Waste generated by health care activities includes a broad range of materials; from used needles and syringes to soiled dressings, body parts, diagnostic samples, blood, chemicals, pharmaceuticals, medical devices and radioactive materials.
Poor management of medical wastes potentially exposes health care workers, waste handlers, patients and the community at large to infection, toxic effects and injuries, and risks polluting the environment. Hence, it is essential that all medical wastes are segregated at the point of generation, appropriately treated, and finally disposed.
The path between segregation and disposing can be segmented schematically into the following steps:
- Waste minimization: reducing as much as possible the amount of medical wastes to be produced by setting up an efficient purchasing policy and having a good stock management.
- Segregation and containerization: identification of different waste categories and the separate disposal in accordance with the category. Containers should be properly color-coded and have the international infectious waste symbol clearly marked. Suitable gloves must always be used when handling infectious waste.
- Intermediate storage: wastes must be collected on a regular daily basis, and not to be made accessible to unauthorized people such as patients and visitors.
- Internal transport: Wheelie bins should be easy to load and unload, have no sharp edges that could damage waste bags or containers, and easy to clean. They should be marked with the corresponding coding color. Transport must be carried out separately from collection to avoid potential cross contamination or mixing different categories of waste.
- Central storage: Storage time should not exceed 2448 hours especially in countries that have a warm and humid climate.
- External transport should be done using dedicated vehicles. They shall be free of sharp edges, easy to load and unload by hand, easy to clean/disinfect, and fully enclosed to prevent any spillage in the hospital premises or on the road.
In many countries, the lack of resources in the health sector tends to affect negatively the way medical wastes are managed. Furthermore, for a given country, the situation can differ significantly from one region to another depending on the resources locally available.
Under these adverse circumstances, planning remains a key issue. It requires the definition of a strategy that takes into account the given constraints and opportunities, appropriate allocation of resources, clear formulation of objectives, practical indicators of achievement, a well-structured timeframe, raising awareness, and consolidating an assessment of the current situation.
International agreements and principles underlie the way medical wastes should be managed. These should be translated into practical guidelines and codes of practice at health care facilities level.
References
www.who.int
www.healthcarewaste.org
www.basel.int
http://chm.pops.int