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PubMed1990

Medical waste. The growing issues of management and disposal.

When addressing the impact of medical waste management and regulatory controls on the health care industry, it is important to remember that as long as modern medicine continues to maintain and sustain its current quality of life and wellness standards, industry will continue to generate various byproducts that have adverse effects on both people and the environment. It is important, therefore, to carefully evaluate the impact of societal demands. Unless government, industry, environmental groups, and health care providers abandon their current adversarial relationships and work together to solve shared problems, there will be no improvement in the growing problem of medical waste. The long-term solutions to today's growing waste problems depend to a great extent on human factors and the willingness of industry, medical community, and governmental bodies to cooperate with each other, recognizing the cause-effect relationship of a continued demand for disposable products. There are many pieces to the waste management puzzle. Obviously, surgeons cannot perform surgery without exposure to blood, tissue or body fluids, and nurses cannot maintain asepsis without sterile products. Because the health care team cannot totally eliminate the source of medical waste, they must learn to more effectively manage and control it. Health care professionals must encourage industry and government to work together to develop standards for products and materials used as barriers and use more biodegradable materials. Health care facilities must learn to minimize the amount of medical waste designated as regulated or infectious. Segregating potentially infectious material from clean waste at the point of generation may reduce both volume and cost.

Humans↗
PubMed1989

Medical waste: socioeconomic impact.

The proper disposal and management of medical waste is a never-ending problem and one which is of grave concern to the general public. The amounts that are produced each day by hospitals and other small-generators are staggering, e.g., in the U.S. ca. 6000 tons per day. Approximately fifteen (15%) percent of this waste is considered infectious. This latter type of waste is usually incinerated or autoclaved (steam sterilization). In addition to the daily accumulation of solid waste, chemical wastes (liquids) and low-level radioactive wastes are generated. The proper disposal of all types of wastes is discussed as well as the overall cost and its impact on society.

Medical Waste↗
PubMed2005

Medical wastes management in the south of Brazil.

In developing countries, solid wastes have not received sufficient attention. In many countries, hazardous and medical wastes are still handled and disposed together with domestic wastes, thus creating a great health risk to municipal workers, the public and the environment. Medical waste management has been evaluated at the Vacacai river basin in the State of Rio Grande do Sul, Brazil. A total of 91 healthcare facilities, including hospitals (21), health centers (48) and clinical laboratories (22) were surveyed to provide information about the management, segregation, generation, storage and disposal of medical wastes. The results about management aspects indicate that practices in most healthcare facilities do not comply with the principles stated in Brazilian legislation. All facilities demonstrated a priority on segregation of infectious-biological wastes. Average generation rates of total and infectious-biological wastes in the hospitals were estimated to be 3.245 and 0.570 kg/bed-day, respectively.

Brazil↗
PubMedDate not supplied

Defining and managing biohazardous waste in U.S. research-oriented universities: a survey of environmental health and safety professionals.

A survey was conducted of environmental health and safety professionals responsible for biohazardous waste management at 122 institutions. The overall response rate was 82.6 percent (100 out of 122). Results indicate that university policies for biohazardous waste are heavily influenced by state environmental regulations, the Occupational Safety and Health Administration Bloodborne Pathogens Standard, and the biosafety guidelines of the Centers for Disease Control and Prevention and the National Institutes of Health. With respect to definition of waste, 84 percent of the universities treat non-infectious human-cell-culture waste as biohazardous. Sharp items, including hypodermic needles, syringes with needles, and scalpel blades, are commonly treated (by 85 percent of universities) as biohazardous sharps regardless of contamination status. Importantly, while 90 percent of universities use autoclave sterilization for waste treatment, only 52 percent use a biological indicator to validate the process. On-site incineration is currently used by 42 percent of universities. Twenty-two of 42 incinerators are hospital/medical/infectious-waste incinerators, and 10 of these will continue to operate under the U.S. Environmental Protection Agency's revised incinerator regulations. Eighty-seven percent of the respondents indicated that some portion of their university's biohazardous waste is treated and disposed of through a licensed medical waste hauler (MWH). To ensure compliance with institutional policy, most universities segregate and package waste, train waste generators, and conduct inspections.

Centers for Disease Control and Prevention, U.S.↗
PubMed2004

Alternatives for treatment and disposal cost reduction of regulated medical wastes.

Many hospitals or health care facilities have faced financial difficulties and thus they have attempted to find cost-effective treatment and disposal methods of their regulated medical wastes (RMWs). This study investigated generation volume and sources, composition, and treatment and disposal methods for RMWs obtained from three out of the five typical city hospitals in Massachusetts for which we could obtain relevant data on medical waste. Also, this study compared the generation patterns and amounts of RMWs between the hospital and the medical school. The yearly operational treatment and disposal costs of RMWs based on different treatment and disposal methods were analyzed for one hospital. The most cost-effective option of four different treatment and disposal options studied was to combine on-site incineration and microwave technologies. Finally, this study identified measures for the effective waste characterization methods for the reduction of treatment and disposal costs of RMWs. By careful exclusion of non-RMW from RMW waste streams, hospitals can reduce the RMW volume that requires special treatment and reduce disposal costs.

Cost Control↗
PubMed2006

Characterization and management of solid medical wastes in the Federal Capital Territory, Abuja Nigeria.

BACKGROUND: Medical establishment such as hospitals and research institutes generate sizable amount of hazardous waste. Health care workers, patients are at risk of acquiring infection from sharps and contamination of environment with multiple drug resistant microorganisms if wastes are not properly managed. OBJECTIVES: To characterize types and evaluate waste disposal techniques employed in the management of solid medical wastes in five selected hospitals in the Federal Capital Territory, Abuja. METHODS: This was a cross section study involving the use of questionnaires, in-depth interview, meetings, discussions and participant observed strategy. It also involved the collection, sorting (segregation), identification and characterization and weighing of waste types from wards and units in the selected hospitals. RESULTS: The average waste generation rate per bed/day was determined and found to be 2.78 kg of solid waste, 26.5% of the total waste was hazardous in nature. Waste segregation was found not to be practiced by any of the hospitals surveyed, 18.3% of the hospitals incinerated waste in a locally built brick incinerator; 9.1% bury; 36.3% burn waste in open pits while 36.3% dispose of a waste into municipal dumpsites. CONCLUSION: Waste management officers do not have formal training in waste management techniques; and hospital administrators pay very little attention to appropriate management of medical waste. Therefore, we must educate waste generators of their responsibility to properly manage the waste so that their staff, patients, environment and community is protected.

Cross-Sectional Studies↗
PubMed2004

Medical waste management in Trachea region of Turkey: suggested remedial action.

The main objective of this paper was to analyse the present status of medical waste management in the Trachea region of Turkey and subsequently to draw up a policy regarded with generation, collection, on-site handling, storage, processing, recycling, transportation and safe disposal of medical wastes. This paper also presents the results of study about awareness on how to handle expired drugs. Initially all health-care establishments in Tekirdağ, Edirne and Kýrklareli provinces in Trachea region were identified and the amounts of hospital wastes generated by each of them were determined. Current medical waste-management practices, including storage, collection, transportation and disposal, in surveyed establishments were identified. Finally, according to results, remedial measurements for medical waste management in these establishments were suggested. Unfortunately, medical wastes are not given proper attention and these wastes are disposed of together with municipal and industrial solid wastes. The current disposal method is both a public health and environmental hazard. When landfill sites are visited, many scavengers can be seen sorting for recyclable materials, a practice which is dangerous for the scavengers. In addition, it was found that some staff in health-care establishments are unaware of the hazard of medical wastes. It is concluded that a new management system, which consists of segregation, material substitution, minimization, sanitary landfilling and alternative medical waste treatment methods should be carried out. For the best appropriate medical waste management system, health-care establishment employers, managers and especially the members of house- keeping divisions should be involved in medical waste management practice.

Evaluation Studies as Topic↗
PubMedDate not supplied

Management of bio-medical waste: awareness and practices in a district of Gujarat.

With the objective of assessing the level of awareness about the various aspects of biomedical waste and disposal practices by the medical practitioners this study was conducted. It was a cross sectional study. 30 hospitals with more than 30 beds minimum were randomly selected from Sabarkantha district, Gujarat. The doctors and auxiliary staff of those 30 hospitals were the study population. While all the doctors knew about the existence of the law related to biomedical waste but details were not known. Doctors were aware of risk of HIV and Hepatitis B and C, whereas auxiliary staff (ward boys, ayabens, sweepers) had very poor knowledge about it. There was no effective waste segregation, collection, transportation and disposal system at any hospital in the district. There is an immediate and urgent need to train and educate all doctors and the staff to adopt an effective waste management practices.

Cross-Sectional Studies↗
PubMed2004

Bio-medical waste management in the U.T., Chandigarh.

Investigations were carried out to assess the generation and disposal of biomedical waste in the various medical establishments in the urban and rural areas of the U.T. Chandigarh. It was found that there were 474 medical establishments in the U.T., Chandigarh including Nursing Homes, Clinics, Dispensaries, Pathological labs., Hospitals, Veterinary Institutions and Animal houses. The total quantity of bio-medical waste generated in Chandigarh is 811.35 kg/day and the rate of generation of bio-medical waste varies from 0.06 kg/day/bed to 0.25 kg/day/bed. Though the major hospitals are equipped with incinerators, proper bio-medical waste management system is yet to be implemented. The medical establishments in the rural area and smaller ones in the urban area dispose off their bio-medical waste along with municipal solid waste and no waste management system exists. It is recommended that an integrated waste management plan using the three incinerators installed at the major hospitals can safely dispose off the total bio-medical waste generated in the city.

Health Facilities↗
PubMed2000

[A trial of pollutant release and transfer register in a university school of medicine].

At Hamamatsu University School of Medicine, the Pollutant Release and Transfer Register (PRTR) was tried. The following results were obtained. On solid chemical substances, the stored quantity was comparatively greater than the purchased or disposed quantity. However, on liquid substances, the purchased volume was similar to the disposed volume.

Environmental Monitoring↗
PubMed2004

[Investigation of radioactivity measurement of medical radioactive waste].

To explore the possibility of which medical radioactive wastes could be disposed as general wastes after keeping them a certain period of time and confirming that their radioactivity reach a background level (BGL), we made a survey of these wastes in several nuclear medicine facilities. The radioactive wastes were collected for one week, packed in a box according to its half-life, and measured its radioactivity by scintillation survey meter with time. Some wastes could reach a BGL within 10 times of half-life, but 19% of the short half-life group (group 1) including 99mTc and 123I, and 8% of the middle half-life group (group 2) including 67Ga, (111)In, and 201Tl did not reach a BGL within 20 times of half-life. A reason for delaying the time of reaching a BGL might be partially attributed to high initial radiation dose rate or heavy package weight. However, mixing with the nuclides of longer half-life was estimated to be the biggest factor affecting this result. When disposing medical radioactive wastes as general wastes, it is necessary to avoid mixing with radionuclide of longer half-life and confirm that it reaches a BGL by actual measurement.

Half-Life↗
PubMed2006

Assessment of medical wastes management practice: a case study of the northern part of Jordan.

This study includes a survey of the procedures available, techniques, and methods of handling and disposing of medical waste at medium (between 100 and 200 beds) to large (over 200 beds) size healthcare facilities located in Irbid city (a major city in the northern part of Jordan). A total of 14 healthcare facilities, including four hospitals and 10 clinical laboratories, serving a total population of about 1.5 million, were surveyed during the course of this research. This study took into consideration both the quantity and quality of the generated wastes to determine generation rates and physical properties. Results of the survey showed that healthcare facilities in Irbid city have less appropriate practices when it comes to the handling, storage, and disposal of wastes generated in comparison to the developed world. There are no defined methods for handling and disposal of these wastes, starting from the personnel responsible for collection through those who transport the wastes to the disposal site. Moreover, there are no specific regulations or guidelines for segregation or classification of these wastes. This means that wastes are mixed, for example, wastes coming from the kitchen with those generated by different departments. Also, more importantly, none of the sites surveyed could provide estimated quantities of waste generated by each department, based upon the known variables within the departments. Average generation rates of total medical wastes in the hospitals were estimated to be 6.10 kg/patient/day (3.49 kg/bed/day), 5.62 kg/patient/day (3.14 kg/bed/day), and 4.02 kg/patient/day (1.88 kg/bed/day) for public, maternity, and private hospitals, respectively. For medical laboratories, rates were found to be in the range of 0.053-0.065 kg/test-day for governmental laboratories, and 0.034-0.102 kg/test-day for private laboratories. Although, based on the type of waste, domestic or general waste makes up a large proportion of the waste volume, so that if such waste is not mixed with patient derived waste, it can be easily handled. However, based on infections, it is important for healthcare staff to take precautions in handling sharps and pathological wastes, which comprises only about 26% of the total infectious wastes. Statistical analysis was conducted to develop mathematical models to aid in the prediction of waste quantities generated by the hospitals studied, or similar sites in the city that are not included in this study. In these models, the number of patients, number of beds, and hospital type were determined to be significant factors on waste generation. Such models provide decision makers with tools to better manage their medical waste, given the dynamic conditions of their healthcare facilities.

Conservation of Natural Resources↗