This study evaluates the energy, economic, environmental, and logistics feasibility (3E+1L model) of an integrated infectious medical waste-to-energy (IMWtE) system with a combined heat and power (CHP) configuration under a super waste center (SWC) framework. The assessment is based on operational data from hospitals in Chiang Mai, Thailand, with a treatment capacity of 24,000 kg/day. The waste is processed using dual T-2000 steam sterilization units in combination with a drying system utilizing recovered heat, with a net thermal capacity of 1,761 kW, producing RDF-3 at 592.09 kg/h with a low heating value of 26.29 MJ/kg. The RDF-3 is subsequently combusted in an incineration system integrated with an organic Rankine cycle (ORC), producing a gross electrical output of 274.05 kW e . The system delivers a net CHP electrical output of 156.62 kW e , with an overall efficiency of 44.35%. Economic analysis indicates a total capital investment of approximately 3.17 million USD and a levelized cost of energy (LCOE) of 0.0202 USD/kWh over a 20-year project lifetime. The system also demonstrates strong financial performance, with a payback period (PB) of 2.10 years, a net present value (NPV) of 25.17 million USD, and an internal rate of return (IRR) of 47.58%. Environmental and logistics performance, evaluated through life cycle assessment (LCA), yields a single-score impact of 5.35 × 10 -3 Pt per functional unit of 1 kWh. By integrating economic and environmental indicators, the combined energy–economic–environmental–logistics burden is quantified at 1.08 × 10 -4 (USD·Pt)/kWh. Overall, the results demonstrate that the proposed IMWtE–CHP–SWC system is a technically feasible and sustainable solution for centralized infectious medical waste management, while simultaneously supporting energy recovery and environmental protection in Thailand.
Chaiyat et al. (2026) studied this question.