Medical Waste Management Practices Research Articles

Review on medical waste management in China and Nigeria.

Medical waste management is an essential component of healthcare delivery globally due to the toxic and contagious potentials on human health and the environment. There are resource limitations in developing nations when it comes to the appropriate handling of medical wastes. In this article, we examined previous studies to evaluate the practices of medical waste management in China and Nigeria. Contextually, this work addresses medical waste practices in the context of waste generation, segregation, collection, storage, transportation, treatment and disposal. In addition to reviewing additional important aspects of medical waste management, the current study addresses potentials and challenges for efficient medical waste management in both countries. For this study; Scopus, Web of Science, Google Scholar, PubMed, Agencies, Conferences, National and International Conventions were searched from 1998 up to 2023 for all studies reporting medical waste management in China and Nigeria. To further guarantee that only resource materials with similar research interests in medical waste management were selected, a double screening process was employed. The challenges of medical waste management in both countries are limited financing, inadequate training, ineffective legislation, ineffective medical waste transport system and insufficient treatment technology. Furthermore, this study offers practical recommendations by identifying the particular areas that require attention and development, such as training of healthcare workers, adequate financing of medical waste management projects, including research and development on efficient toxic emission reducing technologies, and partnership with other relevant authorities and stakeholders to ensure enforcement of national and local legislation.

Medical Waste Management: A Case of Tier-II Cities

Medical waste management is a critical aspect of healthcare operations, ensuring the safe handling, treatment, and disposal of waste generated from medical activities. This report provides a comprehensive overview of Medical waste management practices, regulations, and challenges. It highlights the importance of adhering to regulatory frameworks, such as the Medical Waste Management Rules, to mitigate health risks and environmental impacts associated with improper waste management. Keywords : Medical waste management, Regulations, Healthcare facilities, Hazardous waste, Waste handling, Waste disposal

Health Workers’ Attitude Mediates the Relation of Knowledge and Interest in Medical Waste Management Practice

Health Workers’ Attitude Mediates the Relation of Knowledge and Interest in Medical Waste Management Practice

Medical waste generation rate and management practices among government hospitals in Eastern Ethiopia. A descriptive survey.

Healthcare facilities generate medical waste, also known as healthcare waste or health facility waste, during the healthcare delivery process, which is improperly managed as a result of underfunded healthcare systems, poor training, and lack of awareness of policies and legislation on handling medical waste as well as do not have national guidelines in place to adhere to the correct disposal of such wastage in developing countries like Ethiopia. To estimate the healthcare waste generation rate among selected public hospitals in eastern Ethiopia. A cross-sectional study design was conducted in eight public in eastern Ethiopia from 1st June 2023 to 30th July 2023. The "Bed-Patient-healthcare wastes" model was used to estimate the healthcare waste generation rate based on WHO and empirical evidence. HCW generation rate = No of (Inpatients (Inpts) + Outpatients (Outpts))/day*0.53 kg/day. Meanwhile, general (GW), infectious (IW), pharmaceutical (PW), sharps (SW), and pathological (PtW) are computed as follows: GW = No. of (Inpt + Oupt)/day*0.53 kg/day and IW, PW, SW, and PtW = No. of Inpts/day*0.53 kg/day. In contrast, for hazardous and non-hazardous healthcare wastes, No of HCWs/day*0.8 and no. of HCWs/day*0.2 were utilized, and Key informant interviews and field observational were also applied. Descriptive analysis such as percentage, mean, and standard deviation were presented. According to the current assessment, 105.1-142.8 kg/day healthcare waste was generated from outpatient and 167.3-244.2 kg/day from inpatients of public hospitals. From these, the Mean ± SD of daily healthcare waste generation rate estimated by non-hazardous and hazardous waste were 164.6 ± 80.9 kg/patients/day and 41.2 ± 20.2 kg/patients/day, respectively. In daily generation, the mean and standard deviations (Mean ± SD) of general wastes, infections waste, pharmaceutical wastes, sharp wastes, and pathological waste/patient were 62% (521.9), 23% (194.8), 4% (35.4), 2% (17.7), and 9% (70.9), respectively. The current assessment concluded that a large volume of healthcare waste is generated from selected public hospitals, which were not effectively segregated, separated at the source, and haven't conventional or standard treatment. As a result, the study advised that regional and global collaboration in hospital waste and wastewater management be encouraged.

Environmental Health-Based Medical Waste Management: Implementation of Local Government Responsibilities in Central Java

Purpose: Medical waste, generated by hospitals, clinics, and other healthcare facilities, has the potential for harm if not managed properly. The responsibility of the Central Java local government in managing medical waste is the main focus in this study. This study aims to determine the extent of the implementation of local government obligations in Central Java in carrying out their obligations to manage medical waste in maintaining environmental health. Methods/design/approach: This research uses descriptive analysis methods and case studies, by collecting data from primary and secondary sources, such as government policies, regulations, and medical waste management practices. Results: The results showed that the Central Java regional government has taken significant steps in an effort to manage medical waste by taking into account environmental health principles. They have issued regulations governing the collection, treatment, and disposal of medical waste, as well as providing guidelines to health facilities in the implementation of safe medical waste management practices. However, the study also revealed a number of challenges in implementing local government responsibilities. Some hospitals and clinics may still not fully comply with existing regulations, and medical waste management infrastructure may need to be improved in some areas. Conclusion: Environmental health-based medical waste management is a crucial aspect in maintaining public health and environmental sustainability in Central Java. Local governments have taken significant steps, but there are still challenges that need to be overcome. With further efforts in improving infrastructure, awareness, and supervision, it is expected that medical waste management in Central Java will become more effective, safe, and sustainable. It will support public health and contribute to the sustainable development goals in Central Java.

Environmental Sustainability and Waste Management Practices

Background: The study aims to explore environmental sustainability and medical waste management practices in Ghanaian private hospitals in the Greater Accra Region. It also sought to determine if there is any form of collaboration between private hospitals and district assemblies in managing medical wastes. Methods: A qualitative research approach with a cross-sectional study design was used to collect data from employees of the three private hospitals and the district assemblies. A structured interview guide was employed to gather data from 13 purposively selected participants. Results: The findings of the study indicated that there is a collaboration between private hospitals and district assemblies with regard to medical wastes management activities. Conclusions: It is recommended that policies on medical waste management are enforced to ensure sustainable healthcare waste management. Keywords: Environmental sustainability, collaboration, medical waste, private hospitals, district assemblies.

An emerging concern of medical waste management in Rohingya refugee camps at Cox’s Bazar, Bangladesh: existing practice and alternatives

The plight of humanity in refugee camps is an age-old issue, as is the ever-increasing issue of waste management, especially medical waste. Though situations have improved in recent times for refugee camps, the same cannot be concurred about medical waste management, as it increases in amount every day. This is the first study on the refugee camp, which was conducted to assess the status of medical waste management and to quantify and characterize medical wastes disposed of in the Rohingya refugee camp at Cox’s Bazar, Bangladesh. A cross-sectional, qualitative, and quantitative study was done. A total of 499 households, 30 solid waste collectors, 30 HCF workers, and 21 solid waste management (SWM) plant workers were interviewed by KoBo Toolbox. Monthly medical waste collection data from February to June 2022 was also collected. Data collection, processing, and statistical analysis were done using Origin Pro and SPSS software. It was found that the camps did not follow any specific guidelines for medical waste management except for a few segregations in healthcare facilities (HCF). Though 88% of the respondents were aware of the hazardous nature of medical waste, most of them disposed of these wastes in open places (49%) and drains (44%), and 70% did not segregate it from regular waste at the household level. Moreover, 73% of solid waste management workers found medical waste daily in communal bins. The HCF did not keep any records on the production of medical waste. Different types of medical waste were found in communal bins; glass bottles containing medicines were common among them. Data from the material recovery facility (MRF) of this camp showed that the highest amount of medical waste found in the communal bins was in April (65 kg) during the seasonal change from spring to summer and the lowest in February (12.7 kg). Moreover, HCF’s existing medical waste management practices were analyzed with SWOT and DPSIR framework. Based on all the findings, a comprehensive on-site and off-site management plan for medical waste is also proposed here. That will help the concerned prepare a camp medical waste management guideline.

Medical Waste Management Practices in Sylhet City among Healthcare Providers

Introduction: In the present world, large amount of wastes are clinical wastes, generated during diagnosis, treatment and research purpose. Most of the clinical wastes are hazardous like infectious, toxic of radioactive compounds. It is challenging to ensure proper waste management for developing countries like Bangladesh. Materials and Methods: This cross sectional study was conducted among doctors, nurse, nursing assistants, OT technicians, janitors, helper, sanitary worker and security guards at different private hospitals, clinics and diagnostic centers in Sylhet city. 300 healthcare staffs were purposively interviewed to evaluate the extend practices of biological or hospital waste management from January 2021 to December 2021. The study was conducted after taking informed written consent. Results: The outcomes of the present study indicated that maximum of the study participants were knowledgeable. But majority (71%) still do not use PPE (Personal protective equipment), 53% were not immunized against hepatitis B. They also had less practice to keep the hospital wastes in correct color coded container and less practice of washing the waste container properly. Conclusion: Most participants valued the significance of waste management practice to prevent health hazards but average practice was observed among them. For proper waste handling and disposal, frequent awareness program should be conducted among the health personnel. Medicine Today 2023 Vol.35(1): 12-15

Mediation Analysis of Organizational Support in Medical Waste Management Practices Through Structural Equation Modeling

Proper medical waste management (MWM) from generation to separation, collection, transportation, treatment, and disposal is needed to protect human health, the community and the environment. The aim of this study is to recognize the factors influencing MWM practices and to evaluate the mediation effect of organizational support in medical waste management practices.

Health-care waste management practices: The case of Ho Teaching Hospital in Ghana

Approximately 15% of wastes generated in hospitals is hazardous. Improper handling of this waste renders the remaining fraction infectious which is perilous to the health of hospital workers, patients, visitors and even communities. Sufficient data on medical waste management practices particularly in low-income countries such as Ghana is required for effective monitoring and policy making. This study sought to assess the waste generation rates, waste management practices, frequency of sharp injuries and the knowledge of health-care workers on waste management guidelines in Ho Teaching Hospital in Ghana. Data was collected through observations and questionnaire administration from 100 health-care workers. The results revealed that the total amount of wastes generated was 1.70kg/patient/day (490.62 kg/day) comprising of 57.48%, 33.98% and 8.54% of general, infectious and hazardous wastes respectively. Further investigations showed that 52% of the health-care workers knew about the existence of a hospital waste management policy and 89% attested that they had received training on medical waste management. The existing waste management committee was however, non-functional. Waste segregation at source and the use of color-coded waste receptacles were not strictly followed. Contaminated general wastes were landfilled whiles hazardous wastes were either incinerated or buried. Only 11% of the waste handlers were always completely dressed in personal protective equipment and about 77% of the waste handlers always sustained sharp injuries. Incentivizing the waste management team to ensure strict adherence to a waste management plan would improve waste management at the hospital.

Assessment of Compliance with Medical Waste Management Practice in Selected Hospitals in Urban Bauchi, Nigeria

This study assesses compliance with medical waste management practice in hospitals across urban Bauchi. Ten hospitals were randomly selected in each ward, representing the ten administrative wards of urban Bauchi, in which 148 set of questionnaires were administered among the waste handlers in the selected hospitals. In addition, the heads of units in each of the selected hospitals were interviewed. The results were compared with standard guidelines stipulated by the World Health Organization (WHO). It was revealed that the main treatment and disposal method in 50% of the hospitals were incineration and deep burial which were mostly in compliance with the stipulated guidelines. In the remaining 50% of the hospitals, the dominant treatment and disposal methods used were general collection of the waste, open dumping and burning. This is of significant concern because open dumping and open burning are not sustainable practices. Therefore, the study recommends that waste handling manual be developed and provided to all waste handlers to guide on handling medical waste properly.

Medical waste management improvement in several private hospitals in Amanat Al-Asimah –Yemen

Handling medical waste presents several environmental challenges in most Yemeni hospitals that need immediate attention before they get out of control. This study aims to assess current practices of medical waste management in some of the major private hospitals in Amanat AlAsimah-Yemen. This study relied on several methods of data collection, visits, observation, and interviews with health cadres, cleaners, and workers in the municipality, with the use of a checklist that contains several questions and then follow-up. The results of the study, which were conducted in the four largest private hospitals in Amanat Al-Asimah, which are the Science and Technology Hospital, Azal Hospital, European Modern Hospital, Dr. Abdul Qader Al Mutawakil Hospital showed that there were no independent and specialized administrative units within the hospitals studied how to manage, follow up on the collection, transport, and disposal of medical waste and the lack of laws and regulations on medical waste management and how to deal with them. Moreover, liquid medical waste is discharged through a sewage network that is treated only from organic matter regardless of harmful chemicals that in turn affect humans, the environment, and agriculture.

Assessment of COVID-19 vaccination-related medical waste management practices in Bangladesh.

The COVID-19 pandemic forces people to be vaccinated as early as possible. The COVID-19 vaccination program certainly raised the medical waste volume all over the world, including in Bangladesh. Numerous recent reports showed a fragile medical waste management system in Bangladesh; during the pandemic, the situation became worse. In addition, the nation-wide ongoing COVID-19 vaccination processes have been posing an extra burden to the existing biomedical waste management in the country. Failing to proper management of this waste might be a threat to human and environmental health. Therefore, the study investigated the current COVID-19 vaccine waste management practices in Bangladesh and made a comparison to the proposed standard operating procedures of international organizations and vaccine waste management practices of two other countries (USA and India). The study was carried out through a mixed methodological approach such as qualitative and quantitative, including a questionnaire survey in 15 Upazila of 4 Districts (Dhaka, Narayanganj, Manikganj, and Gazipur) of Bangladesh. The article focused on a nation-wide legitimate COVID-19 vaccination waste estimation, strength, weakness, opportunity, and threat (SWOT) analysis and drivers, pressure, state, impact, and response (DPSIR) framework analysis to identify the present state of medical waste management in the study area. The study found an excellent segregation system (100%) but very poor waste handling (35.5%) along with very poor syringes and sharps disposal method (open burning without buried 46.6%) and poor vials disposal method (without disinfection/open dump 52%) of vaccine waste. It is estimated that about 58 and 257.85 tonnes of syringes (with needles and packaging) and vaccine vials (Sinopharm 2 doses) waste have been generated since the mass-vaccination program started. Upon SWOT analysis, good separation techniques, poor waste management (ex-situ), enough space for management, and environmental and human health concerns were mostly identified as a strength, weakness, opportunity, and threat, respectively. Finally, a DPSIR framework was prepared for vaccine waste generation and its consequences in the studied area. This study will be useful to prepare a suitable vaccination waste management system in Bangladesh.

Solid medical waste management practices and awareness in COVID-19 screening stations

Solid medical waste management practices and awareness in COVID-19 screening stations

Assessment of knowledge, attitudes, and practices of medical waste management for healthcare providers in government hospitals in Basra, southern Iraq

Infectious waste, which is substances contaminated with blood or secretions from the patient's body (10-15%) of the total waste produced by health facilities and that requires special treatment to make it safe to dispose of because of its risks to public health. This study aims to assess the knowledge, attitudes and practices of health care providers in Basrah Governorate Hospital towards medical waste. A cross-sectional study was conducted using a questionnaire distributed to health care providers in three selected hospitals by stratiZied method. The results showed the level of knowledge, attitudes and practices of healthcare providers towards medical waste 91.6%, 85.4% and 87.8%, respectively. There is statistical signiZicance between health care providers' knowledge, attitudes and practices towards medical waste, and their educational level and training courses. In addition to the recording of the statistical signiZicance that were between attitudes, practices and years of experience. The levels can be categorized as positive but it is important to focus on increasing and improving the training of health care providers as it is the basis of the medical waste treatment process.

Medical Waste Management Practices at Healthcare Facilities in Cape Coast Metropolis

Objectives: This study examined the level of knowledge of health hazards associated with medical waste management, among healthcare workers and management staff of healthcare facilities in the Cape Coast Metropolis. Methods: Three hundred and twenty (320) healthcare workers were surveyed from two public hospitals in the Metropolis and 7 management staff were purposefully selected and interviewed. The participants include nurses, orderlies, administrators, and environmental health officers. Frequency, percentages and linear regression analyses were performed on the data. Results: The results showed that 95.9% (n = 307) of health professionals recorded good knowledge about management of medical waste in their facilities. However, arrangement for managing medical waste was inadequate at the facilities (Mean = 1.47, SD = 0.221, CV = 15.03%). The finding revealed that compliance with occupational health and safety guidelines was high (Mean=3.99, SD=0.39, CV=9.82%). Moreover, regression analysis indicated that training is a strong predictor of medical waste practices (0.357) even though educational level, working experiences, and age of the workers were also predictors (-0.356; -0.103; 0.010). Conclusion: Level of knowledge of hospital workers on medical waste health hazards is high, but arrangements for managing such waste are inadequate or weak. Compliance to Ministry of Health’s occupational health and safety guidelines is high. Meanwhile, training of healthcare workers would increase their medical waste management practices. A well-structured training with appropriate storage facility and good supervision at the point of waste generation should be prioritized to assist workers to practice safer and proper waste segregation.

The Impact of Economic Growth and Tiered Medical Policy on the Medical Waste Generation: An Empirical Analysis Based on the Environmental Kuznets Curve Model

Medical waste has a high environmental risk, economic development and medical policies can affect medical waste generation. Per capita gross domestic product (GDP) is an important indicator to measure the macroeconomic development status, and the tiered medical policy plays an important role in the process of China’s medical reform. The study considered the Environmental Kuznets Curve (EKC) of medical waste generation (MWG) in eight cities in China from 2013 to 2019, using economic indicator (GDP per capita) and policy indicator (tiered medical policy) to reveal the impact of economic development and medical policy on MWG. Furthermore, residents, especially the elderly, are the main consumers of medical resources, and medical institutions are the main places where medical waste is generated. Education level can affect waste management practices. Therefore, the research introduced population size, number of medical institutions, aging degree and education level as control variables. The results confirmed the validity of the N-shaped EKC curve between medical waste and GDP per capita. The amount of medical waste would continue to increase with economic growth, but the growth rate was not fixed. Implementing the tiered medical policy had shown a trend towards reducing medical waste. Population size and aging degree positively affected the generation of medical waste. The number of medical institutions negatively affected the generation of medical waste. The effect of education level on MWG could be ignored. Based on the empirical analysis results, this research put forward relevant policy suggestions in the light of medical waste management practice in China.

Skill Improvement for Public Health Center Staffs in the Management of Toxic and Hazardous Materials

Highlight:There was an increase in the accumulation of B3 waste in health centers during the COVID-19 pandemic.The knowledge and skills level of health center staff in medical THM waste management before and after medical THM waste management training were determined.Medical THM waste management training was increasing the knowledge and skills level of health center staff. Abstract:The generation of medical toxic and hazardous material (THM) waste at public health centers tends to increase during the Covid-19 pandemic. Only 6.89% of the health centers have medical waste management practices that meet the standards. Medical waste management practices not in accordance with the procedures can be a source of infection, even though only 56% of health workers have good knowledge and attitudes in solid medical waste management. For this reason, it is necessary to increase the skills of health center staff in managing medical THM waste during the Covid-19 pandemic. The purpose of this study was to determine the level of knowledge and skills of health center staff in medical THM waste management before and after medical THM waste management training. The training participants were 20 health center staffs who filled out a pretest questionnaire to measure their level of knowledge and skills prior to the training. The training materials include THM waste, medical THM waste, medical THM waste management and medical THM Temporary Storage. After the training, a post-test was conducted to measure the knowledge and skills scores of the trainees. The results of this study indicated that there was a significant difference in knowledge before and after training (p < 0.05). The average knowledge score before training was 6.2 (sufficient knowledge) and after training 8.15 (good knowledge). There was a significant difference in skill scores before and after training (p <0.05). The average skill before training was 6.3 (adequate) and after training 8.65 (good). In conclusion, there was an increase in the skills of health center staff in managing medical THM waste during covid-19 pandemic after participating in medical THM waste management training by the Community Service Team, Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

Correlation between knowledge and medical waste management practices of puskesmas officers in Medan City

Health care industry has contributed to the increasing amount of medical waste. It is very important for health care providers to have the necessary knowledge to practice medical waste management. The study aims to determine the correlation between knowledge and solid medical waste management practices by city health center (puskesmas) officers in Medan City in 2021. This study was an analytical observational study and was collected using questionnaires to 41 puskesmas officers in Medan City, North Sumatra, Indonesia. The independent variable was knowledge of puskesmas officer in solid medical waste management and the dependent variable was practice of puskesmas officer in solid medical waste management. The result is there are puskesmas officers who have less knowledge and less practice as many as 2 respondents (4,9%), puskesmas officers who have less knowledge and good practice as many as 6 respondents (14,6%), puskesmas officers who have good knowledge and good practice as many as 1 respondent (2,4%), and puskesmas officers who have good knowledge and good practice as many as 32 respondents (78%). The results of the statistical test obtained a p-value of 0.032, so there is correlation between the level of knowledge and solid medical waste management practices at puskesmas in Medan City in 2021. To improve knowledge and practice of medical waste management, it is recommended for puskesmas officers to attend training and implement the standard operating procedures and for the government, it is recommended for carrying out training, providing adequate temporary disposal sites, and supervising medical waste management.

Correlation between knowledge and medical waste management practices of puskesmas officers in Medan City

Correlation between knowledge and medical waste management practices of puskesmas officers in Medan City