A survey on home generated medical waste in Mauritius

This study was carried out to evaluate home-generated medical waste in Mauritius. A questionnaire survey was undertaken among a random sample population in 250 houses in the nine districts of the island. Results of this study showed an overwhelmingly large proportion of medical waste arising from the domestic environment joins the common municipal solid waste stream and ends in landfills. This improper disposal process poses a serious health hazard to the general public, waste haulers and landfill personnel. It is therefore recommended that a national policy on medical waste management be urgently implemented, proper training of waste haulers be offered and education campaign be carried out to sensitize the general public on safe disposal of medical waste.     

Hospital Workers' Awareness of Health and Environmental Impacts of Poor Clinical Waste Disposal in the Northwest Region of Cameroon

Abstract

Due to the infectious nature of some clinical waste, poor disposal practices have sparked concern regarding the impact on public health and the environment. Lack of sufficient knowledge of the associated risks may be a strong factor contributing to inadequate disposal practices. We conducted a survey to evaluate hospital workers' awareness of health and environmental impacts of poor clinical waste disposal in Cameroon. We randomly distributed 500 questionnaires to hospital workers in three hospitals in the Northwest Region of Cameroon in April 2008. In addition, we observed collection, segregation, transportation, and disposal of clinical waste at the three hospitals. Of 475 total respondents, most lacked sufficient awareness of any environmental or public health impacts of poor clinical waste disposal and had never heard of any policy—national or international—on safe clinical waste management. Methods of collecting, segregating, transporting and disposing clinical waste at the three hospitals was poor. The development of a comprehensive policy on efficient clinical waste management in Cameroon is imperative.     

Medical Waste Act. Requires physician compliance

In Michigan, the medical care community has a long history of carefully managing infectious medical wastes within their facilities to control communicable diseases. Never the less, concerns have surfaced about health risks posed by medical waste because of the notoriety of reported incidents of improperly disposed medical waste that led to the promulgation of emergency rules and now permanent statutes. As the environment reemerges as a national issue, the proper disposal of medical waste remains, at the very least, a highly visible and volatile part of this nation's solid waste crisis. To better develop appropriate controls for dealing with regulated medical waste, we will need to work together. Journal articles such as this provide an important opportunity to share and more forward our understanding of this problem so that we may all enjoy a safer and better environment. Proper handling and disposal of medical waste will remain a public issue as long as wastes believed to be of medical origin are found on beaches or at unauthorized storage or disposal locations. Hence, compliance with the regulations for the handling, storing, treating, transporting and ultimate disposal of regulated medical waste by providers of health care in Michigan must be observed.     

Report of the Council on Scientific Affairs. Biohazardous waste management: what the physician needs to know. American Medical Association

Sources of biohazardous waste include not only large hospitals and laboratories, but also physicians' offices, dental offices, clinics, research facilities, surgery centers, veterinary offices, funeral homes, and a growing number of settings where home health care is delivered. State and local municipality definitions and regulations on biohazardous waste vary widely. Most regulations exempt home health care settings, but include physicians' offices. Although the infectious public health risk posed by medical waste is exceedingly low, this fact is not well understood by the general public. Physicians should develop biohazardous waste management programs that fulfill their county, state, and municipal regulations and that consider the difference between health risks to employees and risks to the general public. Physicians can considerably reduce the amount and costs of biohazardous waste disposal by proper identification and segregation of waste in a manner that meets their state's criteria. Using products that can be recycled may reduce the amount and costs of disposal of biohazardous waste. Processing costs also may be reduced by cooperative arrangements among medical groups or health care facilities to negotiate group disposal rates with vendors.     

张家港口岸应对突发公共卫生事件能力评估与对策分析

目的调查张家港口岸突发公共卫生事件应对能力,为完善应急预警体系提供依据。方法采取调查问卷与专题讨论相结合的方式,调查各层次的张家港口岸突发公共卫生事件处置人员共67人。结果卫生检疫人员与医务人员相关知识总体掌握情况较好,但医务人员检疫传染病和禁止入境传染病知晓率两项指标掌握情况不好;卫生检疫人员与医务人员在应对突发公共卫生事件自评方面显示出专业优势不同,但在应对核与辐射事件、生物恐怖、不明原因疾病和自然灾害事件等方面的评分总体较低。结论张家港口岸突发公共卫生事件应对能力总体较好,但卫生检疫人员与医务人员均需进一步加强相关知识学习。     

Medical waste management practices in a Southern African hospital

PURPOSE: The purpose of this paper is to examine the medical waste management practices of a hospital in Southern Africa. DESIGN/METHODOLOGY/APPROACH: A case study methodology was utilised. FINDINGS: The results revealed that the hospital does not quantify medical waste. Segregation of medical waste into infectious waste and non-infectious 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-site transportation of waste. Off-site transportation of waste is outsourced to a private firm. Incineration is used in the final disposal of infectious waste. Non-infectious waste is disposed using land disposal method. There is no policy and plan in place for managing medical waste. A number of problems were identified with respect to medical waste management. ORIGINALITY/VALUE: The paper gives recommendations with the aim of improving medical waste management in hospitals.     

The medical waste audit. A framework for hospitals to appraise options and financial implications

The generation, handling, and disposal of medical wastes involve virtually every department in the hospital. To enhance coordination, managers must comprehensively describe the total system and specify the roles of key functions and individuals. Hospitals produce about 77 percent of the approximately 500,000 tons of regulated medical waste produced annually in the United States. The amount produced by different hospitals varies, primarily because of differences in "waste-management practices." The Environmental Protection Agency is trying to develop a greater understanding of the types of medical wastes that are infectious, methods of transmission, and the likelihood of transmission in the handling and disposal of waste within the hospital environment. To ensure that medical waste is being handled and treated in the most cost-effective manner and with the least health risk to employees and the community, hospital administrators must undertake a comprehensive appraisal of the activities associated with the generation, handling, and disposal processes. A "medical waste audit" requires the following steps: Generation profile to identify origination points, categories or types of waste, and associated generation rates. Inventory of handling practices, including existing regulations, procedures and protocols, training programs, definitions regarding waste segregation, and documentation. Review of current disposal practices and existing and developing alternatives. Cost analysis     

Hospital waste management and it's probable health effect: a lesson learned from Bangladesh

A study was conducted to evaluate the current status of hospital waste management (HWM) in Bangladesh. The aim is to recognize the health effect of the existing practice, to determine the awareness level of doctors and nurses about hospital waste, to identify the weaknesses, and to provide suggestions for improvement. Hospital staff, waste pickers, and local residents were interviewed while in depth field observation, which included sample collection and laboratory analysis was also conducted. Through this investigation, it has been quite evident that a satisfactory hospital waste management system in government hospitals and several private clinics is severely lacking. At present, Bangladesh has no rigorous laws or regulation, which are enforced in this area. The waste is generally dumped together in a public place such as the hospital surroundings, the roadside or City Corporation dustbin. Many doctors and nurses are not fully aware about what constitutes as medical waste. Health care workers have only a basic understanding of health care and do not perceive handling or disposal of medial waste as a hazardous work. Laboratory analysis shows existing contamination of infectious agents in the environment. Some staff members interviewed were suffering from various kinds of infectious diseases such as viral hepatitis B/C, typhoid, skin disease/allergy, diarrhea, dysentery, tuberculosis, and malaria. During field observation it was discovered that improved HWM systems have only recently been introduced in a small number of private hospitals and clinics, some of which could be used as references to formulate guidelines for reaching the optimal at the national level. The study indicates that there is a need to improve the handling and disposal methods of hospital waste in almost all the available medical facilities. There are a few NGOs that have started awareness building and training on waste management for selected hospital staff and NGO officials. Based on the analysis of the situation, several suggestions and recommendations have been made to aid in the development of a waste management system.     

A comparative study on the medical waste disposal in some hospitals in Alexandria

Though healthcare services aim to reduce the health problems and prevent the potential risks to the health of the community. These services create wastes which are considered as hazardous materials due to the higher potential of infection and injury possessed by these wastes than any other type of waste. Healthcare waste management is an integral part of healthcare services, and can create harm through inadequate waste management; thus reducing the overall benefits provided by healthcare centers. In the current study, a survey for medical waste disposal was performed in order to examine the current status of medical waste disposal in some hospitals in Alexandria and to properly assess management of this type of hazardous waste. A questionnaire was designed for hospitals to assess the quantity of medical waste, collection, sorting, storage, transportation and way of final disposal. From the total waste generated by healthcare activities, almost 80% are waste similar to domestic waste. The remaining approximate of 20% is considered as hazardous waste. As Alexandria has about 3911 healthcare facilities providing medical services for people, a huge amount of medical waste are generated daily with about 208 tons generated per month. The results revealed that the most common problems associated with healthcare wastes are the absence of waste management, lack of awareness about their health hazards, insufficient financial and human resources for proper management, and poor control of waste disposal. The current situation of medical waste disposal in Alexandria is depending on incinerators. Some of these incinerators are not working anymore. Incinerations as a system is not accepted at the time being in most developed countries due to the risks associated with it and suitable substitution management system for medical waste disposal is now taking its place.     

Health risks for waste disposal industry workers]

Waste disposal currently constitutes a major public health problem in Italy and other industrialized countries. In view of the increasing volume of waste accumulated and disposed of without control, there is now an ever pressing need for regulated disposal that involves minimum risk for the environment and the community. Hence a new industrial sector has emerged that is highly specialized and varied, on account of the wide field of activity and technology, from collection and storage of refuse, processing and definitive disposal, to reclamation and improvement of illegal dumps. The industrial waste sector has not been fully developed and it is currently believed that most disposal is performed without sanitary control. Little attention has been given to the environmental impact of these operations and similarly little is known of the possible health effects for the operators. Acquisition of toxicological and health data is therefore essential to establish correct and appropriate regulations for the development of this industrial sector. An objective risk evaluation will require filling in many information gaps, which are partly the results of a natural uncertainty surrounding any innovative process, but are above all due to the vastness of the problem that is not easily defined in concrete terms as regards types of waste and number of operators involved.     

Dental waste management in municipal health clinics in Belo Horizonte, Brazil]

OBJECTIVE: To investigate whether municipal health clinics in the city of Belo Horizonte, Brazil, comply with the legal requirements for managing dental wastes. METHOD: We collected information from 54 of the city's 105 municipal health clinics that provide dental care. At each clinic we interviewed the clinic manager, one dental assistant, and one general assistant. Based on the requirements outlined in the Belo Horizonte Health Waste Management Manual, we assessed characteristics in the following three areas: (1) technical and operational (waste classification and characterization, minimization, segregation, pretreatment, conditioning, collection and internal and external transportation, and external storage); (2) general and organizational (inspection, amount of clinic space, environmental permits, floor plan showing waste-generating areas, and whether the clinic had a technical specialist responsible for managing the health wastes); and (3) human resources (employee vaccination records and oversight, occupational safety and occupational medicine program, environmental risk prevention program, medical oversight and occupational health program, hospital (clinic) infection control committee, and training in health waste management). RESULTS: The clinics produced an average of 270 liters of solid waste per day. None of the clinics surveyed had a plan for managing health wastes. The only requirements with which all the clinics complied were: segregation of needles and mercury, adequately identified cardboard containers used for disposal of cutting and piercing items, and daily internal collection and transportation of wastes. CONCLUSIONS: When the risks associated with each class of waste have not been established, all the wastes should be considered potentially dangerous. Further, a law by itself does not guarantee that the public's health will be protected. Before public agencies impose legal requirements, it is necessary to know if the agencies themselves are capable of enforcing those requirements. Any proposed waste management legislation should be based on scientific research.     

Field survey of enteric viruses in solid waste landfill leachates.

Because municipal solid waste may contain fecal material from a variety of sources, there is concern that the leachate discharged from some solid waste landfills may contain enteric pathogens, including enteric viruses. In this study, 22 leachate samples from 21 different landfills in the United States and Canada were examined for enteric viruses. The sites represented a broad range of conditions for solid waste landfills and the leachate samples ranged from 10.3 to 18 liters in volume. Enteric viruses were found in only one of the 22 leachate samples examined. Two viruses, identified as poliovirus types 1 and 3, were found in an 11.8 liter sample obtained from a site where solid waste landfill practice was deficient. The low levels of enteric viruses detected in field samples of raw leachate and the opportunities for further reductions in the virus concentration of leachates by such processes as thermal inactivation, removal by soil and dilution in ground and surface waters, suggest that leachates from properly operated solid waste landfills do not constitute an environmental or public health hazard due to enteric viruses.     

广州港港湾医院医疗废物规范化管理对策

目的规范化管理医院医疗废物.方法评估广州港港湾医院医疗废物管理现状,按照<医疗废物管理条例>,完善医疗废物管理机构及管理细则,并开展全员培训工作.结果通过制度制约,强化人员培训,提高了医务人员等对医疗废物规范化管理的自觉性,达到分类处置目的.结论该院医疗废物管理制度有效可行,可指导临床工作,从而降低医疗废物对环境、人的健康造成的危害.     

Gravimetric characterization of potentially infectious material in urban solid waste in southern Belo Horizonte, Minas Gerais State, Brazil

This study investigated potentially infectious waste (feces, urine, blood, body fluids) in the composition of total municipal solid waste. From August to September 2002, solid waste samples from southern Belo Horizonte, capital of the State of Minas Gerais, were collected and sent to the solid waste treatment and disposal site at BR-040 for segregation and quantification. Sharps (objects that can cause cuts or puncture wounds) made up 0.02+/-0.02% of the collected waste, while non-sharps accounted for 5.47+/-1.11%. In the sharps category, the majority were razor blades (0.01+/-0.01%), while among non-sharps the most frequent components were toilet paper (3.00+/-0.90%), diapers (2.21+/-1.08%), and sanitary napkins (0.22+/-0.12%). Household infectious waste was twice the total amount of waste (infectious + common) from healthcare units. The study was discussed in light of the health hazards and safety aspects for formal and informal waste collectors.     

Public and occupational health aspects related to municipal solid waste management

Based on a literature review, the paper calls attention to public and occupational health problems related to poor municipal solid waste management resulting from a development model that views environmental protection, public health, and workers' health as secondary issues. The authors emphasize the need for research to support a new waste management model highlighting the importance of environmental preservation and protection of human health, in addition to suggesting measures to achieve such goals. The discussion aims to incorporate solid waste management into the public health agenda.     

某医院医疗废物处置状况调查

[目的]了解某医院医疗废物处置状况,探讨医疗费物处置措施。[方法]采用查阅医院医疗废物回收处理记录和问卷方法,调查1所二级甲等医院2008年1～6月医疗废物从产生到最终处置的状况、管理过程及相关工作人员对医疗废物处置的认知情况。[结果]2008年1～6月共产生一般性废弃物210000kg,医疗废物115058kg,医疗废物占医院废物的35．40％。在医疗废物中,感染性废弃物占11．24％,病理性废弃物占0．26％,回收的一次性塑料占4．46％,输液玻璃瓶占84．04％。医疗废物中88．50％被厂家回收。相关人员对处置方式知识的了解情况、焚烧等毁灭性彻底处理方式知晓率为10％左右,高压消毒等回收再利用性处置知晓率较高,为77．78％。[结论]医疗废物中部分废弃物暂无有效的处理方法,人们对彻底处置医疗废物的知晓率不高,对环境构成潜在的污染,危害人们的健康。     

Results of the health survey of a population living in a vicinity of a large waste site (Warsaw, Poland)

Although attracting rapidly increasing attention from the public, the health impact of environmental exposures related to the operation of waste dumping sites is a relatively new issue in Poland. However, the problem cannot be neglected in light of the fact that environmental impact assessment in selected sites revealed the lack of sufficient documentation concerning quantity and quality of dumped materials and poor technological management of the sites. The paper describes the results of health survey performed in a vicinity of a country's largest municipal waste site. Although the study came across methodological obstacles involving low participation and difficult to estimate representativeness of the examined group its findings obtained in 393 adults and 188 children and the results of internal comparisons revealed some interesting observations. Three "exposure-classification" variables were used in data analysis (geographical location, distance, "waste traffic" intensity) and health status was examined by means of self- and physician-administered questionnaire, physical examination and routine laboratory analyses. Relationship, although weak, of subjective symptoms and objective findings with the place of residence vis-a-vis the waste site location suggests that potential health effects of waste site-related environmental exposures might include psychological problems, digestive tract disorders and respiratory disorders as well as allergic symptoms. An intriguing observation concerning pregnancy-related health outcomes was made. The exact role of environmental determinants in this respect remains unclear and should be addressed by specific environmental epidemiological and toxicological studies. The findings as well as subjects' concern about health consequences of exposures to waste-related pollution (paralleled by subjective perception of impaired health) justify further investigations and public health initiatives including environmental impact assessment and health monitoring activities targeting populations living in a vicinity of waste sites in Poland.     

Hazardous medical waste management as a public health issue

The amount of waste produced is connected with the degree of a country's economic development; more developed countries produce more waste. This paper reviews the quantities, manipulation and treatment methods of medical waste in Croatia, as well as hazardous potentials of medical waste for human health. Medical waste must be collected and sorted in containers suitable for its characteristics, amount, means of transportation and treatment method in order to prevent contact with environment and to protect people who are working with waste. Hazardous medical waste in Croatia is largely produced by hospitals. Even though only one hospital has a licence to incinerate infectious medical waste, many other hospitals incinerate their hazardous waste in inappropriate facilities. Healthcare institutions also store great amounts of old medical waste, mostly pharmaceutical, anti-infectious, and cytostatic drugs and chemical waste. Data on waste treatment effects on human health are scarce, while environmental problems are covered better. Croatian medical waste legislation is not being implemented. It is very important to establish a medical waste management system that would implement the existing legislation in all waste management cycles from waste production to treatment and final disposal.     

Citizen action for environmental health: report on a survey of community organizations

A convenience sample of 242 community organizations involved in environmental health issues was surveyed regarding each group's goals, activities, and problems. The 110 groups that replied identified 153 health-threatening hazards including toxic waste dumps, pesticide spraying, and air or water pollution. The most common health conditions which respondents attributed to these hazards were cancer, respiratory problems, birth defects, and reproductive difficulties. The goal identified most frequently was the correction of the specific hazard facing their community. To achieve this aim, groups engaged in a variety of activities including research, public education, demonstrations, lobbying, and legal action. Most groups reported extensive and helpful interactions with scientists or health professionals. Respondents reported problems in obtaining information from local health officials, other government agencies, and industry. A majority of the groups rated their efforts at environmental health protection as being very or somewhat successful. The implications of these findings for local health officials are discussed.     

Health effects of hazardous chemical waste disposal sites in New Jersey and in the United States: a review.

The hazardous chemical waste disposal issue is a widespread problem. Large quantities of chemical wastes have been produced by the chemical industries in the past forty years. Estimates now number disposal sites in the United States at least 30,000. The public and scientists have grown increasingly concerned about the effects of these waste disposal sites not only on the environment, but also on the human body. In this article, we review the number of hazardous chemical waste disposal sites (HCWDS), their construction, difficulties in defining their contents, and the establishment of the Superfund Act. We then discuss various studies in the literature that have attempted to define adverse health effects of HCWDS, particularly those examining Love Canal and sites in New Jersey. In our conclusions, we note the difficulties in establishing direct causal links between HCWDS and dangerous health effects. We suggest that more epidemiological studies are needed, with improved methodology for gathering complete data and studying large samples. Both positive and negative findings of epidemiological studies are important. Positive results will substantiate an association of health effects with HCWDS. Negative results may reduce the concerns of people living near HCWDS. Future investigators need sufficient information about HCWDS materials, possible routes of exposure, and measurements of exposure, as well as sufficient statistical power to detect even modest associations of health effects with HCWDS exposure.