Environmental issues caused by HOSPITAL WASTE- BY SPRING

Environmental issues caused by  HOSPITAL WASTE

– BY SPRING

AMAL SASIDHARAN

JUBI.M.F

MALINI.S

IMK Senate House Campus

introduction

Hospital is a place of almighty, a place to serve the patient. This was prepared on the basis of information collected from a reputed hospital in Kochi. Since beginning, the hospitals are known for the treatment of sick persons but we are unaware about the adverse effects of the garbage and filth generated by them on human body and environment. Now it is a well established fact that there are many adverse and harmful effects to the environment including human beings which are caused by the “Hospital waste” generated during the patient care. Hospital waste is a potential health hazard to the health care workers, public and flora and fauna of the area. Hospital acquired infection, transfusion transmitted diseases, rising incidence of Hepatitis B, and HIV, increasing land and water pollution lead to increasing possibility of catching many diseases. Air pollution due to emission of hazardous gases by incinerator such as Furan, Dioxin, Hydrochloric acid etc. have compelled the authorities to think seriously about hospital waste and the diseases transmitted through improper disposal of hospital waste.

A modern hospital is a complex, multidisciplinary system which consumes thousands of items for delivery of medical care and is a part of physical environment. All these products consumed in the hospital leave some unusable leftovers i.e. hospital waste. The last century witnessed the rapid mushrooming of hospital in the public and private sector, dictated by the needs of expanding population. The advent and acceptance of “disposable” has made the generation of hospital waste a significant factor in current scenario.

What is hospital waste?

Hospital waste refers to all waste generated, discarded and not intended for further use in the hospital. Hospital waste is some of the most dangerous waste that exists. A hospital is filled with sick individuals, thus any waste produced in a hospital could contain dangerous bacteria or viruses

Classification of hospital waste

(1)        General waste: Largely composed of domestic or house hold type waste. It is non-hazardous to human beings, e.g. kitchen waste, packaging material, paper, wrappers, plastics.

(2)        Pathological waste: Consists of tissue, organ, body part, human foetuses, blood and body fluid. It is hazardous waste.

(3)        Infectious waste: The wastes which contain pathogens in sufficient concentration or quantity that could cause diseases. It is hazardous e.g. culture and stocks of infectious agents from laboratories, waste from surgery, waste originating from infectious patients.

(4)        Sharps: Waste materials which could cause the person handling it, a cut or puncture of skin e.g. needles, broken glass, saws, nail, blades, scalpels.

(5)        Pharmaceutical waste: This includes pharmaceutical products, drugs, and chemicals that have been returned from wards, have been spilled, are outdated, or contaminated.

(6)        Chemical waste: This comprises discarded solid, liquid and gaseous chemicals e.g. cleaning, housekeeping, and disinfecting product.

(7)        Radioactive waste: It includes solid, liquid, and gaseous waste that is contaminated with radionuclide’s generated from in-vitro analysis of body tissues and fluid, in-vivo body organ imaging and tumour localization and therapeutic procedures.

 

Biomedical waste

Any solid, fluid and liquid or liquid waste, including its container and any intermediate product, which is generated during the diagnosis, treatment or immunisation of human being or animals, in research pertaining thereto, or in the production or testing of biological and the animal waste from slaughter houses or any other similar establishment. All biomedical waste are hazardous. In hospital it comprises of 15% of total hospital waste.

How does hospital waste affect us?

If hospital waste is not managed properly it proves to be harmful to the environment. It not only poses a threat to the employees working in the hospital, but also to the people surrounding that area. Infectious waste can cause diseases like Hepatitis A & B, AIDS, Typhoid, Boils, etc.A common practice in Pakistan is the reuse of disposable syringes. People pick up used syringes from the hospital waste and sell them. Many drug addicts also reuse the syringes that can cause AIDS and other dangerous and contagious diseases. If a syringe, previously used by an AIDS patient, is reused, it can affect the person using it. So, the hospital staff should dispose off the syringes properly, by cutting the needles of the syringes with the help of a cutter, so that the needle ca not be reused.
When waste containing plastics are burnt, Dioxin is produced, which can cause Cancer, birth defects, decreased psychomotor ability, hearing defects, cognitive defects and behavioral alternations in infants. Flies also sit on the uncovered piles of rotting garbage. This promotes mechanical transmissions of fatal diseases like Diarrhea, Dysentery, Typhoid, Hepatitis and Cholera. Under moist conditions, mosquitoes transmit many types of infections, like Malaria and Yellow fever. Similarly, dogs, cats and rats also transmit a variety of diseases, including Plague and Flea born fever, as they mostly live in and around the refuse. A high tendency of contracting intestinal, parasitic and skin diseases is found in workers engaged in collecting refuse.

 

Approach for hospital waste management

Based on Bio-medical Waste (Management and Handling) Rules 1998, notified under the Environment Protection Act by the Ministry of Environment and Forest (Government of India).

1. Segregation of waste

Segregation is the essence of waste management and should be done at the source of generation of Bio-medical waste e.g. all patient care activity areas, diagnostic services areas, operation theaters, labour rooms, treatment rooms etc. The responsibility of segregation should be with the generator of biomedical waste i.e. doctors, nurses, technicians etc. (medical and paramedical personnel). The biomedical waste should be segregated as per categories mentioned in the rules.

2. Collection of bio-medical waste

Collection of bio-medical waste should be done as per Bio-medical waste (Management and Handling) Rules. At ordinary room temperature the collected waste should not be stored for more than 24 hours.

3. Transportation

Within hospital, waste routes must be designated to avoid the passage of waste through patient care areas. Separate time should be earmarked for transportation of bio-medical waste to reduce chances of its mixing with general waste. Desiccated wheeled containers, trolleys or carts should be used to transport the waste/plastic bags to the site of storage/ treatment.

Trolleys or carts should be thoroughly cleaned and disinfected in the event of any spillage. The wheeled containers should be so designed that the waste can be easily loaded, remains secured during transportation, does not have any sharp edges and is easy to clean and disinfect. Hazardous biomedical waste needing transport to a long distance should be kept in containers and should have proper labels. The transport is done through desiccated vehicles specially constructed for the purpose having fully enclosed body, lined internally with stainless steel or aluminium to provide smooth and impervious surface which can be cleaned. The drivers compartment should be separated from the load compartment with a bulkhead. The load compartment should be provided with roof vents for ventilation.

4. Treatment of hospital waste

Treatment of waste is required:

  • to disinfect the waste so that it is no longer the source of infection.
  • to reduce the volume of the waste.
  • make waste unrecognizable for aesthetic reasons.
  • make recycled items unusable.

5. Safety measures

5.1   All the generators of bio–medical waste should adopt universal precautions and appropriate safety measures while doing therapeutic and diagnostic activities and also while handling the bio-medical waste.

5.2   It should be ensured that:

  • drivers, collectors and other handlers are aware of the nature and risk of the waste.
  • written instructions, provided regarding the procedures to be adopted in the event of spillage/ accidents.
  • protective gears provided and instructions regarding their use are given.
  • workers are protected by vaccination against tetanus and hepatitis B.

6. Training

  • each and every hospital must have well planned awareness and training programme for all category of personnel including administrators (medical, paramedical and administrative).
  • all the medical professionals must be made aware of Bio-medical Waste (Management and Handling) Rules 1998.
  • to institute awards for safe hospital waste management and universal precaution practices.
  • Training should be conducted to all categories of staff in appropriate language/medium and in an acceptable manner.

7. Management and administration

Heads of each hospital will have to take authorization for generation of waste from appropriate authorities as notified by the concerned State/U.T. Government, well in time and to get it renewed as per time schedule laid down in the rules. Each hospital should constitute a hospital waste management committee, chaired by the head of the Institute and having wide representation from all major departments. This committee should be responsible for making Hospital specific action plan for hospital waste management and its supervision, monitoring and implementation. The annual reports, accident reports, as required under BMW rules should be submitted to the concerned authorities as per BMW rules format.

8. Measures for waste minimization

As far as possible, purchase of reusable items made of glass and metal should be encouraged. Select non PVC plastic items. Adopt procedures and policies for proper management of waste generated, the mainstay of which is segregation to reduce the quantity of waste to be treated. Establish effective and sound recycling policy for plastic recycling and get in touch with authorised manufactures.

9. Coordination between hospital and outside agencies

  • Municipal authority : As quite a large percentage of waste (in India upto 85%), generated in Indian hospitals, belong to general category (non-toxic and non-hazardous), hospital should have constant interaction with municipal authorities so that this category of waste is regularly taken out of the hospital premises for land fill or other treatment.
  • Co-ordination with Pollution Control Boards: Search for better methods technology, provision of facilities for testing, approval of certain models for hospital use in conformity with standards ‘aid down.
  • To search for cost effective and environmental friendly technology for treatment of bio-medical and hazardous waste. Also, to search for suitable materials to be used as containers for bio-medical waste requiring incineration/autoclaving/ microwaving.

CONCLUSION

Medical waste is directly relevant to the practice of medicine, as it represents a misuse of resources that could otherwise be spent on patient care. Operating rooms produce a disproportionately large portion of total hospital waste. Much more can and should be done to better manage supply and drug waste resulting from surgical procedure.

 

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2 responses to this post.

  1. Posted by RAINBOW on October 24, 2011 at 2:36 pm

    done an excellent job .way of presentation is good ,first you are categorizing the hospital waste into many types and find an alternative for each category.

    Reply

  2. Posted by poseidon on December 17, 2011 at 3:45 pm

    area of selection is good.hospital wastes are increasing day by day.they are suggesting some better methods to categorizing the hospital wastes and some safety measures that should adopt in hospitals.

    Reply

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