Medical Waste Management Practices Research Articles

Medical Waste Management Survey in Primary Health Care Centers, Saudi Arabia

Background & Aims: Primary healthcare services aim to promote health and prevent health problems. However, waste generated from primary healthcare centers (PHC) potentially harmful to public health and the environment. The aim of this study was to assess wastes management of these centers. Methods: The data of this observational – cross-sectional study were collected from the available primary healthcare centers in Al-Baha city, Saudi Arabia (N=15 PHC centers). Data collected using standardized questionnaire and observations. Results: Contaminated sharp and pharmaceuticals pressurized wastes were generated in all PHC centers. About 14 (93.3%) and 13 (86.7%) of the centers were generating wastes of live attenuated vaccines vials and articles contaminated with blood, respectively. Eight (53.6%) of the centers generated more than 3 kg per day of contaminated sharps, followed by; live and attenuated vaccines’ vials. Eleven (73.3%) and 7 (46.7%) of the PHC centers produces 1 to 3 kg of hazardous wastes per day of articles contaminated with blood and waste contaminated with excretion, respectively. All health centers except one were practicing waste segregation properly, and 2 (13.4%) of the centers lacked waste storage method. A total of 5 (33.5%) centers also did not practice any type of dis infection, 7 (46.7%) and 9 (60.0%) of these centers did not have medical waste plan, nor specification for the collection and handling procedures of their medical wastes, respectively. The most common methods used for medical waste packaging were bags (68.8%) and plastic containers (18.8%). Conclusion: Medical waste management practices were found to be deficient and their amendment highly recommended.

Knowledge, Attitude and Practice of Healthcare Managers to Medical Waste Management and Occupational Safety Practices: Findings from Southeast Nigeria.

Awareness of appropriate waste management procedures and occupational safety measures is fundamental to achieving a safe work environment, and ensuring patient and staff safety. This study was conducted to assess the attitude of healthcare managers to medical waste management and occupational safety practices. This was a cross-sectional study conducted among 54 hospital administrators in Ebonyi state. Semi-structured questionnaires were used for qualitative data collection and analyzed with SPSS statistics for windows (2011), version 20.0 statistical software (Armonk, NY: IBM Corp). Two-fifth (40%) of healthcare managers had received training on medical waste management and occupational safety. Standard operating procedure of waste disposal was practiced by only one hospital (1.9%), while 98.1% (53/54) practiced indiscriminate waste disposal. Injection safety boxes were widely available in all health facilities, nevertheless, the use of incinerators and waste treatment was practiced by 1.9% (1/54) facility. However, 40.7% (22/54) and 59.3% (32/54) of respondents trained their staff and organize safety orientation courses respectively. Staff insurance cover was offered by just one hospital (1.9%), while none of the hospitals had compensation package for occupational hazard victims. Over half (55.6%; 30/54) of the respondents provided both personal protective equipment and post exposure prophylaxis for HIV. There was high level of non-compliance to standard medical waste management procedures, and lack of training on occupational safety measures. Relevant regulating agencies should step up efforts at monitoring and regulation of healthcare activities and ensure staff training on safe handling and disposal of hospital waste.

Correspondence: Knowledge, Attitude and Practice of Healthcare Managers to Medical Waste Management and Occupational Safety Practices: Findings from Southeast Nigeria.

Correspondence: Knowledge, Attitude and Practice of Healthcare Managers to Medical Waste Management and Occupational Safety Practices: Findings from Southeast Nigeria.

Assessment of medical waste management in seven hospitals in Lagos, Nigeria.

BackgroundMedical waste (MW) can be generated in hospitals, clinics and places where diagnosis and treatment are conducted. The management of these wastes is an issue of great concern and importance in view of potential public health risks associated with such wastes. The study assessed the medical waste management practices in selected hospitals and also determined the impact of Lagos Waste Management Authority (LAWMA) intervention programs. A descriptive cross-sectional survey method was used.MethodsData were collected using three instrument (questionnaire, site visitation and in –depth interview). Two public (hospital A, B) and five private (hospital C, D, E, F and G) which provide services for low, middle and high income earners were used. Data analysis was done with SPSS version 20. Chi-squared test was used to determine level of significance at p < 0.05.ResultsThe majority 56 (53.3 %) of the respondents were females with mean age of 35.46 (±1.66) years. The hospital surveyed, except hospital D, disposes both general and medical waste separately. All the facilities have the same process of managing their waste which is segregation, collection/on-site transportation, on-site storage and off–site transportation. Staff responsible for collecting medical waste uses mainly hand gloves as personal protective equipment. The intervention programs helped to ensure compliance and safety of the processes; all the hospitals employ the services of LAWMA for final waste disposal and treatment. Only hospital B offered on-site treatment of its waste (sharps only) with an incinerator while LAWMA uses hydroclave to treat its wastes. There are no policies or guidelines in all investigated hospitals for managing waste.ConclusionsAn awareness of proper waste management amongst health workers has been created in most hospitals through the initiative of LAWMA. However, hospital D still mixes municipal and hazardous wastes. The treatment of waste is generally done by LAWMA using hydroclave, to prevent environmental hazards except hospital B that treats its sharp with an incinerator. In order to enhance uniform and appropriate waste management practices in the entire State, there is need for capacity building at all levels and also policies and guidelines formulations.

Medical waste management practices in developing countries: a case study of health facilities in Akure, Nigeria

Poor medical waste management (MWM), which is a serious problem in developing countries, is reported to have direct health and environmental consequences. Therefore, this study investigated the mode of medical waste collection, segregation, pre-treatment, storage and disposal of ten randomly-selected health facilities in Akure, the capital city of Ondo State, Nigeria. A total of 32 questionnaires and 17 oral interviews were conducted. There are numerous factors impeding proper MWM in the city; however, the following are the most significant: inappropriate waste storage structures sited in public places and held in unhygienic conditions; general lack of medical waste pre-treatment; establishment of internal regulations that are generally not followed; provision of PPE by only 40% of the hospitals; and scavengers gaining access to the state approved permanent dump site. There is, therefore, an urgent need for the legal regulation of MWM practices in the state to reduce health/environmental risks posed by medical waste.

Evaluation of bio medical waste management practices in select health care facilities of Karnataka, India

Background: Health care sector has expanded to a great extent in both private and public sectors to cater to the needs of the increasing population of the country. Mismanagement of bio medical waste can expose health care personnel and public to various potential hazards. Methods: Cross sectional study was conducted during September- November 2014 to assess current practices of Bio- Medical waste management (BMW) among the health care facilities (HCF) that had participated the selected districts level training program. Two stage sampling method was used to select eight districts and 15 HCFs in each district of Karnataka. An observational check list was used to observe macro and process areas of BMW. Results: Efficiency of each of the process of waste management was calculated by using a scoring system. A total of 116 HCF were observed-9 large, 17 medium and 90 small. Segregation efficiency was poor in 22 (24.4%) small HCFs. Disinfection was practiced in 50% of the locations observed in small HCFs. The storage efficiency was excellent in 56.3% and 57.7% among medium and small HCFs respectively. No containment of sharps was observed in 34.7%, 23.4%, 26.8% locations of small, medium and large HCFs respectively. Final disposal of waste was managed by common treatment facility in 88.8% of large and 88.2% of medium sized hospital respectively. Conclusions: Practices of bio medical waste management need to be improved at all levels.

Bio Medical Waste Generation and Management Practices in V.S.S. Medical College &amp; Hospital, Burla, Odisha, India

Background: An important issue of environmental protection process is the solid waste management that includes responsible planning of collecting, transporting, processing and disposing of hazardous and non-hazardous solid waste material. The health of public, patients and professionals alike are affected by poor waste management practices. The study highlights a holistic approach of biomedical waste management with regards to the chain of environmental and health risks and concerns aimed in achieving the fundamental premises for a systemic approach of biomedical waste management. An attempt has been made to critically review the current management practices adopted in V.S.S. Medical College & Hospital. Following the Rules and Regulation the methods for segregation, packaging, labeling and the treatment techniques for reduction in volume, neutralization and final disposal of the biomedical waste are analysed. Methods: Personal observations of the waste treatment and disposal practices and Assessment of knowledge, attitude and practices of working personnel with the help of questionnaires were followed in this study. The information obtained has been confirmed by means of direct spot visit. The views and suggestions of working personnel over existing conditions/methods of biomedical waste management in the hospitals were also recorded. The information obtained was later confirmed by means of direct observations. Results: There are 20 units having total bed capacity of 1006. The daily generation of category 1 & 2 is 40-50 kg/day. The daily generation of category 3 waste is 2-3 kg which was measured one day after one day. Category 4&5 waste generation amounting 30-40 Kg/ day. The Solid waste, (category 6) generation amounting 80-90kg/ day. The solid waste, category 7 waste generation is 30-40 kg/ day. Waste generated from laboratory (category,8) was estimated and found to be 30-40 litres/ day and the incineration ash category 9 generation was recorded as 3-4 Kg/ day. The chemical waste category 10 was not properly assessed by the CBWTF. The current segregation practice is not that efficient in reducing the waste going to incinerator. According to the opinion of employees at V.S.S.Medical College and hospital burla, the important reasons for the improper segregation of wastes are; inappropriate location of waste bins, waste bins being full and lack of knowledge regarding the constituents of medical waste. Conclusion: The performance of CBWTF can be enhanced with cooperative efforts of BMW generators possible if a healthy co-ordination exists between CBWTF and BMW generators.

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).

Medical Waste Management Practices in North Eastern Free State, South Africa

This paper presents a study undertaken to investigate the state of medical waste management practices in different hospitals in the north eastern Free State Province, South Africa. A random sample ...

English

Inappropriate medical waste (MW) management practices have become one of the major concerns in developing countries. The objectives of this study are to appraise the procedures and techniques available in collection and segregation of MW, treatment and recycling processes, disposal practices and compliances with rules and regulations in the Health-care Facilities (HCFs) in Ota, South West Nigeria. The HCFs visited includes general hospital, private hospitals, clinics, and primary health-care centers. The survey involved the use of structured questionnaires, in-depth interviews and on-site observations. Statistical Package for Social Sciences (SPSS) software application was employed for analysis. Responses were coded using a linkert scaling procedure. Hypotheses were tested using Bivariate regression technique involving inferential statistics. In addition, the study utilized chi-square non-parametric test for normal distributional effect of the variables. Results showed that MW management practices in most facilities are not totally in line with prescribed standards as expected. It is recommended that a sustained cooperation should be developed among all key actors (government, HCF’s responsible and waste managers) so as to implement a safe and reliable medical waste management strategy. This should not only be limited to legislation and policy formulation but also in its monitoring and enforcement. Key words: Medical waste management, health-care facilities, statistical analysis, health risk, sustainability practice.

Assessment of Medical Waste Management within Selected Hospitals in Gaza Strip Palestine: A Pilot Study

The present study aims to provide information about the management, segregation, storage and disposal of medical wastes in public as well as private hospitals in Gaza Strip-Palestine. A cross sectional study was employed and simple random sampling technique were used to distribute a semi structured questionnaire among 164 health workers at two hospitals in Gaza Strip with 100 respondents from governmental hospital and 64 respondents from private hospital. The results disclosed that, healthcare facilities whether private and governmental hospitals still suffer from inappropriate biomedical wastes management which have not received sufficient concern according to 60% of participants who pointed out that hazardous and medical wastes are still handled and disposed together with domestic wastes and segregation was applied only for sharp waste which is collected in special sharp boxes at the beginning after usage. Furthermore, around 47% of respondents don't know where medical storage place is, and don't know if there is mark to show place of storage. Besides, 42% of respondents don't know if it's there mean for transferring medical waste, and 43% don't know its type or if it's available always. In the surveyed hospitals, there is deficiency in implementing training courses about healthcare waste management as 23% only of all study subjects had been provided with training on how to deal with medical waste. Therefore, the Ministry of Health and healthcare institutions should give more consideration towards policies for the proper management and disposal of health care wastes in order to develop medical waste management practices in Palestine.

HOSPITAL WASTE MANAGEMENT;

Introduction: Hospital waste is a special type of waste which carries high potential of infection and injury. Objectives: Thisstudy was conducted to examine Medical Waste Management Practices in different hospitals of Peshawar. Methodology: Simpleobservational, cross-sectional study. was conducted with a case study approach. Aug-Sep 2011, with selection of 15 hospitals. The datawas collected through a pre-designed questionnaire with a checklist. Results: The study showed that 80% of the hospital personnel knewhospital waste and its management. There was waste management plan present in 30% of hospitals. Although hospitals did not quantifiedwaste amounts but on average the amount of waste generated daily was 0.5-1 kg/bed/day. Segregation into risk and non risk waste wasdone in 93.3% of hospitals. For non risk waste, disposal through Municipal Corporation was conducted in 86.67% of the hospitals, whilein 13.3%, it was burnt. For risk waste, either it was buried or burnt. Proper incineration was carried out in only 33.3% of the hospitals.Discussion: Hospital waste generation, segregation, collection, transportation &amp; disposal practices were not in accordance with standardguidelines. The average waste generation in most of the hospitals was almost equivalent to other under developed countries but less thanthat of developed countries. Conclusions: The hospital waste in the majority of hospitals of Peshawar was mismanaged. No properhospital waste management plan existed except at few hospitals.

Profile of medical waste management in two healthcare facilities in Lagos, Nigeria: a case study

Proper management and safe disposal of medical waste (MW) is vital in the reduction of infection or illness through contact with discarded material and in the prevention of environmental contamination in hospital facilities. The management practices for MW in selected healthcare facilities in Lagos, Nigeria were assessed. The cross-sectional study involved the use of questionnaires, in-depth interviews, focused group discussions and participant observation strategies. It also involved the collection, segregation, identification and weighing of waste types from wards and units in the representative facilities in Lagos, Nigeria, for qualitative and quantitative analysis of the MW streams. The findings indicated that the selected Nigerian healthcare facilities were lacking in the adoption of sound MW management (MWM) practices. The average MW ranged from 0.01 kg/bed/day to 3.98 kg/bed/day. Moreover, about 30% of the domestic waste from the healthcare facilities consisted of MW due to inappropriate co-disposal practices. Multiple linear regression was applied to predict the volume of waste generated giving a correlation coefficient (R(2)) value of 0.99 confirming a good fit of the data. This study revealed that the current MWM practices and strategies in Lagos are weak, and suggests an urgent need for review to achieve vital reversals in the current trends.

Medical waste management practices in southern Jordan

The purpose of this work was to study medical waste practices in southern Jordan. Five major hospitals in that area were used to conduct this study. It involved distributing a modified version of the questionnaire that was adopted by the World Health Organization (WHO). The surveyed hospitals had total number of beds ranging from 72 to 131 beds, while the average amount of medical waste generated in these hospitals was 0.73 kg bed−1 day–1. The practices of medical waste management were found to be suffering from major defects owing to the lack of both training and proper education.

Medical Waste Management: A Case Study of the Souss-Massa-Dr&amp;#226;a Region, Morocco

Medical waste management is of major concern due to the potentially high risks to both human health and the environment caused by inadequate waste management practices. In Morocco, as in many developing countries, little information is available regarding generation handling, and disposal of medical waste. The specific objective of this study was to analyse the medical waste management practices in the Souss-Massa-Draa region, Morocco. The study was carried out in seven of the twelve hospitals in the region, covering 66.2% of the bed capacity. A total of 219 healthcare personnel and their assistants were included: 35 doctors, 98 nurses, and 86 housekeepers. Site visits, interviews, and survey questionnaires were implemented to collect information regarding different medical waste management aspects, including medical waste generation, separation, collection, storage, transportation, and disposal. The results indicated that the medical waste generation rate ranged from 0.4 to 0.7 Kg/bed-day with a weighted average of 0.53 Kg/bed-day. The percentage of infectious and hazardous wastes in the total medical waste stream was about 30.5%. The remaining 69.5% was general wastes similar in properties to municipal wastes. Concerning waste separation, housekeepers demonstrate a slightly higher knowledge about waste separation, with 49.4% of correct answers, with nurses at 45.7%, and doctors the lowest value at 38.6%. The results about other management aspects indicated that practices in most surveyed hospitals did not comply with the principles stated in Moroccan legislation. Based on the findings, some measures are suggested to improve the present conditions and ensure that potential health and environmental risks of medical waste are minimized.

Medical waste management at the Oncology Institute of Vojvodina: possibilities of successful implementation of medical waste regulation in Serbia

Implementation of National waste management strategy, which included most of Healthcare facilities (HCF) in Serbia, began in 2009. The present study aimed to evaluate the medical waste management strategy protocol at Oncology Institute of Vojvodina, which is the first institution in Vojvodina and one of the first institutions in Serbia which has implemented the recomended medical waste management protocol. Segregation, storage, transportation and treatment were all evaluated and that was all performed according to National strategy. Biohazard generation rate was 0,17 kg/bed/day, which correspods with values in the HCF in Eastern Europe. The results show that the methods for safe management of medical waste are acceptable, affordable, and economically justifable to accomplish the reduction in the financial costs in HCF business, and can serve as representative of proper medical waste management practice for other HCF.

La gestion des déchets d'activité de soins à risques infectieux par les professionnels de santé libéraux : étude de pratiques

Résumé Une enquête transversale auprès d’un échantillon de 278 professionnels de santé (médecins généralistes et spécialistes, dentistes, kinésithérapeutes et infirmiers) en cabinet libéral à Paris a étudié, en 2004, la production et le traitement des déchets d’activité de soins à risques infectieux (DASRI). À l’exception des kinésithérapeutes, la plupart des professionnels produisaient des DASRI (72 % à 96,2 % selon les professions), avec un volume mensuel médian de 3 litres (interquartile 1-15 litres). 100 % des déchets piquants et coupants étaient triés, puis 91 % éliminés via une filière spécifique. Ces pourcentages étaient, respectivement, de 84 % et 69 % concernant les déchets souillés non piquants ni coupants. 48 % rapportaient l’existence de documents de traçabilité de l’élimination des DASRI. Pour améliorer les pratiques, les professionnels ont cité en premier lieu la collecte au cabinet (74 %) et la fiabilité du prestataire (59 %). L’étude a montré un besoin d’information des professionnels de santé sur la réglementation relative aux DASRI, concernant la traçabilité de l’élimination, et relevé l’imprécision de la définition du risque infectieux : 31,7 % des professionnels déclarant ne produire que des déchets piquants et coupants n’ont pas précisé de critère d’un risque infectieux.

Medical Waste Management Practices in a Southern African Hospital

This study examined the medical waste management practices of a hospital in Southern Africa. The results revealed that the hospital does not quantify medical waste. Segregation of medical wastes into infectious medical waste and non-infectious medical waste is not conducted according to definite rules and standards. Separation of medical waste and municipal waste is however practiced to a satisfactory extent. Wheeled trolleys are used for on-sitetransportation of waste from the points of production to the temporary storage area. Staff responsible for collecting medical waste use almost completes personal protective equipment. Offsite transportation of the hospital waste is undertaken by a private waste management company. Small pickups are mainly used to transport waste daily to an off-site area for treatment and disposal. The main treatment method used in the final disposal of infectious waste is incineration. Noninfectiouswaste is disposed off using land disposal method. The study showed that the hospital does not have a policy and plan in place for managing medical waste. There are a number of problems the hospital faces in terms of medical waste management, including; lack of necessary rules, regulations and instructions on the different aspects of collections anddisposal of waste, failure to quantify the waste generated in reliable records, lack of use of coloured bags by limiting thebags to only one colour for all waste, the absence of a dedicated waste manager, and no committee responsible for monitoring the management of medical waste. Recommendations are given with the aim of improving medical waste management in hospitals.

Status and challenges of hospital solid waste management: case studies from Thailand, Pakistan, and Mongolia

Healthcare waste management is a serious public health concern. In developing countries, compared to developed nations, the management of infectious wastes has not received sufficient attention. Recently, worldwide awareness has grown of the need to impose stricter controls on the handling and disposal of wastes generated by healthcare facilities. This exploratory study attempted in seven selected hospitals to explain the situation of healthcare waste management, with a focus on handling practices, occupational safety, and the implementation status of waste management policy, together with other pertinent policy issues. It was noted that the current system of healthcare waste management was underdeveloped and was in dire need of immediate attention and improvement, especially in Mongolia and Pakistan; the medical waste management practices were better in the hospitals studied in Thailand. This study underscores the importance for improvement of medical waste management of a national regulatory framework, a sound internal management system, and programs to train and ensure the safety of related personnel, as well as programs to estimate quantities of waste generated and to evaluate appropriate techniques of disposal. Once a healthcare waste management plan has been prepared, a regular program of inspection and review can be undertaken within the healthcare institution. A good inspection program can also expose problems and new issues in managing healthcare wastes.

Management of medical waste in Tanzania hospitals

A survey was conducted to study the existing medical waste management (MWM) systems in Tanzanian hospitals during a nationwide health-care waste management-training programme conducted from 2003 to 2005. The aim of the programme was to enable health workers to establish MWM systems in their health facilities aimed at improving infection prevention and control and occupational health aspects. During the training sessions, a questionnaire was prepared and circulated to collect information on the MWM practices existing in hospitals in eight regions of the Tanzania. The analysis showed that increased population and poor MWM systems as well as expanded use of disposables were the main reasons for increased medical wastes in hospitals. The main disposal methods comprised of open pit burning (50%) and burying (30%) of the waste. A large proportion (71%) of the hospitals used dust bins for transporting waste from generation points to incinerator without plastic bags. Most hospitals had low incineration capacity, with few of them having fire brick incinerators. Most of the respondents preferred on-site versus off-site waste incineration. Some hospitals were using untrained casual labourers in medical waste management and general cleanliness. The knowledge level in MWM issues was low among the health workers. It is concluded that hospital waste management in Tanzania is poor. There is need for proper training and management regarding awareness and practices of medical waste management to cover all carders of health workers in the country.