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Hospital waste

Presented by
DR. Amany Mokhtar
Professor of public health an preventive medicine
Faculty of Medicine Ain Shams University

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Public health and environment

Key Points
Of the total amount of waste generated by
health-care activities, about 80% is general
waste.
The remaining 20% is considered hazardous
material that may be infectious, toxic or
radioactive.
Every year an estimated 16 000 million
injections are administered worldwide, but not
all of the needles and syringes are properly
disposed of afterwards.
Health-care waste contains potentially harmful
microorganisms which can infect hospital
patients, health-care workers and the general
public.
health and environment
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Hospital Waste
The role of the hospital is to
treat patients , but improper
hospital waste disposal the
hospital may act as a
reservoir that emits
hazardous agents
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Public health and environment

What is health-care waste?


Something owner no longer wants it at a
given place and time
Medical waste : materials generated as a result
of patient diagnosis or treatment
Infectious waste :portion of medical waste that
could transmit an infectious disease

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Public health and environment

Categories of health
care waste

General waste:

domestic type waste, packing


materials or any substance that does not pose any hazard.

Sharps: Used or unused sharps


e.g. hypodermic, intravenous or other needles; auto-disable
syringes; syringes with attached needles; infusion sets;
scalpels; pipettes; knives; blades; broken glass

Infectious: Infectious waste is material suspected to


contain pathogens (bacteria, viruses, parasites or fungi) in
sufficient concentration or quantity to cause disease in
susceptible hosts. This category includes: waste contaminated
with blood or other body fluids, cultures and stocks of infectious
agents from laboratory work, waste from infected patients in isolation
wards; dressings, bandages and other material contaminated with

blood or other body fluids

Pathological:
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Human tissues, organs or fluids; body


Public
healthfetuses;
and environment
parts;
unused blood products

Categories of waste (cont)


Pharmaceutical :

Pharmaceuticals that
are expired or no longer needed.

Chemical:

discarded solid, liquid, and

gaseous waste

Hazardous chemical waste : toxic, corrosive, flammable,


reactive, and genotoxic

Radioactive:

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Waste containing
radioactive substances
(e.g. unused liquids from radiotherapy or
laboratory research; contaminated glassware,
packages, or absorbent paper; urine and
excreta from patients treated or tested with
unsealed radionuclides; sealed sources)

Public health and environment

Types of Hazards to
Consider
Flammable
Toxic - mutagenic, cytotoxic,
teratogenic, etc
Reactive
Allergen, contact sensitiser
Explosive
Infectious
Radioactive
Corrosive
Caustic

5:ManagingMedicalWaste
7 | Public health and environment

Slide7

Alcohol
Cancer chemotherapy, tarbased products
Sulphuric acid, chlorine
powder
Glutaraldehyde
Picric acid, fertiliser,
ammonia
TB cultures
Barium enema, X-rays
Bleach
Lye

Hazardous Health Care


Waste
Infectious hazard:
Anatomic waste
Laboratory cultures
Sharps
Live viruses

5:ManagingMedicalWaste
8 | Public health and environment

Corrosive, teratogenic,
reproductive hazard:

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Heavy metals
Pesticides
Cleaning products
Pressurised containers
Mercury
Cancer therapy

Impact on health
1) To the patient : nosocomial infection
2) To workers in the hospitals

Infection by hepatitis
Droplet infection
Skin infection

3) To the environment : contamination

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Public health and environment

General definition and


characteristics

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Public health and environment

Process of HC Waste
management

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Waste classification
Waste segregation
Waste minimization
Containerization
Color coding
Labeling and
signage

Public health and environment

Handling
Transport
Storage
Treatment
Final disposal of
waste.

Waste segregation is key


Careful segregation and
separate collection of hospital
waste is the key to safe, sound
management of health-care
waste.
Segregation can substantially
reduce the quantity of healthcare waste that requires
specialized treatment.

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Public health and environment

Segregation of health-care
waste

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Public health and environment

Sharp waste management


SharpsHandlingRecommendations
Donotrecapneedles
Neverpassusedsharpsfromone
persontoanother
Locateneedledestroyerand
containernearthepointof
generationtohavegoodvisibility
Sharpsshouldbedisposedofin
punctureresistantsharps
containers

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Public health and environment

Infectious waste
management
Infectiouswasteshouldgointo
yellowleakproofplasticbagsor
containers.
Bagsandcontainersfor
infectiouswasteshouldbe
markedwiththeinternational
infectioussubstancesymbol

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Public health and environment

Special precautions in waste


management

1)Segregation of medical waste


must be carried out from original
site
2)Workers must be protected by
safety measures
3)Transportation: special trolley
4)Storage places must be closed
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Public health and environment

Special precautions in waste


management
5) Incineration is the preferred method
for hazardous waste
6) Radioactive waste must be kept in
special containers
7) General waste : managed as
domestic waste
8) Recycling for non infectious waste
9) Pharmaceutical waste : returned to
the pharmacy
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Public health and environment

WHO recommendations for waste


management
1. HC waste management requires a system
approach
2. Training for all personnel involved in
health care
3. Segregate hazardous from other waste
4. Reduce the quantity of at source as far as
practical
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Public health and environment

WHO recommendations for waste


management
6. Radioactive waste should follow the national

and international standards of disposal


7. All health care facilities should have

comprehensive waste disposal plans


8. Collection and exchange of information about

the performance of healthcare facilities


9. Legislation on healthcare waste management
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Public health and environment

In Egypt we have a law from


Egyptian Environmental
Affairs in 1994 regulating :
Handling , collection , and
final
disposal of hazardous waste
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Public health and environment

THANK YOU

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Public health and environment