Summary

SUMMARY ................................................. ......................

............................ ................................................. 2
0 - INTRODUCTION ............................................... ..............
.................................... ..................................... 3 1 -
WHAT IS WASTE ...... .................................................. .......
........................................... ............. 5 2 - CLASSES OF WASTE
:.............................. ...............................................
... ................................... 6 3 - MUNICIPAL SOLID WASTE ......... ..
................................................ ...............................
........... 7 3.1 - TYPES OF WASTE .. ..........................................
........ .................................................. ....................
..... 8 4 - INDUSTRIAL WASTE .................... ..............................
.................... ............................................. 9 5 - HOSPITA
L WASTE .................................................. .....................
............................. ........ 10 5.1: GROUPING OF HOSPITAL WASTE ......
............................. ..................................................
....... June 10 - SCREENING, AND TREATMENT OF WASTE COLLECTION HOSPITAL .......
.................. 14 6.1 - STORAGE AND SCREENING OF HOSPITAL WASTE ............
.................................... ..................... 14 6.2 - COLLECTION O
F HOSPITAL WASTE ...................... ........................................
.......... ........................ 15 6.3 - HOSPITAL WASTE TREATMENT ..........
......... .................................................. ...................
... 15 6.3.1 - Incineration ...................... .............................
..................... .................................................. ... 15
6.3.2 - Disinfection ......................................... .................
................................. ................................ 16 6.3.3 - Ch
emical disinfection ........... ................................................
.. .................................................. 17 6.3.4 - Thermal Disinfe
ction ........................................... ..............................
.................... Autoclave ............................... .................
17 .................................................. .........................
......................... Microwave ............................................
.. .. 17 .................................................. Incineration versus
autoclaving ........................................ 18 ...... .................
................................. ..............................................
July 18 - PROCEDURES TREATMENT ADVANTAGES AND DISADVANTAGES ...................
.............. 19 7.3 - A MATTER OF COMMON SENSE .... ..........................
........................ .................................................. 20 .
...... 7.4 - a legal question ..................................... ............
...................................... ................................... 20 7.
5 - A QUESTION TÉCNICA1 ......... ..............................................
.... .................................................. ......... 21 7.6 - an ec
onomic issue ................................... ...............................
................... .............................. August 22 - CONCLUSION ......
.......... .................................................. ..................
................................ .................. September 23 - BIBLIOGRAPHY
............................ ..................................................
.................................................. .. 25
2
0 - Introduction
This paper aims to respond to a moment of evaluation of the discipline of Commun
ity Nursing, part of the 1st year of the Bachelor of Nursing School of Health So
usa Valley, whose theme focuses on the treatment of medical waste and its effect
on global warming. Global warming is a natural phenomenon, due to the release o
f gases resulting from human activity has increased. Solar radiation that affect
s the land part is reflected by the atmosphere while the other is absorbed by th
e Earth generate heat which is radiated in the form of infrared radiation. The g
reenhouse gases absorb part of the infrared radiation of longer wavelengths. The
main greenhouse gases released by human activities are CO2 (results from burnin
g fossil fuels, the burning of forests to obtain land for farming), methane (ori
ginated in rice paddies and livestock), nitrous oxide (derived fuel fossils and
chemical fertilizers);€chlorofluorocarbons (used as aerosol propellants and refr
igerant gases). Besides the aforementioned, we can find the treatment of medical
waste another factor that contributes to global warming. So we do a little on t
he approach that these are the type of separation used among others.
3
With the excess waste production, and subsequent treatment of waste, there is an
increase of gases released into the atmosphere which promotes the deterioration
of global warming, with consequences such as rising sea levels, climate change,
which affect the availability of water and food due to prolonged droughts, heat
waves, floods and severe storms.
4
1 - What is waste
According to Decree-Law No. 152/2002 of May 23, by means waste any substance or
object which the holder discards or intends or is required to discard, pursuant
to Decree-Law No. 239/97 of September 9 and in accordance with the EU Waste List
Europeia.1
1
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2 - Classes of Waste:
Class 1 - Hazardous Waste: those that pose health risks
public and the environment, requiring special treatment and disposal according t
o their characteristics of flammability, corrosivity, reactivity, toxicity and p
athogenicity.
Class 2 - Non Hazardous Waste: waste that are not present
danger, but are not inert, may have properties such as combustibility, biodegrad
ability and water solubility. Are basically the waste with the characteristics o
f household waste.
Class 3 - Inert waste: those which, when subjected to
Solubilization tests (ABNT NBR-10 007), have any constituents dissolved in conce
ntrations above the drinking water standards. This means that when drinking wate
r will remain in contact with the waste. Many of these wastes are recyclable. Th
ese wastes do not degrade or not decompose when placed in the soil (they degrade
very slowly). Fall into this classification, for example, demolition debris, st
ones and sand taken from escavações.2
2
http://www.inresiduos.pt 6
3 - Solid Waste
Definition: According to Decree-Law No. 239/97 of September 9, are
household waste or similar wastes, because of its nature or composition, particu
larly those from the service sector or in commercial or industrial establishment
s and units providing health care, provided that in either case, the daily produ
ction does not exceed 1100 liters per producer.
Origin:
Within any urban space can be considered as
main sources of waste households (dwellings), trade and services (hotels, shops,
offices) and industry (there is a trend away from this sector to the periphery
of urban areas). Wastes originating from the set are generated from cleaning pub
lic, whether by human activity (markets, stroke vehicles or containers and disca
rded object directly to the public highway) or by natural causes (tree leaves, a
nimal droppings). Are still considered as waste of public cleaning those resulti
ng from treatment of public gardens and other areas verdes.3
3
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3.1 - Types of Waste
- Glass - Plastics - Organic matter - Paper and Board.
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4 - Industrial Waste
Definition: According to Decree-Law No. 239/97 of September 9 are
waste generated in industrial activities, as well as those resulting from the ma
nufacture and distribution of electricity, gas and water.
Origin: Originated in the activities of various branches of industry such
as the metallurgical, chemical, petrochemical, stationery, food industry, etc..
The industrial waste is quite varied and can be represented by ash, sludge, oils
, alkalines or acids, plastics, paper, wood, fiber, rubber, metal, slag, glass,
ceramics. This category includes a great amount of toxic waste. This type of was
te needs special treatment for its potential to envenenamento.4
4
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5 - Hospital Waste
Definition: According to Decree-Law No. 239/97 of September 9 are
waste generated in units to provide health care, including medical activities in
diagnosis, prevention and treatment of disease in humans or animals, and even r
esearch activities related.
From discarded by hospitals, pharmacies, veterinary clinics (cotton,
syringes, needles, remnants of drugs, gloves, dressings, clotted blood, organs a
nd tissues removed, culture media and animals used in testing, synthetic resin,
photographic film X-ray). Depending on their characteristics, requires special a
ttention in packaging, handling and final disposal. Must be incinerated and the
waste taken to a landfill sanitário.5
5.1: Grouping of hospital waste
Clinical wastes are grouped as follows:
Group I: do not require special care in their treatment because they are
treated as waste. Examples:-wastes from offices, meeting rooms, lounges, toilets
, and others-waste from shops, gardens, warehouses and others;
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Packaging and common-wrappers;-Waste from the activities of restaurants and hote
ls, and debris resulting from preparation of food served to patients than in Gro
up III. Packaging and common-wrappers;-Waste from the activities of restaurants
and hotels, and debris resulting from preparation of food served to patients tha
n in Group III.
Group II: Do not require special care in their treatment because they are
treated as waste. Examples:-Material orthopedic uncontaminated and without trace
s of blood, disposable diapers and no guards and no traces of contaminated blood
-personal protective equipment used in general support services, other than the
one used in waste collection;-empty packaging of drugs or products or common cli
nical use, except in Group III and Group IV, non-contaminated vials of serum, wi
th the exception of group IV.
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Group III: contaminated wastes that are expected, and with biological risk.
In these cases it is demanding the use of more effective treatments (incineratio
n or pre-treatment). Examples:-waste from patient rooms or wards (or suspected)
infection, hemodialysis units, the operating units, the treatment rooms, autopsy
rooms, among others, all materials used in dialysis, non-anatomical parts ident
ifiable;-waste resulting from the administration of blood and blood products;-sy
stems used in the administration of serums and medicines, with the exception of
group IV;-collecting bags of fluids and related systems;-infected orthopedic mat
erial;-guards and disposable diapers contaminated personal protective equipment,
used in healthcare and support services in general there is contact with contam
inated products.
Group IV: specific hospital waste - waste of various types of
incineration mandatory. Examples: 12
-Recognizable anatomical parts, fetuses and placentas, until publication of spec
ific legislation;-corpses of animals (laboratory experiments);-cutting and pierc
ing materials: needles, catheters, and all the stuff invasive;-chemicals and pha
rmaceuticals discarded when not subject to specific legislation;-Cytostatic and
all materials used in handling and administration. Of the four groups of hospita
l waste, only groups III and IV are considered hazardous. The former are biohaza
rd waste, contaminated, and material used in dialysis, napkins and scraps of blo
od, and can be incinerated or receive pre-treatment for disposal as waste. In gr
oup IV are specific hospital waste, including fetuses and placentas, needles, ex
pired medicines, and is required for incineration and treatment.
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6 - Sorting, Collection and Treatment of Hospital Waste
6.1 - Screening and storage of Hospital Waste
The sorting and packaging of medical waste should be done with the place where h
e gave his production, and packaged so as to clarify its origin and group: Not a
ll wastes are present the same danger, so it is ranked second largest or lower r
isk that their presence implies
Group I and II - black containers. Group III - showing white biohazard Gro
up IV - red (except cutting and piercing material, which
must be stored in containers or containers imperfuráveis). It should be noted al
so that the containers used in group III and IV should be easily manageable, dur
able and waterproof, keeping airtight, washable and desinfectáveis if they are m
ulti-purpose storage of clinical waste must be carried out at a specific site an
d signaled, in order to separate the Group I and II of III and IV.€The storage a
rea should be sized according to the frequency of collection and / or eliminatio
n, and its ability to meet minimum three days of production. If this deadline is
exceeded, up to 7 days, there should be refrigerated conditions in the storage
area. 6
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The fate of the medical waste poses serious problems in view of its nature - a c
onsiderable portion is contaminated by biological or chemical is hazardous and r
adioactively.
6.2 - Disposal of Hospital Waste
They are also blamed the management bodies of each health unit the following mea
sures: awareness and training of personnel engaged in general and that particula
r sector, particularly in aspects related to personal protection and the correct
procedures, signing of protocols with other units health or resource to entitie
s duly licensed, when do not have a treatment capacity of its waste; date regist
er of waste produced. 7
6.3 - Treatment of Hospital Waste
6.3.1 - Incineration
Currently, medical waste produced are mostly subjected to treatment by incinerat
ion. Incineration is a treatment process of industrial solid waste, defined as t
he chemical reaction in which combustible organic materials are gasified in a pe
riod of time fixed in advance, giving an oxidation of the waste with the help of
oxygen contained in air that is supplied in excess of stoichiometric needs. Thi
s process of thermal decomposition of waste has, over recent years, technologica
l advances, and the modern design of pyrolytic incinerators two stages governed
by the following principles: temperature, residence time and turbulence. In the
first stage, called
7
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pyrolysis, the residues are subjected to temperatures of 650-800 º C, in an envi
ronment with lack of oxygen which gives complete combustion, with formation of g
aseous fuels. In the second stage (the term reactor), takes place the combustion
gases from the pyrolysis temperature of 1100 ° C for 2 seconds at least, in the
presence of excess oxygen to ensure complete combustion. The operation of an in
cineration plant can be considered correct if the solid waste from combustion -
ash and slag - and the gases emitted into the atmosphere is sterile and does not
contribute to environmental pollution of soil and air, thus facilitating soluti
ons final destination. It is therefore necessary to treat the gaseous emissions
due to the type of waste (chlorinated) from the material incinerated. The therma
l energy, originated in the burning of waste can be used to heating by steam, or
be used to produce electricity, and we can recover half the energy dissipated.
Because of their environmental risks and costs, the incineration process should
be used only when no other alternative technologies for the treatment of certain
types of resíduos.8
6.3.2 - Disinfection
Disinfection, chemical or thermal energy, appears as a treatment alternative to
incineration. The disinfection technologies is best known for chemical treatment
, autoclaving and microwave. These alternative technologies for treatment of a m
edical waste permit routing of processed waste to the normal waste
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Solid (MSW) without any danger to public health and may represent a lower cost t
o the institutions without incineration itself. The main disadvantage of this te
chnology is that only disinfect the waste, which makes its implementation relati
vely inefficient chemical and radioactive material.
6.3.3 - Chemical Disinfection
The chemical treatment consists of a series of cases in which the waste is invol
ved and / or injected with solutions disinfectants and germicides such as sodium
hypochlorite, ethylene oxide and formaldehyde, although recently they are being
put to use disinfectant cleaner. The processes can be complemented with a crush
ing, prior or subsequent, and / or compression, always needing treatment of liqu
id and gaseous effluents. This treatment is used primarily for the decontaminati
on of waste from microbiology laboratories, waste of blood and body fluids as we
ll as cutting and piercing. 9
6.3.4 - Thermal Disinfection Autoclaving
Autoclaving (moist heat disinfection) is a treatment that is quite usual to keep
the contaminated material at an elevated temperature and in contact with water
vapor for a period of time sufficient to destroy potential pathogens, or reduce
them to a level which does not pose risk. The process includes autoclave cycles
of compression and decompression in order to facilitate contact between the vapo
r and waste.
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The usual values of pressure are the order of 3 to 3.5 bar and the temperature r
eaches 135 º C. Values This process has the advantage of being familiar to healt
h professionals, who use it to sterilize various types of hospital supplies.
Microwave
The microwave irradiation is a newer technology for treatment of hospital waste
and consists of disinfection of the waste to a high temperature (between 95 and
105 ° C), which are crushed before or after this operation. The heating of all s
urfaces is achieved by creating a mixture of water and waste .10
Incineration versus autoclaving
Medical waste biohazard belonging to group III can be incinerated or subject to
an effective treatment that would allow its disposal as waste, whereas group IV
includes specific hospital waste incineration mandatory. In this study there was
an area of about incineration to autoclaving as final treatment of waste of gro
up III, there are also two cases where chemical disinfection is used. Since the
incineration and sterilization are the most used treatments in our country for t
reatment of group III, is presented in Table 1 summarize the advantages and disa
dvantages of each.
10
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7 - Procedures for the processing advantages and disadvantages
7.1 - Incineration - effective in treating all waste;
- Weight reduction to 10% - Reduction of volume to 3% - Recovery and / or energy
production; - No smells - High cost of investment and exploitation; - significa
nt need for treatment of waste gases - Negative Feedback population.
7.2 - Autoclavegem - low operating cost;
- Reduced volume (20%) - Case considered clean, not requiring environmental impa
ct assessment - Use restricted to biohazard waste; - Production of liquid and ga
seous effluents, although minor
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7.3 - A question of good senso11
The separation of medical solid waste is primarily a matter of common sense, res
ponsibility and habit. The success of screening of medical solid waste depends o
n all health professionals, who as producer of medical solid waste has the neces
sary training to identify and separate waste correctly and efficiently - not tre
ated as hazardous or municipal - Hazardous point microbiology and / or chemical,
the waste likely to cause disgust sensitivity and negative public opinion, shou
ld be careful separation and packaging.
7.4 - A question legal12
The medical solid waste are subject to specific rules published in the Official
Gazette. The orders of the State Gazette No. 242/96, of August 13 and No. 761/99
of August 31, establish rules for the management of medical solid waste in part
s of the sorting, packing selective collection, storage, transportation and trea
tment. The hospital waste must be separated into groups.
December 11
Infection Control Committee of the Hospital Padre Américo - Penafiel
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7.5 - A question técnica1
To implement an efficient screening and operational, it is necessary to provide
clinical services institutions and their means of handling solid waste hospital
needed to perform this activity. The containers for packaging of medical solid w
aste currently in Health Care are: - Plastic bags - cardboard boxes and containe
rs of high density polyethylene reusable - plastic containers for single use, co
ntainers for storing solid waste in hospitals, should include features to allow
a clear identification of their origin (the service and date) and waste group, f
rom actors. The adoption of color codes for the containers is essential for this
purpose, according to the order 242/96, of August 13.
21
7.6 - A question económica13
By carefully separating the waste produced,€savings achieved due to: - Reduce th
e amount of waste likely to specific treatment - Reduction of treatment costs -
Separate collection of recyclable waste - promoting green image of the Instituti
on of Health;
13
Infection Control Committee of the Hospital Padre Américo - Penafiel
22
8 - Conclusion
The preparation of this work provided an explanation on hospital waste, the trea
tment to which they are subject and its effect on the environment. The treatment
of hospital waste causes besides a prior willingness of professionals to an eff
icient screening, high costs and negative environmental impact. An awareness of
certain medical waste (blood, secretions, ionized material, chemicals and human
tissues), while outbreaks, constitute a danger to public health has become more
acute from the development of serious diseases, such as AIDS and hepatitis B. Th
is led to increased concerns about the care of hospital waste. Indeed, the heter
ogeneity of the mass of medical waste and lack of preparation for incineration p
lants for the processing of increasing amounts of waste have led to the impossib
ility of compliance with emission limits for gases increasingly strict. Efforts
to remedy this situation and that include the installation of incineration large
r and adequate treatment of gaseous emissions that cause costs currently contrib
uting to a significant increase in costs of medical institutions. Thus, it has b
ecome necessary to develop different management practices of hospital waste whic
h allow reducing the amount of waste to be treated and the introduction of alter
native treatment processes for incineration.
23
The developments that occurred in the concepts that support the management of ho
spital waste determined the need for a classification that would guarantee a mor
e selective separation at source and enable the use of diverse processing techno
logies. He qualified medical waste into four distinct groups, and the waste trea
ted differently according to the appropriate group to which they belong.
24
9 - Bibliography

http://www.aguaonline.co.pt/aguasresid/sobre.htm http://www.inresiduos.pt http:/

/pt.wikipedia.org/wiki/Lixo http://www.aguaonline.co.pt / aguasresid / sobre.htm
http://www.aguaonline.co.pt/aguasresid/sobre.htm http://www.netresiduos.com/cir
/rhosp/introrhosp.htm http://www.netresiduos.com/ cir / rhosp / introrhosp.htm h
ttps: / / repositorium.sdum.uminho.pt/bitstream/1822/361/2/Corpo + of + TES e.pd
f Control Commission of Hospital Infection, Hospital Padre Américo - Penafiel

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