10446 - Euromedic International

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Environmental Review Summary

Project Number

10446

Company Name

Euromedic Diagnostics B.V. & International Hemodialysis Centers B.V.

Date ERS Disclosed

Sep 5, 2001

Country

Eastern Europe Subregion

Region

Europe

Environmental Category

B - Limited

Status

Completed

Previous Events

Approved : Oct 9, 2001
Signed : Nov 14, 2001
Invested : Nov 28, 2001

Sector

Hospitals and Clinics

Industry

other

Department

Gbl Ind, Manufact, Agribus & Services

Project Description

The project involves the expansion of a network of diagnostic imaging centers and the establishment of hemodialysis centers, frequently but not always located in local hospitals, throughout Hungary, Poland and other Central and Eastern European countries. Euromedic provides a full range of diagnostic services including MRI, CT, Gamma camera, mammography, bone densitometry, and ultrasonography. Hemodialysis is provided as a principal treatment method for patients with end-stage renal disease. Space for most centers is leased from the associated hospital, as are certain other services (see below). Operations are managed mostly on a country-by-country basis by country-based managers and Medical Directors. Existing centers are certified to the ISO 9002 quality management system international standard, and new centers are in the process of becoming certified. Each center has (or will) established policies and procedures related to patient and employee health and safety and waste management.

Environmental and Social

The sponsor has presented plans to address these issues and to demonstrate that the proposed project will, upon implementation of the specific measures listed below, comply with applicable host country laws and regulations and World Bank/IFC requirements. The information provided about how these potential impacts are, or will be, addressed by Euromedic is summarized below:

Handling and disposal of medical, bio-hazardous, and radioactive wastes. Each center will develop and implement a comprehensive waste management plan in the form of a Safety and Waste Management and Disposal Manual for its own operations. Because the wastes generated by Euromedic centers are ultimately disposed according to the methods practiced by the hospital with which it is associated, each center’s plan necessarily addresses the handling and storage of all pathogenic, infectious, and hazardous/radioactive wastes that it generates. Where appropriate, wastes are segregated into bio-hazardous, non-hazardous/general, sharps, radioactive containers. At a new hemodialysis center in Banja Luca, Euromedic operates a “Sterimed” waste conversion system, whereby all bio-hazardous waste is processed/sterilized prior to its off-site disposal as general refuse. Waste containers are labeled or color coded. Bio-hazardous waste containers are constructed of metal and have lids. Euromedic regularly confirms that its bio-hazardous wastes are incinerated by locally-licensed medical waste disposal contractors. General solid waste is separately stored in refuse bins and subsequently collected by a licensed solid waste disposal contractor and disposed via facilities operated by the municipal authorities for this purpose. Radioactive waste is stored in segregated containers within shielded areas and allowed to decay until it has been determined through regular monitoring with radioactivity scanners that adequate decay has occurred for it to be disposed according to the above described methods. Sewage is discharged to the local municipal sewerage systems.

Hygiene and implementation of good hospital management practices. Euromedic follows internationally accepted principles and best practices of hygiene and infection control. This includes providing appropriate personal protective supplies (gowns, eyewear, decontamination supplies, utility gloves for cleaning, etc.), single-use materials and instruments, equipment (including engineering controls for radiation exposures), work practices, pathogenic and radiation exposure procedures, post-exposure follow-up, and handling and disposal of instruments and materials contaminated with blood, other body substances, and low-level radiation.

Fire prevention and life safety. Euromedic’s clinics are designed and constructed to meet both local municipal requirements and those of NFPA 101, including the installation of automatic sprinkler systems, fire extinguishers, and, in some centers, heat and smoke detection devices.

Employee health and safety. Employees at each facility will be properly trained in health and safety procedures for themselves, other employees and patients. Training courses and materials will be developed consistent with each center’s Safety and Waste Management and Disposal Manual procedures. All new employees will be trained, and refresher courses will be provided periodically. Training will include precautions and procedures for the safe use and handling of blood pathogens and radiation exposures, including objects contaminated with blood and body substances, toxic materials, and radiation. Training will also emphasize the need to utilize appropriate protective clothing (aprons, gowns, rubber gloves, masks, goggles, and gumboots, as appropriate) and work practices at all times. As regards radiation safety, it is the policy of the company to minimize exposures to its employees and to maintain comprehensive records of the radiation exposures received.

Conclusion & Monitoring

IFC will evaluate the project''s compliance with the applicable environmental and social requirements during the lifetime of the project by:
- Reviewing the annual monitoring reports (AMRs) prepared for the project covering: (i) the status of implementation of the various measures intended to mitigate identified environmental and health and safety issues; (ii) ongoing performance of project-specific environmental, health and safety activities addressed by World/IFC environmental and social policies and guidelines; and
- Conducting periodic site supervision visits.

This Environmental Review Summary (ERS) is prepared and distributed in advance of the IFC Board of Directors' consideration of the proposed transaction. Its purpose is to enhance the transparency of IFC’s activities, and this document should not be construed as presuming the outcome of the Board of Director’s decision. Any documentation that is attached to this ERS has been prepared by the project sponsor or in conjunction with the project sponsor and authorization has been given for public release. IFC has reviewed this documentation and considers that it is of adequate quality to be released to the public but does not endorse the content. The following ERS is disclosed in accordance with IFC's Disclosure of Information Policy that went into effect September 1998.

The map is for illustrative purposes and does not imply the expression of any opinion on the part of the World Bank, concerning the legal status of any country or territory or concerning the delimitation of frontiers or boundaries. Country borders or names do not necessarily reflect the World Bank Group's official position. In some cases, available project location information is limited to the country of the project's activities. Locations are approximate.

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