ABSTRACT
In developing countries, hospital wastewater management is
an issue of major concern. The purpose of the study was to evaluate the
performance of the waste stabilization pond at the Cape Coast Teaching Hospital
in Ghana. Wastewater samples were taken from the raw sewage (anaerobic pond)
after screening. The process was repeated in both the facultative and maturation
ponds, sequentially. Fifty four samples representing 18 samples each from the
three stages of the waste stabilization treatment were analysed to evaluate the
efficiency of the ponds over a period of six months. The selected parameters
were analysed based on a well-established protocols. Descriptive and
inferential statistics were used to determine the distribution and
relationships among wastewater parameters measured in the stabilization ponds.
The results showed that the final effluent values obtained for most of the
parameters were within the acceptable limits of the Ghana Environmental
Protection Agency. However, conductivity, TSS, turbidity, nitrate, phosphorus,
magnesium and mercury levels were not compliant. The efficiency of the WSP for
turbidity was 56.78%, TSS 71.96%, BOD 64.78%, magnesium 3.55%, total coliforms
34.48%, E.coli 53.53%, Iron 50.60%, manganese 75.40%, and cadmium 47.83%. The
rest of the parameters exhibited negative values. Based on the low efficiency
removal of some of the parameters, the effluent should be treated to prevent
any possible pollution in the environment.
CHAPTER ONE
INTRODUCTION
This chapter presents an overview of the thesis in terms of
the background to the study and the statement of the research problem. The
purpose and objectives of the study followed by the hypotheses that were
formulated to guide this thesis are part of the chapter. This chapter also
presents the significance of conducting the research work as well as the scope
of the research work.
Background to the Study
Urbanization and rapid industrialization in many cities
throughout the world have occurred as a result of an increase in human
population. This situation has led to an increase in the discharge of domestic
and industrial as well as hospital effluents into receiving water bodies
(Massoud, Chami, Al-Hindi, & Alameddine, 2016). Wastewater released sometimes
contain all sorts of chemical and biological pollutants which include nitrogen,
phosphorus, heavy metals, detergents, pesticides, hydrocarbons, viruses,
bacteria and protozoa. Chemicals such as heavy metals (Cd, Cr, Cu, Pb, Hg, Zn
and Fe), metalloids (As) and biological pollutants if not treated properly may
cause deleterious effects on organisms and the environment (Mansouri &
Ebrahimpour, 2011; Akpor & Muchie, 2011; Nziku & Namkinga, 2013; Armah
& Gyeabour, 2013; Armah, Quansah, & Luginaah, 2014). Heavy metals such
as cadmium, chromium, copper, lead mercury, nickel, selenium, silver and zinc
are toxic to wastewater treatment systems (Wissenschaftszentrum, 2005). These
heavy metals are toxic to humans and other organisms, which may end up in
surface water where they may influence the aquatic ecosystem and interfere with the food
chain. Humans are particularly exposed to the drinking water, produced from
surface water (Pauwels & Verstraete, 2006).
Wastewater from hospitals may constitute environmental
potential contamination hazard due to chemical and microbiological
characteristics of the effluent (Bohdziewicz & Sroka, 2005). According to
Steven, Matt, & Rai (2008), wastewater effluents when released directly
into the environment are responsible for the degradation of natural ecosystems
and impacts may arise from an increase in nutrient loads leading to
eutrophication, decreased levels of dissolved oxygen and releases of toxic
substances, many of which can bioaccumulate and biomagnify in aquatic organisms
(Morrison, Fatoki, Persson & Ekberg, 2001).
Currently, there are several techniques used to treat
wastewater. These can be classified into two groups: conventional and
non-conventional treatment techniques. The former has high-energy requirements
whilst the latter is solely dependent on natural purification processes.
The conventional systems of wastewater treatment include
trickling filters, activated sludge systems, bio-disc rotators and aerated
lagoons. On the other hand, non-conventional systems, which are also called
eco-technologies include constructed wetlands and waste stabilization ponds,
WSPs (Nhapi & Gijzen, 2005). Out of the several technologies available, the
recommended type for developing countries is the WSPs (Awuah, 2006). Several
conventional wastewater management practices are not effective in the complete
removal of antibiotics (Brown, 2011).
WSPs are biological treatment systems in which processes and
operations are highly dependent on the environmental factors such as
temperature, wind speed and light intensity that are highly variable and any
given combination of these environmental parameters is usually unique to a
given location (Gray, 2004).
WSPs are commonly used as efficient means of wastewater
treatment relying on little technology and minimal regular maintenance. They
generally consist of a series of ponds usually between 1 and 3m deep depending
on the type of pond (Toumi, Nejmeddine, & Hamouri, 2000), namely anaerobic,
facultative and maturation pond. The use of WSP in domestic applications is
about 100 to 200 L per person per day, but the quantity for hospitals ranges
from 400 to 1200 L per day per bed (Emmanuel, Perrodin, Keck, Blanchard, &
Vermande, 2005).
Hospital wastewater normally contains several organic
substances that are resistant to biological degradation and attended by low
biodegradability ratio of biochemical oxygen demand (BOD5) to chemical oxygen
demand (COD) of 0.3, which shows a resistance toward conventional activated
sludge biological treatment process (Kajitvichyanukul & Suntronvipart,
2006; Polar, 2007).
Studies have shown that the release of wastewater from
hospitals is associated with an increase in the prevalence of antibiotic
resistance (Elmanama, Elkichaoui, & Mohsen, 2006). Exposure even to low
concentrations over long periods of time may result in selection and consequent
spread of resistance to pharmaceuticals.
The general wastewater treatment methods depend on biological
processes, principally bacteria feeding on organic material in the wastewater
and most wastewater treatment plants are designed to remove biodegradable
organic material, but not even low concentrations of synthetic pollutants (Karin,
2005). A study conducted in Thailand on hospitals where activated sludge and
oxidation ditch were used, bacteria load exceed standard levels; pathogenic
bacteria and parasites were found in two-thirds of the hospitals and heavy
metals, namely lead, chromium and cadmium were also found in hospital effluents
within an acceptable range (Danchaivijitr, Wongchanapai, Assanasen, &
Jintanothaitavorn, 2005). A study conducted in Iran on seven hospitals revealed
that activated sludge process, that is, secondary treatment was not effective
in treating hospital wastewater (Mesdaghinia, Naddafi, Nabizadeh, Saeedi, &
Zamanzadeh, 2009).
Waste stabilization ponds are the most important method of
wastewater treatment in developing countries where sufficient land is normally
available and where temperature is most favourable for their operation (Mara,
2003). If properly designed and operated, waste stabilization ponds (WSPs) can
attain a 99.9% faecal coliform reduction and are capable of attaining l00%
removal of helminths (USEPA, 2007). They are arranged in a series of anaerobic
ponds, facultative pond and finally one or more maturation ponds, where
anaerobic and facultative ponds are designed for BOD removal and maturation
ponds are designed for faecal bacterial removal (Mara, 2003).
Some studies have been carried out in Ethiopia on solid waste
management in hospitals but little or no previous data is available on
wastewater.
It is, therefore, difficult to estimate the damage that wastewater
from hospital has inflicted on human health and the environment. More so,
observations indicate that, most health facilities have not put in place an
organized management system to address Health Care Waste Management (HCWM)
properly and where such a system was present, it did not meet the minimum
requirements (Federal Ministry of Health, 2008).
Waste stabilization ponds have been used successfully and
widely to treat municipal wastewater (Mara, 2003). Although the quality of
hospital wastewater is similar to municipal wastewater, wastewater effluent
from hospitals may contain non-metabolized pharmaceutical compounds,
antibiotics, disinfectants, anaesthetics, radioactive elements, X-ray contrast
agents and other persistent and dangerous compounds (Boillot, 2008; Carballa et
al., 2004; Jolibois & Guerbet, 2005).
Statement of the Problem
Hospitals consume large volumes of water every day. The
consumption of domestic water on the average is 100L per person per day, while
that of hospitals varies from 400 to 1200L per bed per day (Dehghani &
Azam, 2008) and this generates significant amounts of wastewater loaded with
microorganisms, heavy metals, toxic chemicals, and radioactive elements. Such
waste effluents could endanger public health and welfare if they are discharged
into water bodies without treatment (Amouei et al., 2015). Wastewater could
bring about skin diseases or enteric illnesses if it is not treated well before
discharge into the environment. So far studies on the treatment of hospital wastewater
by WSPs and their ability to remove various pollutants and pathogens are
rather scanty especially in developing countries such as Ghana. Few
experimental studies have focused on the full range of biological and chemical
contaminants and their interactions in hospital wastewater. Majority of these
experimental studies, the compounds analysed in wastewater were not necessarily
the most important ones in terms of toxicity or impact on the environment and
human health. This gap in the literature is a fundamental motivation for this
thesis.
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