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Awareness and management of hospital waste in developing countries: A case study in Thailand

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Abstract

Awareness and management of hospital waste in developing countries: A case study in Thailand

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... The authors also considered the independent variables of doctors, staff, and the number of beds. In Thailand, Manowan (2009) studied healthcare waste management and the awareness levels in hospitals in the Bangkok metropolitan area. The results showed that although most had implemented a healthcare waste management system, most programmes were inadequate. ...
... Smoke containing heavy metals emitted from SMW during open burning are discharged in the environment, exposing unsuspecting persons to contaminants which could contribute to respiratory diseases. In UK and Sweden, people are encouraged to return their expired or unused medicines through pharmacies to be incinerated at high temperatures [38]. A study conducted on a retrieval system for expired or unused medicines in Ghana suggested less than 5% of the respondents were willing to return their unwanted medicines to be incinerated [39]. ...
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The study aimed to assess disposal practices and quantify the microbial load present in SMW from ten sub-district level healthcare facilities and 385 households in Yilo Krobo municipality, Ghana. Disposal of solid medical waste (SMW) was assessed by questionnaire-based surveys, unstructured interviews and field observations. Microbiological analysis identified species and counts of bacteria present in SMW from both sources. Sociodemographic factors influencing the method of SMW disposal in households were evaluated using logistic regression analysis, with statistical significance set at p<0.05. Open burning (29%), burying (25%) and disposal at a dumpsite (49%) were common methods used by households to discard SMW. SMW disposal at a dumpsite was associated with age of respondents in households. Older people (50+ years) were three times more likely to place SMW in household waste later discarded at a dumpsite, compared to younger persons (20–30 years) [a0R, 95%CI = 3.37, 1.41–8.02]. In sub-district level healthcare facilities, open burning and burying were the most common methods used. Bacillus subtilis, Klebsiella pneumonia, Pseudomonas aeruginosa, Clostridium tetani, Enterococcus faecalis, Acinetobacter spp. Escherichia coli, Bacillus cereus and Enterococcus faecium) were bacteria identified in SMW recovered from both the healthcare facilities and the households. Klebsiella pneumoniae, Acinetobacter spp. and Clostridium tetani were found exclusively in untreated SMW generated in the healthcare facilities. Bacillus spp. and Pseudomonas spp. were found in one sample of treated SMW. The microbial load in SMW from healthcare facilities and households ranged from 0.036 x 10³cfc/mg to 0.167 x 10³ cfc/mg and from 0.118 x 10³cfc/mg to 0.125 x 10³cfc/mg respectively. This highlights the need for institutionalizing appropriate treatment methods in sub-district level facilities or strengthening the linkages with higher level facilities to ensure regular and adequate treatment of SMW. Public guidance on management of SMW generated in households which is context specific should also be provided.
... In another study consistent with this research, conducted by the authors [61,62], it was determined that in most of the healthcare facilities surveyed in Turkey, top management, managers, and senior nurses did not pay any attention to hospital waste, due to their insufficient knowledge and the significance of medical waste and their lack of interest. However, in examining the extent of the relationship between organizational culture, structure, and healthcare waste management practice among Libyan public hospitals, in some recent and past studies, the focus was on type of healthcare facilities, thereby identifying health waste management practices from a one-dimensional approach, such as organizational structure [11], organizational culture [72], and organizational size [73]. This one-dimensional concept may have brought about outcomes on the definition of healthcare waste management and research instruments that do not gather all the dimensions influencing the management of healthcare waste in the context of best practices. ...
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This study aims to investigate factors contributing to healthcare waste management practices among Libyan public hospitals. The organizational culture and structure are proposed to have their effect upon hospital organizational units in charge of healthcare waste production by a theoretical review to develop two main hypotheses. Hence, this study used the stratified random sampling technique to select respondents such as top management officials, heads of departments, and administrators who work in all the hospitals located in the south of Libya, from whom data was collected. The data for the study was gathered via a survey questionnaire from Libyan public hospitals in the country’s southern region. A total of 210 questionnaires were distributed and 171 usable responses were received, yielding a 70% response rate. Though the findings of the study show some inconsistency, the two dimensions of the culture examined in this study are found to have a positive relationship and significant influence on the management practices of health waste. Besides, it shows the positive relationship between organizational structure and healthcare waste management practices (HWMP). However, the findings of this study suggested that nurses and cleaners’ practices should critically consider structure dimensions such as formalization as well as moderating variables such as hospital location and type of services supplied on the interactions to improve the management of healthcare waste in Libya’s public hospitals.
Chapter
Waste of any origin, if not properly disposed, possess a significant threat to the environment. Biomedical waste is a potential health hazard generated from institutions and laboratories providing health care facilities which includes all sorts of pathological, pharmacological, gentoxic, chemical, and radioactive wastes. About 20% of waste generated during patient care is hazardous and carries various health risks to hospital staff, patients, attendants, and the general population. Proper segregation and disposal of biomedical waste is the need of the hour as it will prevent contamination of groundwater sources that affect the health of humans and animals. Proper packaging and labelling of waste prevent the spread of infection through humans and animals. Biomedical waste is the source of water contamination and, if not rendered harmless before it is buried in land or disposed of in the water. Biomedical waste contaminates air if not segregated or incinerated properly, resulting in highly hazardous airborne particles of contagious diseases. The diagnostic laboratories using radioactive substances are potential pollutants of landfills and the atmosphere. The spread of air pollutants over huge areas of inhabited land has the potential to trigger several illnesses. Hence, there should be the management of biomedical waste at each level (i.e., places of its generation, collection, storage, transportation, treatment, and disposal). The stakeholders, including health care sector, state pollution control board, and the municipal bodies, should work together to make the place safe for living with a neat and clean environment.
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The research is a cross-sectional comparative study carried out to determine the variations and similarities in the activities of clinical waste management practices within three district hospitals located in Johor, Perak and Kelantan. Using physical observation, administered questionnaire and interview questions, sectional data within each hospital were collated and analyzed by employing Microsoft Excel and relevant statistical analysis tools like ANOVA. The results showed similarities in many areas, confirming that similar activities take place within the hospitals and variations in other areas confirming that many factors both external and internal affects of the clinical waste management and other activities within the hospitals. Studies revealed many deficiencies in the management mostly weaknesses in segregation process.
Article
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The research is a cross-sectional comparative study carried out to determine the variations and similarities in the activities of clinical waste management practices within three district hospitals located in Johor, Perak and Kelantan. Using physical observation, administered questionnaire and interview questions, sectional data within each hospital were collated and analysed by employing Microsoft Excel and relevant statistical analysis tools like ANOVA. The results showed similarities in many areas, confirming that similar activities take place within the hospitals and variations in other areas confirming that many factors both external and internal affect the clinical waste management and other activities within the hospitals. Studies revealed many deficiencies in the management mostly weaknesses in segregation process. Keywords: clinical waste management; generation; segregation; storage eISSN 2514-7528 © 2018. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
Article
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The research is a cross-sectionalcomparative study carried out to determine the variations andsimilarities in the activities of clinical waste managementpractices within three district hospitals located in Johor, Perakand Kelantan. Usingphysical observation, administered questionnaire and interviewquestions, sectional data within each hospital were collated andanalyzed by employing Microsoft Excel and relevant statisticalanalysis tools like ANOVA. The results showed similarities in many areas, confirming thatsimilar activities take place within the hospitals and variations inother areas confirming that many factors both external andinternal affect the clinical waste management and other activitieswithin the hospitals. Studies revealed many deficiencies in themanagement mostly weaknesses in segregation process.
Article
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Hospital waste is not necessarily difficult to dispose of. In most cases it can be safely dumped in a properly designed waste pit. Waste management problems at district hospitals in developing countries are usually caused more by lack of information than by financial or technical difficulties.
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It was noticed that a large volume of medical waste was being generated for incineration at our hospital. The 2 incinerators at our facility were unable to effectively deal with the load of waste and, therefore, were operating for extended periods of time. This caused a significant amount of soot and other emissions to be produced as pollutants into the surrounding environment, which is considered to be a real health hazard. A waste-management plan was introduced that included education, mandatory inservice training, auditing of the type and volume of waste generated by each department, and introduction of a written policy on waste management. Within a few months of implementation of the waste-management plan, the amount of medical waste was reduced by more than 58%, from 609 skips/mo (2000 kg/day) in the year 1999, to 256 skips/mo (850 kg/day) in the year 2000; skips are steel containers filled with infectious waste. This reduction was maintained throughout the year 2001 and lead to a 50% reduction in total financial costs (17,936 US dollars) with savings in fuel of 5262 US dollars, labor-cost savings of 8990 US dollars, and maintenance and spare parts savings of 3680 US dollars. This article discusses problems encountered in waste management in our health care facility, solutions and control measures introduced, and achievements. It also demonstrates that effective waste management can reduce health risk, save money, and protect the environment.
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Medical waste is infectious and hazardous. It poses serious threats to environmental health and requires specific treatment and management prior to its final disposal. The problem is growing with an ever-increasing number of hospitals, clinics, and diagnostic laboratories in Dhaka City, Bangladesh. However, research on this critical issue has been very limited, and there is a serious dearth of information for planning. This paper seeks to document the handling practice of waste (e.g. collection, storage, transportation and disposal) along with the types and amount of wastes generated by Health Care Establishments (HCE). A total of 60 out of the existing 68 HCE in the study areas provided us with relevant information. The methodology for this paper includes empirical field observation and field-level data collection through inventory, questionnaire survey and formal and informal interviews. A structured questionnaire was designed to collect information addressing the generation of different medical wastes according to amount and sources from different HCE. A number of in-depth interviews were arranged to enhance our understanding of previous and existing management practice of medical wastes. A number of specific questions were asked of nurses, hospital managers, doctors, and cleaners to elicit their knowledge. The collected data with the questionnaire survey were analysed, mainly with simple descriptive statistics; while the qualitative mode of analysis is mainly in narrative form. The paper shows that the surveyed HCE generate a total of 5,562 kg/day of wastes, of which about 77.4 per cent are non-hazardous and about 22.6 per cent are hazardous. The average waste generation rate for the surveyed HCE is 1.9 kg/bed/day or 0.5 kg/patient/day. The study reveals that there is no proper, systematic management of medical waste except in a few private HCE that segregate their infectious wastes. Some cleaners were found to salvage used sharps, saline bags, blood bags and test tubes for resale or reuse. The paper reveals that lack of awareness, appropriate policy and laws, and willingness are responsible for the improper management of medical waste in Dhaka City. The paper also shows that a newly designed medical waste management system currently serves a limited number of HCE. New facilities should be established for the complete management of medical waste in Dhaka City.
Article
An international meeting held at the State Department in Washington, DC on hazardous waste management is discussed. The conference was held by the Committee on the Challenges to Modern Society of the North Atlantic Treaty Organization. Among the wastes considered at the meeting were chromium wastes, lead wastes, pesticides, mercury wastes, nickel wastes, oil refinery wastes, PCBs, cadmium wastes, and others. Radioactive wastes were not considered. Legislation, landfill use, recycling, and the Common Market's approach to these wastes were also discussed. (JMT)
Article
The paper considers UK and EC Legislation regulating clinical waste disposal. The legal definition of clinical waste is distinguished from both 'health care waste' and 'infectious waste'. Waste can be pre-treated so as to enable it to be disposed of through the normal waste stream. The legislation is looked at by reference to (i) production and storage; (ii) handling and transportation; and (iii) disposal. It is vitally important to draw up a waste management strategy. Effective segregation at source is a key factor in the waste management strategy and it will enable hospital authorities to make economic savings in waste disposal costs. The Paper considers the Duty of Care under the Environmental Protection Act 1990 and stresses the obligation on each person in the waste disposal chain to discharge the Duty. Landfilling as a method of disposal is discouraged except for waste where no possibility of infection arises. There are problems with hospital incinerators meeting modern emission standards. Requirements for licensing new incinerators are examined. The new Waste Management Licensing Regulations 1994 require applications for Waste Management Licenses to demonstrate technical and financial competence as 'fit and proper persons'. The Paper concludes by examining penalties for breach of regulatory provisions.
Article
The disposal of clinical wastes is often poorly conducted and inadequately supervised despite the publication of clear and definitive working guidelines and the introduction of increasingly stringent legislative control. The move away from landfill disposal of clinical wastes, and the further development of high temperature incinerators able to meet increasingly tight emission limits, is to be applauded but has inevitably increased the cost of waste disposal. Moreover, such developments fail to address the continuing 'shop floor' problems whereby wastes enter an inappropriate waste stream or colour coded wastes containers are used for inappropriate purposes thus undermining the value of a nationally approved hazard warning policy. The development of newer waste treatments, including microwave exposure of macerated wastes, may reduce costs and aid in the control of environmental pollution. However, stringent control of this and existing technologies remains essential. Additionally, increasing resources must be directed to improvements in primary waste disposal practices whereby all health care staff have a clear responsibility to ensure correct disposal of wastes without risk to themselves, their colleagues and others, or to the environment.
Article
It is a requirement that hospitals and other areas that generate clinical waste must comply with good practice and legislation regarding its disposal. To meet the stringent European emission standards enforced in October 1995, there is a need to find an alternative to local incineration for dealing with clinical waste. The options included technologies such as gasification, steam sterilization or heat disinfection which can be used to process certain categories of clinical waste prior to landfill--all have advantages and disadvantages. Segregation of clinical and domestic wastes in healthcare settings is important to avoid accidents and litigation and to contain costs. Evidence that most clinical waste (other than perhaps waste from patients with certain infections and sharps) is a significant hazard to the public is lacking. More still needs to be done in the area of clinical waste management to assess the real risks and hazards of this waste.
Article
Laws require that infectious waste be segregated from noninfectious waste. Companies certified to dispose of infectious waste offer both reusable and single-use containers. The focus of this study was to determine if there would be a microbiologic advantage to the use of one type of container over another in a burn hospital. Monthly swab cultures were taken from the tops of >250 infectious waste containers during 2 years. Bacteria and fungi were identified. In a substudy swab cultures were taken from an area of reusable tops before and after cleaning to evaluate the efficacy of cleaning on both the number and type of microbes present. Infection rates for acute patients were compared before and after control measures were instituted to decrease microbial transfer from infectious waste containers to patients. Cultures taken from reusable boxes when received from the container company showed that >99% were contaminated with bacteria or fungi; most were normal environmental or skin flora, but some cultures showed microorganisms that can be potentially harmful to patients with compromised immunity. Wiping the lids with a phenolic disinfectant decreased both the total microbial load (P <.001) and the variety of microbes present (P <.001). In contrast, only 10% of the incoming single-use boxes showed any contamination. Infection rates dropped from 5.8 to 3.2 per 100 burn patients (P <.05) after the institution of cleaning and other changes made to decrease the possibility of microbial transfer from the infectious waste boxes to the patients. Upon delivery, significantly fewer single-use infectious waste boxes were contaminated than reusable ones (P <.001). Extra infection control measures were needed when reusable infectious waste boxes were used in areas housing patients with compromised immunity. Facilities need be aware of the possible contamination of reusable infectious waste containers with microorganisms capable of causing nosocomial infections in patients who are compromised.
Article
The health-care facility environment is rarely implicated in disease transmission, except among patients who are immunocompromised. Nonetheless, inadvertent exposures to environmental pathogens (e.g., Aspergillus spp. and Legionella spp.) or airborne pathogens (e.g., Mycobacterium tuberculosis and varicella-zoster virus) can result in adverse patient outcomes and cause illness among health-care workers. Environmental infection-control strategies and engineering controls can effectively prevent these infections. The incidence of health-care--associated infections and pseudo-outbreaks can be minimized by 1) appropriate use of cleaners and disinfectants; 2) appropriate maintenance of medical equipment (e.g., automated endoscope reprocessors or hydrotherapy equipment); 3) adherence to water-quality standards for hemodialysis, and to ventilation standards for specialized care environments (e.g., airborne infection isolation rooms, protective environments, or operating rooms); and 4) prompt management of water intrusion into the facility. Routine environmental sampling is not usually advised, except for water quality determinations in hemodialysis settings and other situations where sampling is directed by epidemiologic principles, and results can be applied directly to infection-control decisions. This report reviews previous guidelines and strategies for preventing environment-associated infections in health-care facilities and offers recommendations. These include 1) evidence-based recommendations supported by studies; 2) requirements of federal agencies (e.g., Food and Drug Administration, U.S. Environmental Protection Agency, U.S. Department of Labor, Occupational Safety and Health Administration, and U.S. Department of Justice); 3) guidelines and standards from building and equipment professional organizations (e.g., American Institute of Architects, Association for the Advancement of Medical Instrumentation, and American Society of Heating, Refrigeration, and Air-Conditioning Engineers); 4) recommendations derived from scientific theory or rationale; and 5) experienced opinions based upon infection-control and engineering practices. The report also suggests a series of performance measurements as a means to evaluate infection-control efforts.
Article
A research project sponsored by the EC-LIFE programme was conducted to compare waste management in five different European hospitals. A comparison of the regulations governing current waste management revealed different strategies for defining infectious hospital waste. The differences in the infrastructure were examined and the consequences for waste segregation and disposal were discussed under economic and ecological aspects. In this context the definition of infectious waste is very important.
Article
Hospital waste is considered dangerous because it may possess pathogenic agents and can cause undesirable effects on human health and the environment. In Iran, neither rules have been compiled nor does exact information exist regarding hospital waste management. The survey presented in this article was carried out in all 15 private hospitals of Fars province (Iran) from the total numbers of 50 governmental and private hospitals located in this province, in order to determine the amount of different kinds of waste produced and the present situation of waste management. The results indicated that the waste generation rate is 4.45 kg/bed/day, which includes 1830 kg (71.44%) of domestic waste, 712 kg (27.8%) of infectious waste, and 19.6 kg (0.76%) of sharps. Segregation of the different types of waste is not carried out perfectly. Two (13.3%) of the hospitals use containers without lids for on-site transport of wastes. Nine (60%) of the hospitals are equipped with an incinerator and six of them (40%) have operational problems with the incinerators. In all hospitals municipal workers transport waste outside the hospital premises daily or at the most on alternative days. In the hospitals under study, there aren't any training courses about hospital waste management and the hazards associated with them. The training courses that are provided are either ineffective or unsuitable. Performing extensive studies all over the country, compiling and enacting rules, establishing standards and providing effective personnel training are the main challenges for the concerned authorities and specialists in this field.
Article
The objectives of this study were: (i) to assess the waste handling and treatment system of hospital bio-medical solid waste and its mandatory compliance with Regulatory Notifications for Bio-medical Waste (Management and Handling) Rules, 1998, under the Environment (Protection Act 1986), Ministry of Environment and Forestry, Govt. of India, at the chosen KLE Society's J. N. Hospital and Medical Research Center, Belgaum, India and (ii) to quantitatively estimate the amount of non-infectious and infectious waste generated in different wards/sections. During the study, it was observed that: (i) the personnel working under the occupier (who has control over the institution to take all steps to ensure biomedical waste is handled without any adverse effects to human health and the environment) were trained to take adequate precautionary measures in handling these bio-hazardous waste materials, (ii) the process of segregation, collection, transport, storage and final disposal of infectious waste was done in compliance with the Standard Procedures, (iii) the final disposal was by incineration in accordance to EPA Rules 1998, (iv) the non-infectious waste was collected separately in different containers and treated as general waste, and (v) on an average about 520 kg of non-infectious and 101 kg of infectious waste is generated per day (about 2.31 kg per day per bed, gross weight comprising both infectious and non-infectious waste). This hospital also extends its facility to the neighboring clinics and hospitals by treating their produced waste for incineration.
Article
This study was initiated to characterize solid and liquid wastes generated in healthcare institutions and to provide a framework for the safe management of these wastes. The project was carried at three major medical institutions, namely, the Jeetoo Hospital, the Sir Seewoosagur Ramgoolam National (SSRN) Hospital and the Clinic Mauricienne. A waste audit carried out at these sites revealed that approximately 10% of solid wastes was hazardous in nature, consisting mainly of infectious, pathological and chemical wastes. The average amount of hazardous wastes per patient per day was found to be 0.072 kg at Jeetoo hospital, 0.091 kg at SSRN hospital and 0.179 kg at the clinic. The amount of hazardous wastes generated as a function of the number of occupied beds was found to follow a relationship of type y=0.0006x-0.19, where y was the amount of hazardous wastes generated per bed per day and x was the number of occupied beds. The waste quantifying process also revealed that at SSRN Hospital, 0.654 m(3) of water was being consumed per patient per day and the amount of wastewater produced was 500 m(3)/day. Further analysis revealed that the wastewater was polluting with chemical oxygen demand (COD), biological oxygen demand (BOD(5)), total suspended solids (TSS) and coliform content well above permissible limits.
Article
The management of waste materials arising from home health and medical care services (HHMC wastes) in Japan is now receiving greater attention from governmental workers dealing with general household waste materials. In general, HHMC waste materials are collected in a mixed form, transported and disposed of along with municipal solid wastes. As a result, municipal workers are suffering needle stick accidents so that infections associated with HHMC waste materials may occur. The collection and transportation by patients and their families of HHMC waste materials with sharp-edges, such as injection needles, to medical-related facilities can prevent municipal workers from experiencing needle-prick accidents. One of the most important strategies for medical-related facilities is hence the education of patients and their families. Improved rules for handling HHMC waste materials are essential for the safe and effective management.
Article
This study includes a survey of the procedures available, techniques, and methods of handling and disposing of medical waste at medium (between 100 and 200 beds) to large (over 200 beds) size healthcare facilities located in Irbid city (a major city in the northern part of Jordan). A total of 14 healthcare facilities, including four hospitals and 10 clinical laboratories, serving a total population of about 1.5 million, were surveyed during the course of this research. This study took into consideration both the quantity and quality of the generated wastes to determine generation rates and physical properties. Results of the survey showed that healthcare facilities in Irbid city have less appropriate practices when it comes to the handling, storage, and disposal of wastes generated in comparison to the developed world. There are no defined methods for handling and disposal of these wastes, starting from the personnel responsible for collection through those who transport the wastes to the disposal site. Moreover, there are no specific regulations or guidelines for segregation or classification of these wastes. This means that wastes are mixed, for example, wastes coming from the kitchen with those generated by different departments. Also, more importantly, none of the sites surveyed could provide estimated quantities of waste generated by each department, based upon the known variables within the departments. Average generation rates of total medical wastes in the hospitals were estimated to be 6.10 kg/patient/day (3.49 kg/bed/day), 5.62 kg/patient/day (3.14 kg/bed/day), and 4.02 kg/patient/day (1.88 kg/bed/day) for public, maternity, and private hospitals, respectively. For medical laboratories, rates were found to be in the range of 0.053-0.065 kg/test-day for governmental laboratories, and 0.034-0.102 kg/test-day for private laboratories. Although, based on the type of waste, domestic or general waste makes up a large proportion of the waste volume, so that if such waste is not mixed with patient derived waste, it can be easily handled. However, based on infections, it is important for healthcare staff to take precautions in handling sharps and pathological wastes, which comprises only about 26% of the total infectious wastes. Statistical analysis was conducted to develop mathematical models to aid in the prediction of waste quantities generated by the hospitals studied, or similar sites in the city that are not included in this study. In these models, the number of patients, number of beds, and hospital type were determined to be significant factors on waste generation. Such models provide decision makers with tools to better manage their medical waste, given the dynamic conditions of their healthcare facilities.
Article
Hospital waste management is an imperative environmental and public safety issue, due to the waste's infectious and hazardous character. This paper examines the existing waste strategy of a typical hospital in Greece with a bed capacity of 400-600. The segregation, collection, packaging, storage, transportation and disposal of waste were monitored and the observed problematic areas documented. The concentrations of BOD, COD and heavy metals were measured in the wastewater the hospital generated. The wastewater's toxicity was also investigated. During the study, omissions and negligence were observed at every stage of the waste management system, particularly with regard to the treatment of infectious waste. Inappropriate collection and transportation procedures for infectious waste, which jeopardized the safety of staff and patients, were recorded. However, inappropriate segregation practices were the dominant problem, which led to increased quantities of generated infectious waste and hence higher costs for their disposal. Infectious waste production was estimated using two different methods: one by weighing the incinerated waste (880 kg day(-1)) and the other by estimating the number of waste bags produced each day (650 kg day(-1)). Furthermore, measurements of the EC(50) parameter in wastewater samples revealed an increased toxicity in all samples. In addition, hazardous organic compounds were detected in wastewater samples using a gas chromatograph/mass spectrograph. Proposals recommending the application of a comprehensive hospital waste management system are presented that will ensure that any potential risks hospital wastes pose to public health and to the environment are minimized.
Article
This study investigated the medical waste management practices used by hospitals in northern Jordan. A comprehensive inspection survey was conducted for all 21 hospitals located in the study area. Field visits were conducted to provide information on the different medical waste management aspects. The results reported here focus on the level of medical waste segregation, treatment and disposal options practiced in the study area hospitals. The total number of beds in the hospitals was 2296, and the anticipated quantity of medical waste generated by these hospitals was about 1400 kg/day. The most frequently used treatment practice for solid medical waste was incineration. Of these hospitals, only 48% had incinerators, and none of these incinerators met the Ministry of Health (MoH) regulations. As for the liquid medical waste, the survey results indicated that 57% of surveyed hospitals were discharging it into the municipal sewer system, while the remaining hospitals were collecting their liquid waste in septic tanks. The results indicated that the medical waste generation rate ranges from approximately 0.5 to 2.2 kg/bed day, which is comprised of 90% of infectious waste and 10% sharps. The results also showed that segregation of various medical waste types in the hospitals has not been conducted properly. The study revealed the need for training and capacity building programs of all employees involved in the medical waste management.
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