Introduction Medical care is vital for our life, health and well being. The waste generated from medical activities can be hazardous, toxic. Diseases like cholera, plague, skin infection, hepatitis , AIDS (HIV), pose grave public health risks. Environmental pollution. Institutional/Organizational set up, training and motivation. Great research & awareness have increased recently.
Definition ‘Medical Waste’ means any solid and/or liquid waste including its container and any intermediate product, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research or in the production or testing. Any waste which consists entirely or partly of human or animal tissue, blood or other body fluids, excretions, drugs or other pharmaceutical products, dressings or syringes, needles or other sharp instruments. Sources: Arising from medical, nursing, dental, pharmaceutical or similar practice, investigation, treatment, care, teaching or research or the collection of blood from transfusion.
Generation Public hospitals produce more healthcare waste than private hospitals. Mismanagement of Waste and lack of segregation of waste. North America produces 7–10 kg of healthcare waste per bed/day, South America produces 3kg . Western Europe produces 3–6 kg, Eastern Europe 1.4–2 kg, In Asia, richer countries produce 2.5 kg per bed/daily, and poorer countries 1.8–2 kg per bed/daily.
Worldwide Waste Generation South Africa 0.60 kg/bed/day Algeria 0.70 kg/bed/day Brazil 2.63 kg/bed/day Jordan 6.10 kg/bed/day Greece 8.4 kg/bed/day Bangladesh 1.71 kg/bed/day China 1.22 kg/bed/day
Handling & Transportation Risks to healthcare staffs, the public and the environment. Codes of practices and guidelines for handling and disposal Problematic due to its enormous volume of generation, serious threat for the human health as well as disposal cost. Clinical waste cannot mix with non-clinical waste. workers are not educated enough and most of them have not had any special training on the management of clinical waste. Do not have appropriate colour coded bags or containers for sorting the different types of waste.
Storage of Waste Recommended Labelling and Color Coding Segregate Storage in Separate Containers (at the Point of Generation). Certification. Common/Intermediate Storage Area.
Incineration According to the EPA 90% of medical waste is incinerated Very effective and secondary benefit of powering boilers in the facility Strict regulations regarding air emissions Incinerator Ash is generally landfilled
Autoclaving Applied heat, pressure, and sometimes steam for sterilization. Often followed by compaction process, and eventually reaches landfills Many landfills are reluctant to accept the waste due to concerns that it still is infectious
Microwaving On-site installation or mobile treatment vehicles in US First the waste is shredded and then it is mixed with water. Microwaving is applied internal heat (autoclaving is external heat) According to the EPA not Industrial Microwaving Belt recommended for treatment of pathological waste
Chemical Disinfecting Primarily through the use of chlorine products Waste is first shredded and mixed with water According to the EPA, chemical disinfection is the most appropriate way to treat liquid medical waste
Irradiation Exposure of Waste to Cobalt source Gamma Radiation inactivates all microbes Special treatment sites are required (No Mobile or in house process) High capital cost Operators’ safety risk in irradiation plant is an issue Does not sterilize pathological wastes
Case Studies Metro Health Hospital, Wyoming, MI: Divert and Purchase Reprocessing Medical DevicesSpectrum Health: Medical Plastics RecyclingGermany Waste Act: 1991
Metro Health Hospital, Wyoming, MI: Divert and Purchase Reprocessing Medical Devices What Benefits Reprocess many Cost savings of $235,803 from purchasing previously single-use reprocessed SUDs devices between 2008 and 2010 Including: harmonic „ 1.84 tons of waste avoided due to scalpels, orthopedic reprocessing in 2010. burrs, and orthopedic „ Avoided $900 in cannulas/trocars regulated medical waste disposal fees in 2010.
Spectrum Health: Medical Plastics Recycling Plastics Benefits „ plastic casing 42,000 pounds of blue wrap hard plastic from devices diverted to recycling in 2010 paper lined with plastic „ 100 bags per day diverted plastic from surgical gowns from OR outer casings of syringes „ Recycling cost half as soft plastics from glove much as general waste wrappers „ Increases staff satisfaction rigid saline bottles relative to reducing wash basins, and surgical environmental impact of the preparation kits OR
German Waste Act: 1991 Retailers and producers required to take back a certain percentage of packaging materials Duales System Deutschland (DSD) collects all the packaging with a Green Dot Licenses this symbol for the products they recycle Reimbursement will be given to companies only after recycling occurs and quotas are met
Targets for collection, sorting and recycling packaging materials in 1996