It is the Problem Based Learning (PBL) Presentation

1. Hospital Hazardous Waste Management
Practices in Punjab, Pakistan
Name : Asadullah
Roll No : F16EE02

2. Table of
Content
Introduction Hospital Waste and Management
Generation and quantification of Hospital Hazardous waste in
Punjab
Characterization and composition of Hospital Hazardous waste in
Punjab
Status of current disposal and treatment practices in Punjab
Gap analysis through literature survey
Conclusion and recommendation
References

3. Introduction to Hospital Waste
• The term "Hospital" means a clinic, laboratory, dispensary,
pharmacy, nursing home, health unit, maternity Centre, blood
bank, autopsy Centre, mortuary, research institute, and
veterinary institutions including any other facility involved in
health care and biomedical activities
• Hospital waste includes both Hazardous waste and non-
hazardous waste. Following types of waste are produced by
hospitals in different quantities:
• “Non-hazardous waste” includes paper and cardboard,
packaging, food waste, and aerosols and the like.
• “Hazardous waste” means infectious waste, pathological waste,
sharps, pharmaceutical waste, genotoxic waste, chemical waste,
and radioactive waste.

4. Introduction Waste Management
• Waste Management is the collection, transport,
processing or disposal, managing and monitoring of
waste material. Or
• Waste management includes waste segregation,
waste collection, waste transportation, waste
storage, waste disposal, and waste minimization and
reuse.
• There are many hospitals in the districts of
Punjab which produce lots of wastes that can be
harmful if not disposed of properly.

5. Generation and Quantification of Waste in Punjab
• Total waste generation in Punjab is 0.65kg/ bed/day, Lahore has 44 hospitals, 500 clinics, (total bed strength 12480). Most
contagious of hazardous hospital waste are sharps especially used syringes, infusion sets, scalpels, knives, broken glasses.
Infectious waste includes dressings, clothes, used catheters, contaminated by blood and body fluids of patients, in addition,
chemical, pharmacological and radiological waste is also associated with risks to the population 5.24 billion syringes are used in
Pakistan every year. Pakistan has highest injection: patient ratio and highest rate of unnecessary injections in the world 6.30%
population is using 10 injections/person/year.
• As per annual report, the state of Punjab generated around 1266 tonnes per day (TPD) of MSW in 1999-2000 which has increased
to around 2793 TPD in 2011.
• And the hazardous waste inventory report of 2009, the province had 3023 hazardous waste generating units and it generated
180,000 tonnes of hazardous waste (13601 tonnes landfillable, 14831 tonnes incinerable and 89481 tonnes recyclable) on an annual
basis.

6. • According to one of the research Using TERI (The Energy and
Resources Institute) estimates for the urban population projections
in the year 2011, 2021, 2031 and 2041, the total amount of waste
generated in the Punjab can be calculated, as shown in the Table
Year Waste generated T/day
2011 2793.5
2021 3802.6
2031 4992.5
2041 6366.8

7. Characterization and Composition
of Waste in Punjab
 Punjab is the most populous province of Pakistan with an
urban population of 40% and total population of about
110,012,442 in 2017.
 Medical waste was sorted into 10 categories whereas
general waste was classified into 11 categories.
 The studied hospital produced an average 297 kilograms
of medical waste daily and it comprises plastics (71.0%),
glass (13.9%), papers etc. (3.8%), cotton/dressings
(5.7%), masks/gloves/sheets (0.3%) diapers (0.4%),
wasted machines used in operation theatres (2.0%) and
blades (0.1%).
 Laboratories, cancer ward, nursery ward, OPD and
emergency ward are the largest infectious waste
producing departments in the hospital.

8. Status of current disposal and treatment practices in Punjab
• Last year Provincial Minister for Health Dr Yasmeen Rahsid formulated a new central policy for disposing of
medical waste of hospitals in Punjab.
• According to new policy the medical waste of every hospital would be collected and superintendents will be
wholly responsible for the safe disposal of hospital waste
• Techniques for Hospital Waste
• Incineration
• Steam Autoclave Disinfection
• Microwave Disinfection
• Mechanical/Chemical Disinfection
• Incineration is mostly used as a treatment options in Punjab.
• Which is the simple and Basic.
• Un-regularised incineration leads to harmful effects on health.

10. Gap analysis through literature survey
• Pakistan is a rapidly urbanizing country in South Asia While the population growth rate in the country is
only 1.6%, the urbanization rate in Pakistan is 3.0% .
• Studies from Pakistan show that around 1.35Kg of waste is produced every day for each hospital bed
occupied. There were about 92,000 hospital beds in Pakistan in 2006 and about 2 Kg of waste per bed
produced every day. In total about 0.8 million tons of waste is produced every day in Pakistan
• One estimate shows that in Punjab some 5.2 million people (including 4 million children) die each year from
waste-related diseases. Hospital wastes pose a significant impact on health & environment. So there is a
dire need for the enforcement and implementation of HWM rules in all the hospitals of Punjab for the proper
handling, minimization and final disposal of the waste.

11. Conclusion and recommendation
• Hospitals in Pakistan whether private or public do not follow and oblige HCWM guidelines of WHO and do not
practice Pakistan bio-safety rules 2005.
• There is an urgent need to raise awareness and educate general public and concerned persons on Hospital
Hazardous waste issues.
• Proper waste management strategy is needed to ensure health and environmental safety
• The health officer should inspect hospital, incinerator or landfill located within the area of his jurisdiction to check
the provision of HWM Rules
• Find alternatives & appropriate technologies for developing countries
• Need to collect information and examples from developed countries or the country, which has sound medical waste
management system
• Ensure the presence of hospital waste management committee in every hospital of all districts
• A careful evaluation of training programs offered in other countries, and how they can be applied in Pakistan

12. Reference
• epd.punjab.gov.pk/hospital_waste
• https://www.slideshare.net>mobile
Environmental and Medical Waste
Management Plan – Punjab Health …
• http://www.ayubmed.edu.pk/JAMC/PA
ST/22-4/Ramesh.pdf
• http://www.health.Punjab.gov.pk
• http://www.ncbi.nlm.nih.gov

13. Thank You