Self-Sustaining Smouldering Combustion as a Novel Disposal Destruction Method for Waste Water Biosolids

Managing biosolids, the major by-product from wastewater treatment plants (WWTPs), persists as a major global challenge that often constitutes the majority of WWTP operating costs. Self-sustained smouldering is a new approach for organic waste treatment, in which the waste (i.e., the fuel) is destroyed in an energy efficient manner after mixing it with sand. Smouldering has never been applied to biosolids. Column experiments, using biosolids obtained from a WWTP, were employed to identify if - and under what conditions - smouldering could be used for treating biosolids. The parameter space in which smouldering was self-sustaining was mapped as a function of key system metrics: (1) sand/biosolids mass fraction, (2) biosolids moisture content, and (3) forced air flux. It was found that a self-sustaining reaction is achievable using biosolids with water content as high as 80% (with a biosolids lower heating value greater than 1.6 MJ/kg). Moreover, results suggest that operator-controlled air flux can assist in keeping the reaction self-sustaining in response to fluctuations in biosolids properties. An economic analysis suggests that smouldering could be a cost-effective management approach for WWTP biosolids in a number of scenarios by providing on site destruction with minimal energy input and limited preliminary dewatering

ENV-601: A NEW METHOD FOR CONVERTING SEWAGE TO ENERGY USING SELF-SUSTAINING SMOULDERING

A major challenge in designing resilient infrastructure is to meet the needs of sustainable development (Kennedy & Corfee-Morlot, 2013). Sustainable development requires a high degree of energy efficiency. Municipal wastewater treatment plants (WWTPs), in particular, have the potential to be much more sustainable. In the U.S., 3 – 4% of the total energy consumed is dedicated to WWTPs and drinking water services, accounting for 30 – 40% of energy consumed by municipalities (U.S. EPA, 2014). In Canada, 25% of the $123 billion municipal deficit in 2006 was tied to water supply systems (i.e., drinking water, wastewater, and storm water) (Mirza, 2006). This problem becomes further complicated as much of North America’s WWTP infrastructure approaches the end of its design life. An estimated$298 billion and $39 billion is required in the U.S. and Canada, respectively, to satisfactorily refurbish WWTP infrastructure (ASCE, 2013; Félio et al., 2012). Within WWTPs, around 50% of the operating and capital costs are dedicated to managing the solid by-product, biosolids, making it the most expensive system component (Khiari et al., 2004). In Canada, 90% of biosolids are either incinerated or land applied for agricultural purposes (Apedaile, 2001). These methods are expensive, requiring high energy inputs in various forms (e.g., fuel, labour, transportation) (Wang et al., 2008). Land application is also subject to limitations and uncertain risks due to the potential for introducing synthetic contaminants into the environment (Hale et al., 2001; U.S. EPA, 1995). In general, managing biosolids persists as a major energy intensive challenge within WWTPs and there is a strong need to provide novel solutions (Tyagi & Lo, 2013). Self-sustaining smouldering combustion of organic wastes was originally developed as a chemical waste management and soil-clean up technology (Pironi et al., 2011; Scholes et al., 2015; Switzer et al., 2009). Smouldering is a flameless form of combustion for solid and liquid fuels, where a common example is glowing red charcoal in a traditional barbeque (Ohlemiller, 1985). The fuel (e.g. oil sludge) is mixed with sand to form a fixed-bed; this increases the surface area for reaction, provides porosity for the oxidant (air), and efficiently transfers, stores, and recycles the released reaction energy (Switzer et al., 2009). The smouldering reaction typically reaches temperatures between 500-800°C for many minutes in one location resulting in upwards of 99% conversion of organic waste to heat (Pironi et al., 2011). Smouldering in this configuration is unique as it supports an extremely energy efficient, self-sustaining reaction; therefore, following ignition, no external energy is required to sustain the reaction indefinitely. As a result, the process can smoulder fuels containing little energy or significant water contents that would otherwise not burn (e.g., via incineration) (Switzer et al., 2009; Yermán et al., 2015). Proof-of-concept experiments demonstrated for the first time that biosolids, obtained from Greenway Pollution Control Centre (London, ON) could be successfully destroyed via self-sustained smouldering. Thirty experiments in 40 cm tall, 15 cm diameter fixed-bed columns mapped the parameter space of self-sustained smouldering as a function of sand dilution, biosolids water content, and injected air flow rate. The results demonstrate that a self-sustaining reaction was achieved using biosolids with water contents as high as 80% (1.6 MJ/kg, effective calorific value). With little input of energy, the biosolids were converted to heat, steam, and emissions dominated by carbon dioxide. These ENV-601-2 results suggest that smouldering presents strong potential as a cost and energy effective waste management alternative for WWTP biosolids, achieving on-site destruction with minimal energy input and limited preliminary processing (Rashwan et al., 2016). This underscores the beneficial application of smouldering as a novel waste management technique that may be useful in designing resilient infrastructure

Elucidating the characteristic energy balance evolution in applied smouldering systems

Applied smouldering systems are emerging to solve a range of environmental challenges, such as remediation, sludge treatment, off-grid sanitation, and resource recovery. In many cases, these systems use smouldering to drive an efficient waste-to-energy process. While engineers and researchers are making strides in developing these systems, the characteristic energy balance trends have not yet been well-defined. This study addresses this topic and presents a detailed framework to uncover the characteristic energy balance evolution in applied smouldering systems. This work provides new experimental results; a new, validated analytical description of the cooling zone temperature profile at steady-state conditions; insight into the characteristic temperature changes over time; a re-analysis of published data; and a robust framework to contextualize the global energy balance results from applied smouldering systems. Altogether, this study is aimed to support researchers and engineers to better understand smouldering system performance to further the development of environmentally beneficial applications

Exploring the governing transport mechanisms of corrosive agents in a Canadian deep geological repository

All nuclear energy producing nations face a common challenge associated with the long-term solution for their used nuclear fuel. After decades of research, many nuclear safety agencies worldwide agree that deep geological repositories (DGRs) are appropriate long-term solutions to protect the biosphere. The Canadian DGR is planned in either stable crystalline or sedimentary host rock (depending on the final site location) to house the used nuclear fuel in copper-coated used fuel containers (UFCs) surrounded by highly compacted bentonite. The copper-coating and bentonite provide robust protection against many corrosion processes anticipated in the DGR. However, it is possible that bisulfide (HS−) produced near the host rock-bentonite interface may transport through the bentonite and corrode the UFCs during the DGR design life (i.e., one million years); although container performance assessments typically account for this process, while maintaining container integrity. Because the DGR design life far exceeds those of practical experimentation, there is a need for robust numerical models to forecast HS− transport. In this paper we present the development of a coupled 3D thermal-hydraulic-chemical model to explore the impact of key coupled physics on HS− transport in the proposed Canadian DGR. These simulations reveal that, although saturation delayed and heating accelerated HS− transport over the first 100s and 10,000s of years, respectively, these times of influence were small compared to the long DGR design life. Consequently, the influence from heating only increased total projected HS− corrosion by − corrosion. Therefore, those parameters need to be carefully resolved to reliably forecast the extent of HS− corrosion

Applied smouldering for co-waste management: Benefits and trade-offs

Smouldering combustion is emerging as a valuable application for many environmentally beneficial purposes, including waste-to-energy. While many applied smouldering systems rely on small fractions of fuel mixed within inert porous media (IPM) like coarse grain silica sand, there is also an opportunity to pursue co-waste management with much higher fuel loadings. This study explores these co-waste systems by blending non-smoulderable wastes (e.g., sewage sludge) with smoulderable wastes (e.g., construction waste woodchips) to form porous solid fuels (PSFs). Key differences between these IPM and PSF systems were identified by contrasting the temperature profiles in space and time, specific mass loss rates, and emissions profiles across experiments in multiple reactors (with 0.054, 0.080, and 0.300 m radii). For example, the PSF systems exhibited higher throughputs, a more straightforward path towards continuous operation, improved scalability, and higher production of potentially useful by-products (e.g., CH4, H2) than the IPM systems. However, the PSF systems were more sensitive to extinction and exhibited lower fuel moisture content limitations than the IPM systems. Altogether, this study illuminates the benefits and trade-offs of co-waste smouldering

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)