does not collect and treat reasonably will affect directly negatively to the construction worker’s health, land sight as well as the land and surface water.
3.2.1.4. Noise
Noise pollution is relatively light but it must be concerned because of the long operation time of machines and equipments. Noise affects badly to people’s psychophysiology, directly to hearing organs. The subjects will be impacted with noise are:
• Direct operating workers;
• Surrounding people;
• Passer.
3.2.1.5. Accident, fire and explosion
labor accident, fire and explosion affect to people’s health and environment. When explosion occurs, the loss of people, asset and environment are very significantly.
3.2.2. The entity impacted in the stage of operation
3.2.2.1. Air polluted waste
Although the waste gas created in this stage is insignificant, if there is no reasonable management measures it will affect directly to:
• People’s health
• Building and animal and plant system;
• Climate
3.2.2.2. Wastewater
The hospital wastewater is from two sources: domestic region and examination and treatment region. The wastewater will impact on:
• Water of receiver source;
• Atmosphere;
• People;
• Ecological system
3.2.2.3. Waste solid
The hospital waste solid composes the common domestic waste solid and medical waste, disposed medical tools. The second waste is classified in hazardous category which affects greatly to environment if it is not managed tightly. The subjects are impacted:
• People’s health;
• Air quality;
• Land environment;
• Animal and plant system.
3.2.2.4. Noise
Noise created in this stage is mainly from the technical equipment such as generator, air conditioners, pumps. If the hospital does not have the efficient measures to limit the noise from the above equipments, it will affect to people’s health in the hospital and people living surrounding. Especially the generator can affect inside 100m range compared to the center of source in day and 150m range in night.
3.3. IMPACT ASSESSMENT
3.3.1. Environmental impact assessment in the stage of construction and equipment installation
3.3.1.1. Impact of the source of air polluted waste
The level of impact of waste gas depends on its concentration in the air, time of operation, microclimate properties at the concerned region (rain regime, wind velocity, temperature, humidity,…)
Table 3.1: Estimation coefficient for load of dust, stone
|Polluting reason |Coefficient |
|Dust from loading building materials |0.1 – 1 g/m3 |
|Sand carrying by vehicle left on road |0.1 – 1 g/m3 |
Source: WHO, assessment of Sources of Air, Water and Land Pollution, 1993
In this stage there are the construction material transportation, construction machines. The fuel combustion of these vehicles emit the polluting gas into environment.
The concentration of pollutants depend on the kind of fuel used, operation state and engine life.
Table 3.2: Polluted coefficient for internal combustion engine using gasoline
|Polluted substances |Polluted coefficient(kg/1000 litter petrol) |
|CO |291 |
|CxHy |33.2 |
|NOx |11.3 |
|SO2 |0.9 |
|Aldehyde |0.4 |
|Copper |0.3 |
Source: WHO, assessment of Sources of Air, Water and Land Pollution, 1993
Table 3.3: The composition of the waste gas from the internal combustion engine
|Operating status |CxHy |CO |NO2 (ppm) |CO2 |
| |(%) |(%) | |(%) |
|Not loading |750 |5.2 |30 |9.5 |
|Fast |300 |0.8 |1500 |12.5 |
|Slow |400 |5.2 |300 |10.2 |
|Reducing speed |4000 |4.2 |60 |9.5 |
Source: WHO, assessment of Sources of Air, Water and Land Pollution, 1993
a. Impact to human health
•
• At low concentration, SO2 may be convulsive in throat. High level may cause increase the fluid discharge and serious dwelling.
• SOX may infect the skin, decrease the alkaline reservation in blood, eliminate ammoniac in piss and alkaline in slaver,
• The common properties of SOX showed transformation troublesome of protein, sugar, lack of vitamins B and C, oxydaza enzyme inhibition. The absorption of high quantity of SOX may cause the infection for blood system and creates met hemoglobin, intensify the oxidization of Fe II to Fe III.
NOX is the gas which excite strongly respiratory system. When being perniciously poisonous causes cough violently, headache and digestion disorder. Some cases cause the blood change, nervous injury and myocardium change.
CO is a choking gas because of its stronger affinity with hemoglobin in blood than oxygen that replaces oxygen in blood and decreases the oxygen supply for the body. At low concentration CO causes headache, dizzy. At the concentration of 10 ppm CO causes highly the heart disease and at 250 ppm it may cause death.
b. Impact to the fauna and flora system
Most of the substances that cause the air pollution impact negatively to flora. The main symbol is the plants growing slowly. The air polluted agents as SO2, NOX, CO even at low concentration have the above impact, at high one causes yellow leaf, small seed, broken and at higher one will cause the fruit dropped or tree dies.
SO2 affects to the growth of tree with its concentration as 3 ppm. At the higher concentration may cause leaf fall and tree dies.
CO at the concentration as 100 – 10,000 ppm may cause leaf fall or twisted leaf disease, young tree dies.
SO2, NOX are oxidized in the air and combine with rain water will cause acid rain which affect to tree growth and vegetation cover.
c. Impact to climate
Some of the above waste gases have the negative impact on the climate such as: SO2, NOX, CO and may cause the acid rain. NOX contributes to tear the ozone layer, CO2 causes the greenhouse effect, increase the earth’s temperature and warmness.
d. Impact to buildings and assets
When the waste gas contains SO2, NOX, CO… contacts with humid air will creates the corresponding acids which may corrode the building, equipments and decrease their lifetime. CO2 reacts with vapor to form H2CO3 causes the skin corrosion.
It may predict the impact to environment by the traffic activities and having the measures to limit them. Moreover these are not the main wastes and with the present traffic pollution control, this problem can be overcome.
3.3.1.2. Impact of waste water
In this stage the hospital does not go into operation that the wastewater is mainly from the worker activities. The daily flow rate as well as pollution properties of the wastewater are not seriously. However, it must be concerned their impacts during the construction and installation stage. The characteristic of the domestic wastewater is containing the infectious microorganism. If they are not collected and treated they will affect negatively to environment quality as well as people health.
WHO polluted coefficient for the developing countries presented in the following table
Table 3.4: Daily polluted coefficient from person into environment (not treated)
|Polluted substances |Polluted coefficient |
|Suspended solid |70 -145 |
|BOD5 |45 – 54 |
|COD |85 – 102 |
|Ammonia (N – NH4) |3.6 – 7.2 |
|Total Nitrogen (N) |6 - 12 |
|Total Phosphors (P) |0.6 – 4.5 |
|Grease non mineral |10 - 30 |
Source: ENTEC
On the hygiene and health aspects, excretion substances are urine and dung. Many infectious diseases transmit through urine and dung, from the sick people to the strong people. Dung is the carrier and disperser of some common diseases. The quantity of organic substances of urine and dung is evaluated through BOD5 index or the similar indexes (COD and TOC). The urine has BOD5 as 8,6 gO2/L and dung has has BOD5 as 9,6 gO2/100g. If they are discharged directly from the worker huts to the land will be the pollution source for land and water environment in the project area.
The groups of infectious microbes in the excretion substances are virus, bacterium, parasites. Moreover the excretion substances are also the medium for infectious organisms developed such as fly, mosquitoes, mousse, cockroach and cause the rotten odor. Every gram of dung contain 109 infectious viruses. Although they are not develop outside the suitable original animal but they can survive many weeks in the environment. In the wastewater can contain 105 viruses/L. The careless discharge of the excretion substances from the worker hut will let these infectious viruses have enough time to transmit to people and epidemic. The infectious viruses in dung can be listed as
Table 3.5: The disease microorganism in human excrement
|Bacteria |Disease |Owner |
|Campylobacter ferrous, jejune |Diarrhoea |People and animals |
|Escherichia coli |Diarrhoea |People |
|Salmonella | | |
|S.typhi |Typhoid fever |People |
|S.paratyphi |Typhoid fever |People |
|Shigella SPP |Dysentery |People |
|Vibro | | |
|V.cholorae |Cholera |People |
|Other vibro types |Diarrhoea |People |
|Yersinia enterocolitica |diarrhoea |People and animals |
Source : Feachem and partners, 1983
3.3.1.3. Impact of waste solid
The workers concentration will create the domestic waste solid in the construction site. The domestic waste solid generally contains organic substances, easily destroyed (excluding plastic packaging).
Although its quantity is not much (18 kg/day), but there is no reasonable collection and treatment, it will accumulate during construction time more and more and affect to air quality by organic destroy and make the surface water more turbid, block the water flow, sedimentation. It also facilitates the disease microorganism develop which may pathogenic cause to workers and further to surrounding people.
The hazardous waste such as grease clout, adhesive, paint, paint container, oil and gasoline, battery have the insignificant quantity but they are hazardous so they must be collected and treated.
3.3.1.4. Other impacts
The operation of driller, concrete mixing trucks, generator… will make noise significantly. The noise level from some construction machines will be presented in table below. However it is the project to innovate that these machines’ operation are limited, but any machine operation also exceeds the allowable noise for administrative agency ( 60 dBA) from 6 AM to 6 PM.
Table 3.6: The noise level from the construction machines
|Equipments |Noise level (dBA), 15 m away from source |
| |(1) |(2) |
|Road-roller |72.0 – 74.0 |- |
| |87.0 – 88.5 |- |
|Truck |82.0 – 94.0 |- |
|Concrete mixing machine |75.0 – 88.0 |- |
| |- |85.0 |
|Generator |72.0 – 82.5 |- |
|Compressor |75.0 – 87.0 |- |
|Stone driller |81.0 – 98.0 |- |
Source: CENTEMA 2003
Beside the noise, the construction will also the other impacts as:
• The material transportation trucks affect to the local traffic, lose the city good-looking when the soil and rock drop on the street;
• The material transportation trucks are always cumbersome will contribute to the difficult traffic. However it is interrupted that does not impact significantly to traffic, safety on the streets near the project site;
• The construction workers’ activities will affect partly to the local security status.
3.3.2. Environmental impact assessment in the stage of operation
3.3.2.1. Impact of the source of air polluted waste
❖ Impact of the waste gas
When the hospital goes into operation the waste gas created mainly from the traffic inside and outside the hospital and from the reserved generator. The components of the waste gas includes SO2, NO, CO, CH4… Their affections and impacts to people, climate and surrounding atmosphere in the operation stage are also similar to the construction stage but the different impact level depend on the concentration of waste gas and impact time.
❖ Impact of waste gas from generator’s operation
The operating parameters of the project generator will be:
- Power 250 kVA
- The fuel: DO with S content 0.5%
- Fuel consumption rating: 80 liter/h
The waste gas parameters in operation calculated as follows:
Air waste flow
The theoretical quantity to combust totally 1 kg DO
Pollution load
The waste gas created from DO combustion includes dust, SO2, NOX, CO, THC and the emission coefficients are as follows
Table 3.7: Polluted coefficient of the waste gas from the DO internal combustion engine
|Pollutant |Polluting coefficient (g/kg fuel) |
|dust |0.71 |
|SO2 |20S |
|NOx |9.62 |
|CO |2.19 |
|VOC |9.79 |
Source: WHO, assessment of Sources of Air, Water and Land Pollution, 1993
Based on the consumption norm and emission coefficient, the load and the concentration of pollutants in waste gas from DO combustion in the generator operation are as follows
Table 3.8: Load and concentration of pollutants in the waste gas from DO combusted generator
|Pollutant |Polluting load (g/s) |Concentration (mg/m3) |TCVN 5939, column B (mg/m3) |
|Dust, smoke |0.0086 |18.37 |200 |
|SO2 |0.0012 |2.58 |500 |
|NOx |0.1120 |248.92 |850 |
|CO |0.0264 |56.67 |1000 |
|VOC |0.1182 |253.32 |- |
Note: TCVN 5939-2005: Air quality-The quality of industrial waste gas for dust and inorganic substance.
Compare the concentration of polluted substances in waste gas to the standards of dust, SO2, NOX, CO they are attainable. However the generator does not often operates and the pollution load is insignificant and not affect to atmosphere in the hospital.
❖ Impact of air waste and dust from traffic
Refer to WHO “Assessment of polluting sources to air, water and land” and Dinh Xuan Thang “Air Pollution”, polluting coefficient of traffic and diesel engine are presented in the below table
Table 3.9: Polluting coefficient of motorbikes
|Air waste |Polluting coefficient |
| |2 strokes |4 strokes |
| |g/km |Kg/ tons fuel |g/km |Kg/ tons fuel |
|Dust |0.12 |4 |- |- |
|SO2 |0.6S |20S |0.76S |20S |
|NOx |0.08 |2.7 |0.3 |8 |
|CO |22 |730 |20 |525 |
|VOC |50 |120 |3 |80 |
Source: WHO, assessment of Sources of Air, Water and Land Pollution, 1993
S is sulfur content of fuel (%), Petrolimex’s document, sulfur content of gasoline is 0.15%.
Pollution load (PL) from motorbike is determined as follows:
(PL) = (number of motorbikes) x 8.3 x 10-3 x (polluting coeff.)/1000x1000
It can calculate the waste gas created from the actual calculated traffic quantity when the project does into operation.
The content of hazardous gas in the waste gas from motorbike and polluting coefficient of diesel engine shown in the below table
Table 3.10: The hazardous gas content in the cars’ waste gas
|Toxic gas (%) |Operating mode of engine |
| |Run slowly |Accelerating |Stably |Accelerating |
| |fuel |
|CO |7.2 |
|Hydrocarbon |16.3 |
|NO2 |26.6 |
|SO2 |4.8 |
|Aldehyde |1.2 |
|Organic acid (acetic) |3.7 |
|Dust |13.2 |
Source: Dinh Xuan Thang, Air pollution, HCMC National Universitiy Publisher, 2003
From the above presentation, it can predict the affection level to environment from the traffic and have the measures to limit these waste sources. Moreover this is not the main waste and this problem can be overcome by the activities of traffic pollution control.
The waste gas from the drainage and wastewater treatment station is actually not much but it has the characteristic odor that make people feel uncomfortable. So the hospital needs to have the overcome measures as: tightly cover, tree fence isolation.
It is uncomfortable to inhale the odor of organic solvent, disinfectant and they are not good for health.
❖ Impact of noise, pulse
The significant noise source in the hospital operation is from the stand-by generator when the power is off. As presented above, the noise intensity from this source may attain 110 dBA. If there is no reasonable and treatment measures it will affect to the hospital atmosphere that needs highly quiet and the surrounding people.
With the compressor, their noise are relatively high but till lower than generator’s noise. However the hospital needs to have measures to control the noise for the compressor and pump house in the wastewater treatment station to ensure the quiet for hospital atmosphere.
Table 3.12: The noise level of the technical equipments in hospital
|Equipment |Sound capacity level(dBA) |
| |Low |Average |High |
|Condenser by air |90 |100 |115 |
|Pump |55 |80 |105 |
|Transformer |80 |85 |90 |
|Refrigerator on the roof |80 |90 |100 |
|Generator |100 |105 |110 |
|TCVN 4949:1998 |55 – 60 |
Source: Nguyen Hai, acoustics and noise test, Education publisher
The noise will reduce by the transmission distance as compared with the source and actually in the transmission distance of 30m the noise measured fluctuated within 76 – 84 dBA.
In the case of generator room is well soundproof the noise is less, most of the control cases are not over the allowable standards for people area over 30m.
The noise of generator is very high (100-110 dBA in compared with the allowable standards 55-60dBA). People is impacted mostly and the predicted distance is 200m diameter within the hospital and 150m out of the hospital. However the hospital environment requires the high calmness, the investor arranges the generator in the soundproof room that the noise of generator is not serious.
The noise from air compressor in the wastewater treatment station will impact on the hospital environment if there is no efficient soundproof. However the impact level lessens in compared with the generator’s noise.
The noise affects firstly to people’s hearing. Contact with the intense loud noise in the long time will reduce hearing ability and being deaf. Moreover the noise also affects to other people’s organisms such as nervous disturbance, headache, dizzy and threat feeling. The noise is also infected to cardio system and increase the digestion disease.
3.2.2.2 Impact of waste water
The first impact recognized is the flooding that causes unhygienic in the hospital. This often occurred in the hospital which have no private drainage of the polluted wastewater or which have the very old, degraded drainage that make the wastewater mixed with rainwater to flow around the hospital without exit. When there is big and long time rain that will floods the lower location in the hospital and not drains timely.
The reasons of overflow that make unhygienic in the hospital environment are the unreasonable design or in the usage that lets garbage drop into the drainage make the drainage blocked, especially let directly the waste into the drainage without preliminary treatment (sedimentation and decompose). The other reason is also the disintegrate and subsidence at some points on the drainage after the using time.
Installation of the drainage and wastewater treatment station is the item of the INH project. This makes the good drainage and ensures the quality of the outlet treated wastewater not over the standards
Table 3.13: The parameters of the outlet wastewater
|No. |Parameters |Unit |After processing |
| | | |TCVN 6772 – 2000 (Level I) |
|1 |pH |mg/l |5-9 |
|2 |BOD |mg/l |30 |
|3 |Suspended solid |mg/l |50 |
|4 |Sediment solid |mg/l |0.5 |
|5 |Sunfua ( H2S) |mg/l |1.0 |
|6 |Nitrat (NO3-) |mg/l |30 |
|7 |Grease (food) |mg/l |20 |
|8 |Phosphate (PO4-) |mg/l |6 |
|9 |Total coli form |MNP/100mL |1000 |
If it attains the quality as presented in the above table, it can predict that the operation of hospital does not impact badly to the quality of the surface water in the hospital area and the main receiver.
In the case that the above plans do not implement well not only the hospital environment is impacted negatively but also the surrounding water source is polluted with the presence of the contaminants and microbes in the hospital wastewater. The untreated or non attained treated wastewater flows into the receiving source will make the water contaminated. At that time the aqua biology and people’s health are affected.
The property and composition of the mixed wastewater (excluding rain water) of some hospital in Ho Chi Minh city
Table 3.14: The composition and properties of wastewater of Trung Vuong Hospital
|No. |Specific polluting figure |Unit |Concentration |
|1 |pH |- |6.87 |
|2 |Suspended solid (SS) |mg/l |168 |
|3 |(BOD5) |mg/l |124 |
|4 |(COD) |mg/l |158 |
|5 |Total nitrogen (N) |mg/l |38 |
|6 |Total phosphor (P) |mg/l |3.5 |
|7 |Total coli form |MPN/100ml |8.5x104 |
|8 |E.coli |MPN/100ml |4.2x104 |
Source: CEFINEA, 2005
Table 3.15: The composition and properties of wastewater of Nguyen Tri Phuong Hospital
|No. |Specific polluting parameters |Unit |Concentration |
|1 |pH |- |6.97 |
|2 |Suspended solid (SS) |mg/l |182 |
|3 |(BOD5) |mg/l |114 |
|4 |(COD) |mg/l |152 |
|5 |Total nitrogen (N) |mg/l |36 |
|6 |Total phosphor (P) |mg/l |3.2 |
|7 |Total coliform |MPN/100ml |4.6x104 |
|8 |E.coli |MPN/100ml |3.2x104 |
Source: CEFINEA, 2005
From these above data it shows that the wastewater of INH in the future is also similar with the different hospitals in the region. It therefore requires INH must have the measures and plan for investing the wastewater treatment station to ensure the quality of the treated wastewater attain the standards to flow into the urban drainage.
The predicted composition and pollution load of the wastewater as follows:
|pH |4.5 – 5.5 |mg/l |
|Suspended solid (SS) |180 |mg/l |
|(BOD5) |160 |mg/l |
|(COD) |120 |mg/l |
|Total nitrogen (N) |40 |mg/l |
|Total phosphor (P) |5 |mg/l |
|Coliform |10.000 |MPN/100ml |
Briefly, the operation of the hospital without the wastewater treatment station attain the standards will contribute to increase the pollution of surface water, bad impact on people life in the region, epidemic disease expansion and affect partly to water ecology.
The polluted water will bring about the air pollution, odor and also land polluted it flows. From that the cost for innovation, environment treatment will be more times than treatment at the source and it needs the long time to recover.
The control of these negative impacts overcomes completely by implementing the technical measures in environment protection which are presented in chapter 6 of this report.
3.3.2.3. Impact of waste solid
The waste solid which created from the hospital is always concerned for the environment from its hazardous properties. Its components are presented below:
Table 3.16: The composition of medical garbage in Vietnam
|Components |Percentage (%) |Hazardous substances |
|Organic substances |52.0 |No |
|PVC, PE,PP bottles |10.1 |Yes |
|Dressing cotton |8.8 |Yes |
|Metal box |2.9 |No |
|Glass bottle, tube, |2.3 |Yes |
|Injection needle |0.9 |Yes |
|Waste paper, carton |0.8 |No |
|After surgery medical waste |0.6 |Yes |
|Soil, sand, ceramic, other waste solid |20.9 |No |
|Total |100 | |
|Hazardous percentage |22.6 | |
Source: Ministry of Health report, 1998
As estimated, during all day and night, every patient bed makes 2.5 kg of solid waste. Therefore the hospital in operation will discard daily about 250 kg solid waste and 15 kg waste mud from the wastewater treatment station.
In the total of the waste above is nearly 80% of common waste (similar to domestic waste) and approximately 20% of hazardous materials that can be infectious, poisonous and radioactive. It includes:
Infectious waste
• The infectious wastes (that is not sharp) are the wastes from infectious patients, infectious blood and blood products, diagnosed waste, infectious experimented living being, dressing cotton…, one use medical tools and the surgery waste are the main components of the infectious wastes are 15% of total waste from the hospital.
• The sharp things which is infectious (injection needle, surgery knife, one use knife…) is about 1%.
Chemical waste
• Out of date, non use, infectious drugs, poisonous chemicals and their derivatives, vaccine and serum is about 3%,
• Poisonous waste, radioactive waste and heavy metals is about 1% which includes mercury (from he broken thermometer, sphygmomanometer), cadimi (from the battery), lead (from the lead covered board to prevent the radioactive rays from the image diagnose, radioactive therapy).
Radioactive waste
The radioactive wastes include the liquid, solid and gas created from the diagnose activities, treatment, research and production.
Additionally in the components of the hospital waste something can be reused:
• Plastic: Plastic bottles contain the non hazardous solutions as: NaCl 0.9% Glucose solution, Sodium Bicarbonate, ringer lactate, polymer solution and other bottle containing non hazardous solutions.
• Glass: Glass bottles contain non harzadous solutions, glass bottles contain non harzadous injectable drug.
• Paper : Paper board, carton box, and other paper materials.
When the hospital goes into operation, the hazardous waste is estimated about 50 kg per day. However this quantity is not large but if there is no reasonable management and treatment measures it will impact negatively to environment and community health, especially the impacts from the waste reuse for life of people.
The hospital waste considered on dirty and infectious can be regarded as the most infectious waste in community and of course it will make many negative impacts on environment and community health if their collection is not thoroughly, fast conveying and treating out of the source. The impact from the hospital waste can be summed up as follows:
❖ Impact to health
The domestic waste has the high content of organic substances which is the good condition for disease microbes, the food for mosquitoes, flies… and the risk to transmit the disease for people and epidemic. The organic substances will decompose to the intermediates, the bad odor substances for a long time.
The medical waste is the source containing disease microorganism and can make the patients, medical cadres and people infectious. The risk of anti-drug from the hospital to the environment is not investigated. The waste and the remaining of the waste can make injury, e.g. radioactive burn or injured by the sharp objects, poisoned and polluted or from the drugs especially antibiotic, poisonous cell in the wastewater, or from mercury, dioxin.
The wastes are injectable needles, surgery knife… have the danger from the manual digging and sorting at the hospital. They can be injured immediately by the injectable needles, contact with the poisonous and dirty substances.
Water and leachate from the waste solids at the waste containing site are often highly polluted and if there is no good drainage to wastewater treatment station and permanently cleaning the floor will negatively impact to environment.
❖ Polluting the water source
If the domestic waste are not collected and discharged to the river will cause the surface water polluted, make the flow blocked and not beautiful-looking region. Moreover the unhygienic bury will cause the leachate penetrate to the ground water, make it polluted and be able spread to surrounding.
The garbage baskets along the corridors, the corners, the pathways, the yard in the hospital may impact to the environment if they are not covered carefully and they may pollute the environment if the rain water dissolves the hazardous substances and take with the microorganism.
The hazardous waste may emit the pollution into the water source through the transmission into water and land.
❖ Polluting air
The domestic waste has the component which is easily biodecomposed. Along with high temperature and humidity they will be anaerobic or aerobic digestion in short time to form the hazardous gases and unpleasant bad odor CO2, CO, CH4, H2S, NH3… right at the collection, transportation to the burying yard.
The medical waste may cause the air pollution by its emission to the air form the kind of the hazardous waste.
If the region for collection – sorting – waste treatment of the hospital (waste containing house) is not managed reasonably will pollute the environment: bad odor and the germ for epidemic.
❖ Other impact of transport
The conveying the solid waste from the rooms to the collection – sorting – waste treatment region is also concerned, especially in the hospital. If conveying the waste from the upper floors to the down floors by manual equipments and walking ladder may block the movement in the hospital and make the unpleasant feeling for the people using the ladder and the collision between people and equipments may occur.
Up to the level of collision it will drop or break the waste solid along the ladder and lose the good sightseeing of the hospital. The remark is the medical waste along with water, blood, other lactates in the body and they must be transported in the safe container or they will leak along the route. However they are transported in special elevator for garbage, patient blanket will reduce these affect.
The last is transportation these wastes from the hospital to the yard or burning. The negative impact from this case is from the air pollution (bad odor), polluting the water from the rain water solves the contaminants and microbes in the waste. From this it affect to land and underground water and the epidemic spread by the insect, fly, mosquito developed from the waste yard.
Briefly the hospital waste solid is hazardous and impacts to the environment and health, but the waste in the hospital operation is collected and sorting daily and on time that make this waste is only the local and negligible impact.
3.3.2.4. Social impact
The environment pollution from the overall activities (in case of the hospital does not implement the reasonable measures to control and treat the pollution) will affect to the regional buildings. The construction materials are corroded and reduce the life time of buildings. The concrete, steel are also corrupted by CO2 in the air. There are also many negative impacts from the air pollution to the economy: the cost to replace the accuracy equipments and protect from pollution corrosion, cost for food cleaning, water purification, house and households cleaning, the cost for the lost materials. However the probability of these harm is very low.
The INH’s activities are the great meanings in the socio-economy. When it goes into operation will follow the development of some careers in the region especially the social services. The INH’s birth brings the following the social-economy as follows:
• Create directly the jobs for many workers
• Contribute to the overload of the neurosurgery departments of the public hospital in Ho Chi Minh city, meet the demand of high grade health care of the patients which need to be treated in neurosurgery.
• Create the need to establish the service at the local (pharmaceutics, medical utensils, food…), contribute to the local economic development of Tan Tho Hoa Ward and Tan Phu district in general.
CHAPTER 4. MINIMIZATION MEASURES OF NEGATIVE IMPACTS, PREVENTION AND COUNTERMEASURES OF ENVIRONMENTAL ACCIDENTS
4.1. BAD IMPACT MINIMIZATION MEASURES, PREVENTION AND COUNTERMEASURE OF ENVIRONMENTAL RISK IN CONSTRUCTION STAGE
4.1.1. The impact minimization measures on the water
The appreciable pollution source in this stage is the wastewater from construction workers. The wastewater is estimated about 1.8-2.0 m3/day. It will be collected through the temporary channel in the construction site and is treated by the mobile simple digestion sump.
4.1.2. The impact minimization measures on the air
Digging, concrete mixing, transportation of building material and dirt will affect to the atmosphere by the pollution agents such as dust, noise, vibration…and to limit the above impact, it needs to implement the following measures:
• The trucks convey the material must be covered in circulation;
• Not use too old trucks and not convey too full, ensure traffic safety and do not drop material;
• Watering on the land at the building site and on the transportation street to reduce dust;
• Limit the noise by dispatch the construction activities to reduce the concentration of noisy activities;
• Limit the air pollution at the construction site and on the transportation route by control their registration and equipments in good conditions;
• Limit the transportation blockage by dispatch the building material transportation, not in high peak.
4.1.3. The impact minimization measures from site hut
The following measures are implemented to limit the above impacts:
• Employ the local workers to reduce the hut;
• Construct the temporary rest room, collect the waste and store at the right place;
• Right regulation of activities inside the construction site and worker management.
4.1.4. The measures to ensure the labor safety
The investor selects the contractor who has the commitment and implement seriously the labor safety measures in order to avoid the regrettable labor accidents. Some compulsory labor regulation in the construction stage, specifically as follows:
4.1.4.1. The use of vehicles and construction machines
• The moving parts of machines that can make danger for workers must be covered or have the protection parts. If not, they must be equipped with the signal equipments;
• The structure of machines must ensure that in abnormal working conditions they have the signals or they have to stop automatically or eliminate the danger;
• The moving machines must be equipped with light or sound signals. It must have the signal board in the working area;
• The locations to set the equipments or machines must be safe for them and workers during the operation;
• The machines operating near the ditch must have the safe distance as table 4.1
• When the machines in operation, the operators must not to go away or let the others operate.
Table 4.1: Regulation on safe distance of construction machines to ditch
|Excavation’s depth (m) |Kind of soil |
| |Sand |Sandy soil |clay |argil |
| | |
|1 |1.5 |1.25 |1.00 |1.00 |
|2 |3.0 |2.40 |2.00 |1.50 |
|3 |4.0 |3.60 |3.25 |1.75 |
|4 |5.0 |4.40 |4.00 |3.00 |
|5 |6.0 |5.30 |4.75 |3.50 |
Source: CETEMA, 2005
4.1.4.2. The safety in site hut installation and dismantling
Prohibit to use the malfunctioned frameworks, support, ladders.
Prohibit the frameworks, supports:
• Not meet the technical requirements and labor safety presented in design, no hook, ligament or they are fastened to the unstable components as banister, roof… and the uncalculated position to force.
• Deformation, cracking, corrosion or lack of some components.
• The clearance between working floor and wall is greater than 0.05m in construction and 0.20m in finishing.
• The distance between the edge of working of frameworks, supports to the edge of vehicle is smaller than 0.60m.
• The poles of frameworks and the supports on the unstable platform (weak floor, bad drainage, sinking over permissible limits, joints, firmness frame as brick, waste construction material…) may be slid or the are based on the floor which is not calculated carefully to suffer the stable forces.
4.1.4.3. The labor safety land work
This project is not new construction of all items so there is no digging for the foundation and floor. But there is soil digging in the construction of the wastewater treatment station. Therefore it requires pay attention to the safety in land work:
• If the hazardous gases in digging, it must stop right away and the workers have to go out of the danger site until there is the measure to delete all of them.
• Digging the ditch along the pathway, in the people site have to the fences, warning board, warning lamp in night. The fences have to let not smaller 1m from the edge of pathway.
• In the digging site it must have the drainage channel (including in the heavy rain) to avoid the water flow into the ditch and make the ditch wall drop. Stop digging when reaching the underground water level until having the measure to keep stable the wall.
• Not digging like the “frog jaw” ditch of discover the underground objects the workers must leave there until the “frog jaw” or that object are destroyed.
• Control daily the ditch wall, declined roof. Stop working if discovering the cracks along the wall. The workers and machines must transferred to the safety place until having the reasonable measures to resolve.
4.1.4.4. The labor safety in masonry work
• Before working the technical officer or working team leader must control the foundation of the wall constructed in advance a well as the status of framework, construction materials and the location of workers on the framework.
• Transfer the materials (bricks, cement…) to the framework 2m in high has to use the elevator. The brick conveyor must have the safety container not to drop them. Not allow to throw the brick over 2m.
• When put the platform in house for working it will put the fence or warning board 1.5m from the foot of the wall if the height is not over 7m or 2m from the foot of the wall if the height is over 7m. It must cover the wall hole from the 2nd floor and over.
• Prohibit to construct over 2 stages when the middle stage have no beams or temporary floor.
• During building if it has heavy rain, thunderstorm or the 6th level wind over it must cover, support the building not to erode or corrupt and all workers must go to safe shelter.
4.2. BAD IMPACT MINIMIZATION MEASURES, PREVENTION AND COUNTERMEASURE OF ENVIRONMENTAL RISK IN OPERATION STAGE
4.2.1. The measures to control the air pollution
4.2.1.1. Control the impact from the traffic
The air pollution agents may be from: vehicles, the solid waste and bad odor from drainage system. However as analyzed and evaluated in chapter 3, these air polluting agents are negligible. So it only proposes some common measures to contribute to create the cleaner atmosphere in the project area, specifically:
• Growing the reasonable plants (light perfume plants) in the hospital campus in order to create green landscape and improve the surrounding atmosphere. The trees have the great effect to limit the air pollution as dust suction and keeping, air filtration, noise absorption, air temperature reduction, some green trees are also absorbed the heavy metals as lead, cadmium. The area percentage of green tree over campus has to attain minimum 15% and they are care for and water periodically.
• Limit the traffic vehicles in the hospital campus (for example the motorcycles must turn off at the hospital gate and cars possible)
4.2.1.2. Control the air pollution from the operation of wastewater treatment system and solid waste collection
• Arrange the wastewater treatment station and waste solid collector in the lower end of wind compared to other facilities;
• To control the air pollution from the hazardous air and smell from the wastewater treatment station, it must be underground and tightly covered by concrete. Bad smell and air created from the special treatment tank or sedimentation tank with anaeration treatment will be flowed to air disposer. The disposer absorbs the order gas like H2S, NH3…with the light alkali solution;
• At the waste solid entrepot, after sorting all the organic waste collected is transported to the burying yard in day, avoid keeping it many days will digest anaerobic ally and create the bad odor.
• To clean periodically the rainwater drainage as well as the wastewater in the hospital site in order to reduce the air and bad smell.
4.2.1.3. Control the impact from the waste gas from the generator
From the above calculation, the waste gas load from the reserved generator attain the waste gas standards TCVN 5939-2005 (column B), it does not make the air polluted. However it must be concerned. The fuel used is DO that is relatively clean and the generator is only in stand-by operation that emit the flue gas through the chimney is reasonable, not affect to surrounding atmosphere. The installation of chimney will be done at the same time with the installation of ventilation pipe in order to reduce the area and good-looking architecture.
4.2.1.4. The measures to control the noise and vibration
❖ Control the noise of the generator operation
To control the noise from the generator and central air conditioner, it needs to implement the control measures right at their installation stage:
• Place them in the soundproof room at the technical site;
• Accurate installation of motor and direct linking with the acceptable semi soft joints;
• The generator is put on the diligent U steel platform and designed to tighten in order to suffer from collision and vibration;
• Place the generator with springs to reject the vibration and noise transmission to the house structure;
• Installation of springs is recover of compression state and stability, keeping and completing with the soundproof friction sheet made by 6mm rubber and support. Every springs is the rating ones and their movement must have the minimum up to the hard part equal 50% the elastic and their static elastic must be 25mm.
• Let the noise wiping at the generator not to let its weight bearing on the generator and with the suitable stainless steel flanges, auxiliaries and soft joints (lower kind) installed as the provider’s recommendation and not to let the smoke discharge extended by heat. The smoke chimney must have the right dimensions to ensure the pressure not over the standard. The noise wiping and the chimneys must be insulated with asbestos to keep the outside surface temperature not over 65.50C.
• The walls and the roof of the generator room must be soundproof with the thickness of soundproof material being about 900mm;
• Checking the abrasion of the generator details must be implemented periodically and regular lubricating or replace the damaged details. These will reduce remarkably the noise, vibration from the generator.
❖ Minimization the noise impact to examination area
The windows ensure the tightness with 2 glass layers which have the different thickness in order to the noise and dust impact from the outside as well as from the technical operation inside the hospital.
4.2.2. The measures to minimize the bad impact from wastewater
4.2.2.1. Classification of waste water
It depends on the characteristics and polluting of every source of wastewater presented in chapter 3, the INH wastewater classified into 2 groups:
1st group: Wastewater “clean consent”
It includes all the rain water drop in the hospital campus, cooling water for the stand-by generator and the water from the air conditioners. These wastewater, in principle, may be drained directly to the receiver without treatment
2nd group: Polluted Wastewater
It includes all the domestic wastewater and from the examination and treatment activities, floor cleaning, waste solid collection and sorting area. These common properties are containing much waste matters, dissolved organic substances, nutrients and especially much infectious microorganisms.
It must be treated in the wastewater treatment station to attain the standard TCVN 6772-2000, level I.
The total hospital wastewater flow rate needs to collect and treat at the wastewater treatment station is calculated with the design capacity Q = 60 m3/ day and night and excess coefficient k = 1.2.
4.2.2.2. Construction of drainage system:
The drainage system is very important and it affects very to the environment. If it is not efficient it will create the overflow in the hospital campus.
a. Drainage system of rain water
This system is reserved for rain water and “clean” wastewater flowing. The contaminated wastewater which is preliminarily and attainably treated flows in this system. This system includes close drainage ditches constructed around the house to collect all the rain water from the proofs and flow to the underground water inlet sluice along the pathways. The rain water on the pathway and the yards will flow to the soakage pits and to the underground water inlet sluice. The distances between the pits are about 20 – 30m depending on the arrangement of houses in the hospital campus. The rain water drainage sluices are made with concrete and the calculated diameter based on the regional rain data, cover surface, hydraulic regime…is from 200 – 300mm, they are put following to the calculated slope to collect all rain water in the hospital to flow into the city drainage system.
In the case of the outlet point of the hospital drainage system be lower than the city drainage system and be aware of flood tide as well as storm the hospital needs to construct the rain water collector and using pump to ensure no flooding in the hospital campus.
b. Drainage system of waste water
The drainage system of waste water reserved for the 2nd kind of wastewater to drain to the wastewater treatment station and flow the treated wastewater to the city drainage system.
All the wastewater from the hospital restrooms have to be treated in the digestion 3 compartment tank before flowing to the wastewater treatment station and flow to the city drainage system
4.2.2.3. Preliminary domestic wastewater
The wastewater from canteen and restrooms in the hospital which contain much organic substances and they are not directly flowed to the wastewater treatment station because they make easily the choke of drainage system, wastewater overflow, decomposition of organic substances making bad odor. To reduce the concentration of the pollutants in the wastewater, all domestic wastewater in the hospital must be treated locally to attain before flowing into the hospital wastewater drainage system.
The operating principle of the local treatment station are sedimentation and organic sediment decomposition. Its form is proposed to use for all restrooms in the hospital is 3 compartments digestion tank in which one is filtration. This application will attain the efficiency of suspending treatment be 65- 70% and BOD5 be able 60 - 65%.
Table 4.2: The treatment efficiency of domestic wastewater in the digestion tank
|Specific polluting parameters |Original Pollutant content |Pollutant content after treatment|Treatment efficiency, % |
|Biological oxygen demand (BOD5), mg/l |250 - 350 |100 - 400 |60 |
|Suspended solid (SS), mg/l |200 - 300 |70 - 105 |65 |
4.2.2.4. The wastewater treatment system
The functions of the wastewater treatment system are to receive and treat all contaminated wastewater of the hospital
a. The calculated parameters
- The wastewater flow rate: Q = 60 m3/day and night
- The wastewater drainage regime: almost continuous during 24 h/day, much in the office hours, the operation time of the wastewater treatment system during 24/24h.
- The wastewater after treatment attains TCVN 6772:2000: The standards of water quality – domestic wastewater – The allowable pollution limit (Level I).
b. Treatment technology of the wastewater treatment station
- The treatment technology of the wastewater treatment system is selected based on the input and output data, designed capacity, surface area, scientific background and the investment possibility of the hospital.
- The technology flowchart of the wastewater treatment system of INH is presented in figure 4.2.
c. Technology description
The wastewater from the hospital activities flows in the silage pit to the last ditch before into the wastewater treatment station.
The wastewater from the ditch to equalization tank. Its function is the equalization of flow rate and polluted concentration, create the stable operation regime for the following treatment steps. The wastewater in the equalization tank is mixed continuously by the submerged pumps in order not to sediment the residues and to reduce the bad odor from anaerobic decomposition. Moreover in the equalization tank happens the anoxic biological decomposition to reduce remarkably the organic pollutants.
The wastewater then flows to the aerotank. In this tank, the aerobic microorganisms (bio mud) and oxygen provided continuously by submerged compressors will decompose the organic pollutants (COD, BOD, nitrate, nitrite, ammonium – the characteristic pollutants in the domestic wastewater, and P).
After the bio treatment, it flows to the bio sedimentation tank to sediment the bio residues (bio mud) created from the above bio treatment. At the same time the wastewater will be decomposed the remaining pollutants (nitrate, ammonium) via anaerobic treatment.
The sediment wastewater flows to the disinfected tank to kill the microorganisms and the infectious substances remaining in the wastewater such as E.coli… before the wastewater flows into the city drainage system.
A part of the mud created during the treatment is recycled to aerotank, the remaining is back to the mud tank and taken periodically by mud transportation truck.
All the tanks in the treatment system are built underground. Every tank has the gas receiver and leads it to the deodorization unit before going out to atmosphere.
The wastewater after treatment attains TCVN 6772 – 2000 level I
d. Technology diagram:
Figure 4.2: The flowchart of INH Wastewater Treatment System
4.2.2.5. The measures to prevent the water pollution
Some pollution prevention measures plays the important role to reduce the waste at the source and to overcome the negative impacts of the pollutants to the environment.
To set up the periodical environment cost will help the INH have the detailed information of resource consumption, especially in water, during its operation. This is the base to instruct the hospital staff understand the importance of good housekeeping to reduce the water consumption as well as the wastewater created. Setting up the cost of water consumption and wastewater treatment includes the following contents:
- Use the drawings, flowcharts, maps to show the location, capacity of the water supply pipes in the hospital, flow meters, drainage pipes, the locations of checking valves if any…
- The data gathering during the INH operation such as: water supply and wastewater quantity as well as the quality of wastewater at the main silage pit of INH along with the corresponding data of operation capacity (by hour, shift, day or year).
- This monitoring program of water consumption needs to be implemented seriously to identify: the purpose of water consumption at each stage in the hospital operation and the causes of wastewater creation. This is the base to minimize the water consumption (for the unnecessary operations) as well as wastewater creation.
4.2.3. The measures to manage and treat the solid wastes
The waste solids created in the hospital is mainly from the activities, surgery, treatment…and the mud created from the wastewater treatment. The hazardous waste solids created in the hospital affect very much on the community health that the collection and treatment must be strictly.
The hospital will create the documents to follow and transport the daily waste solids, the records of medical wastes and common wastes transported to be destroy ed as regulation.
To solve the hospital solid wastes requires to apply measures and stages at the same time as follows:
4.2.3.1. Collection and classification stage
Collecting and sorting the solid wastes efficiently, the hospital must equip at the examination and treatment rooms the garbage bags with color codes for every kind of garbage:
- The yellow bag to contain the infectious wastes. It must be PE or PP plastic, not use PVC plastic. On the bag and bin have the biological hazardous symbol.
- The black bag (minimum thickness 0.1mm) contains the hazardous chemical and radiation wastes.
- The green bag contain the common wastes and the low pressure pots.
- The white bag contain the medical wastes that may be reprocessed.
All the bins have the cover. On the outside has the line to show ¾ of bin and the sentence “ NOT OVER THIS LINE”.
These bins have to collect following the stable schedule, it may be 2 times per day: one before 8 AM and one before 6 PM. These are then transferred to the temporary containing room. As for the medical wastes, after the surgery or the other treatment they will be transferred right away to the waste collection by the special tools and means to be burned and destroyed. It is absolutely not to allow them in the room of hospital for a long time.
The garbage is then transferred to the garbage room and transported to be treated by the special trucks of the functional companies. At the garbage room it ensure the above kinds of garbage are stored at the different areas with hazardous label at the hazardous area.
4.2.3.2. Treatment stage
The specific waste will have the corresponding treatment method:
The infectious wastes
The hospital will contract with the specialized company to transport to burn in the medical waste incinerator.
The chemical wastes
To treat and destroy the out of date pharmaceutical wastes, cell infectious wastes it may choose to apply the following methods:
• to return to the supplier as contract
• contract with the specialized company to transport and to treat as regulation (burning or inertizing).
Treatment and destroy the radiation wastes
The hospital use the radioactive substances and the instruments relating to radioactive substances must obey the present legal regulations about radioactive safety.
The common solid waste
The common solid waste must be put in the garbage house and coordinate with the city hygienic service company to collect periodically and to transport to the yard and then be treated there.
The wastes as metals, glass and plastic are recovered to reprocess. The allowable reprocessed and reused wastes only provide for the legal companies which have license for waste reprocessing.
Waste mud
The mud from the wastewater treatment station will be treated as regulation by contract with the functional company to transport and treat.
4.2.4. The measure to prevent the environmental risks
4.2.4.1. The measures to prevent the fire and explosion:
In order to prevent fire and explosion, hospital will apply comprehensively technical method, training, education and legislation.
Hospital will collaborate with local fire fighting agencies to establish specific fire fighting method, find the amount of fire fighting equipment essential for each building items, specific regulation table and order of fire fighting, layout these signs at each items, also organize training sessions of fire fighting for all hospital ‘s staffs.
- Installation of automatic Fire Alarm system and signal lights for each area.
- Installation of CO2 container, sand container, shower, pressure water pipeline system for fire fighting.
- Annual training of fire fighting for hospital’s staffs.
4.2.4.2. The accident relating to electricity
Power for hospital’s activities is from city power network. The cause of the electricity burning can include:
- Power overloading
- Short circuit
- Wire joint not good
- Electrostatic spark
- Equipment in fire
- Lightning strike
❖ Prevention of fire by electricity overload
Overload is the over electricity consumption. When connecting the electricity to the hospital with the necessary power for all equipments and machines and then define the suitable wires which are not too hot and ensure the safety when all of them operate. If there are more equipments consuming electricity that are not calculated before, the electricity circuit will be overloaded. To prevent the electricity overloads, the hospital should apply the following measures:
- When in operation it does not use too many high power electric equipments if the circuit does not include them.
- Control the temperature of the electric equipments not too hot over regulation.
- At the damaged electric insulation plastic, it easily fire when the electric circuit is overload and it has to replace the new one.
- It has to use the circuit breaker and fuse when using the electric equipments
❖ Prevention of fire by short circuit
The short circuit is the phenomenon that the phases connect together. To prevent the short circuit, the hospital should apply the following measures:
- When installing the wires and equipments, machines it must follow the technical standards and safety as the outside naked wires must be 0.25 m in distance;
- Prohibit to use the nails, wire to fasten the other wires;
- The wires connected to the equipments must be tightened, tidy; the joint between two wires is not the same place.
❖ Prevention of fire by bad wire connection
When there is the current in the wire, if the connection is not tightened it will be hot and burns the wire and adjacent materials. Moreover the untightened connection will discharge into the air. This happens at the fuse, breaker, switch…The temperature of the electric spark is 1,500 – 2,0000C
❖ prevention of fire by electrostatic spark
Electrostatic spark generated by friction between insulators or insulator and conductor. Due to impact of insulating fluid (fuel, oil) or between insulating fluid and metal. Electrostatic is also generated in small insulating solid object during the grinding. The occurrence of electrostatic is the result of complex processes related to the distribution of electronic and ion when having the contact of opposite electrical objects.
During the operation, electrostatic generated and accumulated when the movement of insulating fluids in ungrouding containers and in ground-isolated pipelines, the movement of air including dust, fluid in fog compressed or burnt out of pipe or container, the movement of dust in pipe(odor movement), driving strap contacts the axis. And other frictional processes. The high electrically charged the more dangerous. The experiment shows that voltage of 5KV will cause the burning of flammable objects such as fibers, cotton dust, rubber… In order to prevent electrostatic, it can be applied the following measures:
- Transmit electrostatic by grounding for machinery equipment, tanks, pipes
- Increasing relative humidity of atmosphere in the workshops containing machinery equipments that having dangerous electrostatic up to 70% (because most of the fire caused by electrically charged when the low humidity of 30-40% and less conductive), ionize the atmosphere to improve the conductivity of atmosphere.
- All parts of driving strap (as permanent electrostatic generators with great high voltage) are best to be grounded such as metal parts, driving strap should be oiled with conductive oil as graphite on the surface when generators in rest.
❖ prevention of fire by equipment in fire
Electric engine is equipment that changing electric energy into mechanical energy. There must be power supply for equipment in run. This electric energy is not completely converted into mechanical energy but partly into thermal energy. If the engine runs more fast, big back electromotive force, low electric energy into mechanical energy, low electric energy loss. In contrast, run slowly so small back electromotive force, high electric energy loss. If there is power and engine is not running, there is no back electromotive force, strength increased highly that making coil in engine can’t bear and be burned. Therefore, while power to the engine without in run, it is essential to disconnect to power and repair in soon unless the engine will be in burn.
❖ method of fire fighting for electrical equipment
In the fire, electricity always have that bright blue flash of electrical sparks, burnt smell of Ozone or burnt insulation cover. Burnt electrical equipments are often burnt little but dangerous. If not extinguished in time, it will cause burning factory, equipment, materials. Before fire fighting, it is required to disconnect the power and repair then. Meu small fire can be used to study CO 2 to treat. When the fire has developed, depending on the specific situation that having appropriate remedy.
When the power off, the fire fighter must be facilitated with protectors such as insulating rod, insulating deck, gloves and pulling power cut. These protectors must specify allowable voltage of usage.
4.2.4.3. The accident relating to radiation
Some expertise rooms in diagnostic function require the utilization of electron beam and radioactive substances. These substances are harmful to the environment and public health, so the hospital will have a plan to implement anti-leaking this substance to the environment by lead coated the entire face of the wall and inside the room using radiation.
4.2.4.4. The accident from labor and occupational diseases
- Apart from measures to control air pollution, noise, activities of staff in hospital. Hospital must have the appropriate action to protect the labor safety and environmental sanitation such as compliance with the rules of labor safety when making out construction organization report, the layout of equipments and devices, power safety precautions, and the arranged order of warehouse, raw materials, and lightning resistance.
- Must ensure the infrastructure’s conditions for the hospital staff such as kitchen, rest area, cleaning room...
- Reasonable layout of transport route.
- Insulating barrier of dangerous areas such as transformer stations, flammable materials.
- Lighting designed for working at night.
- Installation of noise protection equipment in areas of high level noise such as generators, compressor.
- Measures of safety protection for hospital staff would be not missing. Therefore, employees must be facilitated with full labor protection equipment as labor protection clothes, caps, gloves, eye protection glasses, boots...
- Cover of areas having dust and watering-cart for freshening road.
These measures mentioned above are the basic measures to protect the environment, labor safety and health of employees. When carrying out, it is needed to add additional measures specifically, appropriately to achieve good results.
CHAPTER 5 . COMMITMENT TO IMPLEMENT THE ENVIRONMENT PROTECTION MEASURES
During the stage of construction and operation of the project, the investor commits:
1. Comply the regulation of State and local government in environment protection:
• Law of environment protection No 52/2005/QH and approved by National Assembly at 29/11/2005 and be valid at 01/7/2006.
• Decree No 80/2006/NÑ-CP dated 09/8/2006 of the Government to assign the details and executing guide some articles of Law of environment protection.
• Circular No 08/2006/TT-BTNMT dated 08/9/2006 of Ministry of Natural Resource and Environment on guiding Strategic Environment Assessment, Environment Impact Assessment, Environment Protection Commitment.
• Decision No 43/2007/QÑ-BYT on enforcing the regulation of medical waste management.
2. Control the sources of wastes, building the wastewater treatment station and put it into operation right after the hospital goes into operation, ensure the concentration of waste dispersing into environment meet the following standards:
• Wastewater: attains TCVN 6772-2000 level I
• Surrounding atmosphere: attains TCVN 5937-2005 level I, noise attains TCVN 5949-1998
• Waste gas from reserved generator attains the air quality – industrial source for inorganic substances and dust TCVN 5939-2000 (column B).
The investor will develop comprehensively the treatment of domestic wastewater, restrict the air pollution and noise and control strictly the waste solid generation during the construction and operation, periodically inspect to ensure the construction and operation do not affect negatively to environment. If there are any environmental problems we will inform to the local environment management agencies.
CHAPTER 6. ENVIRONMENTAL TREATMENT BUILDING, ENVIRONMENTAL MANAGEMENT AND MONITORING
6.1. THE LIST OF ENVIRONMENT TREATMENT BUILKDINGS
The main environment treatment buildings includes:
• The wastewater treatment station
• Region to collect and classify the waste solid
6.2. MANAGEMENT PROGRAM
During the building and repair as well as in operation stage, management board of project prepared the real plan to implement the EMP to control and limit the environment problems and risks occurred.
6.2.1. Environment management program during the construction stage
During the building and repair as well as in operation stage, management board of project has the following duties:
• To stipulate and agree the environment protection measures during the building stage with the building company in charge of project building implementation.
• Setting up EIA to be approved by administration agency
• Permanent control, inspection of the environment protection actions at building site.
• Develop the environment supervision during the building stage.
• Propagandize and raise the awareness for the workers in the environment protection.
6.2.2. Environment management program during the operation stage
When the hospital goes into operation, the board of project management will be reorganized in board of directors and its duties are as follows:
• Instruct and raise the awareness for the patients and their relatives and the officers in the environment protection.
• Control periodically the wastewater treatment station, quality and hold the documents
• Inspect strictly the waste solid management, right classification, ensure the separate domestic and hospital waste holdings. Absolute avoid the mix of hazardous waste with the domestic waste
• Establish the risk dealing plan
• Control periodically the technical equipments, ensure the safety during operation, avoid the environment risk occur.
• Permanent check the efficiency of RMP and adjust it if necessary.
6.3. ENVIRONMENT MONITORING PROGRAM
Environment quality inspection is one of the important functions of RMP. Environment quality inspection is monitoring repeatedly and measuring the pollution parameters to ensure that the project activities not making negative impacts on surrounding environment and evaluate the efficiency of the pollution treatment. Based on the Circular08/2008/TT-BTNMT dated 08 September 2006 of MONRE, the following environment inspection are proposed and implemented during the building as well as operation stage.
To ensure the hospital’s stable operation and development and limit the affection oh the negative impact to surrounding environment, board of management or director later establishes the units in charge of environment protection with the following proposed EMP as follows;
• Inspect the water environment’s quality
• Inspect the surrounding air environment’s quality and at the technical buildings,
• Inspect the waste solid management
The environment inspection is as follows:
6.3.1. Air quality monitoring
Inspection locations: Air quality inspection locations and parameters inside and outside of project site.
6.3.1.1. Surrounding atmosphere quality monitoring
Location: 1 points at the hospital’s main gate (KK1)
Inspection parameters: Temperature, Humidity, Dust, CO, SO2, NO2, Noise.
6.3.1.2. Hospital atmosphere quality monitoring
Air quality inspection at the technical buildings:
Location: 1 points at the waste garbage collection (KK2)
1 points at the wastewater treatment station (KK3)
Inspection parameters: CO, SO2, NO2, H2S.
Method and frequency: Sampling and analyzing as TCVN. Frequency is 2 times per year for surrounding atmosphere and 4 times per year for the technical buildings
6.3.2. Water quality monitoring
6.3.2.1. Wastewater quality monitoring
Location: 1 points at the outlet of the wastewater treatment station (N)
Inspection parameters: pH, TSS, BOD5, COD, total N, total P, total oil, Zn, Cu, Ni, Cr, Coli form.
Method and frequency: Sampling and analyzing as TCVN. Frequency is 4times per year.
6.3.2.2. Monitoring of solid waste management
Control and inspect the collection of solid waste during the building stage, hazardous solid waste in the hospital 1 time per month.
CHAPTER 7. COST ESTIMATION FOR ENVIRONEMNTAL BUILDING
7.1. COST ESTIMATION OF WASTE WATER TREATMENT SYSTEM:
The general waste water treatment system:
This system will be constructed in 2 modules, construction cost of 2 modules as follows:
7.1.1. Construction:
Table 7.1: Schedule of construction cost of waste water treatment system
|No. |Item |Amount |
|1 |Regulation tank |1 |
|2 |Aerotank |1 |
|3 |Biological clarifier |1 |
|4 |Disinfecting holder |1 |
|5 |Mud holder |1 |
|6 |Control room |1 |
|Total |110,000,000 Dong |
7.1.2 Equipment- Installation- Operation- Acceptance
Table 7.2: Scheduling equipment cost of waste water treatment system
|No. |Items |Amount |
|1 |The central distribution system. Drain trough for sedimentation tank |1 |
| |Central distribution pipe + drain trough (steel and epoxy coating). | |
| |Fabrication: AQC Co | |
|2 |Waste water pump (submerged pump) |2 |
| |Materials: pumping chamber & inox paddle | |
| |Q = 1.2 – 16.8 m3/h, H = 3.2 – 13.6 m, P = 1,0 Hp | |
| |Producer: EBARA (Italy) | |
|3 |Waste water mix pump (submerged pump) |1 |
| |Materials: pumping chamber & inox paddle | |
| |Q = 10 m3/h, H = 6 m, P = 1,5 Hp | |
| |Producer: EBARA (Italy) | |
|4 |Mud circulating pump (submerged pump) |1 |
| |Materials: pumping chamber & inox paddle | |
| |Q = 4 m3/h, H = 1.9 – 7.9 m, P = 1,0 Hp | |
| |Producer: EBARA (Italy) | |
|5 |Air blower (submerge) |2 |
| |Q = 25 m3/h, H = 3 m, P = 2,2 kW, 380 V/3 phases | |
| |Producer: TSRUMI (Japan) | |
|6 |Chemicals metering pump |1 |
| |Capacity: 240V/1 phase, 50 Hz | |
| |Q = 8 litters/hour, 30 psi | |
| |Poly propylene pump head, Teflon pump film | |
| |Origin: SEKO - ITALY | |
|7 |Chemicals agitation system: |1 |
| |Capacity: 0.5 Hp, 360V/3 phases | |
| |Origin: TGP (Taiwan) | |
|8 |Chemical tank |1 |
| |Capacity: 300L | |
| |Materials: PVC | |
| |Origin: Viet Nam | |
|9 |Technical pipeline system |1 |
| |Materials: PVC | |
| |Valve: PVC, Zinc (1 way) | |
|10 |Deodorizing system |1 |
| |Materials: CT3 | |
| |Producer: AQC Technology | |
|11 |Automatic control system: |1 |
| |Power cabinet: Viet Nam | |
| |Components: LG | |
| |Wire: Cadivi | |
|12 |Microbial mud: |1 |
| |Microbial mud( ) | |
| |Origin: AQC Technology | |
|13 |Operation test |1 |
| |Chemicals for operating | |
| |Microbial mud | |
| |Operator: AQX Technology | |
|14 |Operating instruction, acceptance |1 |
| |Operating instruction | |
| |Acceptance, | |
|Total cost |250,000,000 dong |
7.2. COST ESTIMATION OF ENVIRONMENTAL QUALITY MONITORING
Table 7.3: Schedule of environmental quality monitoring cost
|No. |Monitoring parameters |Unit price, VND | |Monitored point |Cost |
|(i) |The wastewater quality monitoring |
|1 |pH |20,000 | | | |
|2 |BOD |80,000 | | | |
|3 |COD |80,000 | | | |
|4 |SS |50,000 | | | |
|5 |Total N |80,000 | | | |
|6 |Total P |70,000 | | | |
|7 |Total grease |100,000 | | | |
|8 |Zn |70,000 | | | |
|9 |Cu |70,000 | | | |
|10 |Ni |70,000 | | | |
|11 |Cr |70,000 | | | |
|12 |Coliform |60,000 | | | |
| |Sample analyzing cost |820,000 |4 |1 |3,280,000 |
|(ii) |The surrounding atmosphere monitoring |
|1 |Temperature |10,000 | | | |
|2 |Humidity |20,000 | | | |
|3 |Dust |60,000 | | | |
|4 |CO |80,000 | | | |
|5 |SO2 |70,000 | | | |
|6 |NO2 |70,000 | | | |
|7 |Noise |30,000 | | | |
| |Sample analyzing cost |340,000 |2 |1 |680,000 |
|(iii) |The surroundingatmosphere monitoring at technical facility |
|1 |CO |80,000 | | | |
|2 |SO2 |70,000 | | | |
|3 |NO2 |70,000 | | | |
|4 |Noise |30,000 | | | |
| |Sample analyzing cost |340,000 |2 |1 |680,000 |
|Total | |5,960,000 |
CHAPTER 8. COMMUNITY CONSULTING
During the time of doing environment impact assessment report for international neurosurgery hospital project, International hospital JSC have the cooperation with AQC company to conduct consult the opinions of the related local authorities such as: people committee, fatherland committee of Tan Thoi Hoa ward, Tan Phu district.
8.1. OPINIONS OF TAN THOI HOA WARD’S PEOPLE COMMITTEE
People committee of Tan Thoi Hoa Ward have given a written reply for document no.07/08 CV-IHC dated 21/10/2008 of International Hospital JSC about contributing community’s opinions for the environment regarding to international neurosurgery hospital project at 65A Luy Ban Bich Tan Thoi Hoa ward, Tan Phu district, Ho Chi Minh city.
People committee of Tan Thoi Hoa Ward, Tan Phu district has a review on a brief report of environment impact assessment of company and has the following comments:
People committee of Tan Thoi Hoa Ward have considered and no additional suggestion to environment protection project proposed by AQC- environment consultancy company.
8.2. OPINIONS OF TAN THOI HOA WARD’S FATHERLAND COMMITTEE
People committee of Tan Thoi Hoa Ward have given a written reply for document no.07/08 CV-IHC dated 21/10/2008 of International hospital JSC about contributing community’s opinion for the environment regarding to international neurosurgery hospital project at 65A Luy Ban Bich Tan Thoi Hoa ward, Tan Phu district, Ho Chi Minh city.
After a review on a brief report of environment impact assessment of neurosurgery hospital project, fatherland committee of Tan Thoi Hoa ward as a review and no additional suggestion to environment protection project proposed by AQC- environment consultancy company.
CHAPTER 9. DATA SOURCE AND EVALUATION METHOD
9.1. DATA SOURCE
9.1.1. Data source for reference
• Dinh Xuan Thang, Air Pollution, State University of Ho Chi Minh city Publisher
• Nguyen Quoc Binh, Air and Noise Pollution.
• Trinh Xuan Lai, Wastewater Treatment Design, Construction Publisher.
• Data of natural, economical and social conditions of Tan Thoi Hoa Ward, Tan Phu District.
9.1.2. Data source created by the investor
• Investment Report of The International Neurosurgery Hospital at 65A Luy Ban Bich St, Tan Thoi Hoa Ward, Tan Phu District.
• Design drawings of The International Neurosurgery Hospital.
9.2. APPLIED METHOD IN EIA:
Table 9.1: Monitoring environmental impact method
|No. |Method |Utilizing goal |Accuracy |
| | | |High |Average |Low |
|1 |Identifying |Describe current status |x | | |
| | |Identify components of production | | | |
| | |Identify environment impacts | | | |
|2 |Predicting |Predict changes, environmental quality | |x | |
| | |happening | | | |
|3 |Quick assessment |Calculation and assessment of polluting | |x | |
| | |load | | | |
|4 |Enumeration |List of impacts, impact assessment |x | | |
|5 |Surveying, sample |Selecting sampling point, analyze |x | | |
| |analysis |environmental status | | | |
|6 |Expert |Predict changes, environmental quality | |x | |
| | |happening | | | |
| | |Impact level assessment, , socio-economic | | | |
| | |condition and human health | | | |
9.3. REMARK ON THE DETAILED, RELIABLE EVALUATION METHOD
• EIA is done fully, detailed based on the reliable scientific methods.
• The predictions, evaluations of the impact, the environmental risks, explosion are analyzed to every stage of project, not missed the impact in the stage of construction and operation of project.
• The sources of pollution (air, water, solid waste…) are analyzed very clearly, detailed and concrete quantitative evaluation.
CONCLUSION AND PROPOSAL
I. CONCLUSION
Along with the strong development of service demand in HCM city, the International Neurosurgery Hospital Project is developed to contribute to the great community health care and bring the important meaning towards the regional economical development at Tan Thoi Hoa Ward, Tan Phu District.
The idea to establish the International Neurosurgery Hospital has the backgound with the number of patients on the large area and the high level specialized staff and that is the urgent demand of of patients and neurosurgery doctors.
The operations of the hospital in the future may create the polluting wastes such as: wastewater, waste gas and waste solid but these pollution sources may be overcome by the scientific designs, selecting the reasonable technology, installing the treatment system and right technical operation.
With the pollution treatment measures, the project investor has proposed the strict management measures in environment hygien, limit maximum the wastes, develop the measures o ensure labor safety, fire and explosion safety and prevent the risks.
During the project is put into operation, the investor commits to ensure to treat the wastes attaining the enviroment standards and implement correctly the monitoring program of the environment qualily as the report proposed.
II. PROPOSAL
The International Hospital JSC proposes to the environment agencies facilitate the advantages for the project go into operation, especially in the environment protection during the construction and innovation stage as well as in operation stage.
The International Hospital JSC respectedly proposes Department of Natural Resource and Environment regconizes and approves the EIA project.
PART 2: ENVIROMENT REPORT
TABLE OF CONTENTS
ACRONYM page 3
1. Overview 4
1. Introduction 4
2. Aims, items of the project for the loan from HDP 5
3. The consultant’s responsibility 5
4. Method 5
2. Environmental safeguard requirement compliance of the INH in comparison with those required by HDP 6
1. Brief introduction of INH 6
2. Appropriateness assessment according to the ES requirements of the INH 9
3. Conclusion and recommendation 12
3. Risk management plan (RMP) 13
1. Operational manual of WWTS with capacity of 100m3/day(provided by the construction contractor as promised by the investor) 13
2. Risk assessment, mitigation measures and implementation duties
3. Environment parameter monitoring plan 18
4. Internal monitoring and inspection reports 19
5. RMP implementation monitoring carried out by specialists of WB and HIFU 19
6. Responsibility to implement the RMP 19
4. Conclusion 20
5. Annexure 21
1. List of agencies/officials contacted by the consultant 21
2. Documents for reference 21
3. Some pictures 22
ACRONYM
|DONRE |Department of Natural Resource and Environment |
|EIA |Environment Impact Assessment |
|EMP |Environmental Management Plan |
|EPC |Environment Protection Commitment |
|ES |Environment Safeguard |
|GOV |Government of Vietnam |
|HCMC |Ho Chi Minh City |
|HIFU |Hochiminh city Investment Fund for Urban development |
|INH |International Neurosurgery Hospital |
|MONRE |Ministry of Natural Resource and Environment |
|MOSTE |Ministry of Science, Technology and Environment |
|RMP |Risk Management Plan |
|SS |Society Safeguard |
|VS |Vietnam Standardization |
|WB |The World Bank |
|WWTS |Waste Water Treatment System |
REPORT ON THE COMPLIANCE WITH
THE ENVIRONMENTAL GUIDELINE OF
HIFU DEVELOPMENT PROJECT (HDP)
OF THE INTERNATIONAL NEUROSURGERY HOSPITAL
CAPACITY: 100 BEDS
1. Overview
1.1 Introduction
The project of International Neurosurgery Hospital (INH) invested by Joint Stock International Hospital Company which address is 203 Dong Khoi st, District 1, Ho Chi Minh city and is represented by Ms Tran Ngoc Lan Trang, President of Board of Management. The business license number 4103007748 and secondly registered at 10th July 2008.
International Neurosurgery Hospital is established under the formal document No 210/KCB-HN dated 17/9/2008 by Treatment and Examination Bureau signed 17/9/2008 which approved Joint Stock International Hospital Company replace Can Gio Joint Stock Pharmaceutical Company to change Hong Thai Pregnant Hospital to International Neurosurgery Hospital.
The construction of International Neurosurgery Hospital was complied with the following documents:
• Certification of Right of Land and Property Use issued by People Committee of Tan Phu District No 4550/2007/UB-GCN dated 25th July 2007;
• Construction license number 260/GPXD dated 28th December 2007 issued by HCM city Department of Construction;
• Decision No 763/QĐ-TNMT-QLMT dated 27th Novmber 2008 approved EIA;
• Results of X ray Safety Assessment No 1087/HĐKT-TTHN issued by HCMC Atomic Safety Center dated 26th November 2008;
• Results of Radiation Safety Assessment for CT Scanner Room No 748/HĐKT-TTHN issued by HCMC Atomic Safety Center dated 08th September 2008.
The main contents of project is the construction and improvement of International Neurosurgery Hospital at the scale of 100 beds.
INH Project uses the loan from WB via HIFU Development Project (HDP). Therefore, INH project has to comply with the environmental safeguard policy of WB, specificly the environmental safeguard guideline of HDP. In this report, INH project is a subproject of HDP. This is the due diligence report on complying with the environmental safeguard (ES) requirements repaired by the investor compared with those in ES guideline of HDP.
This enviromental compliance report includes the following contents:
1) Background;
2) Appraisal on complying with th from e environmental safeguard (ES) requirements of WTS of INH compared with those in ES guideline of HDP
3) Develop a risk management plan (RMP) of subproject if necessary.
1.2. Aims, items of the project for the loan from HDP:
Expectedly, the utilization of loan from HDP project’s fund to make the investment investing in the following items in the projects:
|Item |Total |Fund (1.000đ) |
| |(1.000đ) | |
| | |Own fund |HDP’s loan |
|Land |45.645.000 |45.645.000 |- |
|Existinf building |4.628.000 |4.628.000 |- |
|Design and construction cost |31.849.816 |- |31.849.816 |
|Medical Equipment |77.683.974 |26.419.337 |51.264.637 |
|Other assets |5.791.441 |1.739.894 |4.051.547 |
|Emergency cost |2.834.000 |- |2.834.000 |
|Other cost |5.757.000 |5.757.000 |- |
|Working capital |6.143.000 |6.143.000 |- |
|Total |180.332.231 |90.332.231 |90.000.000 |
|Rate |100% |56% |44% |
1.3. Responsibility of the consultant
• Review the documents, proofs related to ES in 1.1. of the subproject and appraise the accordance with those required by HDP.
• List the differences, shortcomings of documents (if any) compared with SS and ES guidelines of HDP
• Develop a risk management plan (RMP) of subproject if necessary.
1.4. Methods
1.4.1 Desk review
Desk review includes the collection and considering the documents of the subprojects relating to ES such as:
• Investment Project of International Neurosurgery Hospital
• The environment impact assessment (EIA) of INH
• ES guideline of HDP
• ES Policies of VN Government at the time of EIA approval
• Subproject implementation progress
• Propose the environment impact mitigation measures
• Develop a RMP
1.4.2. Directly observe at the subproject site and discuss with the investor’s officials
Discussed with the officials of the investor on the environmental issues of INH project such as medical waste solid, flowrate and wastewater treatment station, receiver, radiation safeguard for CT Scanner and X-ray Rooms, the source of oxygen, the measures to overcome and manage as well as the subproject implementation progress.
2. Environmental safeguard requirements compliance of the subproject INH compared with those required by HDP
2.1 Introduction of INH and the issues of solid waste, waste water and radiation
2.1.1 The International Neurosurgery Hospital
The International Neurosurgery Hospital is constructed on the land located at 65A Luy Ban Bich St, Tan Thoi Hoa Ward, Tan Phu District, HCMC which area is 1,257.1 m2 with their directions are:
• North East is Luy Ban Bich street;
• South East is inhabitants;
• South West is inhabitants;
• North West is inhabitants and school.
with the planned items were described in the EIA as follows:
• Total land area: 1,257.1 m2
• Construction site area: 715.5 m2
• Construction density: 57%
• Land for trees: 514.5 m2
• Level of construction: 5 stories
• Coefficient of land use: 3,28
• Total site area: 4,125.5 m2
and the site arrangement:
Ground floor: 715.5 m2 is reception, patient receiving, emergency aid, and professional support …
1st floor: 756.0 m2; ultrasonic test, điện tim, XR can thiệp, rooms for patient, nurses, doctors…
2nd floor: 756.0 m2; rooms for patient, kitchen, canteen…
3rd floor: 756.0 m2; rooms for patient, rooms for VIP patient, administration
4th floor: 756.0 m2; rooms for patient, anaesthetizing room …
Terrace: Surgery technique, washing room, drying ground…
Transportation design for disables is followed the international standards.
2.1.2 . The aims of the project
At present the need for medical examination and treatment in internal neurosurgery at the public hospitals in HCMC and provinces is increasing overloaded, not meet the people’s treatment demand and it affected to their treatment quality as well as not to meet the demand for high quality treatment of rich people. It leads to the demand for deep specialty treatment in nearby countries with high cost and not always be convenient for patients and their family during treatment progress.
For the above reason, Joint Stock International Hospital Company decided to invest the International Neurosurgery Hospital with its scale 100 beds to contribute to care the health for a part of people at the international standards at HCMC and southern provinces as well as the surrounding countries.
2.1.3. Land use plan and environmental actuality at the INH
The status of site use and environment at INH.
Table 2: The basic items of INH [2]
|Floor |Name of rooms |Area, m2 |
|Ground | |715.5 |
| |Examination |203.1 |
| |Emergency |174.2 |
| |Support |202.7 |
|1st | |733.52 |
| |X ray |34 |
| |Blood test sample |10 |
| |Test |16 |
| |Cardio Ultrasonic |13.5 |
| |Treatment |335.7 |
| |Administration |324.32 |
|2nd | |733.02 |
| |Treatment |337.7 |
| |Administration |79.72 |
| |Support |315.6 |
|3rd | |721.75 |
| |Treatment |349.4 |
| |Administration |372.35 |
|4th | |800.42 |
| |Treatment |100 |
| |Surgery |700.42 |
The treatment block includes the sick rooms.
The administration block includes meeting room, chief’s room, warehouse, duty room, accounting room, nurse room, rest rooms, corridor and elevator…
The surgery block includes surgery room, intermission room, consultation room, receiving room, anaesthetic room, sterilization room.
Examination and emergency rooms are placed at the ground floor with waiting place which are convenient for patients. The 1st, 2nd and 3rd are designed for sick rooms, the 3rd floor is for VIP sick rooms with all comforts to serve the patients who have high demands in examination and treatment. The surgery block is arranged at the 4th floor with all the functional rooms meeting the demand for surgery and postsurgery.
6 The environmental issues at INH
When the International Neurosurgery Hospital goes into operation, the following environmental issues needs to be concerned
1) Air pollution in the hospital
Air pollution may be from the traffic in and out of the hospital and from the dense traffic on Luy Ban Bich street. The odor may cause from the collecting the solid waste and from the drainage system and waste water treatment.
2) The impact of the hospital waste water
Building the drainage and waste water treatment system is the important item of the reconstruction project of INH. This helps for the clear drainage in the hospital and ensure the quality of the treated wastewater attain TCVN 6772-2000, level I, not to affect to the quality of the ground water in the hospital area and the receiver.
3) The medical waste
The hospital waste solid is always the anxiety to environment. Following to [2] when the hospital goes into full operation, the created waste solid is 250 kg in which 200 kg is domestic waste, 50 kg is hazardous waste which may be infectious, poisonous and radiated, and 15 kg waste slurry from the wastewater treatment system.
4) Irradiation problems
The radiation substances may be from X ray camera, CT Scanner which may cause to the health and surrounding atmosphere if there is no the siutable protection measures.
2.2. Appropriateness assessment according to the ES requirements of the subproject INH
Appropriateness assessment to ES requirements of the WWTP includes the assessment according to the requirements of GOV and those of WB as “Environment Safeguard Guideline” of HDP. It includes:
1) Review the environment safeguard documents provided by the investor before building the subproject, particularly the approval decisions and appraisals of the authorities;
2) Compare the availlable ES documents to the requirements of HDP;
3) Visit the subproject site.
Below is the consultant’s detailed assessment
2.2.1. Appropriateness assessment to the ES requirements of GOV
When the investor met with HIFU’s authorities to arrange the budget for the subproject, he had already the ES relating documents:
(1) The modified and corrected project of building and improving INH from Hong Thai Pregnant Hospital.
(2) The base report of INH in which presented fire and explosion precaution plans
(3) EIA of INH Project and Approval Decision No 763/QĐ-TNMT-QLMT dated 27th November 2008 of Department of Natural Resource and Environment (DONRE) of HCMC.
(4) The construction liscence No 260/GPXD dated 28th December 2007 of Department of Construction of HCMC.
(5) The test results of radiation safety No 1087/HĐKT-TTHN issued by Radiation Safety Center of HCMC at 26th November 2008; The test results of radiation safety of CT Scanner room No 748/HĐKT-TTHN issued by Radiation Safety Center of HCMC at 08th September 2008.
(6) The official documents No 230/UBND dated 22th October 2008 of The People Committee of Tan Thoi Hoa Ward on the contribution of community about environment of INH Project and No 05/UBMTTQ dated 22th October 2008 by Committeee of Fatherland of Tan Thoi Hoa Ward of Tan Thoi Hoa Ward on the contribution of community about environment of INH Project.
Some comments after reviewing these documents presented as follows:
• In principle, one of the compulsory proceedings for a project approved is the investor has to present the approval decision of EIA.
• The subproject of building and improving INH had the documents relating to radiation safety issued by the functional agencies for X ray and CT Scanner Rooms.
• Collecting, holding and transporting the waste and medical solid out of the hospital presented in EIA approved meets the requirements of Decision 43-2007 BYT of Ministry of Health on the management of the hospital waste solid.
• Environment Management during operation presented by investor in EIA is contracting with the functional agencies carried out as regulations.
• In EIA also presented enough the preventive measures of the environment risks, however the hospital use the central oxygen source in the warehouse and air flows through the pipes. So it needs the preventive measures of fire and explosion as well as keeps the warehouse temperature not high rise in summer.
The investor provided the document no E03172/03/HCM/KD92-010 of 2nd Region Safety Verification Center verified the attained safety containers of compressed gas signed by Head of Verified Pressure Equipment by order of Director dated 20th November 2008.
• In the project document it had also in details the plan and equipments to prevent the fire and explosion in hospital according with Tvietnamese Standards on fire and explosion prevention.
• About the investor’s commitment of environment protection, the investor needs to commit furtherly:
1) comply the Regulations on medical waste management based on Decision 23-2006 of MONRE dated 26th December 2006 about the list of harzadous wastes in which the code of medical hazardous is 13.
2) comply the Regulations on medical waste management based on Decision 43-2007 of Ministry of Health dated 30th November 2007;
3) comply the Ordinance on Radiation Safety and Decision No 33/2006/QĐ-BYT of Ministry of Health dated 24th February 2006 on the list radiation medicines and compounds in prescription and treatment.
2.2.2 Appropriateness assessment according to the ES requirements of HDP
Apart from the compliance with the ES requirements of GOV, the subproject needs also to comply with the ES requirements of HDP. The item 2.10 “ES Guideline” of HDP guides to assess the appropriateness via some issues that often have the differences between the ES requirements of GOV and those of WB such as:
• Community consultation and information dissemination.
• Investor’s ES implementation capacity.
• Risk management plan of subproject that had EIA.
• Cost for implementing the mitigation measures, environmental works and monitoring plan and the investor’s commitments which reserves the budget to do these activities.
The below detailed assessments are as following:
:
❖ Community consultation and information dissemination: Discussing with the investor’s staffs that the information dissemination of the subproject and its EIA were implemted with the meeting with local people via the following formal letter (1) No 230/UBND dated 22nd October 2008 of People Committee of Tan Thoi Hoa Ward, Tan Phu District on the community comment on environment of project and (2) No 05/UBMTTQ dated 22nd October 2008 Fatherland Committee of Tan Thoi Hoa Ward, Tan Phu District on the community comment on environment of the international neuro surgery project .
❖ The investor’s ES implementation capacity: At present, the investor had signed the contract with medical and enviromental consultant company to do the environmental management during the project in operation.
❖ EMP/RMP (Environment Management Plan-EMP / Risk Management Plan-RMP): According to “ES guideline of HDP”, the EMP/RMP is a compulsory requirement to comply with the ES requirement of HDP. The EMP/RMP needs to be prepared by an investor’s consultant company when the investor contacts with HIFU to borrow loan from HDP for a subproject which. The documents relating to ES of INH subproject do not have the EMP/RMP plans that it needs to prepare and develop these plans.
❖ Cost to implement ES and the investor’s disbursemnet commitment :
The investment report of the subproject mentioned cost items to implement ES excluding the construction costs. These items include the operating costs of WWTS, collecting the hospital waste. But this cost may be considered as a part of ES implementation cost.
❖ The above cost does not include the monitoring cost of the quality of the wastewater after treatment implemented by the independent agency.
In brieft: The above analysis shows that is also the evironment safeguard documents of the subproject met the Government’s safeguard requirements, but it still the lack of RMP/EMP and adding more some commitments.
2.2.3 Subproject site visit
International Neurosurgery Hospital was built and improved on the base of the old pregnancy hospital.
International Neurosurgery Hospital is in the stage of building and installing completeness, test operation of equipments, infrastructure including solid waste collecting system and storage and the waste water treatment system is also completed and in test operation. It is unnecessary to propose and apply the measures to minimize the passive impacts to environment for the construction stage.
2.3 Conclusion and recommendation
The analysis above shows that the subproject of INH of Joint Stock International Hospital Company met the ES requirements of GOV. However, if using the loan of the World Bank via HDP, the subproject has to comply with the ES requirements of HDP, namely
1) need to develop a EMP/RMP for the subproject and
2) disclose the plan for the community at People Committee of Tan Thoi Hoa, Tan Phu District.
3. Risk management plan (RMP)
Because of no standard format for a RMP, the consultant suggests the main contents of the RMP for the INH subproject as follows:
1) operational process of WWTS,
2) potential risk assessment, mitigation measures and responsibility for implementation
3) monitoring plan
4) estimate the cost for monitoring and inspection
5) propose the capacity enhancement
6) Internal monitoring and inspection reports
3.1 Operational manual of WWTS phase 1 at capacity of 100m3/day (provided by the construction contractor as committed by the investor)
3.1.1. Requirements for system safety
Before starting the system, operator needs to read carfully “Operation Manual”. It is only the responsible official operate the system. Unresponsible workers go in and operate the system is strictly prohibited.
3.1.2. Before putting the system into operation
1- Control the water level in chemical tank.
2- Let the control buttons to OFF or PAUSE position
3- Turn on the CB to ON position – The main lamp turns on
3.1.3. Modes of operation
The system has 2 modes of operation: Manual or Automatic and selected by button “AUTO – MENU”
3.1.4. Description of technology of waste water treatment
Wastewater from the hospital’s activities was collected by the drainage system leading to manhole terminal prior to the treatment system.
Wastewater from the collector is flowed to regulating tank to be regulated, stable flow and concentration of the pollution. Wastewater in regulating tank is continuously mixed with the underwater pumping system to prevent the sedimentation and reducing smell due to anaerobic decomposition. In addition, in regulating tank has also anoxic decomposition which significantly reduce the organic pollution
Then, wastewater will be taken through AEROTANK. Here, under the effect of the aerobic microorganism (microbiological sludge) and oxygen continuously supplied by submerged air blower, organic pollutions (COD, BOD, N {nitrat, nitrit , amonium, here are the characteristic pollutions of wastewater },, and P) will be decomposed. This process also created a large amont of mud called biological mud.
After biological process, wastewater is brought to biological clarifier which clarifies biological sediment swimming (biological sludge) generated by the above biological processing. Meanwhile, there is process of eliminating part of other pollutions remaining in the wastewater (nitrat, Amonium) through aerobic process
Clarified wastewater in biological clarifer will flow to pasteurizing tank to kill bacteries and remaining contituents that may cause disease such as Ecoli bacteria. Then, water is pumped to the absorption FILTER (pressure filter) to absorb all remaining pollutants before wastewater go to the city sewer.
Created sludge in the treatment processing is partly turned back to Aerotank, the remaining is flowed into sludge tank and will be taken periodically by sludge exhausting truck.
All tanks in the treatment system are built underground. Each tank has collector to collect the gas and let the gas (smell) to the adsorption equipment with the activated carbon before released to the surroundings.
Wastewater after treatment attains standard of level I (according to TCVN 6772 - 2000).
3.1.5. System operation
A. Treatment phase:
← Control the quantity of chemical enough for all day operation.
← Control the set of chemical pump
← Turn on the valves:
• Adjust the water flow from regulating tank to aerotank accordance with the capacity design.
• Adjust the volume of sludge circulating to Aerotank or sludge tank.
← Switch on CB in electric
• The system only works when chemical tank and regulating tank is not exhausted.
Automatic mode:
Change control bar to AUTO position, the system will work as follows:
• Wastewater from regulating tank to Aerotank by wastewater pump 1A / B. Chemical metering pump is also working.
• Waste water from equalizing tank is pumped to Aerotank by pump 1A/B and chemical meterpump is also operated at the same time.
• Using pump to mix waste water in equalizing tank and submerged compressor in Aerotank is operating continuously to ensure the treatment process.
• Sludge pump is operated periodically by the set time.
Manual mode:
Transfer the control button to MENU, the system will operate upon the operator
B. Stop phase
Stop all the system by transfer the switches, CB to “OFF” position
3.1.6. Maintenance
It is very necessary to maintain the system and implement regularly to ensure the system in good condition. The breakdowns can happen any time with the machine details, if they are not discover in time the whole system may be stopped operation.
3.1.6.1. Breakdown
Table 3: Breakdown, Causes and Repair
|Equipment |Breakdown |Causes |Maintenance - Repair |
|Waste water pump |Pump not attain capacity |Rubbish inside the pump |Clean the pump regularly |
| |Pump is overheated and |Pump not operating |Control the on/off valves from the pemp to tanks |
| |strange noise | | |
| | |Pump axis worn out or failed |Replace upmp or pump axis |
|Chemical Pump |Not operating |Suction pipe of buffer is out of order |Control and repair |
| | |having solid in chemical solution |Control and mix the chemical solution carefully |
| | |Pump’s membrane is out of order. |Control and replace if necessary |
| |Pump is overheated and |Gear box is out of order |Control and replace if necessary |
| |strange noise | | |
|Air Compressor |Compressor is overheated |Bearings |Control regularly and lubricating. eplace if |
| |and strange noise | |necessary |
|Mixing motor |Overheat motor or strange|Bearings |Control regularly and lubricating. eplace if |
| |noise | |necessary |
3.1.6.2. Maintenance
1. Daily Maintenance
← Checking chemical tanks to detect leakage
← Checking the amount of chemicals in chemical tank that enough for daily use, preparing additional chemicals when the remaining in tank is little..
← Checking valves and pipes to detect leakage
← Checking electrical control cabinet
( Check equipments:
• Waste water pump Every week, being sure to check the pipes of pump and waste in pump’s wings
• Chemical Meterpump being sure to daily check the operation and pipeline of pump. Being sure to weekly clean one way valve and compressing head of pump by opening and cleaning
• Air compressor being sure to check regularly in oder to detect problems and have method of overcoming.
• Odor treatment system Checking regularly to detect congestion and replace adsorbent as needed
2. Monthly/Annual Maintenance
+ Lubricating pump appropriately
+ Clean the internal side of pump, air blower
3.1.7. Chemical Preparation
Wastewater Treatment Technology uses 01 chemical: Clorine. Clorine is soluted at the concentration: 200 g/100 litre of clean water(20/00).
Direction of chemical mixing: Put 100litre of pure water in chemical tank, weight approximately 200g of Clorine and mixing welll.
In chemical mixing, operator pay attention:
- There are 2 operators in mixing chemical. It is available the clean water to wash the hands.
- Wear protection cloth, gloves, glasses.
- Avoid the chemical throwing to body or things…..
- No eating, drinking when mixing chemical.
- After finishing it must clean hands, protection cloth, equipments.
- When the chemical throws to body, it must clean fastly, thoroughly with strong flow of water during 3 – 5 minutes.
3.2. Risk assessment, minimization measures and implementing responsibility
Table 4: Environmental risk assessment, minimization measures
|No |Risk / Potential Problem |Reasons/Minimization Measures |Responsibility |
|1. Building stage: (since the progress of construction is finished now, consultant have not deal with impacts and migitation measures in construction |
|more) |
|2. Operating stage |
|1 |Bad odor, quantity of organic |Intense aeration to increase the oxygen content to raise the rate of |Operators |
| |substances at the drainage gate ove|decomposition of organic substance. |Investor |
| |r the standards |Develop the tree corridor around the hospital and its WWRS to reduce the odor| |
| | |to surrounding area. The width is as large as possible depending on the | |
| | |remaining land. | |
| | |Control the active sludge as directed by the contractor. | |
|2 |Polluting the drainage |Control regularly the quality of the treated waste water; |Operators |
| | |Control the opeartion process. | |
| 3. Plan to deal with the risk in WWTS operation |
|1 |Rubbish choking screning bars |- Control regularly the screning bars |Operators |
|2 |pH is not right at pH adjusting |Control the pH sensor; |Operators |
| |tank |Control the electricity circuit | |
| | |Control the chemical content | |
|3 |Troubleshooting at aeration | |Operators |
| |biological tank | | |
| |White foam on the surface |Less activated sludge, no taking out of sludge |Operators |
| |Black sludge |Less oxygen, increase the aeration |Operators |
| |Air foam at some places in tank |Air difuser is cracked nd need to replace |Operators |
|4 |Troubleshooting at sedimentation | |Operators |
| |tank | | |
| |Black sludge on the surface |High residence time of sludge, remove the sludge more reguarly |Operators |
| |Turbid waste water |Less sedimentation of sludge, increase the content of sludge |Operators |
|5 |Prevent to discharge the sludge not|Sludge from WWTS still has the high microbiological content and hdden risk of|nt |
| |as regulation |disease and pollution. | |
| | | | |
| | |Investor signs the contract with City Environment Company (Contract attached | |
| | |in Index) | |
3.3 Environment parameter monitoring plan
3.3.1. Monitoring plan
Effectiveness of the WWTS is assessed via monitoring the quality of environmental parameters. The monitoring is to find in time environment problems and suggest treatment measures if there is something unusual. Monitoring plan (internal monitoring implemented by the investor of INH) is to reserve the human and budget resources for the WWTS operation
Table 5: Environmental quality monitoring
|Source |Parameters |Location |Frequency |Number of sample per |
| | | | |year |
|Waste water after |1. pH |- At the outside of |1 per quarter |4 |
|treatment |2. BOD |wastewater treatment | | |
| |3. COD |system and attain TCVN | | |
| |4. SS |6772-2000 level I | | |
| |4.Settlable solids | | | |
| |5. Total dissolved solid | | | |
| |6. Sunfur (H2S) | | | |
| |7. Nitrate (NO3) | | | |
| |8. Oils (food) | | | |
| |9. Phosphate (PO43-) | | | |
| |10. Total colifoms | | | |
|Surrounding atmosphere |Temperature |TCVN 5937 - 2005 |1 per 2 quarters |2 |
| |Humidity | | | |
| |Dust | | | |
| |CO | | | |
| |SO2 | | | |
| |NO2 | | | |
|Air quality at the |1. CO | |1 per quarter |4 |
|treatment system |2. SO2 | | | |
| |3. NO2 | | | |
| |4. Noise | | | |
3.3.2. Monitoring cost
Environment monitoring of the WWTS and gas treatment system is to ensure that the quality of wastewater and waste gas after treatment attains the designed standards as approved EIA is TCVN 6772-2000 level I. The monitoring cost is estimated for 4 monitorings per year. Total yearly monitoring cost is about 6,000,000 VND. The prices are from the Circular Number 83/2002/TT-BTC dated 25th September 2002 of Ministry of Ftnance.
3.4. Internal monitoring reports
After participating HDP and put the WWTS and INH into operation, the investor of INH has to report periodically about the RMP implementation to HIFU. Based on the report, HIFU synthesizes with other subprojects to submit to WB. The reporting will be terminated after DONRE issues an operational license of the WWTS. The internal monitoring reports in Vietnamese should be done every three months during test run and every six months after approved for opeartion by DONRE and submitting all reports to HIFU. The contents of internal reports could be referred to “Environmental Safeguard Guideline of HDP.
3.5. RMP implementation supervision carried out by specialists of WB and HIFU
Beside the internal inspection of Investor, the subproject belongs to HIFU’s program that it will be inspected strictly by WB and HIFU. The schedule of inspection of RMP/EMP will be informed in advance to investor by HIFU. The content of inspection is mainly the evaluation of RMP/EMP compliance which were agreed by both sides.
3.6. Responsibility to implement the RMP
As soon as all sides approve the RMP, the investor is responsible
1) Publicize the RMP at the office of the people’s committee of Tan Thoi Hoa ward, Tan Phu District
2) Implement all contents stated in the RMP and environment report.
4. Conclusion and recommendation
During the preparation of this ES report, the investor’s officials and environment consultant company were very active to support the HIFU consultant in providing information, discussing to complete the last report. Therefore, the investor and HIFU consultant achieved the agreement in term of contents and the investor committed to implement proposals in the report that was showed in the working minute signed between the HIFU’s official and consultant and the investor’s representative at INH dated on 2009.
It notes that if classified as WB, the subproject is a high-risk classification. The RMP approval is just the initial step in meeting ES requirements of WB. The key point is to develop and implement this plan. Thus the consultant recommends that HIFU needs to request the investor to commit to implement the EMP/RMP and it is one of the conditions to reimburse for the subproject.
5. Annex
5.1 List of agencies/officials contacted by the consultant
Table 6: List of agencies/officials contacted by the consultant
|No |Name of agencies |Officials |Titles |
|1 |International Neurosurgery hospital |Ms Nguyen Thi Lan Trang |President |
| | |Mr Dang Van Nhan |Director |
| | |Mr Trieu |Environment Company |
| | |Mr Tham |Environment Company |
|2 |Hochiminh City Investment Fund for Urban|Nguyễn Hà Lam |Official of HIFU |
| |Development (HIFU) |Vũ Bá Minh |Environment consultant |
5.2. Tài liệu tham khảo
[1] CÔNG TY CỔ PHẦN BỆNH VIỆN QUỐC TẾ , “Dự án Bệnh viện Ngoại Thần kinh Quốc tế”có bổ sung chỉnh sửa, tháng 7/2008
[2]CÔNG TY CỔ PHẦN BỆNH VIỆN QUỐC TẾ , “Báo cáo đánh giá tác động môi trường Dự án Bệnh viện Ngoại Thần kinh Quốc tế”, tháng 10/2008
[3] Ngân Hàng Thế giới và Bộ Kế hoạch Đầu tư, “Chính sách an toàn môi trường của Ngân hàng thế giới – Hướng dẫn kỹ thuật”, NXB Thống kê, 12/2004
Các văn bản tham khảo
[1] Decision No 43-2007 BYT of Ministry of Health about Management of the hospital waste
[2] Joint Circular No 2237/1999/TTLT/BKHCNMT-BYT dated 28th December 1999 on the direction of radiation safety in health.
[3] Decision No 763/QĐ-TNMT-QLMT dated 27th November 2008 of DONRE approved EIA of INH Project
[4] Construction license number 260/GPXD dated 28th December 2007 issued by HCM city Department of Construction
[5] Results of X ray Safety Assessment No 1087/HĐKT-TTHN issued by HCMC Atomic Safety Center dated 26th November 2008
[6] Results of Radiation Safety Assessment for CT Scanner Room No 748/HĐKT-TTHN issued by HCMC Atomic Safety Center dated 08th September 2008.
[7] Formal letter No 230/UBND dated 22nd October 2008 of People Committee of Tan Thoi Hoa Ward on community comments on environment of INH
[8] Formal letter No 05/UBMTTQ dated 22nd October 2008 of Fatherland Committee of Tan Thoi Hoa Ward on community comments on environment of INH
[9] Standard of Domestic Waste Water 6772-2000
[10] Standard of waste gas TCVN 5937-2000
5.3. Some images
|[pic] |[pic] |
|Hand Washing for Solid Waste collection |The covers of the underground watewater treatment system |
|[pic] |[pic] |
|Deodor pipe |Deodor pipe |
|[pic] |[pic] |
|Door of compressed oxygen room |Chemical tank and meter pump |
|[pic]Washing vessel | |
PART 3: RISK MANAGEMENT PLAN
INTRODUCTION
Safety Environment Guide HDP project requires when a sub-project had Report of environmental impact assesment (DTM) or commit to environmental protection (CKBVMT) even approved the last evaluation report found that this did not meet the requirements of ATMT HDP is the borrower must prepare a risk management plan(KHQLRR).
Hướng dẫn An Toàn Môi Trường (ATMT) của dự án HDP yêu cầu: khi một tiểu dự án đã có Báo cáo đánh giá tác động môi trường (ĐTM) hoặc cam kết bảo vệ môi trường (CKBVMT) thậm chí đã được phê duyệt, nếu qua đánh giá cho thấy báo cáo này chưa đáp ứng yêu cầu ATMT của HDP thì bên vay phải chuẩn bị một Kế hoạch quản lý rủi ro (KHQLRR).
In this project the Investor that is International Hospital Corporation has:
▪ EIA approved by Decision No. 763/QD-TNMT-QLMT dated 27/11/2008 of the Department of Natural Resources and Environment of Ho Chi Minh City.
▪ Bulding lience no.260/GPXD on 28/12/2007 of HCMC Department of Construction
▪ The results of radiation safety assessment of CT Scanner No.748/HDKT-TTHN dated 08/9/2008 and result of evaluating radiation safety of X-rays No.1087/HDKT-TTHN dated 26/11/2008 of HCMC Nuclear Center.
The construction of International Neurosurgery Hospital was complied with the following documents:
• Construction license number 260/GPXD dated 28th December 2007 issued by HCM city Department of Construction;
• Decision No 763/QĐ-TNMT-QLMT dated 27th Novmber 2008 approved EIA;
• Results of X ray Safety Assessment No 1087/HĐKT-TTHN issued by HCMC Atomic Safety Center dated 26th November 2008;
• Results of Radiation Safety Assessment for CT Scanner Room No 748/HĐKT-TTHN issued by HCMC Atomic Safety Center dated 08th September 2008.
Therefore, the sub-projects should just develop a risk management plan on the basis of environmental impact assesment (EIA) approved as presented below.
Expectedly, the utilization of loan from HDP project’s fund to make the investment investing in the following items in the projects:
|Item |Total |Fund (1.000VND) |
| |(1.000VND) | |
| | |Own fund |HDP’s loan |
|Land |45.645.000 |45.645.000 |- |
|Existinf building |4.628.000 |4.628.000 |- |
|Design and construction cost |31.849.816 |- |31.849.816 |
|Medical Equipment |77.683.974 |26.419.337 |51.264.637 |
|Other assets |5.791.441 |1.739.894 |4.051.547 |
|Emergency cost |2.834.000 |- |2.834.000 |
|Other cost |5.757.000 |5.757.000 |- |
|Working capital |6.143.000 |6.143.000 |- |
|Total |180.332.231 |90.332.231 |90.000.000 |
|Rate |100% |56% |44% |
RISK MANAGEMENT PLAN:
Due to not having any standard for risk management plan RMP, consultant has proposed the basic content for risk management plan of International Neurology Hospital subproject. The contents of RMP include:
(1) Process of operating wastewater treatment system
(2) Assessment of the potential risks, mitigation measures and performance of respomsibility.
(3) Monitoring plan
(4) Estimated cost of monitoring/inspection
(5) Propose the ability enhancement program
(6) Internal monitoring/ inspection report.
presented in turn below:
(1) OPERATIONAL PROCESS OF WWTS (provided by design/construction contractor)
PART 1: OPERATING SYSTEM
I. SAFETY
Before starting the system, operator needs to read carfully “Operation Manual”. It is only the responsible official operate the system. Unresponsible workers go in and operate the system is strictly prohibited.
II. PREPARING SYSTEM IN OPERATION:
4- Check the water leval in chemical tanks.
5- Move all contral keys to OFF or STOP position.
6- Swich on CB into ON position- The main lamp turns on
III. OPERATING MODE
The system has 2 modes of operation: Manual or Automatic and selected by button “AUTO – MENU”
IV.TECHNOLOGY DESCRIPTION:
Wastewater from the hospital’s activities was collected by the drainage system leading to manhole terminal prior to the treatment system.
Wastewater from the collector is flowed to regulating tank to be regulated, stable flow and concentration of the pollution. Wastewater in regulating tank is continuously mixed with the underwater pumping system to prevent the sedimentation and reducing smell due to anaerobic decomposition. In addition, in regulating tank has also anoxic decomposition which significantly reduce the organic pollution.
Then, wastewater will be taken through AEROTANK. Here, under the effect of the aerobic microorganism (microbiological sludge) and oxygen continuously supplied by submerged air blower, organic pollutions (COD, BOD, N {nitrat, nitrit , amonium, here are the characteristic pollutions of wastewater },, and P) will be decomposed. This process also created a large amont of mud called biological mud.
After biological process, wastewater is brought to biological clarifier which clarifies biological sediment swimming (biological sludge) generated by the above biological processing. Meanwhile, there is process of eliminating part of other pollutions remaining in the wastewater (nitrat, Amonium) through aerobic process
Clarified wastewater in biological clarifer will flow to pasteurizing tank to kill bacteries and remaining contituents that may cause disease such as Ecoli bacteria. Then, water is pumped to the absorption FILTER (pressure filter) to absorb all remaining pollutants before wastewater go to the city sewer.
Created sludge in the treatment processing is partly turned back to Aerotank, the remaining is flowed into sludge tank and will be taken periodically by sludge exhausting truck.
All tanks in the treatment system are built underground. Each tank has collector to collect the gas and let the gas (smell) to the adsorption equipment with the activated carbon before released to the surroundings.
Wastewater after treatment attains standard of level I (according to TCVN 6772 - 2000).
V.SYSTEM OPERATION
C. Treatment phase:
← Control the quantity of chemical enough for all day operation.
← Control the set of chemical pump
← Turn on the valves:
• Adjust the water flow from regulating tank to aerotank accordance with the capacity design.
• adjust the volume of sludge circulating to Aerotank or sludge tank.
← Switch on CB in electric
• The system only works when chemical tank and regulating tank is not exhausted.
1. Automatic mode:
Change control bar to AUTO position, the system will work as follows:
• Wastewater from regulating tank to Aerotank by wastewater pump 1A / B. Chemical metering pump is also working.
• Waste water from equalizing tank is pumped to Aerotank by pump 1A/B and chemical meterpump is also operated at the same time.
• Using pump to mix waste water in equalizing tank and submerged compressor in Aerotank is operating continuously to ensure the treatment process.
• Sludge pump is operated periodically by the set time.
2. Mannual mode:
Move control bar to MENU position, the system will work depending on operator’s control.
D. Stop the entire system
Stop the entire system by moving all switch , CB to “OFF” position.
VI. PERIODIC MAINTENANCE PLANNING:
1. Daily maintenance
← Checking chemical tanks to detect leakage
← Checking the amount of chemicals in chemical tank that enough for daily use, prepare additional chemicals when 1/3 remaining tank.
← Checking valves and pipes to detect leakage
← Checking electrical control cabinet
( Check equipments:
• Wastewater pump Every week, being sure to check the pipes of pump and waste in pump’s wings.
• Chemical metering pump: being sure to daily check the operation and pipeline of pump .
Being sure to weekly clean one way valve and compressing head of pump by opening and cleaning.
• Air blower being sure to check regularly in oder to detect problems and have method of overcoming
• Odor treatment system Checking regularly to detect congestion and replace adsorbent as needed
2. Monthly, Annual Maintenance
+ Lubricating pump appropriately
+ Clean the internal side of pump, air blower
(2) Risk assessment, mitigation measures and implementation duties
Table 1: Risk assessment and reducing measures of environmental treatment system
|No |Risk / Potential Problem |Reasons/Minimization Measures |Responsibility |
|1. Building stage: (since the progress of construction is finished now, consultant have not deal with impacts and migitation measures in construction |
|more) |
|2. Operating stage |
|1 |Bad odor, quantity of organic |Intense aeration to increase the oxygen content to raise the rate of |Operators |
| |substances at the drainage gate ove r|decomposition of organic substance. |Investor |
| |the standards |Develop the tree corridor around the hospital and its WWRS to reduce the| |
| | |odor to surrounding area. The width is as large as possible depending on| |
| | |the remaining land. | |
| | |Control the active sludge as directed by the contractor. | |
|2 |Polluting the drainage |Control regularly the quality of the treated waste water; |Operators |
| | |Control the opeartion process. | |
| 3. Plan to deal with the risk in WWTS operation |
|1 |Rubbish choking screning bars |- Control regularly the screning bars |Operators |
|2 |pH is not right at pH adjusting tank |Control the pH sensor; |Operators |
| | |Control the electricity circuit | |
| | |Control the chemical content | |
|3 |Troubleshooting at aeration | |Operators |
| |biological tank | | |
| |White foam on the surface |Less activated sludge, no taking out of sludge |Operators |
| |Black sludge |Less oxygen, increase the aeration |Operators |
| |Air foam at some places in tank |Air difuser is cracked nd need to replace |Operators |
|4 |Troubleshooting at sedimentation tank| |Operators |
| |Black sludge on the surface |High residence time of sludge, remove the sludge more reguarly |Operators |
| |Turbid waste water |Less sedimentation of sludge, increase the content of sludge |Operators |
|5 |Prevent to discharge the sludge not |Sludge from WWTS still has the high microbiological content and hdden |nt |
| |as regulation |risk of disease and pollution. | |
| | | | |
| | |Investor signs the contract with City Environment Company (Contract | |
| | |attached in Index) | |
(3) Environment parameter monitoring plan
3.1. Monitoring plan
Effectiveness of the WWTS is assessed via monitoring the quality of environmental parameters. The monitoring is to find in time environment problems and suggest treatment measures if there is something unusual. Monitoring plan (internal monitoring implemented by the investor of INH) is to reserve the human and budget resources for the WWTS operation
Table 2: Environmental quality monitoring
|Source |Parameters |Location |Frequency |Number of sample per |
| | | | |year |
|Waste water after |1. pH |- At the outside of |1 per quarter |4 |
|treatment |2. BOD |wastewater treatment | | |
| |3. COD |system and attain TCVN | | |
| |4. SS |6772-2000 level I | | |
| |4.Settlable solids | | | |
| |5. Total dissolved solid | | | |
| |6. Sunfur (H2S) | | | |
| |7. Nitrate (NO3) | | | |
| |8. Oils (food) | | | |
| |9. Phosphate (PO43-) | | | |
| |10. Total colifoms | | | |
|Surrounding atmosphere |Temperature |TCVN 5937 - 2005 |1 per 2 quarters |2 |
| |Humidity | | | |
| |Dust | | | |
| |CO | | | |
| |SO2 | | | |
| |NO2 | | | |
|Air quality at the |1. CO | |1 per quarter |4 |
|treatment system |2. SO2 | | | |
| |3. NO2 | | | |
| |4. Noise | | | |
1 see appendix
(4) MONITORING COST
• Wastewater: Environment monitoring of the WWTS and gas treatment system is to ensure that the quality of wastewater and waste gas after treatment attains the designed standards as approved EIA is TCVN 6772-2000 level I. The monitoring cost is estimated for 4 monitorings per year. Total yearly monitoring cost is about 6,000,000 VND. The prices are from the Circular Number 83/2002/TT-BTC dated 25th September 2002 of Ministry of Ftnance.
• Solid waste and toxic solid waste: Collecting solid waste and hazardous waste, CDT has sign an agreement no.5869 dated 28/11/2008 with HCMC Urban Environment company in accordance with collecting daily medical waste including treatment process of hazardous waste which are:
- Waste containing infectious subtances (hazardous waste Code: 13 01 01)
- Chemical waste including or containing harmful elements (hazardous waste Code: 13 01 02)
- The types of pharmaceutical waste poisioning cells (cytotoxic and cytostatic) (hazardous waste Code: 13 01 03)
- Quality Welding almagam that waste (hazardous waste Code: 13 01 04)
- The types of pharmaceutical waste may contain harmful ingredients (hazardous waste Code: 13 01 05)
And other contents, including other medical waste (lancet needle injection, ... with 100 kg of each month x 15,000 VND / kg = 1,500,000 VND/month. In case of exceeding,accounting on the number of reality.
• Radioactive waste Radioactive Waste is only in X-ray, CT Scanner and DSA computer room. Doctors and technicians directly managed this room which has no radioactive waste but only have X-beam (investor has already built copper system surrounding the room and lead glass, lead shirt to protect patients and people around. Standards of X-beam’s distance is achieved by test that reach the certificates of HCMC Nuclear Center about licensing nuclear safety certificate no.748 / HDKT TTHN-dated 15/9/2008
(5) SUGGESTION STRENTHENING OF INVESTOR
• Solid waste: Investor hire Pan Pacific company specialized in keeping clean and hygiene in the hospital to collect hospital’s waste in oder to transfer to HCMC environmental sanitation company
• Waste water Nước thải: AQC company will be responsible for operating waste treament system. AQC is the company building the waste treament system system for investor and responsible for operating reach the requirement of level I of TCVN 6772-2000.
• CT Scanner và X ray: The operation of CT Scanner X-ray equipment by doctors, technicians that have been through professional trainning. Investor should check and filed records and qualifications, professional certificates.
• High pressure cylinder Cylinders used in hospitcal are put in focus, instead of each room, then piping. Employee control the operation with specific process. Investor builds process of operation, problems can occur and how to overcome.
So requiring the strengthening of environmental management for investor in this sub-projects is not essential.
(6) Internal monitoring reports
After participating HDP and put the hospital into operation, the investor of International Hospital has to report periodically about the RMP implementation to HIFU. Based on the report, HIFU synthesizes with other subprojects to submit to WB. The reporting will be terminated after DONRE issues an operational license of the WWTP. The internal monitoring reports in Vietnamese should be done every three months during test run and every six months after approved for opeartion by DONRE and submitting all reports to HIFU. The contents of internal reports could be referred to “Environmental Safeguard Guideline of HDP.
3. RMP implementation monitoring carried out by specialists of WB and HIFU
Apart from internal monitoring is carried out by the investor, the subproject belongs to the pilot program of HIFU, therefore it will be supervised closely by WB and HIFU. Monitoring schedule of EMP/RMP implementation will be informed beforehand by HIFU to the investor. The contents of supervision are mainly the assessment of level of compliance of EMP/RMP which approved by all sides.
4. RESPONSIBILITYT TO IMPLEMENT THE RMP
As soon as all sides approve the RMP, the investor is responsible for
3) Publicizing the RMP at the office of the commune people’s committee of Tan Thoi Hoa Ward, Tan Phu .DIST and some near the hospital’s barriers
4) Implementing all contents stated in the RMP.
ANNEX
Table 1 – Pollutiom parameters and allowed limitation TCVN 6772-2000
|Parameters |Unit |Allowed limitation |
| | |Level |Level II |Level III |Level IV |Level V |
| | |I | | | | |
|1. pH | |5 - 9 |5 - 9 |5 - 9 |5 - 9 |5 - 9 |
|2. BOD |mg/l |30 |30 |40 |50 |200 |
|3. Suspended solid |mg/l |50 |50 |60 |100 |100 |
|4. Sedimented solid |mg/l |0.5 |0.5 |0.5 |0.5 |KQĐ |
|5.Total dissolved solid |mg/l |500 |500 |500 |500 |KQĐ |
|6. Sulfur (H2S) |mg/l |1.0 |1.0 |3.0 |4.0 |KQĐ |
|7. Nitrate (NO3) |mg/l |30 |30 |40 |50 |KQĐ |
|8. Oil |mg/l |20 |20 |20 |20 |100 |
|(food-grade) | | | | | | |
|9. Phosphat (PO43-) |mg/l |6 |6 |10 |10 |KQĐ |
|10. Total colifoms |PMN/ 100ml |1000 |1000 |5000 |5000 |10000 |
Table 2 : Price for sampling and analysis
|No. |CRITERION |UNIT PRICE(VND) |METHOD |
|1 |pH |30,000 |TCVN 6492:2000 |
|2 |BOD |80,000 |APHA 5210 BTCVN 6001-95 |
|3 |Total suspended solid (TSS) |50,000 |APHA 2540 DTCVN 4560:1998 |
| | | | |
|4 |Total solid (TS) |60,000 |APHA 2540 BTCVN 4560:1998 |
|5 |Total dissolved solid (TDS) |50,000 |APHA 2540 CTCVN 4560:1998 |
|6 |H2S |70,000 |APHA 4500, TCVN 5370-91 |
|7 |Nitrat |60,000 |APHA 4500-NO3-TCVN 6178-96 |
|8 |Total grease, oil |300,000 |APHA 5220 |
|9 |Total P, PO43- |60,000 |APHA 4500 –P TCVN 6202-96 |
|10 |Total Coliform |80,000 |TCVN 4882:2001 |
|Fee for sampling/person/1 time |100,000 |In HCM city |
|Transport cost |200,000 |In HCM city |
|TOTAL |1,140,000 | |
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