Proper management of health care waste is one of the important thing to prevent hospital related infectious disease , this slide is presented to give a highlight for health care professionals

1. Nigusu Kelemework (MPH)

2. • Waste is unwanted or useless materials.
• Waste is introduced in to the environment
due to day to day activities of humans

3.  The main purpose of waste management is to
isolate waste from humans and the environment ,
 Hospital waste handling is important;
◦ to protect staff, patient and community from harm and
accidental injury
◦ to prevent the spread of infection , pest and scavengers
◦ to prevent damage of the incinerator and
◦ For keeping MOH and FMHACA guidelines
◦ In addition , the aesthetic value of better outlook and
clean physical environment is important for our
emotional wellbeing

4. Solid wastes: wastes in solid forms, domestic,
commercial and industrial wastes
Liquid Wastes: wastes in liquid form

5. Bio-degradable ; can be degraded (paper,
wood, fruits and others)
Non-biodegradable ; cannot be degraded
(plastics, bottles, old machines, cans and
others)

6. Hazardous wastes ;Substances unsafe to use
commercially, industrially, agriculturally, or
economically and have any of the following
properties- ignitability, corrosivity , reactivity &
toxicity.
Non-hazardous ; Substances safe to use
commercially, industrially, agriculturally, or
economically and do not have any of those
properties mentioned above. These substances
usually create disposal problems.

7.  Municipal Solid wastes: Solid wastes that include
household garbage, rubbish, construction &
demolition debris, sanitation residues, packaging
materials, trade refuges etc. are managed by any
municipality.
 Bio-medical wastes: Solid or liquid wastes
including containers, intermediate or end
products generated during diagnosis, treatment
& research activities of medical sciences.
 Industrial wastes: Liquid and solid wastes that
are generated by manufacturing & processing
units of various industries like chemical,
petroleum, coal, metal gas, sanitary & paper etc.

8.  Agricultural wastes: Wastes generated from farming activities.
These substances are mostly biodegradable.
 Fishery wastes: Wastes generated due to fishery activities.
These are extensively found in coastal & estuarine areas.
 Radioactive wastes: Waste containing radioactive materials.
Usually these are byproducts of nuclear processes.
Sometimes industries that are not directly involved in nuclear
activities, may also produce some radioactive wastes, e.g.
radio-isotopes, chemical sludge etc.
 E-wastes: Electronic wastes generated from any modern
establishments. They may be described as discarded
electrical or electronic devices. Some electronic scrap
components, such as CRTs, may contain contaminants such
as Pb, Cd, Be or brominated flame retardants.

9. Affects our health
Affects our socio-economic conditions
Affects our coastal and marine environment
Affects our climate

10. Exposures occurs through
 Ingestion of contaminated water or food
 Contact with disease vectors
 Inhalation
 Dermal
Note ; Absolute elimination of all risks is
impossible. A realistic goal is a reasonable degree
of safety at all times without compromising
efficiency and priorities.

11. Waste hierarchy refers to 3 Rs
Reduce, Reuse, Recycle

12. The safe and effective management of medical
waste depends on appropriate
 segregation,
 packaging,
 in house transport,
 storage and
 finally treatment and disposal.

13.  Segregation at the point generation is very
crucial

14.  To follow the policy on waste management
 Segregate at the point of generation
 To ensure supplies are available
 To have appropriate color coded bins for
segregation

15.  Black- non infectious waste materials / General
waste
 Yellow – infectious materials that burn and vial
 Red – only for body parts and placenta for special
separate pit
 Sharp containers – for sharps to be burned
 Recycling bin – for non infectious plastic like
water bottles and large iv bottles
 Box /bin – for dangerous materials that can not
burn eg. Aerosol cans , batteries, metals and
buried in pits ( label dangerous materials )

16. Important
◦ You can only fill all sharp containers ¾ full
so the containers can be closed safely
◦ There can be no liquids in the waste , no IV
Bags with solution and no urine bags with
urine , no blood bags with blood , no plastic
bottles with water .
◦ Fluids need to be emptied in appropriate
sink or toilet before they are disposed in the
bins

17.  There can be nothing that can explode in the
garbage that burns like aerosol can and
batteries . This can damage the incinerator
and injure the incinerator
 Teach patient and relatives to segregate

18. What do staffs ???

21. ◦ Ensure proper color bin is in place at each
station
◦ Sharp containers should be closed shut and
sealed when ¾ full , before transportation
◦ Segregate at a point of generation and remind
and teach others
◦ Pouring liquids or wet waste directly in to a safe
sewerage system
◦ Teach patients and families about segregation
on admission

22.  Use proper personal protective equipment
( industrial glove , aprons, masks, goggles as
required especially when dealing with
infectious fluids )
 NB If a bag contains fluids eg. Iv bag with
solutions or urine bag with urine, do not
pickup the bag , inform the in charge ( to
remind nurses to segregate ) and cleaner to
remove the fluids or needles with heavy duty
gloves )

23. Cleaning staffs / janitors are responsible to ;
◦ Contaminated waste should be collected
and transported to disposal sites in leak
proof , covered and easily washable waste
containers
◦ Collect bins and sharps container when ¾
full and put in utility room and later
transport to incinerator or garbage
container with a chart separated
◦ Do not mix segregated waste

24.  Collect used dressing materials immediately
when the physician or nurses finished the
dressing and other infectious medical wastes
such as urine bags , gloves and the like using
small designated buckets
 Need to also segregate waste while sweeping
eg. Sharps in sharps container

25.  Must transport in safe carts and must wear
PPE ( Industrial gloves, apron, mask , goggles
as required specially when dealing with
infectious materials
 Transport black bins to the green container
 Transport yellow infectious bins and sharp
container to the incinerator

26.  Transport red bins with placenta or body
parts into placenta pits
 Transport dangerous materials like poisonous
, radio active / explosive such as aerosol cans
with consultation of pharmacist and
environmental health officer
 If waste is in wrong bucket please move it in
to the right colored buckets using PPE and
specially heavy duty gloves using pick ups

30.  All waste bins should be properly washed ,
disinfected and return back

31. • Poor segregation of waste
• Absence of Clear directives and
commitment related to waste
• No clear understanding of “medical
waste”
• “Cradle to grave” protocols not
available
• No policy and procedure regarding
requisitioning or rotation of stock, to
prevent overstocking and lapsed expiry
dates of consumables and
pharmaceuticals.

32.  Education of the staff and public is not getting
through
 No structured orientation and induction in service
education programmes that include waste
management for all categories of staff.
 Collection of waste from the various areas not
always satisfactory.
 Lack of continuity due to rotation of staff and leave
 Lack of commitment by institutional managers to
manage and monitor the entire medical waste flow,
from initiation to disposal.

33.  Institutional managers either do not see it as
high priority or are powerless to enforce good
medical waste segregation.
 A care less attitude by the staff concerned

34. This can only be achieved by all health care
facilities ;
 having a documented policy and procedures
 the staff is properly trained
 Fully implement the SOP