This document discusses health care waste management. It defines health care waste as all waste generated by health care facilities. Between 75-90% of health care waste is non-infectious general waste, while 10-25% is infectious waste. Poor management of health care waste can lead to occupational health risks for workers, public health risks if infectious waste is improperly disposed of, and environmental pollution. The document outlines principles for proper health care waste management including polluter pays, precautionary, duty of care, cooperation, and proximity principles.

1. WAM 321: Waste Management II
Part 1: Health care waste management
1.1 Introduction to health care waste
management
Brown Ngenda Dip.EH (CCHS) BSc.EH (UNZA) MSc.ES (UG)
Department of Environmental Health
Chainama College of Health Sciences

2. Introduction
• Health care activities protect and restore health and
save lives but inevitably create waste that may be
hazardous to health. Wherever it is generated, safe
and reliable methods for handling are therefore
essential.

3. Introduction cont…
• Between 75% and 90% of the waste produced by
health-care providers is non infectious or “general”
health-care waste, comparable to domestic waste.

4. Introduction cont…
• The remaining 10–25% of health-care waste is
regarded as infectious and may create a variety of
health risks.
• Note: If no separation of wastes takes place, the
whole mixed volume of health care waste needs
to be considered as being infectious.

5. Definition of Health care waste
• Health care waste (HCW) – all waste generated by
health care facilities, health research facilities,
medical laboratories and that produced during
undertakings in the home e.g. dialysis, insulin
injections and home based care.

6. Health care waste
• Wastes produced in health facilities include sharps
(syringes, disposable scalpels, blades etc.), non-
sharps (swabs, bandages, etc.), blood and
anatomic waste (blood bags, diagnostic samples,
etc.), chemicals (solvents, disinfectants etc.),
pharmaceuticals, and may be infectious, toxic,
create injuries or radioactive.

7. Risks associated with the poor
management of health-care waste
• Poor management of health care waste may have
serious public health consequences and a
significant impact on the environment. Sound
management of health care waste is thus a crucial
component of environmental health protection

8. Risks cont…
• Environmental health problems associated with
improper management of health care waste can be
grouped into three categories i.e. occupational
health risks, public health risks and risks of polluting
the environment.
Discuss risks associated with health care
waste???

9. Occupational Health Risks
• During the handling of health care wastes, the
health workers as well as the waste handling
workers can be injured if the waste has not been
packed safely. Many injuries occur when needles or
other sharps have not been collected in rigid
puncture proof containers or because have been
overfilled.

10. Public Health Risks
• The unsafe disposal of health care waste (for
example, contaminated syringes and needles)
poses public health risks. Contaminated needles
and syringes represent a particular threat as the
failure to dispose of them safely may lead to
dangerous recycling and repackaging which lead to
unsafe reuse.

11. Public Health Risks cont…
• Contaminated injection equipment may be
scavenged from waste areas and dumpsites and
either are reused or sold to be used again. Reuse
puts people at risk of infections such as hepatitis B,
hepatitis C and human immunodeficiency virus.

12. Risks of Polluting the Environment
• Improper disposal of health care waste, such as
open–air burning can constitute a significant source
of pollution to the environment through the release
of substances such as dioxins and furans.

13. Risks of Polluting the Environment
cont…
• Finally, the dumping of health care waste in
uncontrolled areas can have a direct environmental
effect by pollution of soils and underground water.
• Why is heath care waste improperly managed in
Zambia???

14. Why is heath care waste improperly
managed???
• Lack of awareness about the inherent hazards
caused by improper management of health care
wastes;
• Insufficient allocation of resources (financial and
human) for the safe management of the wastes;
• Improper control of the waste management system;

15. Why is heath care waste improperly
managed??? Cont…
• Absence of a national policy for the management of
health care wastes;
• Lack of or inadequate regulatory framework, and
insufficient evidence on the negative impact of
health-care wastes on certain professional groups.
• Insufficient information on sound waste
management and treatment options and their
benefits.

16. Abbreviations
• HCW – Health care waste
• HCWM – Health care waste management
• HCF – Health care facility e.g. hospital, clinic or
health centre
• HCFs – Health care facilities e.g. hospitals, clinics
or health centres or a combination of these

17. Terms used in HCWM
• Below we will define terms that will used frequently
in this course.

18. Container
• Vessel in which waste is placed for handling,
transportation, storage, and/or eventual disposal.
The waste container is a component of the waste
package.

19. Cytotoxic
• Cancer treatment drugs

20. Disposal
• Intentional burial, deposit, discharge, dumping,
placing, or release of any waste material into or on
any air, land, or water.

21. Hazard
• Intrinsic potential or ability to cause harm

22. Infectious waste
• The part of health care waste that is capable of
causing infectious disease.

23. Radioactive waste
• Wastes arising radiography e.g. X-ray, activities

24. Risk
• Probability that a hazard will cause harm, and the
severity of that harm

25. Segregation
• The systematic separation of solid waste into
designated categories.

26. Scavenging
• Illegal manual sorting of solid waste at landfills and
removal of usable material.

27. Objectives of HCWM
• Improve occupational health conditions for
employees in the system, i.e. health workers, waste
collectors and landfill staff
• Reduce the risk of people getting in contact with
infectious waste, i.e. patients, visitors, the public,
and scavengers at landfills

28. Objectives of HCWM cont…
• Enable an environmentally sound treatment and
final disposal of medical waste to be established
and operated
• Help individuals and institutions to manage HCW in
an environmentally sound manner from generation
to disposal.

29. Guiding principles in HCWM
• Guiding principles in health care waste
management include:
–The “polluter pays” principle;
–The “precautionary” principle;
–The “duty of care” principle;
–The “principle of cooperation” and
–The “proximity” principle.

30. The polluter pays principle
• The “polluter pays” principle implies that all
producers of waste are legally and financially
responsible for the safe and environmentally sound
disposal of the waste they produce.

31. The precautionary principle
• All wastes generated from health care institutions
will be treated as risky or hazardous.

32. The duty of care principle
• The “duty of care” principle stipulates that any
person handling or managing hazardous
substances is ethically responsible for using the
utmost care in that task.

33. The principle of cooperation
• Sound management of HCW will call on the
cooperation of all stakeholders that include decision
makers, regulators and waste handlers since
HCWM is a crosscutting issue.

34. The proximity principle
• The “proximity” principle recommends that
treatment and disposal of HCW will take place at
the closest possible location to its source in order to
minimize the risks involved in its transportation.

35. ……….
Thank you