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Abstract

We studied medical waste management in a Palestinian hospital in the West Bank and the role of municipality in this management. In general, "good management practices" were inadequate; there was insufficient separation between hazardous and non-hazardous wastes, an absence of necessary rules and regulations for the collection of wastes from the hospital wards and the on-site transport to a temporary storage location inside and outside the hospital and inadequate waste treatment and disposal of hospital wastes along with municipal garbage. Moreover, training of personnel was lacking and protective equipment and measures for staff were not available. No special landfills for hazardous wastes were found within the municipality.
Eastern Mediterranean Health Journal, Vol. 12, Nos 3/4, 2006 359
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Évaluation de la gestion des déchets médicaux dans un hôpital palestinien
RÉSUMÉ Nous avons examiné la gestion des déchets médicaux dans un hôpital palestinien
de Cisjordanie et le rôle de la municipalité dans cette gestion. De manière générale, les « bonnes
pratiques de gestion » étaient inadéquates ; les déchets dangereux n’étaient pas suffisamment séparés
des déchets non dangereux. Il manquait les règlements nécessaires pour la collecte des déchets
des services hospitaliers et le transport in situ vers un lieu de stockage temporaire à l’intérieur ou à
l’extérieur de l’hôpital ; les procédés utilisés pour le traitement des déchets et l’élimination des déchets
hospitaliers avec les ordures municipales étaient inadéquats. De plus, la formation du personnel faisait
défaut et les équipements et mesures de protection pour le personnel n'étaient pas disponibles. Il n’y
avait pas de décharges spéciales pour les déchets dangereux dans la municipalité.
I.A. Al-Khatib and R.A. Khatib. Institute of Community and Public Health, Birzeit University, Palestine
(Correspondence to I.A.Al-Khatib: ikhatib@birzeit.edu).
Received: 17/03/05; accepted: 17/05/05
Assessment of medical waste management in a Palestinian hospital
ABSTRACT We studied medical waste management in a Palestinian hospital in the West Bank and the
role of municipality in this management. In general, “good management practices” were inadequate; there
was insufficient separation between hazardous and non-hazardous wastes, an absence of necessary
rules and regulations for the collection of wastes from the hospital wards and the on-site transport
to a temporary storage location inside and outside the hospital and inadequate waste treatment and
disposal of hospital wastes along with municipal garbage. Moreover, training of personnel was lacking
and protective equipment and measures for staff were not available. No special landfills for hazardous
wastes were found within the municipality.
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... The challenge in good medical waste management was also found in a Palestinian hospital in the West Bank where there was inadequate segregation between the risks medical waste and non-risk waste; this is attributed to lack of standard rules guiding medical waste management and thus, resulted in dumping hospital waste with the municipal waste i.e. (Co-mingling). The study further reported that medical waste management staffs were exposed to health hazards due to the absence of protective equipment and formal training of managing healthcare waste [57]. ...
Chapter
Medical care activities can produce various types of risks (hazardous) wastes. Poor management of these wastes can lead to environmental pollution and health risks to healthcare personnel, patients, and the community at large. Adequate knowledge, attitudes, and practices of managing medical waste are vital. This paper reviews the main issues in medical waste management by healthcare workers in developing countries. Results from reviewed literature showed that in developing countries, Medical waste management is inefficient. Knowledge and awareness concerning safe medical waste management are inadequate as a result of lack of or absence of training for medical waste management personnel, absence of waste management and disposal systems, lack of safety equipment and immunization in most of the health centers. This paper concludes by recommending ways by which poor medical waste management can be ameliorated in healthcare centers.
... In present study nurses and technicians practice segregation of infectious and non-infectious waste at chair side as compared to attenders as in a study conducted in a Palestinian hospital in the West Bank showed that there was insufficient separation between hazardous and non-hazardous wastes and there was an absence of necessary rules and regulations for the collection of waste materials from the hospital wards. 10 Assessment of medical waste management practice in the northern part of Jordan showed that there are no defined methods for the handling and disposal of these wastes. Moreover, there were no specific regulations or guidelines for segregation or classification of these wastes. ...
Article
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Background: India is one of the most populated and rapidly growing countries in the world and is the source of humongous amounts of waste every year, including municipal solid waste, hazardous waste, biomedical waste or e-waste. Healthcare is one of the largest sectors in India both in terms of revenue and employment. With growing healthcare, there is a requirement of management of bio-medical waste. This study is conducted to assess discernment, apropos on dispensation of hospital waste by paramedics.Methods: A cross-sectional study was conducted to assess the discernment and apropos of paramedical staff in 3 private hospitals regarding disposal of waste in Bhopal city and convenience sampling was used. A total of 204 individuals were approached for the study. The collected data analysed by using SPSS 21.0 and Descriptive analysis was done.Results: Total 204 paramedical staff participated in the study out of which 125 (61.2%) were males and 79 (38.7%) were males. It showed that there was limited level of knowledge, attitude and practices among class 3 workers i.e., attenders as compared to nurses and technicians.Conclusions: Study concluded that there is lack of knowledge about waste management which leads to improper waste disposal and pointed out that class 3 workers have less knowledge as compared to class 1 and class 2 workers. The technicians and nurses comparatively were having better knowledge and attitude, and also practiced waste management better than the attenders.
... A collection and waste disposal survey carried out in Iran in the university hospitals of the Fars province also found insufficient training of personnel, insufficient personal protective equipment and lack of knowledge regarding the proper use of such equipment [15]. A similar study [16] conducted in a Palestinian hospital showed that there was insufficient separation between hazardous and non-hazardous wastes and there was an absence of necessary rules and regulations for the collection of waste materials from the hospital wards. In our study hospital, a proper BMW management committee was established which was continuously monitoring the BMW management. ...
Article
Full-text available
Background: The evolving health care system of India, in its goal of solving health issues and minimizing possible health risks, has unavoidably created waste, which itself may be harmful for health. Inefficient and inadequate knowledge of managing health care waste may have detrimental effects on health and environment. Aim and Objectives: To asses level of Knowledge, Attitude, Practices (KAP) about Biomedical Waste (BMW) management among Health Care Workers (HCWs) with an endeavor to improve the standards and protect the health of HCWs and the environment. Methodology: A Hospital- based cross-sectional descriptive study was carried out at one of the Multispecialty Hospital in Eastern India. A total of 80 HCWs who were available at the time of study were included and the data were collected by means of 'personal interview technique' by using a pre-designed semi-structured questionnaire in Hindi (local language). The relevant data was collected, compiled and analyzed using SPSS 17.0 version. Results: Assessment of KAP with pre-decided scoring system showed, 17.5 % had excellent knowledge, 70% with good to average and 12.5% had poor knowledge with respect to BMW management. Knowledge status was not significantly associated with any of the socio-demographic characteristics. When asked about needle stick injuries, 88% felt that needle stick injury was a concern to them and 86% of them were well aware about the consequences of needle-stick injuries. Conclusion: Although the awareness level was high with various aspects of BMW management among HCWs compared to other studies, but still there exists scope for more improvement. Regular awareness capsule with proper BMW committee monitoring is the need of the hour. All measures to sensitize the HCWs against needle stick injuries including both pre and post incident measures need to be taken.
... Methods used to dispose biomedical waste like incineration produce carbon dioxide and sulfur dioxide, which are greenhouse gases and cause environmental harm and global warming. [17] Lack of knowledge, poor attitude and malpractices among health care workers have been studied in Iran, [18] Palestine, [19] Dhaka, [20] Turkey, [21] South Brazil [22] and India. [23][24][25][26][27][28] These studies primarily focus on biomedical waste management without signifying its importance to recycling. ...
Article
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With ever increasing number of dentists graduating in developing countries like India, biomedical waste management becomes an issue, especially when the country is listed among one of the most polluted countries in the world. Aims: To evaluate the relative awareness about biomedical waste management and recycling of dental materials among dental students, To determine the need for modifications in dental curriculum and to discuss various recyclable dental materials Materials and methods: The study was conducted in two phases, and involved dental interns from various recognized dental colleges in north India. 183 male and 317 female students, representing more than 40 approved and recognized dental institutes were randomly selected and were asked to fill the questionnaire divided into two sections each having fifteen questions. The data collected was analyzed in percent, followed by application of a 5 point unipolar scale for assessing the overall level of awareness about the two different categories. Results: Results show that a large percentage of the students were not aware of the process of biomedical waste management (89%) whereas about half of the subjects were moderate to slightly aware about the recycling/reusing of dental materials. Conclusions: Biomedical waste management is a serious issue globally and requires immediate academic assessment so that students are comprehensively taught about its management. Further studies also need to be conducted to review the current status in other professional medical courses.
Article
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Healthcare waste (HCW) poses a great danger to public health and the environment if it is not properly managed. This study was carried out to identify gaps in the knowledge, attitude and practice of healthcare workers on healthcare waste management. An institution based cross-sectional study design was used in this study. A total of 148 self-administered questionnaires were used in 13 health facilities including Bansang Hospital. Respondents were drawn from different cadres of health staff (nurses, public health officers, laboratory technicians and other auxiliary staff). Univariate analysis was used to summarize the data in frequency tables, percentages and proportions while bivariate analysis through the use of chi-square was used to determine statistically significant associations with the study outcome variables at 95% confidence level and p<0.05. The study revealed that 79.7% of the participants had poor knowledge (awareness) about HCW. Majority of the participants (95.3%) had good attitude towards HCW while 62.2% had good practice towards HCW. Educational level and cadre were found to be significantly associated with participants' knowledge, attitude and practice towards HCW management (P<0.05). The study therefore concludes that it is necessary for healthcare workers to be continuously trained on health and safety issues while managing hazardous healthcare waste. It also establishes the need for healthcare institutions to conduct continuing education on health and safety in the management of healthcare waste.
Article
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Background and Aim: Hospital solid wastes compose important amounts of municipal solid wastes. These materials contain pathogenic and hazardous agents that threaten the health of patients, staff and many other persons. This study was done to determine the quality of collection, transfer and disposal of hospital solid wastes in Birjand. Materials and Methods: A descriptive study carried out in all hospitals of Khorasan-e-Jonoobi province during the year 2008; the study included 2 governmental and 1 Tamin-e-ejtemaii hospitals. Data were gathered via a questionnaire and a revised observational form (check list) in six parts, which their validity and reliability have already been confirmed. Each datum was allocated a number. In terms of the marks and ranking by a Likert scale (excellent, desirable, relatively desirable, weak), data were statistically analyzed in P�0.05. Results: Vali-e-Asr hospital had 200 beds or 54.7% (the most) and 54% of work force but Imam Reza hospital had 53.7% of operating rooms. The total sum up of the scores gained through the revision forms showed that regarding collection, transfer, storage and disposal of the wastes, Vali-e- Asr was the excellent one and the 2 other ones i.e. Imam Reza and Tamin-e- ejtemaii were desirable. In terms of radio active wastes, Imam Reza and Vali-e-Asr hospitals were similarly excellent but Tamin-e-ejtemaii hospital stood in a desirable position. Conclusion: Collection, transfer and disposal of hospital solid wastes in Birjand was desirable. It is recommended to segregate the wastes at source and to burn the hazardous parts, then bury them with other wastes. It is necessary to consider an appropriate technology and management and a statutory supervision on a safe waste handling process, especially in heath centers other than hospitals. Key Words: Infectious wastes; Non infectious wastes; Hospital; Process of disposal
Article
Significant differences exist in the management of health-care waste management, globally. This is particularly so between low, middle and high-income countries. A systematic review of scientific literature on global healthcare waste management spanning the period 2000 - current was undertaken, in order to identify key policies, practices, challenges and best practice. The findings were analysed considering the Gross National Income and the Human Development Index of each country. Effective regulation and operative definitions of waste categories are key-factors requiring improvement at the national level. The economic conditions in the country are an important factor, especially regarding treatment and disposal. Areas for improvement (e.g. the need for improved governance structures, the development of regional clusters, as well as sharps waste segregation) are suggested. Copyright © 2015 Elsevier Ltd. All rights reserved.
Article
Full-text available
Aims: The study aimed to determine the following among the workforce of the Jaipur Dental College, India: their awareness regarding biomedical (BM) waste management policy and practices, their attitude towards biomedical waste management, and their awareness regarding needle-stick injury and its prevalence among different categories of health care providers. Methods: A cross-sectional study was conducted using a questionnaire with closed-ended questions. It was distributed to 144 dentists, nurses, laboratory technicians and Class IV employees (cleaners and maintenance personnel) at Jaipur Dental College. The questionnaire was used to assess their knowledge of biomedical medical waste disposal. The resulting answers were graded and the percentage of correct and incorrect answers for each question from all the participants was obtained. Results: Of the 144 questionnaires, 140 were returned and the answers graded. The results showed that there was a poor level of knowledge and awareness of biomedical waste generation hazards, legislation and management among health care personnel. It was surprising that 36% of the nurses had an extremely poor knowledge of biomedical waste generation and legislation and just 15% of the Class IV employees had an excellent awareness of biomedical waste management practice. Conclusions: It can be concluded from the present study that there are poor levels of knowledge and awareness about BM waste generation hazards, legislation and management among health care personnel in Jaipur Dental College. Regular monitoring and training are required at all levels.
Book
This college level textbook integrates areas of hazardous waste management, geology, geotechnics, and environmental engineering into a balanced text book for students majoring in environmental science and engineering. The book was selected by the Association of Engineering Geologists (AEG) as the "best publication from its member in the past five years" and was given the Claire P. Holdredge Award in 1998.
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The collection, storage and disposal of medical solid wastes is a growing environmental problem in Tanzania which needs immediate attention before it goes out of hand. While the Government of Tanzania is making efforts to expand medical services by allowing private hospitals in the country, the management of medical wastes has received little attention despite their potential environmental hazards and public health risks. This paper discusses the results of a study on management of medical wastes in small hospitals and dispensaries in Dar es Salaam city. The study revealed that medical wastes are not properly managed in most hospitals and dispensaries. The medical facilities are characterized by inadequate and inappropriate refuse storage facilities, lack of refuse collection services, improper disposal methods and inadequate and inappropriate protective gear for refuse handlers. A number of remedial measures to improve the situation including the construction of a commercial incinerator in the city are suggested.
Article
Industrial and medical wastes constitute a larger part on what is known as ‘hazardous wastes’. The production of these wastes is and will continue to be an on going phenomenon as long as human civilization persists. The health impacts of direct and indirect exposure to hazardous wastes include carcinogenic effects, reproductive system damage, respiratory effects, central nervous system effects, and many others. Today, many developed countries have legal provisions with regard to proper management of hazardous wastes. Tanzania, like many developing countries, has little emphasis on the proper handling and disposal of hazardous wastes. There is a serious inadequacy in handling industrial and medical solid wastes in the Dar es Salaam City. Improper waste deposition is increasingly becoming a potential public health risk and an environmental burden. Due to poor control of waste, industrialists and hospital owners are not well checked on how they handle and dispose of the wastes they produce with the result that many hazardous wastes reach the Vingunguti dumpsite without notice. Data on waste generation in Dar es Salaam is also inadequate, making it difficult to plan an efficient solid waste system. Promotion of public awareness, legislation and regulations enforcement and establishment of a proper sanitary landfill are considered to be principal remedial measures to ensure sound environmental maintenance. This paper summarizes the findings of the study on the practices of industrial and medical waste management in Dar es Salaam. The author aims to express the inadequacy in hazardous waste management and suggests possible measures to be applied in order to rectify the situation.
Article
The behavior of dental health personnel was examined with regard to the handling and proper disposal of wastes generated at common dental clinics, and some of the amounts of waste they produce were estimated. In January 2002, a random sample of 37 dental clinics was chosen in the cities of Ramallah and al-Bireh. The visited clinics were distributed between 31 private practices and six public/NGO dental clinics. The dentists were asked about the methods they follow in disposing and discarding of amalgam wastes. An average dentist is estimated to place two small, seven medium and nine large amalgam restorations releasing 22.6 grams of mercury each week. The majority of amalgam wastes ended up in trash or drain.
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