In this article, we discuss the 6 hospital waste management guidelines you must apply for efficient management of hospital waste.
Hospital waste management has become a critical issue as it poses implicit health pitfalls and damage to the terrain. It is also of greater significance due to its implicit environmental hazards and public health pitfalls with high potential to cause and consequently result in epidemics or even pandemics.
It continues to be a major challenge, particularly, in many healthcare installations of the developing countries where it is hampered by technological, economical, social difficulties and inadequate training of staff responsible for the handling of the waste.
Poor conduct and inappropriate management and disposal methods exercised during handling and disposal of Hospital waste is an increasingly significant health hazard and environmental pollution/hazards due to the contagious nature and unwelcoming smell of the waste.
The main areas that have poor management are the same for all stages of operations and units in healthcare though hospital waste management practices vary from hospital to hospital.
In Nigeria, a typical developing African nation, not numerous people are apprehensive that Hospital waste contributes mainly to environmental pollution and hazards. This is reflected by a lack of mindfulness to specific policy to address the imminence of healthcare facility (HCF) waste, some of which are known to be hazardous.
It is important to note that healthcare wastes, if not duly managed, could pose a greater threat and hazards than the original diseases. Hospitals and healthcare centres must take care of public health issues similar to hospital waste.
Specific approaches that may be employed include patient care and enlightenment, ensuring clean and healthy terrain for workers/community. Carefree handling and disposal of hospital Waste impact both directly and indirectly on staff, patient, and environment.
This is because the hospitals represent a unique terrain, providing healthcare to patients and work terrain for hospital staff. In the process of healthcare delivery, hospital waste is generated, which includes sharps, human tissues or body parts, and other contagious materials.
It is good to note that there is a range of technologies that are available to adequately treat hospital waste and can be used in developing or third world countries.
According to World Health Organisations (WHO), unsafe injections disposal and poor waste management systems is responsible for about 8 to 16 million new cases of Hepatitis B virus (HBV), 2.3–4.7 million cases of Hepatitis C virus (HCV), and 80,000–160,000 cases of Human Immunodeficiency Virus (HIV).
Contaminated injection equipment may be scavenged from waste areas and dumpsite either to be reused or sold to be used again. The negative health and environmental impacts of hospital waste include transmission of diseases by viruses and microorganisms, defacing the aesthetics’ of the environment, as well as the impurity of underground water tables by untreated hospital waste in landfills.
Good hospital waste management in the hospital depends on a dedicated waste management team, good administration, careful planning, sound association, bolstering legislation, adequate financing backing, and full participation by trained staff.
However, it is important that before any of these options is used, hospitals and medical facilities will need to assess the problems and put forward a good management strategy that suitably matches their economic circumstances and is also sustainable for use, based on local technology.
Paradoxically, healthcare conditioning which is meant to cover the health, cure cases, and save lives has been known to also induce waste. About 20 % of these wastes pose a high threat, either of infection and chemical or radiation exposure.
Health-care conditioning induces significant quantities of hazardous waste similar to mercury and expired pharmaceuticals, as well as large quantities of general waste. The management of healthcare waste is an integral part of a public healthcare system.
A holistic approach to healthcare waste management should include a clear delineation of responsibilities, occupational health and safety programs, waste minimization and segregation, development, relinquishment of safe and environmentally sound technologies, and capacity building.
Knowing the urgency of this problem, a growing number of countries have taken effective steps in responding to this need.
These steps include the establishment of regulatory frameworks, development of national plans, and the demonstration of innovative approaches but, the funding of hospital waste management remains very ineffective.
This is an issue taking a central place in the national health programs of many countries. However, in most urban areas in Nigeria, there are often no methodical approaches to hospital waste management and it has not received sufficient attention. This may be because veritably frequently, health issues contend with other sectors of the economy for the very limited resources available.
Also, in numerous countries, hospital wastes are still handled and disposed of together with domestic wastes, posing a great health threat to municipal workers, the public, and the environment.
Hospital waste must be separated from municipal waste, but in many parts of Africa, it tends to be collected along with the rest of the waste stream.
Hospital wastes are still mixed with municipal waste in collecting bins at roadsides and disposed of similarly.
In Korea, Hospital waste was often mixed with municipal solid waste and disposed of in residential waste landfills or improper treatment facilities (e.g. inadequately controlled incinerators). This is also evident as some of the hospitals surveyed in Lagos mixes municipal and Hospital waste in their on-site storage facility.
What is Hospital Waste Management?
Hospital waste management which is also called medical waste management is a system that handles the segregation, containment, transportation, treatment, and disposal of waste generated in government hospitals, private hospitals, national hospitals, clinics, dispensaries, research centres, and blood banks.
Hospital waste includes infections, sharps, chemicals, pharmaceutical, toxic, radioactive, anatomic hazards, etc. And they can be very hazardous, pathogenic, infectious, and contagious so, it is very critical for healthcare institutions to take hospital waste management very seriously.
Non-compliance with proper hospital waste management can lead to serious health risks, fines, and damage to a healthcare institution’s reputation.
Since waste poses a risk to the health and well-being of the environment, proper hospital management of waste is essential to maintain hygiene, aesthetics, cleanliness, and control of environmental pollution.
Why is Hospital Waste Management Guidelines Important?
Hospital waste management guidelines are important for the following reasons:
- When hospital waste management guidelines are followed appropriately, the risk and cost of handling and disposal of hospital waste will be significantly reduced.
- Waste can also be classified as hazardous or non-hazardous waste and away one can effectively manage and dispose of this waste in their various classifications is by following hospital waste management guidelines.
- Since waste poses a risk to the health and well-being of the environment, proper management of hospital waste through adherence to hospital waste management guidelines is very essential to maintain hygiene, aesthetics, cleanliness, and control of environmental pollution.
- Hospital waste management guidelines are necessary because hazards can come from infectious waste which contains pathogens and can affect HCWs and BBV transmission can occur through sharp waste.
- Also if chemical waste is mixed with other waste as a result of no colour coding which is one of the hospital waste management guidelines, chemical waste which is toxic and corrosive may cause physical injuries and chemical burns. Some waste can be very hazardous leading to several adverse effects like mutations, cancer, and even tissue destruction.
Who Creates Guidelines for Management of Hospital Waste?
Hospital waste management guidelines are created by healthcare governing bodies worldwide, national and local like the World Health Organisations, national and local health organisations, and Safety Organisations.
6 Hospital Waste Management Guidelines You Must Know
After hospital waste is generated through various healthcare facilities, hospital waste should be managed properly and this is done through strict adherence to the following hospital waste management guidelines:
- Hospital Waste Pre-Treatment
- Hospital Waste Segregation
- Hospital Waste Collection and Transportation
- Hospital Waste Storage
- Hospital Waste Treatment
- Hospital Waste Disposal
1. Hospital Waste Pre-Treatment
Hospital Waste Pre-Treatment is one of the hospital waste management guidelines and it’s done before the waste is segregated at the source. This is done to reduce the contamination of the waste and also to ensure the safety of the personnel involved in the hospital waste management process.
2. Hospital Waste Segregation
Hospital waste segregation is one of the hospital waste management guidelines and it’s generated from healthcare facilities is to be segregated at the point of generation in colour-coded bags and bins for easy identification and collection.
Hospital waste is comprised of different materials of which some can be hazardous or non-hazardous and so to ensure effective treatment and disposal the hospital waste has to be segregated.
Below are the different colour codes for easy segregation at the source:
This is a non-chlorinated plastic bag used for the collection of human and anatomical waste comprising of human tissues, organs, fetuses, amputated parts, and placenta.
Other waste like dressings and bandages, soiled waste (plaster casts, cotton swabs, residual/discarded blood bags), expired and discarded medicine (cytotoxic drugs, antibiotics), discarded linen, mattresses, and beddings,
pre-treated microbiology, biotechnology, and clinical lab waste (blood bags, cultures, residual toxins, dishes and devices, microorganism specimen) and chemical waste (discarded reagents, disinfectants).
These kinds of waste can be incinerated or buried deep underground or treated using plasma pyrolysis.
This is a non-chlorinated plastic bag used for the collection of disposable rubber items which include contaminated waste (recyclable) tubing (IV sets, catheters, NG tube), bottles, intravenous tubes and sets, catheters, urine bags, syringes (without needles), used gloves and a specimen container.
These kinds of waste can be treated by autoclaving, microwaving, and chemical treatment techniques and then sent to recycling. It should not be sent to the landfill.
This is a cardboard box with blue coloured marking used for the collection of infected broken glass/bottle, broken or unbroken glassware vials ampoules, glassware/IV bottle (0.45 NS), Mannitol injection bottle, metallic body, implants glassware item used inward, glass piece, glass bottles, glass siles (laborites), glass syringes.
These kinds of waste can be treated by autoclaving, microwaving, and chemical treatment techniques and then sent to recycling.
This is a white puncture-proof box or container used for the collection of waste sharp including metals, needle, syringe fixed needle, scalpels blade/razor, suture needle, pine needle, contaminated sharp metal objects, lancets, nails.
These kinds of waste can be treated by auto or dry heat sterilisation followed by shredding or mutilation or encapsulation and then sent to the recycling.
This is used for the collection of general hospital waste, food waste, paper waste, and waste bottles.
These kinds of waste can be treated and then sent to a secure landfill.
3. Hospital Waste Collection and Transportation
After the waste generated in the hospital is segregated in the various bins differentiated by their colour codes, the waste is collected every day and transported to a temporal storage centre within the hospital and this is one of the hospital waste management guidelines. These wastes are transported by the use of a trolley, wheeled barrow, trucks, etc.
4. Hospital Waste Storage
Temporal storage of hospital waste is discouraged in the wards / different departments of the healthcare facility. If waste is needed to be stored temporally in the departments, it must be stored in the dirty sections of the hospital. ·
No hospital waste should be stored in patient care areas and procedures areas like the Operation Theatre. All infectious waste should be immediately removed from such areas.
After this, the hospital waste is transported to the central storage area where they are treated and disposed of appropriately making it one of the hospital waste management guidelines.
5. Hospital Waste Treatment
Hospital waste treatment is one of the hospital waste management guidelines and it’s done after the waste is collected and transported to a specialised hospital waste treatment site where they are treated finally.
Hospital waste can be treated through various methods and they including autoclave, microwave, heat, alkaline disasters.
Depending on the hospital waste characteristics and quantity, different chemicals can be used for the waste treatment and they include solutions of 1-10% solution of bleach sodium hydroxide and other chemical disinfectants. Bleach is mainly used for liquid hospital waste.
An autoclave sterilises and reduces the microbiological load of hospital waste to a level in which they are safe to be disposed of using steam and pressure. For microwave, non-contact heating technology is used for disinfection of the hospital waste.
Microwave dielectric heating effects that are based on the efficient heating of materials are used in a microwave system. The cells which have dipoles of the water molecules re-align with the applied electric field when exposed to microwave frequencies.
The alternating electric field is aligned with the dipoles when the field oscillates causing the energy to be lost in the form of heat through molecular friction and dielectric loss.
The use of the microwave for disinfection and treatment of hospital waste is not just a new technology but has an advantage old the existing autoclaves technology reason being that microwave has less cycle time, power consumption and requires minimal usage of water and consumables as compared to autoclaves.
For autoclaves and microwave systems, a shredder may be used as a final treatment step to render the waste unrecognisable. Some autoclaves have built-in shredders.
6. Hospital Waste Disposal
Hospital waste disposal is the final stage of the hospital waste management guideline. In this stage, the hospital waste can either be shredded, sent to a landfill, or incinerated.
Pending the types of hospital waste, the waste can be either sent to the landfill or can be incinerated.
How best should hospital waste be disposed of?
Though poses a risk to the environment, incineration is the best method of disposal available to hospital waste and this is because the waste materials that are harmful and hazardous to the health and environment are burnt off.
How harmful is hospital waste?
Hospital waste is very harmful to humans and this is in many ways as hospital waste can cause epidemics and even pandemics. They can also cause chemical waste which is toxic and corrosive may cause physical injuries and chemical burns.
Also, hazards can come from infectious waste which contains pathogens and can affect HCWs and BBV transmission can occur through sharp waste.