Abstract
Hospital waste management in Ghana faces the risk of cross-contamination from the lack of thorough sorting of the waste at the points of generation, codisposal of hazardous and nonhazardous waste types, and use of open-fire pits and substandard incinerators for burning infectious waste. This has increased the potential for the spread of infections and chemical pollutants. A cross-sectional study was conducted in five hospitals in Ghana to assess behavioral patterns on waste sorting and the effectiveness of hospital waste management in Ghana. A total of 250 questionnaires were distributed purposively to some staff of the five hospitals to assess workers' perceptions on medical waste sorting and handling. Additionally, focused group discussions and transect walks were adopted to examine the current collection, storage, treatment, and disposal methods used in the health facilities. Chi-square analyses showed significant differences in waste-sorting behavior based only on occupation (p < 0.0001, n=180) and not on gender, education, or experience in the health sector. Even though contaminated sharps were separated into brown safety boxes, color coding for other infectious waste containers was inconsistent across the health facilities. The study revealed that incineration is still the modal method of treatment in Ghanaian hospitals and therefore new approaches such as an engineering approach were required to minimize its environmental effects. It is recommended that periodic in-service training workshops be held for healthcare staff on the right source-segregation of medical waste, in order to facilitate the effective and safe handling, transport, treatment, and disposal of waste from health facilities.
Highlights
Healthcare waste is increasing in quantity and in diversity worldwide [1, 2]
Modern healthcare facilities have become large establishments, producing hazardous wastes and general waste such as stationery wastes and food wastes. e World Health Organization (WHO) defines healthcare waste to include all the wastes generated within healthcare facilities, research centers, and laboratories related to medical procedures, as well as from minor and scattered sources, including wastes produced in the course of healthcare undertaken in the home such as home dialysis, self-administration of insulin, and recuperative care [1]
During transect walks to the 5 hospitals in this study, it was observed that even though medical waste sorting at the points of generation was fairly practiced, safe management was still challenged by the lack of consistent color coding for separate waste types
Summary
Healthcare waste is increasing in quantity and in diversity worldwide [1, 2]. Modern healthcare facilities have become large establishments, producing hazardous wastes and general waste such as stationery wastes and food wastes. e World Health Organization (WHO) defines healthcare waste to include all the wastes generated within healthcare facilities, research centers, and laboratories related to medical procedures, as well as from minor and scattered sources, including wastes produced in the course of healthcare undertaken in the home such as home dialysis, self-administration of insulin, and recuperative care [1].the World Health Organization [3] estimates that around 85% of healthcare wastes are nonhazardous (comparable to domestic waste), while 10% are infectious (cultures and stocks of infectious agents, wastes from infected patients, wastes contaminated with blood and its derivatives, discarded diagnostic samples, infected animals from laboratories, and contaminated materials and equipment) and anatomic wastes (recognizable body parts and carcasses of animals) and the remaining 5% is hazardous healthcare waste (chemical, radioactive). Journal of Environmental and Public Health use of disposable equipment in medical care, as well as improved living standards and access to healthcare, have contributed to the increased generation of healthcare waste [4]. In Sub-Saharan Africa, the reuse of contaminated syringes and needles in medical care has accounted for 5% of HIV infections [8]. In 2001, more than 300 million tons of injection-related wastes were generated during a mass immunization of 6 million children against measles across 6 West African countries [9]. Such waste generation levels could create a particular health hazard to health workers and the public. A study by Blenkharn and Odd [13] has shown that sharp waste items such as hypodermic needles have sometimes found their way inside containers meant for soft clinical wastes and this has caused injuries in hospital environments
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