Clinical Waste Management Research Articles

Hospital solid waste management strategies to prevent healthcare-associated infections from occupational exposure to bloodborne pathogens and improve occupational safety

Improving occupational safety and public health is crucial to reducing nosocomial infections in healthcare workers due to the ongoing deficiencies in solid waste management in private clinics. For this reason, it is necessary to implement appropriate solid waste management practices to mitigate risks for clinical staff, patients, and the environment. This research focused on reducing the risk of nosocomial infections in healthcare workers exposed to bloodborne pathogens. It was carried out at the private clinic and concentrated on properly managing hospital solid waste, with special attention to occupational health and safety. 400 health workers were trained online during six sessions, addressing biosafety, conditioning, segregation, storage, collection, and transportation of solid waste. The amount of waste produced in kilograms daily was 232.76 bio-contaminated, 11.23 special, and 218.58 joint. Bio-contaminated waste included patient care, bags with human blood and blood products, surgical and anatomicalpathological waste, sharps and biological objects, pharmaceuticals, and hazardous and radioactive chemicals. Proper solid waste management, supported by adequate training, contributed to a significant decrease in the incidence of nosocomial infections: two cases were reported in August and one in September, and there was no incidence of cases from October to December. The estimation of the method used for solid waste disposal showed an acceptable degree in the stages of conditioning, segregation, primary storage, internal transport within the clinic, and central storage. In addition, the occupational health and safety of the personnel at the private clinic was improved.

Consensus-Based Guidelines for Best Practices in the Selection and Use of Examination Gloves in Healthcare Settings.

Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) present significant challenges in modern healthcare, leading to increased morbidity, mortality, and healthcare costs. Examination gloves play a critical role in infection prevention by serving as a barrier to reduce the risk of cross-contamination between healthcare workers and patients. This manuscript aims to provide consensus-based guidelines for the optimal selection, use, and disposal of examination gloves in healthcare settings, addressing both infection prevention and environmental sustainability. The guidelines were developed using a multi-stage Delphi process involving healthcare experts from various disciplines. Recommendations were structured to ensure compliance with international regulations and sustainability frameworks aligned with the One Health approach and Sustainable Development Goals (SDGs). Key recommendations emphasize selecting gloves based on clinical needs and compliance with EN 455 standards. Sterile gloves are recommended for surgical and invasive procedures, while non-sterile gloves are suitable for routine care involving contact with blood and other body fluids or contaminated surfaces. Proper practices include performing hand hygiene before and after glove use, avoiding glove reuse, and training healthcare providers on donning and removal techniques to minimize cross-contamination. Disposal protocols should follow local clinical waste management regulations, promoting sustainability through recyclable or biodegradable materials whenever feasible. These consensus-based guidelines aim to enhance infection control, improve the safety of patients and healthcare workers, and minimize environmental impact. By adhering to these evidence-based practices, grounded in European regulations, healthcare settings can establish safe and sustainable glove management systems that serve as a model for global practices.

Decision-making tree to support sustainable waste management in optometric clinical practice and healthcare training programmes

ABSTRACT Clinical relevance Waste management strategies are well documented for employee safety, legal compliance and infection control measures; however, appropriate waste disposal is equally important to minimise adverse environmental impacts. Knowledge on best practices related to the disposal of healthcare-generated waste is crucial for environmental sustainability. Background Global healthcare contributes significantly to greenhouse gas emissions, thereby extending the pervasiveness of climate change. Urgent action is required by the healthcare sector to minimise these impacts. Proper waste management is an alleviation measure that can be easily implemented in healthcare practice. The aim of this study was to calculate the approximate mass of plastic waste generated through lens wear and develop an easy-to-use decision-making tree to support optometrists with sustainable waste management. Methods Data were analysed, from an online survey directed to ophthalmic lens wearers, to determine the mass of annual plastic waste associated with lens wear. Information collated from published studies and clinical experience of the researchers, supplemented by a literature search from online databases, EBSCOhost, Google Scholar, ScienceDirect and PubMed, were used to develop the waste decision-making tree. Results Approximately 48 kg of plastic waste was generated from annual lens wear, of which approximately 83% of recyclable materials were landfilled. The waste management decision-making tree was created to guide optometrists regarding sustainable waste management practices. Conclusion Although this study focused on Optometry, its findings and recommendations have applicability across the healthcare field. Environmental stewardship is a joint responsibility of all healthcare professionals. This study highlighted the importance of incorporating and promoting sustainable clinical measures as well as the embedding and regular updating of clinical evidence on waste management best practices into healthcare training programmes. In doing so, the broader healthcare sector can contribute significantly towards reducing healthcare waste and associated emissions and improving health outcomes, thereby safeguarding the planet and its inhabitants.

An Investigation Into Contaminated Waste Composition in a University Dental Clinic: Opportunities for Sustainability in Dentistry.

Many international dental organizations have been advocating for sustainable practices in dentistry, whereby significant reductions in environmental impacts are needed. The aim of this study was to analyze dental clinical waste in a university clinic setting to explore opportunities for sustainable practices. Fifty dental units (chairs) that are routinely used in delivery of dental treatment and involved supervising clinicians, dental students, and patients were randomly selected, and the clinical waste generated was collected, segregated, and weighed. Statistical analysis was performed to analyze differences in waste production based on treatment performed. The mean waste production generated by each chair was 81.4 g of aprons, 56.2 g of gloves, 17.2 g of masks, 24.0 g of sterile wrappings, 48.8 g of other plastics, 100.8 g of cellulose-based items, and 25.8 g of miscellaneous items. Higher waste was generated from the chairs performing endodontic procedures when compared with examinations. A potential annual greenhouse gas saving of approximately 10 kg CO2e per year (when one patient is treated daily) can be achieved if sterile wrapping plastics were to be recycled. Simple yet achievable opportunities for efficient clinical waste management at university clinics exist, which in turn will increase environmental sustainability in the post-COVID-19 era. Increased awareness and incentives for sustainable measures could potentially enhance the possibility of wider adoption of ecofriendly approaches.

Synthetic and natural antibacterial carbon adsorbents for clinical nuclear waste management

Patients undergoing high-dose radioiodine ablation (RAI) therapy in Nuclear Medicine Department need to be isolated in a special designed ward for a few days. Large amount of clinical radioactive wastewater from patient body is produced during high-activity RAI therapy. The radioactive wastewater needs to store in a delay tank until the radioactivity decayed below acceptable limit before being discharged and indirectly limit the patient admission and treatment. This study is to propose an alternative antibacterial adsorbent for I-131 extraction from clinical radioactive wastewater at the nuclear medicine department using graphene oxide silver (GOAg) and bamboo activated carbon (BAC). The synthesised adsorbents and their sediments (filtered sample) were analysed using field emission scanning electron microscopy (FESEM) for morphological analysis and analysed using X-ray photoelectron spectroscopy (XPS), Fourier transform infrared (FTIR) and X-ray diffraction (XRD). XPS spectra for C 1s adsorbents show intensity peaks at 284.45 eV (C=C) and 285.3 eV (C–C) for GOAg and its sediments, and 284.35 eV (C–C), 287.00 eV (C=O), and 290.07 eV (π–π∗ transitions) for BAC and its sediments. FTIR spectra reveal various functional groups of adsorbents: C=C (1637.50772 cm−1), C=O (1340.48041 cm−1), and C–O–C (1031.88060 cm−1) for GOAg and its sediments, and C=C (1635.57897 cm−1), C–C (1257.54421 cm−1), and C–O (1188.10925 cm−1) for BAC and its sediments. XRD patterns exhibit peaks at 2θ = 27.82°, 29.39°, 32.24°, and 46.22°, which can be attributed to the (002) diffraction plane, (220) crystallographic plane, (111) plane of Ag2O, and (200) crystallographic plane, respectively, for GOAg and its sediments. Meanwhile, the peaks at 2θ = 26.56° and 42.41°, which correspond to (002) and (100) planes, respectively, for BAC and its sediments. The d-spacing and the crystallinity index of each adsorbent were also determined. The estimation of the remaining β− particles during the adsorption of I-131 was carried out using PHITS. The finding of this study is beneficial for alternative radionuclide extractions technique from clinical radioactive wastewater in nuclear medicine.

Generation and Management of Clinical Waste in Healthcare Facilities in the Yilo and Manya Krobo Municipalities in Ghana

This study sought to examine reasons for why the health care facilities in the Yilo and Manya Krobo Municipalities in the Eastern Region of Ghana are unable to properly manage clinical waste they generate. The instruments employed to gather the data were questionnaires and interviews. As a result, all the 150 respondents who were involved in this study were made to respond to the questionnaire based on the research questions while 20 of them responded to an interview schedule. The respondents comprised of facility administrators, head of department/unit each from the Pharmacies, Laboratory, and Mortuary, Clinical waste workers, and Laundry and X-ray. Respondents for the study were made to respond to a designed questionnaire. The found less documentation and records keeping on the quantity, type and composition of clinical waste seen as the common reasons why the selected health care facilities could not properly manage the clinical waste generated.

Current Methods and Challenges of Managing Clinical Solid Waste at Juba Teaching Hospital, South Sudan

The amount of clinical solid waste generated at Juba Teaching Hospital has been increasing as a result of the increasing population of Juba city. Despite the increase in the amounts of clinical solid waste, few scientific studies were conducted and the studies focused only on municipal solid waste management and have not explored clinical solid waste management in Juba City. A survey study aimed to explore the current methods and challenges of clinical solid waste management (CSWM) at Juba Teaching Hospital was conducted. The data was obtained through questionnaires, observation and oral interview. Word-excel-2013 and Statistical Package for Social Sciences (SPSS) IBM – 2021 version were used to process the data. The results revealed inappropriate methods of clinical solid waste management practices such as irregular collection, mixing different types of solid wastes together, use of water bottles instead of safety boxes for segregation of sharps, manual transportation of solid wastes, unprotected storage site, irregular incineration, open burning and random dumping. Reasons such as insufficient equipment, negligence of hospital administrators and few numbers of waste collectors was attributed to the inappropriate management of clinical solid waste in the hospital. The study recommended adoption of recycling strategies, employment of more waste handlers, commensurate remuneration and motivation, provision of enough equipment, creation of staff awareness and capacity development on health implications of poor clinical solid waste management.

Process Mapping: The Path Taken by Health Service Waste in a Hospital

Purpose: This research aimed to map the waste management process of the health services of the medical clinic of a university hospital in the south of the country. Theoretical framework: The theoretical basis involves the approach of process mapping, as well as the management and management of health services waste. Method: This is a qualitative research carried out in the medical clinic of a university hospital in the south of the country. Data collection took place through non-participant observation and the data obtained were compiled in a Microsoft® Word file (2021) and used to build the process map of health services waste from the medical clinic, developed through a flowchart. Results and conclusions: It was evident that the medical clinic of the investigated hospital has the recommended documentation, as well as human and material resources. However, inconsistencies were identified in the process, which emphasizes the need for educational actions, replacement of damaged equipment, identification of dumpsters, transport cars and shelters, adequacy of the temporary shelter environment, and restriction of the external shelter to access only for those involved in waste management. Research implications: It was possible to understand the management of clinical medical waste and identify inconsistencies that impact on the effectiveness of its management, highlighting the relevance of mapping processes, especially in the context of health waste. Originality/value: The research contributes by inciting interest in research and practical reflection on the way waste is organized and treated, especially in the context of health.

Overview of Mapping and Environmental Pollution from UKL-UPL Clinic Document Based on Potential Pollution in Jombang District

Background: Clinical activities are activities that can produce various wastes in the form of liquid, solid and gas. Clinics will not only produce ordinary waste, but also infectious waste and other medical waste that can cause health problems which are a source of disease transmission. Management of clinical B3 waste is very important, because if B3 waste is not properly managed, various impacts can arise, namely: environmental pollution, causing injury, and nosocomial diseases. Objectives: This internship activity aims to analyze the mapping and environmental pollution description from the clinical UKL-UPL environmental document based on the potential for pollution in the Jombang DLH. Methods: The implementation methods used include online discussion, online assessment, participation, and literature study. The instrument used in data collection in the implementation of the internship is the draft UKL- UPL environmental document for the Jombang DLH Environmental Impact Study. Results: Data for UKL-UPL clinics registered by DLH Jombang is 12% or 80 clinical institutions. The mapping of the coordinates of the clinics in Jombang Regency illustrates the even distribution of clinical institutions and it can be seen that the majority of clinics in Jombang Regency are concentrated in Jombang District, which consists of clinics that produce 2 types of waste and clinics that produce 3 types of waste. From the map it can be seen that the sub-districts that have the least number of clinics are Wonosalam, Bareng, and Ngusikan sub-districts. Conclusions: The majority of clinics in Jombang Regency are concentrated in Jombang District, which consists of clinics that produce 2 types of waste and clinics that produce 3 types of waste.

Knowledge, Attitude and Practices of Dental Surgeons about Dental Waste Management in Dental Clinics of Karachi

OBJECTIVE: This study aims to assess the contemporary situation of dental waste management in private dental practices in Karachi. METHODOLOGY: A cross-sectional study was done in 5 districts of Karachi (East, West, South, Centre, Malir) from 26th January to 26th April 2021. Total 100 private dental practitioners were recruited using non-probability consecutive sampling. A pretested, 20 items questionnaire was used for recording data of the research participants, and their knowledge, attitude and practices (KAP) of managing dental waste. Inclusion criteria was both male and female dentists, above 25 years of age, who run dental clinics in 5 districts of Karachi. Dental students were excluded. Data were analysed using SPSS version 17. 00 RESULTS: Total 79% of the participants were males and 21% were females. Approximately 68% belonged to the age group of 25-35 years. Total 51% had an experience of 10-20 years and32% were using colour coded bins while 35% were following segregation methods for waste disposal. Only 16% had attended professional training programs for waste management. CONCLUSION: Waste management in dental clinics in Karachi is inadequate and improper. The government should enact monitoring of all dental practices, enforcing the recommended regulations. KEYWORDS: Dental waste management, Knowledge, attitude and practices (KAP), private dental practitioners

Assessment of Medical Waste Management Practices: A Case Study in Gopalganj Sadar, Bangladesh

At this time, waste may be a new concern that's generated and the management of waste is very important. The study was attended in one public hospital, seventeen private clinics and diagnostic centers, and two non-governmental organizations at Gopalganj Sadar in Bangladesh from October to December 2019 where no rigorous estimation of medical waste generation is supported by the scientific way. This study reviews the current situation of medical waste management and practices in several clinics and hospitals. Medical solid waste could be a special style of waste that carries a high potential for infection and injury. The main purpose of the study is to understand the current management system of treated waste and therefore the treatment solid waste disposal system. A convenience sampling technique, field visits, and interviews with health personnel and staff were followed to gather data. The information was gathered through questionnaires target various aspects like waste segregation and collection, storage and transport, awareness in addition. No waste management and resource segregation system was found, the absence of relevant healthcare practical training in dealing with this waste properly. The municipalities aggregate the waste and get rid of it finally.

REVIEWING CLINICAL WASTE MANAGEMENT UNDER THE LEGISLATIVE FRAMEWORK IN PAKISTAN: PRACTICES AND CHALLENGES

The waste generated at healthcare facilities has two distinct categories: hazardous and non-hazardous waste. 10- 15% of the total waste generated at hospitals is hazardous which is termed as clinical waste. This review article has reported and reviewed the practices of clinical waste management in Pakistan’s major cities. Researches demonstrated that about 1.35 Kg / bed waste has been produced by the tertiary health care facilities in Pakistan. Studies for review process are selected through an iterative process. More than 100 research articles, National legislations, international protocols and newspaper reports are consulted and reviewed to extract the data of interest. Clinical waste management in Pakistan is the responsibility of the individual health care facility producing it under Hospital Waste Management Rules, 2005. Due to lack of proper checks and weak implementation of legislations many gaps have been identified in this review article like lack of segregation, inappropriate vehicles for transportation, poor storage and no advanced pollution control treatment strategies. Most of the hospitals lack documented waste management plan. Staff was mostly untrained and under educated. International standards for safe hazardous waste disposal are not being followed resulting in spread of diseases like hepatitis and AIDS. Cases of poor recycling and reuse of used clinical instruments is also documented. However, the condition is much satisfactory in big cities. There is an understanding to focus on the proper implementation of clinical waste management rules with strict checks. Establishment of incineration facility at major hospitals with proper maintenance, safe transportation to secure landfills and utilization of proper SOPs are suggested improvements towards safe management of clinical waste.

An Interventional Study to Improve the Healthcare Waste Management Among Nursing Officers in Type-A Base Hospital in Southern Province - Sri Lanka

Clinical waste management is a burning issue worldwide. Environmental pollution and associated health risks, including disease transmission and social problems are the main consequences of this issue. The most governments are paying more attention to develop effective and efficient healthcare waste management in the curative health sector. This intervention project was conducted among the nursing staff at the Type A Basic Hospital in the Southern Province of Sri Lanka to improve the healthcare waste management among Nursing Officers attached to the hospital. An initial assessment was conducted to determine the waste generation and segregation practices of the hospital. Staff knowledge and waste management practices were assessed, as well as available segregation facilities, and interventions were designed and implemented. A post-intervention analysis was conducted to evaluate the effectiveness of the intervention. The main problems identified were lack of equipment, poor knowledge on health care waste management, and lack of proper guidelines developed by hospital management for proper health care waste management. A new guideline with waste segregation colour coding and practice was developed to improve knowledge of waste segregation, temporary storage, transport, and final disposal. Several training sessions were held for nurses. The improvement in knowledge and practice after the intervention was statistically significant (P = 0.001). The package of strategies such as improvement of knowledge, system change, transferring ownership of the project, provision of basic equipment, supervision and experience sharing has been successful in meeting project goals, and continuing professional training and supervision is recommended to ensuring sustainability.

Original

Management of medical waste or Clinical Solid Waste (CSW) is a major challenge for developing world and poor countries. In a developing country like Bangladesh, poor and inappropriate handling of medical waste continuously increases health risks, as well as environmental risks thus treatment and management of Health-Care Waste (HCW), are important here. This study reviews the current situation of medical waste management (MWM) and practices in Khulna City Corporation, Bangladesh, and examines possible solutions for further study. Both qualitative and quantitative data were used in this study. The study was conducted in 30 HCEs (Health Care Establishments) within Khulna City Corporation. The Result of the study unveiled an unsatisfactory management system in the surveyed HCEs. The entire city corporation's waste management is looked after through a public-private partnership between City Corporation and Prodipan (NGOs). Everyday 3509kg wastes are generated from HCEs within the City Corporation. Only 28% of the waste handling process related personnel claimed that they got training, none of these HCEs has their waste transportation (off-site transportation) facilities and for waste management, they entirely depend on City Corporation and Prodipan. For waste management, absence necessary plan and monitoring team makes it more difficult, only 33% of the surveyed HCEs showed their satisfaction for their manpower in this sector. Only 3.3% Health-Care Establishments (HCEs) have claimed that they have their distinguished treatment facilities for specific non-hazardous wastes. Insufficient collection and storage facilities, inadequate transportation and disposal facilities. The funding also demonstrates that segregation practices were not satisfactory in public and small HCEs. Arrangement of training and awareness program, appropriate plan, skilled staffs, proper storage facilities, regular monitoring are recommended to achieve an efficient medical waste management system.

Improvement of Clinical Waste Management in Selected Medical Officer of Health Areas under Regional Director of Health Services Galle

Improvement of Clinical Waste Management in Selected Medical Officer of Health Areas under Regional Director of Health Services Galle

The Design of Medical Waste Treatment in Public Health Center (MWT-P) for Reducing Total Bacteria Count in Banjarbaru

Introduction: The increase in medical waste in health service facilities in Indonesia is linearly consistent. The quantity of medical waste that causes a complex problem is a high cost of processing clinical waste. Legislation requires medical or clinical waste to be processed not to cause nosocomial and other environmental pollution. Medical or clinical waste treatment requires excessive technology and very high processing expenses. Processing medical waste requires innovation in processing medical waste to be applied easily in health care facilities (Public Health Center). Method: This research was conducted by simulating variations in the stages of processing medical waste used to be the Experiment Pre and Post Test only without Control Group design. Simulation variations used include contact time Chlorine (5 minutes, 10 minutes) and Chlorine Dose Variation (25 ppm, 50 ppm). This research was conducted in the Public Health Center of the City of Banjarbaru in 2018. Result and Discussion: The content of bacteriological numbers in medical waste before processing is, on average, 1,973 MPN / 100 ml; after being treated with MWT-P, the bacteria is reduced to 4 MPN/100 ml. The content of the liquid waste bacterial number of the final processing decreases to 0 MPN/100 ml. Conclusion: The study results concluded that the use of MWT-P decreases the quantity of medic or clinical waste microorganisms or bacteria. The final waste processing with MWT-P resulted in the number of medical waste bacteria in the treatment reaching zero. MWT-P is a low cost and easy to perform medical or clinical waste management tool. MWT-P is a stage of the B3 waste management framework, especially medical waste, in health care facilities.

Clinical waste management under COVID-19 scenario in Malaysia.

Malaysia recorded 8904 coronavirus disease (COVID-19) cases and 124 deaths as of 27 July 2020. Globally, everyday there are thousands of new cases of COVID-19 being recorded. Due to the high number of infections globally and nationwide the increase in the amount of clinical waste (CW) generation was expected. Malaysia has reported a 27% (by weight) increase in the generation of CW which was mostly attributed to COVID-19 related waste. This article presents the impacts of COVID-19 in waste generation, policy and regulation of CW management (CWM) in Malaysia and a case study on the CWM at a selected hospital used as a COVID-19 focal point. The current practice of CWM due to COVID-19 related cases follows the existing policy and legislation of CWM detailed in the Schedule Waste Regulation (2005), Environmental Quality Act, 1974, and with the standard operating procedure provided by the Ministry of Health, Malaysia. The case study conducted through survey and questionnaire interviews revealed that the CWM in government hospitals followed existing guidelines for CWM for COVID-19 waste, with some additional precautions and rules by the waste management contractors.

An analysis of clinical waste management system in a tertiary care hospital

An analysis of clinical waste management system in a tertiary care hospital

Comparing undergraduate student nurses' understanding of sustainability in two countries: A mixed method study

AimTo explore sustainability education in nursing students in two countries. DesignMixed methods including a sustainability survey and focus groups. MethodsFirst-year undergraduate nursing students from two countries were invited to participate. 69 students from China and 32 students from England agreed to take part. Data were collected between December 2015 and February 2016. Students completed the Sustainability Attitudes in Nursing Survey (SANS_2) and a purposive sample were invited to participate in focus groups in each country. ResultsAll students had a positive attitude towards sustainability. However, for these four items, the results indicated that Chinese nursing students rate them significantly higher in importance than English students:Climate change is an important issue for nursingIssues about climate change should be included in the nursing curriculumSustainability is an important issue for nursingSustainability should be included in the nursing curriculum.The qualitative data identified four themes:Student nurses' conceptual understanding of sustainability focused mostly on environmental aspects and clinical waste management;Promoting sustainability within nursing education: teaching and learning methods.Promoting sustainability within nursing education: evaluating and certifying learning.Factors to consider when introducing sustainability to nursing education.The paper outlines the similarities and differences between Chinese and English nursing students' perceptions. ConclusionSustainability in nurse education has similar concerns across countries. ImpactSustainability is an important issue for student nurses but strategies promoting incorporation of sustainability issues within nursing curricula are needed.

Medical waste management in dental clinics in Tripoli/Libya

Background: Dental clinics are important and essential for the health and safety of individuals in the community and they are indispensable for the provision of medical and therapeutic services for the diagnosis of oral diseases, gum and teeth. As important as the other health centers, good and appropriate management of medical waste in dental clinics is very important to ensure safety for staff in the clinic. Objectives: Evaluating the level of medical waste management in dental clinics in Tripoli/ Libya. Methods: A cross-sectional study was conducted on 201 respondents: dentists, nurses, and assistants dentist chosen from 67 clinics out of 135 clinics. A questionnaire was used to two sections. The data were analyzed by using the IBM Statistical Package for Social Sciences (IBM SPSS) software, version 19.0 (SPSS Inc.). Results: 39.8% of respondents who were separating contaminated blood from non-contaminated waste and 82.1% of respondent's disposal liquid waste such as blood and saliva through the sewage network. However, there was no statistically significant difference in medical waste management between male and female dental staff in Tripoli, Libya (t = 0.376, P = 0.170). Conclusions: The methods of medical waste management practiced in the most dental clinics were inappropriate. The study demonstrated that there was lack of knowledge among workers in dental clinics regarding the disposal procedures and dealing with waste. Therefore, it is necessary to re-assess safety protocols by authorities and intervene quickly by introducing spread awareness of health and safety in dental clinics and in forcing regulations.