Infectious Waste Management Research Articles

Effectiveness of Training Program Related to Infection Control and Waste Management Practices in a Private Dental College, Pune − A Quasi-Experimental Study

Introduction: Healthcare workers, in general, are susceptible to contracting with infectious diseases. Thus, appropriate infection control practices are of prime importance in academic institutions, wherein under-graduate students form a major part of the oral healthcare team right from the 3rd year of the curriculum. This fact underlines the need to provide extensive training to prevent healthcare-related infections to the patient and themselves. Aim: To assess the effectiveness of training related to infection control and waste management practices among under-graduate students in a private dental institution. Materials and Methods: The present study conducted among 3rd year under-graduate dental students in Pune, 2015 assessed their knowledge, attitude, and practices related to infection control and waste management followed by an intervention in the form of training. A quasi-experimental design (before and after comparison) was employed. Complete enumeration was performed. Results: Out of the 88 students, 46 (52.27%) had good knowledge at baseline, which improved to 72 (81.81%) after the training; 80 (90.90%) had good attitude, which improved to 88 (100%); and 67 (76.13%) had good practice, which improved to 88 (100%). At the baseline, the results showed that the mean knowledge score was 3.45 ± 1.03, the mean attitude score was 2.90 ± 0.28, and the mean practice score was 7.3 ± 0.76. After the training, the results showed that the mean knowledge score was 4.5 ± 0.25, the mean attitude score was 3, and the mean practice score was 8.1 ± 0.5. Conclusion: The training was effective in improving the over-all score of the participants related to the knowledge, attitude, and practice regarding infection control and waste management. Thus, we propose to train the students on various aspects of infection control and waste management and introduce an on-going training program in the curriculum.

Assessment and selection of the best treatment alternative for infectious waste by modified Sustainability Assessment of Technologies methodology.

BackgroundImproper treatment of infectious waste can cause numerous adverse environmental and health effects such as transmission of diseases through health personnel and other susceptible groups,who come in contact with such wastes. On the other hand, selection of appropriate treatment alternatives in infectious waste management has become a challenging task for public health authorities especially in developing countries. The objective of this paper is to select the best infectious waste treatment alternative by the modified Sustainability Assessment of Technologies (SAT) methodology, developed by the International Environmental Technology Center of the United Nations Environment Program (IETC-UNEP).MethodsSAT methodology consists of three main components, including screening, scoping and detailed assessment. In screening, different infectious waste treatment alternatives undergo screening using the finalized environmental and technical criteria. Short-listed treatment options from the previous step, then go through the comprehensive scoping and detailed assessment (2nd and 3rd components) which is more qualitative and quantitative in nature. An empirical case in Tehran, the largest city in Iran, is provided to illustrate the potential of the proposed methodology.ResultsAccording to the final score, “Hydroclave”, was the most suitable infectious treatment technology. The ranking order of the treatment alternatives were “Autoclave with a shredder”, “Autoclave”, “Central Incineration” and “chemical treatment” on the basis of technical, economical, social and environmental aspects and their related criteria.ConclusionsAccording to the results it could be concluded that the top ranking technologies basically have higher scores in all the aspects. Hence it is easier to arrive at a decision for the final technology selection based on the principles of sustainability.

Cost for infectious and dangerous waste management in hospital

Cost for infectious and dangerous waste management in hospital

The fault tree analysis of infectious medical waste management

Providing an efficient and reliable system of medical waste management is one of the key environmental issues not only for health-care institutions but for a wider range of organizations and communities. Medical waste produced in health care is a special kind of waste, which, if inadequately treated, can cause numerous possible health and safety hazards for people and the environment. In this paper the authors introduce an application for risk assessment of infectious medical waste management in the biggest health institution of South-East Europe – the Clinical Centre of Serbia. The fault tree analysis (FTA) method was used in the assessment regarding its three aspects – functional, qualitative and quantitative. The qualitative analysis provided the structural function of the system and minimal cut sets, whilst the quantitative analysis based on experts' evaluations defined the probability of both basic and top events (spreading of infection with medical waste). Finally, according to Birbaim's, RAW (Risk achievement worth), RRW (Risk reduction worth) and Fussell–Vesely's importance measures, the events have been ranked regarding their effect on the undesired event related to infectious medical waste management. In this paper, we have chosen the FTA approach because it enables the analysis of the individual risks (like the most of the risk assessment methods used in medical waste management – FMEA, HACCP, PHA, CREA) but it also provides the analysis of risk relationships and interdependences. Based on the obtained results we identified the basic failures in the medical waste management systems whose prevention or mitigation have the biggest influence on the observed system improvement. Furthermore, the research presented in this paper has clearly pointed out that the FTA method and importance measures can be used in the risk assessment of the medical waste and should be taken into consideration in appropriate medical waste management systems.

Preparing an Academic Medical Center to Manage Patients Infected With Ebola: Experiences of a University Hospital.

As Ebola has spread beyond West Africa, the challenges confronting health care systems with no experience in managing such patients are enormous. Not only is Ebola a significant threat to a population's health, it can infect the medical personnel trying to treat it. As such, it represents a major challenge to those in public health, emergency medical services (EMS), and acute care hospitals. Our academic medical center volunteered to become an Ebola Treatment Center as part of the US effort to manage the threat. We developed detailed policies and procedures for Ebola patient management at our university hospital. Both the EMS system and county public health made significant contributions during the development process. This article shares information about this process and the outcomes to inform other institutions facing similar challenges of preparing for an emerging threat with limited resources. The discussion includes information about management of (1) patients who arrive by ambulance with prior notification, (2) spontaneous walk-in patients, and (3) patients with confirmed Ebola who are interfacility transfers. Hospital management includes information about Ebola screening procedures, personal protective equipment selection and personnel training, erection of a tent outside the main facility, establishing an Ebola treatment unit inside the facility, and infectious waste and equipment management. Finally, several health policy considerations are presented.

Ebola preparedness: a rapid needs assessment of critical care in a tertiary hospital.

The current outbreak of Ebola has been declared a public health emergency of international concern. We performed a rigorous and rapid needs assessment to identify the desired results, the gaps in current practice, and the barriers and facilitators to the development of solutions in the provision of critical care to patients with suspected or confirmed Ebola. We conducted a qualitative study with an emergent design at a tertiary hospital in Ontario, Canada, recently designated as an Ebola centre, from Oct. 21 to Nov. 7, 2014. Participants included physicians, nurses, respiratory therapists, and staff from infection control, housekeeping, waste management, administration, facilities, and occupational health and safety. Data collection included document analysis, focus groups, interviews and walk-throughs of critical care areas with key stakeholders. Fifteen themes and 73desired results were identified, of which 55 had gaps. During the study period, solutions were implemented to fully address 8gaps and partially address 18gaps. Themes identified included the following: screening; response team activation; personal protective equipment; postexposure to virus; patient placement, room setup, logging and signage; intrahospital patient movement; interhospital patient movement; critical care management; Ebola-specific diagnosis and treatment; critical care staffing; visitation and contacts; waste management, environmental cleaning and management of linens; postmortem; conflict resolution; and communication. This investigation identified widespread gaps across numerous themes; as such, we have been able to develop a set of credible and measureable results. All hospitals need to be prepared for contact with a patient with Ebola, and the preparedness plan will need to vary based on local context, resources and site designation.

Healthcare Waste Management Planning of Hospitals in the Prefectures of Aetoloakarnania and the Island of Lesbos, Greece.

<div> <p>Proper Hospital healthcare Waste Management (HCWM) is imperative for ensuring public health and environmental protection. In this context, three Prefectural hospitals of Mytilene, Agrinio, and Messolonghi, were studied with respect to planning and management of infectious wastes, cost, training of the white Staff involved, security measures to be taken, and also knowledge related to the implementation of the existing National and European Community, legislation. It was found that the existing legislative procedures were broadly applied. However deviations were reported and it was recognized that serious difficulties in the implementation of the legislation throughout the process i.e. from the phase of separation throughout the processing phase did exist. These deviations frequently originated from conflicts in the directions given by the legislation Joint [Governmental Gazette B1537/8-5-2012]. In order to achieve better implementation of HCWM, recommendations are proposed here.</p> </div> <p> </p>

Particulate matter characterization in an indoor workplace environment of a landfill

<div> <p>Proper Hospital healthcare Waste Management (HCWM) is imperative for ensuring public health and environmental protection. In this context, three Prefectural hospitals of Mytilene, Agrinio, and Messolonghi, were studied with respect to planning and management of infectious wastes, cost, training of the white Staff involved, security measures to be taken, and also knowledge related to the implementation of the existing National and European Community, legislation. It was found that the existing legislative procedures were broadly applied. However deviations were reported and it was recognized that serious difficulties in the implementation of the legislation throughout the process i.e. from the phase of separation throughout the processing phase did exist. These deviations frequently originated from conflicts in the directions given by the legislation Joint [Governmental Gazette B1537/8-5-2012]. In order to achieve better implementation of HCWM, recommendations are proposed here.</p> </div> <p> </p>

Practices and challenges of infectious waste management: A qualitative descriptive study from tertiary care hospitals in Pakistan.

Background and Objective:Infectious waste management practices among health care workers in the tertiary care hospitals have been questionable. The study intended to identify issues that impede a proper infectious waste management.Methods:Besides direct observation, in-depths interviews were conducted with the hospital administrators and senior management involved in healthcare waste management during March 2014. We looked at the processes related to segregation, collection, storage and disposal of hospital waste, and identified variety of issues in all the steps.Results:Serious gaps and deficiencies were observed related to segregation, collection, storage and disposal of the hospital wastes, hence proving to be hazardous to the patients as well as the visitors. Poor safety, insufficient budget, lack of trainings, weak monitoring and supervision, and poor coordination has eventually resulted in improper waste management in the tertiary hospitals of Rawalpindi.Conclusion:Study has concluded that the poor resources and lack of healthcare worker’s training in infectious waste results in poor waste management at hospitals.

Infectious and Radioactive Waste Management in a Diagnostic and Nuclear Medicine Centre

Hospital and medical waste management practices are very unsatisfactory in developing countries especially in Pakistan. Existing techniques and practices are not in accordance with the guidelines and levels prescribed by the WHO (World Health Organization) and other international bodies concerned with environment and human health. The objective of this study was to design and implement a proper waste management plan for the PINUM (Punjab institute of Nuclear Medicine) hospital Faisalabad, Pakistan. At PINUM Hospital infectious waste is produced as a result of diagnostic and radioactive waste as a result of diagnostic and therapeutic activities in nuclear medicine. This study was carried out in a period of 10 months in two phases. In first phase a proper infectious waste management plan was designed and incorporated at hospital and in 2nd phase proper management plan for radioactive waste was designed and implemented. Results showed a 43% reduction in volume and treatment cost of infectious waste resulting from proper management. There was significant decrease in prescribed` storage time of radioactive waste which is done to bring its activity to normal level. It was evident from the results if radioactive waste properly segregated, lose radioactive waste (gloves, swabs, absorbing sheets, tissue papers etc.) can be disposed off much earlier than the compact radioactive waste (radioactive vials, needles and sharps).

Analysis of Information, Impact and Control of HIV amongst Dental Professionals of Central India.

Dental health care providers may be exposed to a variety of microorganisms via blood, oral or respiratory secretions. Though the risk of transmission of Human Immunodeficiency Virus (HIV) in dental settings is low, the consequences of being infected are life threatening. Therefore, high standards in infection control and waste management are required in controlling occupational contagion and cross infection. To obtain comprehensive information about the HIV related information, its impact on the health care provider's attitude towards treating patients living with HIV/AIDS (PLWHA), infection control & waste disposal practices among dental professionals of Malwa region of Madhya Pradesh; situated in Central India. A cross-sectional survey was conducted among 320 private dental practitioners. Data was collected using a pretested, self administered 40 item questionnaire and statistically analysed. The response rate was 81.25%. Over all 50.76% dentists were graded as having good knowledge of HIV. Unfortunately, their willingness to treat these patients remained low. In all 39.23% dentist were willing to render care to PLWHA. Junior dentists expressed less hesitation with regard to acceptance of risk patients than other dentists. Over 65% of the respondents reported adherence to universal precautions. The most alarming observation was that dentists were not following safe waste management practices. Dental professionals continue to indicate a reluctance to treat patients with HIV/AIDS or those in high- risk groups. The results suggest need to have a comprehensive motivational program and implementing ways to ensure access and availability of safe dental care for PLWHA. The desire to get training on how to handle PLWHA illustrates that receptiveness to change exists.

Physical space and its impact on waste management in the neonatal care setting.

This paper reports an investigation intended to obtain some understanding of how the working environment might influence the practice and knowledge of those involved in the management of healthcare waste. The National Health Service (NHS) has a continuing waste problem, and the way it manages waste harms the environment and consumes resources. It has been estimated that the carbon footprint of the NHS in England is approximately 20 million tons of CO2e. It has been suggested that better waste segregation could lead to more effective recycling, saving up to 42,000 tonnes of CO2. This qualitative study employed non-participant observation and semi-structured interviews. The interviews were carried out with the key informants within the participating neonatal intensive care unit. Findings from this study indicate that space and the physical arrangement of the environment are significant and influential factors in clinical practice. Where the clinical environment is not supportive, poor infection control and waste management practice is likely to occur. However, proximity of staff caused by a lack of physical space might facilitate situated learning and a collective development of knowledge in practice. The implementation of sustainable waste management practices would be more likely to succeed in an environment that facilitates correct waste segregation.

Using social network and stakeholder analysis to help evaluate infectious waste management: A step towards a holistic assessment

Assessing the strengths and weaknesses of a solid waste management scheme requires an accurate analysis and integration of several determining features. In addition to the technical aspects, any such system shows a complex interaction of actors with varying stakes, decision-making power and influence, as well as a favourable or disabling environment. When capitalizing on the knowledge and experience from a specific case, it is also crucial that experts do not “forget” or underestimate the importance of such social determinants and that they are familiar with the methods and tools to assess them. Social network analysis (SNA) and stakeholder analysis (SA) methods can be successfully applied to better understand actors’ role and actions, analyse driving forces and existing coordination among stakeholders, as well as identify bottlenecks in communication which affect daily operations or strategic planning for the future way forward. SNA and SA, appropriately adjusted for a certain system, can provide a useful integration to methods by assessing other aspects to ensure a comprehensive picture of the situation. This paper describes how to integrate SNA and SA in order to survey a solid waste management system. This paper presents the results of an analysis of On-Nuch infectious waste incinerator in Bangkok, Thailand. Stakeholders were interviewed and asked to prioritize characteristics and relationships which they consider particularly important for system development and success of the scheme. In such a way, a large quantity of information about organization, communication between stakeholders and their perception about operation, environmental and health impact, and potential alternatives for the system was collected in a systematic way. The survey results suggest that stakeholders are generally satisfied with the system operation, though communication should be improved. Moreover, stakeholders should be strategically more involved in system development planning, according to their characteristics, to prevent negative reactions.

Infectious Medical Waste Management System at the Regional Level

AbstractThe objective of this work was to do a preliminary design of a management system for infectious medical waste (IMW) at the regional level and apply it to the region of East Macedonia–Thrace (EMT) in Greece. The main management concept proposed was to collect infectious waste from all sources, transfer it at the appropriate storage room of the general hospital of the respective prefecture, and transport it from there to the central treatment facility of the region. The production of IMW was assessed through direct waste production measurements and also through literature sources. For an average IMW production of 2.4 ton/d, a total 7-day storage capacity of 190 m3 was estimated for the region. Transport to the treatment facility will take place six days a week except Sunday, using two main collection vehicles of minimum capacity of 22.1 and 18.4 m3. The optimum location for a steam sterilization treatment facility was sited near Komotini, the capital city of Thrace, and the total treatment cost w...

171 Health risk with working infectious waste transportation from hospital by private transport sector of Thailand

This study aims to identify problems and the health risk with worker who work with the infectious waste transportation (IWT) from hospital by private transport sector (PTS) in Thailand. The...

Hospital waste generation and management in some provinces of Iran

The purpose of this investigation was to determine the rate of generation of different kinds of hospital waste and its management in 11 provinces of Iran in 2012. Waste samples were separated into two categories (domestic type and infectious waste) and weighed daily for 4 weeks, distributed over four seasons to determine quantities and composition. Data on waste management were collected through a questionnaire and interviews of hospital personnel. The total generation of hospital waste ranged from 2.3 to 4.6 kg bed-day−1 for Razavi Khorasan and Sistan & Baluchistan provinces. Generation of infectious waste varied from 1.0 to 1.7 kg bed-day−1 for Sistan & Baluchistan and Markazi provinces. The lowest and highest percentages of infectious waste generation were found in Golistan (3.8%) and Fars (15.3%). It was also revealed that management of sharps, infectious, and other hazardous wastes was not properly done. A segregation program must be implemented and each fraction of hospital waste must be collected and disposed of separately.

P303: Safety of intravenous samples and risk management of infectious waste: the case of Mali

We conducted a one-day survey in a teaching hospital, two district centers, a community health center and military dispensary in Bamako in February 2012, as part of a multicenter GERES study.

Clinical laboratory waste management in Shiraz, Iran

Clinical laboratories are significant generators of infectious waste, including microbiological materials, contaminated sharps, and pathologic wastes such as blood specimens and blood products. Most waste produced in laboratories can be disposed of in the general solid waste stream. However, improper management of infectious waste, including mixing general wastes with infectious wastes and improper handling or storage, could lead to disease transmission. The aim of this study was to assess waste management processes used at clinical laboratories in Shiraz, Iran. One hundred and nine clinical laboratories participated In this cross sectional study, Data collection was by questionnaire and direct observation. Of the total amount of waste generated, 52% (by weight) was noninfectious domestic waste, 43% was non-sharps infectious waste and 5% consisted of sharps. There was no significant relationship between laboratory staff or manager education and the score for quality of waste collection and disposal at clinical laboratories. Improvements in infectious waste management processes should involve clearer, more uniformly accepted definitions of infectious waste and increased staff training.

Prioritising factors for selection of infectious waste management contractors using fuzzy analytic hierarchy process

Bio-medical or infectious waste has not received its due attention in developing countries like India. It is being collected and disposed off along with the municipal solid waste (MSW). Therefore, infectious waste management schemes should be designed carefully by taking in account the correct factors and giving them due weight age. Consequently, identifying the infectious waste factors for selecting best contractor becomes an essential and crucial process for a waste management scheme to be environmentally and socially viable. The major objective of this paper is to propose an analytic framework to provide infectious waste management experts a more effective and efficient model for prioritising factors for selection of contractors managing infectious waste.

An analytic process model for selection of infectious waste management contractors

Infectious or bio-medical waste so far has not received its due attention. Hospitals in developing countries dispose large amounts of medical waste inefficiently, creating potential environmental hazards and increasing operational expenses, along with the Municipal Solid Waste (MSW). The hospitals lack objective criteria to select the most appropriate waste disposal firm and evaluate its performance, relying on their own subjective judgment and previous experiences. This paper presents an Analytic Network Process (ANP) methodology to objectively select infectious waste disposal contractors. The suggested methodology would reduce overhead costs and enhance medical waste management.