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PubMed2006

[Medical waste management: the law and its application].

Medical waste management in Croatia is regulated by three fundamental legal acts: Waste Act, Ordinance on Waste Types and Directive on Manipulation of Waste Generated in Health Care. The implementation of these acts and waste management in general are also supported by Transport of Hazardous Materials Act and Toxic Substances Act. Modern trends in waste management promote an integral approach also called "waste chain". This integral approach to medical waste management is based on hierarchical structuring of waste management structure from the point at which the waste is produced to its final disposal. Priority is always given to reducing the amount and the harmfulness of waste by replacing harmful materials with those that are not, but where this is not possible, waste management includes reduction by sorting and separating, pretreatment on site, safe transportation, final treatment and sanitary disposal. Methods of choice for the final treatment should be the least harmful for human health and environment. Integral medical waste management could greatly reduce quantities of medical waste and consequently financial strains. Even though Croatian regulations define and cover all steps in the waste management chain their implementation is one of the country's greatest issues. Improper practice is seen from waste production in healthcare institutions to the final disposal, and includes handling, sorting, use of containers, or treatment in incinerators. Information on quantities, type and flow of medical waste are inadequate, just as sanitary control. In addition, Croatia lacks locations for sanitary landfills. Croatia has signed international conventions on the supervision and control of transfrontier waste shipments. Within the CARDS project, Croatia has started to harmonise its laws with acquis communitaire related to waste management. Although waste management is one of the priorities defined within the National Environment Action Plan, Croatia still has not made a strategy for waste management.

Croatia↗
PubMed2004

Public awareness is key to successful waste management.

A critical component in any waste management program is public awareness and participation, in addition to appropriate legislation, strong technical support, and adequate funding. Waste is the result of human activities and everyone needs to have a proper understanding of waste management issues, without which the success of even the best conceived waste management plan becomes questionable. The paper presents an overview of the fundamentals of waste management and, using examples from the United States, illustrates how public awareness and participation results in succcssful waste management. Examples of the methods and techniques that have been very effective in creating and enhancing public awareness of waste management problems, including the author's proven method of public education, are presented in the paper. The details of a course aimed at educating school teachers on waste management issues and a specialized curriculum on waste and litter control, designed for kindergarten through 8th grade students and developed by the author, are discussed in the paper. A case study dealing with remediation of one of the worst contaminated hazardous waste sites in the United States, that included substantial public participation, is reviewed. The paper concludes by emphasizing that the public must be made aware of waste management issues to understand the consequences of improper management of waste and how it may ultimately pose a serious threat to their lives and well-being.

Adolescent↗
PubMed2003

Health hazards and waste management.

Different methods of waste management emit a large number of substances, most in small quantities and at extremely low levels. Raised incidence of low birth weight births has been related to residence near landfill sites, as has the occurrence of various congenital malformations. There is little evidence for an association with reproductive or developmental effects with proximity to incinerators. Studies of cancer incidence and mortality in populations around landfill sites or incinerators have been equivocal, with varying results for different cancer sites. Many of these studies lack good individual exposure information and data on potential confounders, such as socio-economic status. The inherent latency of diseases and migration of populations are often ignored. Waste management workers have been shown to have increased incidence of accidents and musculoskeletal problems. The health impacts of new waste management technologies and the increasing use of recycling and composting will require assessment and monitoring.

Environmental Exposure↗
PubMed2006

Overview of biomedical waste management in selected Governorates in Egypt: a pilot study.

Inadequate management of biomedical waste can be associated with risks to healthcare workers, patients, communities and their environment. This study was conducted to assess the handling and treatment of biomedical waste in different healthcare settings in Egypt. Five hospitals and ten primary healthcare settings were surveyed using a modified survey questionnaire for waste management. This questionnaire was obtained from the World Health Organization (WHO), with the aim of assessing the processing systems for biomedical waste disposal. Researchers found that biomedical waste is inadequately processed in hospitals and primary healthcare settings due to the absence of written policies and protocols. Accordingly, healthcare staff, patients, the community and the environment may be negatively affected by exposure to the hazards of biomedical waste. The development of waste management policies, plans, and protocols are strongly recommended, in addition to establishing training programs on proper waste management for all healthcare workers.

Egypt↗
PubMed2001

Health-care waste management in India.

Health-care waste management in India is receiving greater attention due to recent regulations (the Biomedical Wastes (Management & Handling) Rules, 1998). The prevailing situation is analysed covering various issues like quantities and proportion of different constituents of wastes, handling, treatment and disposal methods in various health-care units (HCUs). The waste generation rate ranges between 0.5 and 2.0 kg bed-1 day-1. It is estimated that annually about 0.33 million tonnes of waste are generated in India. The solid waste from the hospitals consists of bandages, linen and other infectious waste (30-35%), plastics (7-10%), disposable syringes (0.3-0.5%), glass (3-5%) and other general wastes including food (40-45%). In general, the wastes are collected in a mixed form, transported and disposed of along with municipal solid wastes. At many places, authorities are failing to install appropriate systems for a variety of reasons, such as non-availability of appropriate technologies, inadequate financial resources and absence of professional training on waste management. Hazards associated with health-care waste management and shortcomings in the existing system are identified. The rules for management and handling of biomedical wastes are summarised, giving the categories of different wastes, suggested storage containers including colour-coding and treatment options. Existing and proposed systems of health-care waste management are described. A waste-management plan for health-care establishments is also proposed, which includes institutional arrangements, appropriate technologies, operational plans, financial management and the drawing up of appropriate staff training programmes.

Cities↗
PubMed2003

Review of the radioactive waste management system in Nigeria.

The management of radioactive waste in Nigeria from early 1960 to date is reviewed. As in many developing countries, waste management in Nigeria has been shown to be ineffective. The factors that are responsible for this ineffectiveness are identified and discussed. The steps being taken by and the opportunities available to the newly established Nigerian Nuclear Regulatory Authority towards addressing this problem of ineffectiveness are discussed. The efforts of this newly set up body towards managing the resultant radioactive wastes that will be generated during the use of a reactor and an accelerator that will soon be commissioned in Nigeria are also mentioned. Likely ways of further addressing the problems militating against waste management in developing countries are suggested.

Developing Countries↗
PubMed2006

Planning for integrated solid waste management at the industrial park level: a case of Tianjin, China.

Industrial parks play a significant role in the production and use of goods and services. The proper management of solid waste is a major challenge for industrial parks due to the large quantity of wastes and the variability of waste characteristics from these types of developments. Therefore, integrated solid waste management has become very crucial to the industrial park managers. Such an approach requires industrial park managers to assess the overall use of resources, and to seek waste reduction, reuse and recycling opportunities both at the individual company level and among different tenant companies. The adoption of this method can bring both economic and environmental benefits. This paper introduces the planning efforts of a real case in China. It first presents the basic information on Tianjin Economic Development Area (TEDA), and then introduces its current practices on solid waste management. The main focus of this paper is to describe how to plan an integrated solid waste management system at TEDA. Benefits and challenges are all identified and analyzed. The experiences and methods from this case study should be applied in other industrial parks so as to improve the overall eco-efficiency of the whole industrial park.

China↗
PubMed2006

Current strategies for dairy waste management: a review.

Industrial waste management is nowadays one of the main issues for ensuring a sustainable environment. Dairy waste management in particular, is very crucial in view of the high organic matter and high nutrient levels contained in dairy effluents. Dairy waste can be effectively treated either with aerobic or anaerobic processes. The main advantages of the former consist of low yield, high kinetics, pathogen free product, and high temperature operation whereas the latter is a simple, low budget and conservative technology. Occasionally, pre-treatment strategies (i.e. wetlands) are required in order to improve the efficiency of treatment methodology. Wetlands are a promising technology applied in order to remove the greater part of nutrients and minerals contained in milk based products.

Aerobiosis↗
PubMed1991

Hazardous waste management.

The management of waste in the dental office is dictated by the federal, state, and local ordinances in force in the locale in which the office is located. The dentist must first determine what the laws require and then implement the changes in waste management into the office setting. The local component society of the ADA often provides such information; otherwise, the health department of the government branch having jurisdiction over the office locale will either have the information or know where to find it. Once it has been established what constitutes hazardous waste, the next steps are to contain it, store it, and finally dispose of it according to the information gained from the authorities. Storage of sharps should be accomplished in "hard-walled, leak-proof containers," usually red, which can be closed securely when they have been filled, and which are located as close to the point of use as possible. Solid waste should usually be contained in red bags, which are then bagged in a second bag when full or in a hard-walled container. Waste may then be hauled away for disposal by a qualified company that keeps the required records of the waste from the time it leaves the office until final disposal by incineration or burial in an approved landfill. The company chosen to do the hauling should be able to demonstrate that they have appropriate insurance to indemnify your office in the event of a problem while they have the waste in their possession.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Offices↗
PubMed2005

[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.

Brazil↗
PubMed2006

Sustainable waste management in the UK: the public health role.

This paper discusses waste management in the UK and its relationship with health. It aims to outline the role of health professionals in the promotion of waste management, and argues for a change in their role in waste management regulation to help make the process more sustainable. The most common definition of sustainable development is that by the Brundtland commission, i.e. "development that meets the needs of the present without compromising the ability of future generations to meet their own needs". Managing waste sites in a manner that minimises toxic impacts on the current and future generations is obviously a crucial part of this. Although the management of waste facilities is extremely complex, the Integrated Pollution Prevention and Control regime, which requires the input of public health professionals on the regulation of such sites, means that all waste management installations should now be operating in a fashion that minimises any toxicological risks to human health. However, the impacts upon climate change, resource use and health inequalities, as well as the effects of waste transportation, are currently not considered to be part of public health professionals' responsibilities when dealing with these sites. There is also no requirement for public health professionals to become involved in waste management planning issues. The fact that public health professionals are not involved in any of these issues makes it unlikely that the potential impacts upon health are being considered fully, and even more unlikely that waste management will become more sustainable. This paper aims to show that by only considering direct toxicological impacts, public health professionals are not fully addressing all the health issues and are not contributing towards sustainability. There is a need for a change in the way that health professionals deal with waste management issues.

Community Health Planning↗
PubMed1980

Effect of dietary salt, arsenic and copper additions and waste management systems on selected microbial organisms in swine wastes.

Selected microbial organisms were counted in swine wastes during three studies in which the primary objective was to investigate the effects of feed additives and waste management systems on swine waste composition. Dietary salt (NaCl) levels (.2, .5%), dietary arsanilic acid levels (0, 100, 200 ppm), supplemental copper levels (0, 125, 250 ppm) and waste management systems (oxidation ditch, anaerobic deep pit, anaerobic lagoon) were compared in this series of studies. Dietary salt level did not affect total coliform and fecal streptococci concentrations in swine waste. Supplemental copper and arsanilic acid increased total coliform counts (dry matter basis) in anaerobic pit wastes over counts observed with the control. Salmonella spp concentrations were increased in the anaerobic pit waste at the end of the 104-day feeding trial, especially with the 250-ppm copper diet. Staphylococci spp organisms were not affected by supplemental copper. In all studies, concentrations of the microorganisms cultured were higher in freshly excreted waste than in waste stored and partially treated in the waste systems studies. Temperature, diultion and waste handling systems had some effects on microbial populations.

Animals↗
PubMedDate not supplied

Medical waste management. Regulatory issues and current legal requirements.

The effective management of medical wastes poses a broad range of complex, unresolved questions. Definitions for "medical waste" and "infectious waste" must be clarified. Although news media coverage has drawn attention to aesthetic problems raised when medical wastes wash up on beaches, the possibility of significant health and environmental risks presented by such wastes must not be neglected. Many states have passed laws regulating various parts of the medical waste management process. A major new federal law, the Medical Waste Tracking Act of 1988, also has been enacted. Extensive research must be undertaken to seal existing gaps in knowledge affecting medical waste management. The public and generators of medical wastes must be educated about attendant issues and legal requirements. As further research is pursued, regulatory programs should be developed based on the best available data.

Centers for Disease Control and Prevention, U.S.↗
PubMed2005

The effect of dynamic scheduling and routing in a solid waste management system.

Solid waste collection and hauling account for the greater part of the total cost in modern solid waste management systems. In a recent initiative, 3300 Swedish recycling containers have been fitted with level sensors and wireless communication equipment, thereby giving waste collection operators access to real-time information on the status of each container. In this study, analytical modeling and discrete-event simulation have been used to evaluate different scheduling and routing policies utilizing the real-time data. In addition to the general models developed, an empirical simulation study has been performed on the downtown recycling station system in Malmoe, Sweden. From the study, it can be concluded that dynamic scheduling and routing policies exist that have lower operating costs, shorter collection and hauling distances, and reduced labor hours compared to the static policy with fixed routes and pre-determined pick-up frequencies employed by many waste collection operators today. The results of the analytical model and the simulation models are coherent, and consistent with experiences of the waste collection operators.

Computer Simulation↗
PubMed2006

An environmental analysis for comparing waste management options and strategies.

The debate on different waste management practices has become an issue of utmost importance as human activities have overloaded the assimilative capacity of the biosphere. Recent Italian law on solid waste management recommends an increase in material recycling and energy recovery, and only foresees landfill disposal for inert materials and residues from recovery and recycling. A correct waste management policy should be based on the principles of sustainable development, according to which our refuse is not simply regarded as something to eliminate but rather as a potential resource. This requires the creation of an integrated waste management plan that makes full use of all available technologies. In this context, eMergy analysis is applied to evaluate three different forms of waste treatment and construct an approach capable of assessing the whole strategy of waste management. The evaluation included how much investment is needed for each type of waste management and how much "utility" is extracted from wastes, through the use of two indicators: Environmental yield ratio (EYR) and Net eMergy. Our results show that landfill is the worst system in terms of eMergy costs and eMergy benefits. Composting is the most efficient system in recovering eMergy (highest EYR) from municipal solid waste (MSW) while incineration is capable of saving the greatest quantity of eMergy per gram of MSW (highest net eMergy). This analysis has made it possible to assess the sustainability and the efficiency of individual options but could also be used to assess a greater environmental strategy for waste management, considering a system that might include landfills, incineration, composting, etc.

Conservation of Energy Resources↗
PubMed1981

Hazardous waste management system: identification and listing of hazardous waste--Environmental Protection Agency. Interim final rule and request for comments.

The Environmental Protection Agency [EPA] is today revising the regulations for hazardous waste management under the Resource Conservation and Recovery Act to exempt certain categories of mixtures of solid wastes and hazardous wastes from the presumption of hazardousness presently contained in the regulations. EPA is taking this action because the Agency believes that the risk posed to human health and the environment from the management of these waste mixtures is not substantial, so that automatically defining these waste mixtures as hazardous is inappropriate. This amendment will substantially reduce the regulatory burden to those persons who would otherwise have applied the regulations for hazardous waste management to these mixtures.

Hospitals↗
PubMed2005

Alternative approaches for better municipal solid waste management in Mumbai, India.

Waste is an unavoidable by product of human activities. Economic development, urbanization and improving living standards in cities, have led to an increase in the quantity and complexity of generated waste. Rapid growth of population and industrialization degrades the urban environment and places serious stress on natural resources, which undermines equitable and sustainable development. Inefficient management and disposal of solid waste is an obvious cause of degradation of the environment in most cities of the developing world. Municipal corporations of the developing countries are not able to handle increasing quantities of waste, which results in uncollected waste on roads and in other public places. There is a need to work towards a sustainable waste management system, which requires environmental, institutional, financial, economic and social sustainability. This study explores alternative approaches to municipal solid waste (MSW) management and estimates the cost of waste management in Mumbai, India. Two alternatives considered in the paper are community participation and public private partnership in waste management. Data for the present study are from various non-governmental organizations (NGOs) and from the private sector involved in waste management in Mumbai. Mathematical models are used to estimate the cost per ton of waste management for both of the alternatives, which are compared with the cost of waste management by Municipal Corporation of Greater Mumbai (MCGM). It is found that the cost per ton of waste management is Rs. 1518 (35 US dollars) with community participation; Rs. 1797 (41 US dollars) with public private partnership (PPP); and Rs. 1908 (44 US dollars) when only MCGM handles the waste. Hence, community participation in waste management is the least cost option and there is a strong case for comprehensively involving community participation in waste management.

Cities↗