ArticlePublisher preview available

Medical waste management at three hospitals in Jenin district, Palestine

Environmental Monitoring and Assessment

December 2019
192(1)

DOI:10.1007/s10661-019-7992-0

Authors:

Akram Khatib

Weill Cornell Medical College in Qatar

Fathi M. Anayah

Palestine Technical University - Kadoorie

Medical wastes are considered hazardous because they may possess infectious agents and can cause unsafe effects on the environment and human health. This study is to analyze and evaluate the current status of medical waste management at Jenin’s district in light of medical waste control regulations recommended by the World Health Organization. The results demonstrated that the average hazardous healthcare waste generation rate ranges from 0.54 to 1.82 kg/bed/day with a weighted average of 0.78 kg/bed/day. There was no established waste segregation of healthcare waste types in all hospitals, and these wastes were finally disposed of in a centralized municipal sanitary landfill, namely Zahrat Al-Finjan. The results suggest that there is a need for activation and enforcement of medical waste laws. This can be achieved through cooperation among key actors: Ministry of Health, Environmental Quality Authority, Ministry of Local Government, and Non-Governmental Organizations working in related fields. Additional remediation measures proposed to tackle the problematic areas of medical waste management in Jenin’s district hospitals are addressed. Some recommendations to minimize potential health and environmental risks of medical waste are also introduced.

Overall responses of hospital cleaning personnel to survey questions regarding waste containers and sacks

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Overall responses of hospital cleaning personnel to the survey questions regarding sharp boxes

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Percentage distribution of medical (hazardous) and general healthcare wastes in all surveyed hospitals (% mass)

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The average composition of a general healthcare wastes and b hazardous healthcare wastes in all surveyed hospitals (% mass)

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The average generation rates of a general healthcare wastes and b hazardous healthcare wastes in all surveyed hospitals

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Medical waste management at three hospitals in Jenin

district, Palestine

Issam A. Al-Khatib &Abdul-Salam Khalaf &Majed I. Al-Sari &Fathi Anayah

Received: 31 March 2019 /Accepted: 22 November 2019

#Springer Nature Switzerland AG 2019

Abstract Medical wastes are considered hazardous be-

cause they may possess infectious agents and can cause

unsafe effects on the environment and human health.

This study is to analyze and evaluate the current status

of medical waste management at Jenin’sdistrictinlight

of medical waste control regulations recommended by

the World Health Organization. The results demonstrat-

ed that the average hazardous healthcare waste genera-

tion rate ranges from 0.54 to 1.82 kg/bed/day with a

weighted average of 0.78 kg/bed/day. There was no

established waste segregation of healthcare waste types

in all hospitals, and these wastes were finally disposed

of in a centralized municipal sanitary landfill, namely

Zahrat Al-Finjan. The results suggest that there is a need

for activation and enforcement of medical waste laws.

This can be achieved through cooperation among key

actors: Ministry of Health, Environmental Quality Au-

thority, Ministry of Local Government, and Non-

Governmental Organizations working in related fields.

Additional remediation measures proposed to tackle the

problematic areas of medical waste management in

Jenin’s district hospitals are addressed. Some recom-

mendations to minimize potential health and environ-

mental risks of medical waste are also introduced.

Keywords Healthcare waste .Hazardous waste .Wast e

management .Characterization .Medical waste .Jenin

district

Introduction

Medical waste (MW) management is of great impor-

tance due to the infectious and hazardous nature of MW

that can cause undesirable effects on humans and the

environment (Komilis et al. 2012). MWs are generated

in healthcare facilities and include sharps, human tis-

sues, body parts, and other infectious materials (Çalıs

and Arkan 2014; Makajic-Nikolic et al. 2016; Korkut

2018; Su and Chen 2018). MWs pose serious threats not

only to patients and health workers, but also to public

health and the environment.

Additionally, MWs are of significant concern be-

cause they contain toxic pollutants such as mercury,

chlorinated plastics and solvents, and a number of toxic

https://doi.org/10.1007/s10661-019-7992-0

I. A. Al-Khatib (*)

Institute of Environmental and Water Studies, Birzeit University,

P.O. Box 14, Birzeit, Palestine

e-mail: ikhatib@birzeit.edu

e-mail: ikhatib2012@yahoo.com

A.<S. Khalaf

Radiography Department, Faculty of Allied Medical Sciences,

Arab American University, P.O. Box 240, Jenin, Palestine

M. I. Al-Sari

Universal Institute of Applied and Health Research, Nablus,

Palestine

M. I. Al-Sari

The Joint Service Council for Solid Waste Management for

Hebron and Bethlehem Governorates, Hebron, Palestine

F. An ay ah

College of Engineering and Technology, Palestine Technical

University–Kadoorie, P.O. Box 7, Tulkarm, Palestine

Environ Monit Assess (2020) 192: 10

/ Published online: 5 December 2019

Content courtesy of Springer Nature, terms of use apply. Rights reserved.

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Article

Feb 2017

A study on the generation rate and the composition of solid medical wastes (MW) produced by private medical microbiology laboratories (PMML) was conducted in Greece. The novelty of the work is that no such information exists in the literature for this type of laboratories worldwide. Seven laboratories were selected with capacities that ranged from 8 to 88 examinees per day. The study lasted 6 months and daily recording of MW weights was done over 30 days during that period. The rates were correlated to the number of examinees, examinations and personnel. Results indicated that on average 35% of the total MW was hazardous (infectious) medical wastes (IFMW). The IFMW generation rates ranged from 11.5 to 32.5 g examinee⁻¹ d⁻¹ while an average value from all 7 labs was 19.6 ± 9.6 g examinee⁻¹ d⁻¹ or 2.27 ± 1.11 g examination⁻¹ d⁻¹. The average urban type medical waste generation rate was 44.2 ± 32.5 g examinee⁻¹ d⁻¹. Using basic regression modeling, it was shown that the number of examinees and examinations can be predictors of the IFMW generation, but not of the urban type MW generation. The number of examinations was a better predictor of the MW amounts than the number of examinees. Statistical comparison of the means of the 7 PMML was done with standard ANOVA techniques after checking the normality of the data and after doing the appropriate transformations. Based on the results of this work, it is approximated that 580 tonnes of infectious MW are generated annually by the PMML in Greece.

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