title: Clinical waste incinerators in Cameroon--a case study.
abstract: OBJECTIVE
  Incinerators are widely used to treat clinical waste in Cameroon's Northwest Region. These incinerators cause public apprehension owing to purported risks to operators, communities and the environment. This article aims to summarize findings from an April 2008 case study.
  
  
  METHODS
  Three incinerators were randomly selected and investigated for site, design and operating standards. Empirical field observation was adopted and data collected through inventory and informal interviews. Bottom ash samples collected from the incinerators were prepared according to standard procedures and analyzed for heavy metals using Inductively Coupled Plasma (ICP) Emission Spectroscopy.
  
  
  RESULTS
  Shortcomings associated with site selection, design and operation standards were identified. Chemical analysis revealed that Cr, Cu, Fe, Mn, Ni, Pb, Zn, Mg and Ca were present in the bottom ash with mean concentration ranging from 10 mg/kg for Pb to 178080 mg/kg for Ca.
  
  
  CONCLUSIONS
  For logistic reasons, feedstock quantity and quality into the incinerators were not investigated. Neither were soil samples around and away from the incinerators.
  
  
  CONCLUSIONS
  Although highly favored, clinical waste incineration methods in this region have to be reconsidered. A thorough health and environmental impact assessment is suggested before subsequent decisions on choice and disposal site is made. This will curb potential negative impacts to the environment and public health.
  
  
  CONCLUSIONS
  This article adds a different perspective and sheds additional information to the debate on unsatisfactory clinical waste incinerators in resources-poor countries. Alternative methods to incineration are presented that will be helpful to practitioners.
authors.affiliation: Institute for Public Health, University of Southern Denmark, Esbjerg, Denmark. pkuwoh@health.sdu.dk
authors.forename: Peter Ikome Kuwoh
authors.initials: PI
authors.lastname: Mochungong
authors.forename: Gabriel
authors.initials: G
authors.lastname: Gulis
authors.forename: Morten
authors.initials: M
authors.lastname: Sodemann
mesh_terms: D002163:Cameroon; D003362:Cost-Benefit Analysis; D004785:Environmental Pollutants / Q000009:adverse effects / Q000032:analysis*; D004787:Environmental Pollution / Q000009:adverse effects / Q000517:prevention & control*; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D006801:Humans; D017745:Incineration / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D017744:Medical Waste Disposal / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D019216:Metals, Heavy / Q000032:analysis
chemical_list: D004785:Environmental Pollutants; D017744:Medical Waste Disposal; D019216:Metals, Heavy