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ENVIRONMENTAL IMPACT ASSESSMENT (EIA)
Proposed Expansion of Kamunting Incineration Plant for Edgenta Mediserve Sdn. Bhd.
CHAPTER 4
STATEMENT OF NEED
4.0
Introduction
This chapter presents the statement of need for the proposed project covering the
descriptions of its specific needs and reasons as well as the scenarios on the recent
development associated with the clinical waste issues in the country.
4.1
Current Status of Clinical Waste
The generation of clinical waste was predicted through the actual data recorded over eighteen
(18) years of wastes received by EMSB beginning from 1998 to 2015. An interpolation was
performed in order to obtain the predicted trend of future clinical waste generation before
taking into consideration of waste projected to be received from other sources mainly private
entity (i.e. Kidney Centre and Women and Child Hospital), by EMSB beginning 2016 with an
increment of 3,000,000 kg/year. The projection was based on a constant increment of 10%
waste generation growth received by EMSB beginning 2017. It is anticipated from the
prediction that the incoming waste generated from hospitals would exceed the existing EMSB
treatment capacity by 2016. Table 4.1 presents the clinical waste received by EMSB from
1998 to 2015 which showed a tremendous growth of waste received throughout the years.
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ENVIRONMENTAL IMPACT ASSESSMENT (EIA)
Proposed Expansion of Kamunting Incineration Plant for Edgenta Mediserve Sdn. Bhd.
Table 4.1: Total Yearly Clinical Waste Received by EMSB
Year
Clinical Waste Received (kg)
1998
873,060.00
1999
1,028,200.00
2000
1,251,870.00
2001
1,326,540.00
2002
1,589,750.00
2003
1,901,253.79
2004
2,055,418.59
2005
2,173,695.57
2006
2,337,523.07
2007
2,548,359.90
2008
2,629,962.92
2009
2,846,563.77
2010
3,261,015.81
2011
3,805,179.00
2012
4,210,064.60
2013
4,537,655.95
2014
4,924,690.29
2015
5,056,072.00
It is anticipated that a new source of incoming clinical waste from private companies will be
undertaken by EMSB in 2016 at a value of 3,000,000 kg/year. Taken this into consideration,
the future prediction of the clinical waste generated or received by EMSB will be based on the
following conditions:
a)
Additional 3,000,000 kg/year clinical waste will be received by EMSB beginning
2016 from private source; and
b)
10% yearly increment of clinical waste generation.
It is expected that there will be an increase in clinical waste received due to the increase in
such health establishments in the future and the increase in population who are likely to seek
medical treatment. As a result of this, the option of expanding the existing clinical waste
treatment plant is urgently required by the project proponent in order to meet high demand
of clinical wastes generated in the future. Table 4.2 presents the predicted clinical waste
received by EMSB from 2016 to 2026 taken into consideration of the new incoming waste of
3,000,000 kg/year beginning 2016.
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ENVIRONMENTAL IMPACT ASSESSMENT (EIA)
Proposed Expansion of Kamunting Incineration Plant for Edgenta Mediserve Sdn. Bhd.
Table 4.2: Predicted Yearly Clinical Waste Received by EMSB
Year
Clinical Waste Received (kg)
2016
8,056,072.00
2017
8,875,435.10
2018
9,762,978.61
2019
10,739,276.47
2020
11,831,204.12
2021
13,012,524.53
2022
14,313,776.98
2023
15,745,154.68
2024
17,319,670.15
2025
19,051,637.16
2026
20,956,800.88
Figure 4.1 shows the actual and predicted trend of clinical waste to be received by EMSB.
25000000
20000000
15000000
Increased Incoming Clinical Waste
10000000
Current Design Capacity = 7,200,000 kg/year
5000000
0
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Amount of Clinical Waste Received (kg)
Total Yearly Clinical Waste Received (Edgenta Peninsular)
Year
Figure 4.1: Trend of Clinical Waste Received by EMSB
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ENVIRONMENTAL IMPACT ASSESSMENT (EIA)
Proposed Expansion of Kamunting Incineration Plant for Edgenta Mediserve Sdn. Bhd.
4.2
Need of the Project
There is an increased of public concern about the management of health care waste including
clinical waste which is a special category of scheduled waste because it poses a potential
health and environment risks. Typically, it includes sharps, human tissues or body parts and
other infectious materials. Approximately 15-25% (by weight) of clinical waste is considered
infectious. Most countries have laws that prohibit the direct disposal of infectious waste in
landfills. For this reason, clinical wastes are classified as Scheduled Waste under the
Environmental Quality (Scheduled Wastes) Regulations, 2005. The Regulations required that
waste generators such as hospitals and other medical care establishments must comply with
the regulations, which includes the following:
“To ensure that the scheduled wastes generated are properly stored, treated on-site or
delivered to and received at prescribed premises for treatment and disposal (Regulation 7)”
Currently, there are five (5) companies namely Edgenta Mediserve Sdn. Bhd. (formerly known
as Faber Medi-Serve Sdn. Bhd.), Medivest Sdn. Bhd. (formerly known as Pantai Medivest Sdn.
Bhd.), ClinWaste (M) Sdn. Bhd. (formerly known as Radicare Sdn. Bhd.), Sedafiat Sdn. Bhd.
and One Medicare Sdn. Bhd., have recently signed new concessionaire agreement with the
Ministry of Health Malaysia (MOH) which specifies all necessary activities related to healthcare
waste treatment and disposal mainly for government institutions. Part of the agreement
stated that:
i.
The concession company shall be responsible for the incineration of the clinical wastes
collected from the contract hospitals and the disposal of ashes from such thermal
treatment plant. For this purpose the concession company shall:
“Supply, install, commission, operate and maintain dedicated clinical waste incinerators for
the disposal of clinical waste with the capacity to meet the need of the MOH for the entire
products.”
On 11th March 2015, EMSB had signed the Hospital Support Services (HSS) new Concession
Agreement for a 10-year period with the Malaysian Government. Under the new Concession
Agreement, EMSB will be providing services for all public hospitals and the related healthcare
facilities in the northern region of Peninsular Malaysia (covering the states of Perak, Pulau
Pinang, Kedah and Perlis). Also, EMSB has 40% equity partnership shares for the HSS
concession in the states of Sabah and Sarawak to be carried out by Sedafiat Sdn. Bhd. and
One Medicare Sdn. Bhd. respectively. A copy of official letter for the new concession
agreement from Unit Kerjasama Awam Swasta (UKAS) is attached in Appendix F.
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ENVIRONMENTAL IMPACT ASSESSMENT (EIA)
Proposed Expansion of Kamunting Incineration Plant for Edgenta Mediserve Sdn. Bhd.
Despite the fact that current clinical waste management practices vary from hospital to
hospital, the problematic areas are similar at all stages of management, including
segregation, collection, packaging, storage, transport, treatment and disposal. Improper
clinical related waste management can cause health risks impact, thus it is important to
manage it effectively.
Clinical waste is wastes generated at healthcare facilities, clinical research centres and
laboratories. The risks associated with clinical waste and its management has gained attention
across the world at various levels, local and international forums. However, the need for
proper clinical waste management continue to gain recognition due to the contagious disease
burdens associated with poor practices, including exposure to infectious agents (i.e. Ebola
Epidemic) and toxic substances.
There is an increasing trend in the generation of clinical waste due to the increase of a new
private health related establishments and hospitals, as the country is progressing towards a
medical-hub in this region. The list of private customers (but, not limited to) are listed in
Appendix G. In addition, there is an increase in the population who are likely to seek more
medical treatment from these establishments.
The proposed treatment plant or KIP-3 is to meet this growing demand for clinical waste
treatment primarily from private customers. Thus, in anticipation of the continuous growth in
the generation of clinical waste, EMSB takes a positive step expanding its additional treatment
capacity by constructing a new 1,600 kg/hr plant with calorific value of 25 MJ/kg at the
existing Kamunting site.
The existing total operational capacities (from KIP-1, KIP-2 and microwave disinfection
system or MDS) of EMSB are 1000 kg/hr (i.e. 250 + 500 + 250 kg/hr, respectively), and are
now in full 24-hr operation. With the increased of clinical waste generation now and in the
near future, it is deemed for EMSB to expand the capacity of incineration plant at its
Kamunting site in order to meet the increasing demand of waste disposal activity. The
maintenance cost for the KIP-1 is slightly higher compared to the KIP-2. It is recommended
that the expansion of the proposed Kamunting Incineration Plant-3 (KIP-3) is to replace the
existing Kamunting Incineration Plant-1 (KIP-1). However, KIP-1 will still be operating during
the construction of KIP-3 to prevent any waste backlog problem. The newly proposed
incineration plant is designed to cater future waste increment. Due to long standing conditions
of KIP-1, it will be decommissioned once the newly proposed plant is in full operation.
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ENVIRONMENTAL IMPACT ASSESSMENT (EIA)
Proposed Expansion of Kamunting Incineration Plant for Edgenta Mediserve Sdn. Bhd.
To date, thirty two (32) hospitals located in Perlis, Kedah, Pulau Pinang and Perak are sending
their clinical waste to EMSB Kamunting to be treated trough incineration process. The list of
contract hospital under the management of EMSB is shown in Table 4.3.
However, with the continuous increase of clinical waste generation, the concession companies
are experiencing constraints to cater promptly the country’s need for the treatment and
disposal of the generated waste, as the capacity and ability of their incineration plant remains
critically stagnant. Aptly, taking this into consideration, it is deemed for EMSB to initiate the
proposed KIP-3 which has the capability and excess capacity to treat the increasing demand
of generated clinical waste in these states.
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ENVIRONMENTAL IMPACT ASSESSMENT (EIA)
Proposed Expansion of Kamunting Incineration Plant for Edgenta Mediserve Sdn. Bhd.
Table 4.3: List of Contract Hospitals under the Management of EMSB
No.
Contract Hospital
State
1.
Hospital Tuanku Fauziah
Perlis
2.
Hospital Sultanah Bahiyah
Kedah
3.
Hospital Baling
Kedah
4.
Hospital Jitra
Kedah
5.
Hospital Kuala Nerang
Kedah
6.
Hospital Kulim
Kedah
7.
Hospital Langkawi
Kedah
8.
Hospital Sik
Kedah
9.
Hospital Sultan Abdul Halim
Kedah
10. Hospital Yan
Kedah
11. Hospital Balik Pulau
Pulau Pinang
12. Hospital Bukit Mertajam
Pulau Pinang
13. Hospital Kepala Batas
Pulau Pinang
14. Hospital Pulau Pinang
Pulau Pinang
15. Hospital Seberang Jaya
Pulau Pinang
16. Hospital Sungai Bakap
Pulau Pinang
17. Hospital Bahagia Ulu Kinta
Perak
18. Hospital Batu Gajah
Perak
19. Hospital Changkat Melintang
Perak
20. Hospital Gerik
Perak
21. Hospital Raja Permaisuri Bainun
Perak
22. Hospital Kampar
Perak
23. Hospital Kuala Kangsar
Perak
24. Makmal Kesihatan Awam Ipoh
Perak
25. Hospital Parit Buntar
Perak
26. Hospital Selama
Perak
27. Hospital Slim River
Perak
28. Hospital Seri Manjung
Perak
29. Hospital Sungai Siput
Perak
30. Hospital Taiping
Perak
31. Hospital Tapah
Perak
32. Hospital Teluk Intan
Perak
(Source: Concession Agreement of Government of Malaysia and EMSB)
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ENVIRONMENTAL IMPACT ASSESSMENT (EIA)
Proposed Expansion of Kamunting Incineration Plant for Edgenta Mediserve Sdn. Bhd.
In conclusion, with the “NO-PROJECT” options with regard to the proposed expansion of
Kamunting incineration plant at the Kamunting site would mean that the disposal of clinical
waste in the country will soon be at halt whereby very limited incineration capacity of the
existing concessionaire companies including EMSB will not be able to treat future waste
generation. A worst situation is when the disposal of clinical waste will be halted for number
of days or weeks or even months if one or two or even all of the concessionary incineration
plants undergo forced or emergency plant shutdown due to unforeseen circumstances. This
illustrates the dire need of such initiatives on the part of the project proponent and thus, the
approval of the proposed new KIP-3 in this regard, is very crucial and renders the ‘no project’
option to be irrelevant in this case.
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