Hospital waste incinerator ash: characteristics, treatment techniques, and applications (A review)

The amount of medical waste generated has increased enormously since the COVID-19 outbreak. An incineration process is the main method that is usually used to treat this waste, causing an increase in both medical waste bottom ash (MWBA) and medical waste fly ash (MWFA). In this work, the physical and chemical characteristics of MWFA and MWBA were reviewed. This ash contains high levels of polychlorinated dibenzo-p-dioxin (PCDD), dibenzofurans (PCDFs), and heavy metals. Furthermore, medical waste ash appears to have high leachability in the toxicity characteristics leaching procedure (TCLP) test and the European standard test (EN 12457). Owing to its toxicity, medical ash can be treated using various methods prior to disposal based on the covered review. These techniques include chemical, supercritical fluid, cement-based, melting, microwave, and mechanochemical techniques. The shortcomings of some of these treatment methods have been identified, such as the emission of high levels of chlorine from the melting technique, limited applications of the flotation method on the industrial scale, long-term stability of leachate treated by cement-based methods that have not been confirmed yet, and high energy consumption in the supercritical technique. This review also covers possible applications of medical waste ash in cement production, agriculture, and road construction.