Compositional variation and hazards of wood ash in Ireland

The lack of physico-chemical as well as ecotoxicological data on wood energy ash in Ireland hampers its development as a secondary raw material. This study compiled the first compositional account of the energy wastes and leachates as they accrue from ten untreated wood-fired power plants in Ireland. Bottom and fly ash as well as their leachates, were distinguished for five boilers that allowed for separate sampling. Composition of separate wood bottom and fly ash over time was investigated in a case study on a combined heat and power (CHP) model power plant. Samples of these ashes were examined for their quality as plant nutrient sources and their toxicological properties in an aquatic test battery. The MICROTOX test, Pseudokirchneriella subspicata growth inhibition test, Daphnia magna immobilization assay, Lemna minor growth inhibition and Oncorhynchus mykiss acute and prolonged survival tests comprised the ecotoxicological test battery. Further to this, the two ash types from the case study site were sieve fractionated and tested with MICROTOX and L. minor. Leachates were more variable in composition than their parent solid ashes. A large part of the variability and chemical hazards observed in the wood energy waste stemmed from the fly ash portion therein. Segregation of bottom and fly ash allows for higher compositional consistency and thus better predictability of the materials’ properties. The case study site ashes were variable over time, but some compositional consistency is given. Ecotoxicological assessment revealed fly ash from the case study site to be more toxic than bottom ash. Single cell organisms within the test battery were most likely to be adversely affected. Measurable effects of ash on aquatic species were affected by the test regime (native leachates were more toxic than pH neutralized counterparts). Given the observed variability, a case-by-case evaluation of ashes from distinct boilers (over-time) is recommended

Wood ash residue causes a mixture of growth promotion and toxicity in Lemna minor

The use of wood as a sustainable biofuel results in the generation of residual wood ash. The ash contains high amounts of plant macronutrients such as phosphorus, potassium, calcium as well as several micronutrients. To explore the potential use of wood ash as a fertiliser, the growth enhancing properties of Sitka spruce (Picea sitchensis Bong.) wood ash were contrasted with the potential toxic action, using common duckweed (Lemna minor L.) as a model test species. The growth of L. minor exposed to wood bottom and fly ash solids and corresponding leachates was assessed in ultra-oligotrophic and eutrophic media. Ash solids and leachates were also tested as neutralized preparations. Suspended ash solids promoted L. minor growth up to concentrations of 2.5–5 g/L. Leachates promoted growth up to 10 g ash equivalents per litre, but for bottom ash only. Beneficial effects of wood ash were most pronounced on ultra-oligotrophic medium. However, on such nutrient-deficient medium severe inhibition of L. minor biomass and frond growth was observed at relatively low concentrations of fly ash (EC50 = 14 g/L). On standard, eutrophic medium, higher concentrations of fly ash (EC50 = 21 g/L), or neutralized fly ash (EC50 = 37 g/L) were required to impede growth. Bottom ash, or neutralized bottom ash retarded growth at concentrations of 51 g/L and 74 g/L (EC50), respectively, in eutrophic medium. It appears that phytotoxicity is due to the elemental composition of the ash, its alkaline character, and possible interactions between these two properties. Growth promotion was due to the substantial content of plant nutrients. This study underlines the importance of the receiving environment (nutrient status and pH) in determining the balance between toxicity and growth promotion, and shows that the margin between growth promoting and toxicity inducing concentrations can be enlarged through ash neutralization

Enhanced infection prophylaxis reduces mortality in severely immunosuppressed HIV-infected adults and older children initiating antiretroviral therapy in Kenya, Malawi, Uganda and Zimbabwe: the REALITY trial

Meeting abstract FRAB0101LB from 21st International AIDS Conference 18–22 July 2016, Durban, South Africa. Introduction: Mortality from infections is high in the first 6 months of antiretroviral therapy (ART) among HIV‐infected adults and children with advanced disease in sub‐Saharan Africa. Whether an enhanced package of infection prophylaxis at ART initiation would reduce mortality is unknown. Methods: The REALITY 2×2×2 factorial open‐label trial (ISRCTN43622374) randomized ART‐naïve HIV‐infected adults and children >5 years with CD4 <100 cells/mm3. This randomization compared initiating ART with enhanced prophylaxis (continuous cotrimoxazole plus 12 weeks isoniazid/pyridoxine (anti‐tuberculosis) and fluconazole (anti‐cryptococcal/candida), 5 days azithromycin (anti‐bacterial/protozoal) and single‐dose albendazole (anti‐helminth)), versus standard‐of‐care cotrimoxazole. Isoniazid/pyridoxine/cotrimoxazole was formulated as a scored fixed‐dose combination. Two other randomizations investigated 12‐week adjunctive raltegravir or supplementary food. The primary endpoint was 24‐week mortality. Results: 1805 eligible adults (n = 1733; 96.0%) and children/adolescents (n = 72; 4.0%) (median 36 years; 53.2% male) were randomized to enhanced (n = 906) or standard prophylaxis (n = 899) and followed for 48 weeks (3.8% loss‐to‐follow‐up). Median baseline CD4 was 36 cells/mm3 (IQR: 16–62) but 47.3% were WHO Stage 1/2. 80 (8.9%) enhanced versus 108(12.2%) standard prophylaxis died before 24 weeks (adjusted hazard ratio (aHR) = 0.73 (95% CI: 0.54–0.97) p = 0.03; Figure 1) and 98(11.0%) versus 127(14.4%) respectively died before 48 weeks (aHR = 0.75 (0.58–0.98) p = 0.04), with no evidence of interaction with the two other randomizations (p > 0.8). Enhanced prophylaxis significantly reduced incidence of tuberculosis (p = 0.02), cryptococcal disease (p = 0.01), oral/oesophageal candidiasis (p = 0.02), deaths of unknown cause (p = 0.02) and (marginally) hospitalisations (p = 0.06) but not presumed severe bacterial infections (p = 0.38). Serious and grade 4 adverse events were marginally less common with enhanced prophylaxis (p = 0.06). CD4 increases and VL suppression were similar between groups (p > 0.2). Conclusions: Enhanced infection prophylaxis at ART initiation reduces early mortality by 25% among HIV‐infected adults and children with advanced disease. The pill burden did not adversely affect VL suppression. Policy makers should consider adopting and implementing this low‐cost broad infection prevention package which could save 3.3 lives for every 100 individuals treated