1. The Barbados Case Study Results

2. The Current Situation 2 incinerators, one small, one large Not BAT or BEP What is necessary to implement BAT and BEP for these facilities?

3. Many Questions Legislation for hospital waste management? Legislation for incinerator control? Training for incinerator operators? Licensing of incinerators? Waste minimization and separation? Use of alternatives, e.g. autoclaves? Quantities and types of waste? Cases of precedent?

4. Recommendations To close the smaller incinerator. To carry out a waste audit. To develop legislation/policy for management of hospital waste. To implement waste separation and waste minimization. To give priority consideration to non- incineration alternatives.

5. Discussion Convention (Annex F) specifies consideration of: Technical feasibility Health Economics Access to information and public awareness Control and monitoring capacity

6. Discussion (2) Information to be gathered and questions to be answered before final decisions about BAT and BEP can be made. BAT and BEP is not just choosing an incinerator or an alternatives to incineration; it is also putting a management framework in place to support techniques and practices to prevent formation and release of UPOPs. These aspects of BAT and BEP could be more clearly reflected in the guidance.