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HAZARDOUS WASTE MANAGEMENT AT HEALTHCARE …

HAZARDOUS WASTE MANAGEMENT AT HEALTHCARE facilities . *Dr. D. Shreedevi *Associate Professor, Apollo Institute of Hospital Administration, Apollo Health City, Jubilee Hills, Hyderabad 500096. (M) 9441885258 (O) 040-23543269. e-mail Abstract Health care WASTE is a source of generation of HAZARDOUS biomedical WASTE . According to WHO Fact Sheet, of the total WASTE generated by HEALTHCARE activities, about 80% is general WASTE . The remaining 20% is considered HAZARDOUS that may be infectious, toxic or radioactive. It is necessary to design proper policies to avoid the spread of infection through WASTE and illegal reuse of the WASTE material. Policies should provide specification for handling WASTE for generation, segregation, collection, storage, transportation and treatment.

1 HAZARDOUS WASTE MANAGEMENT AT HEALTHCARE FACILITIES *Dr. D. Shreedevi *Associate Professor, Apollo Institute of Hospital Administration, Apollo Health City, Jubilee Hills,

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Transcription of HAZARDOUS WASTE MANAGEMENT AT HEALTHCARE …

1 HAZARDOUS WASTE MANAGEMENT AT HEALTHCARE facilities . *Dr. D. Shreedevi *Associate Professor, Apollo Institute of Hospital Administration, Apollo Health City, Jubilee Hills, Hyderabad 500096. (M) 9441885258 (O) 040-23543269. e-mail Abstract Health care WASTE is a source of generation of HAZARDOUS biomedical WASTE . According to WHO Fact Sheet, of the total WASTE generated by HEALTHCARE activities, about 80% is general WASTE . The remaining 20% is considered HAZARDOUS that may be infectious, toxic or radioactive. It is necessary to design proper policies to avoid the spread of infection through WASTE and illegal reuse of the WASTE material. Policies should provide specification for handling WASTE for generation, segregation, collection, storage, transportation and treatment.

2 This study is conducted to compare the biomedical WASTE MANAGEMENT policies of Apollo Hospital with Delhi Pollution Control Committee (DPCC) guidelines. Policies of Environment Protection Agency (EPA). of USA and National Health care Services (NHS) of UK were studied to perform comparative analysis of global standard. A structured checklist was used to assess the accuracy of handling in compliance with DPCC guidelines. The policies of the hospital are framed in compliance with the guidelines provided with DPCC. Due to negligence and lack of supervision loopholes in the procedure was observed during the stages of storage and transportation. Key words: DPCC, EPA, health care WASTE , HAZARDOUS WASTE , NHS, WHO.

3 Introduction Biomedical WASTE MANAGEMENT is an important aspect of any HEALTHCARE organization. With the increase in the consumption of utilities per bed, there is a tremendous rise in production of biomedical WASTE , disposal or further handling of which has gather concern of all. The biomedical WASTE is the WASTE that is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto, or in the production or testing of biological components. According to Bio-medical WASTE ( MANAGEMENT and Handling) rules 1998, WASTE can be categorized into the following categories. WASTE categories Type of WASTE Category 1 Human Anatomical WASTE Category 2 Animal WASTE Category 3 Microbiology and Biotechnology WASTE Category 4 WASTE Sharps 1.

4 Category 5 Discarded Medicines and Cytotoxic drugs Category 6 Solid WASTE Category 7 Solid WASTE from disposable items Category 8 Liquid WASTE Category 9 Incineration Ash Category 10 Chemical WASTE Source: Delhi Pollution Control Committee guidelines Objectives of the Study To study the MANAGEMENT of HAZARDOUS WASTE in HEALTHCARE facilities To know the biomedical WASTE MANAGEMENT procedure of global standards viz. UK and USA. To compare and analyze the shortcomings in the WASTE MANAGEMENT procedure of Apollo Hospital in comparison to above mentioned standards. Methodology The initial part of the study involved observation of the process flow and functioning of various departments of the hospitals.

5 A structured checklist was used to assess the accuracy of handling in compliance with DPCC guidelines. The hospital was divided into floors and floors were further divided into towers. Following this division the data was collected by observing each set of bins and taking personal interview of people associated with WASTE handling procedure. Policies formulated by DPCC, UK and USA were also studied. Two separate checklists were prepared by keeping in mind the guidelines of DPCC and global standards. Data was collected by observation of all the areas associated with storage, transportation and treatment of the WASTE . Housekeeping staff were interviewed for procedure related information.

6 The study was done by taking both primary and secondary data. Sources of WASTE generation The sources of health-care WASTE can be classified as major or minor according to the quantities produced. 2. HAZARDOUS WASTE Related to Bio Medical WASTE HEALTHCARE WASTE includes a large component of general WASTE and smaller proportion of HAZARDOUS WASTE . Exposure to HAZARDOUS HEALTHCARE WASTE can result in disease or injury. The HAZARDOUS nature of HEALTHCARE WASTE may be due to one or more of the following characteristics: it contains infectious agent;. it is genotoxic;. it contains toxic or HAZARDOUS chemical or pharmaceuticals;. it is radioactive;. it contains sharps;. All individual exposed to HAZARDOUS HEALTHCARE WASTE are potentially at risk, including those within HEALTHCARE establishments that generate HAZARDOUS WASTE and those outside these sources who either handle such WASTE or are exposed to it as consequence of careless MANAGEMENT .

7 MANAGEMENT of Biomedical WASTE : Biomedical WASTE MANAGEMENT is including four major steps. These steps help in achieving effective WASTE MANAGEMENT only when followed accurately and routinely. The steps are as follows. Generation of Biomedical WASTE : 3. Medical activities generate WASTE that should always be discarded at the point of use by the person who used the item. The quantity of HCW generated should always be minimized and precautions must be taken during their handling. 1. Environment Protection Agency (United States of America). Medical WASTE Tracking Act 1988 requires Environment Protection Agency to formulate policies and find alternative means for disposal of biomedical WASTE .

8 A lot of emphasis is given to public education regarding WASTE disposal and WASTE minimization. The policies can be categorized in following manner: 1. WASTE Categorization: Proper WASTE categorization avoids cross contamination of general WASTE from infectious 4. or HAZARDOUS WASTE . It helps in providing effective treatment to a better categorized WASTE . 2. Generation: Types of generators are: Hospitals, Intermediate care facilities , Clinics, Physician Offices, Dental Offices, Laboratories, Funeral Home, Veterinarian, Blood banks, Animal Care, Emergency Care, Hospices, Home HEALTHCARE , Illicit Drug users. All these areas are concerned as potential biomedical WASTE generators and are supposed to follow the guidelines formulated by EPA.

9 A. lot of stress is given on WASTE minimization which helps in reducing the cost of material used per bed and treatment cost of WASTE is also reduced. Collection, Handling and Storage to be done by trained WASTE handlers. Containers should have bio-hazards signs. Bins should be non-corrosive and bags should be heavy plastic material. Storage area should be durable and easily cleansable. It should be protected from wind, rain, vermin & vector and should be maintain in odorless state. Floor should be impermeable to liquid with perimeter curve. 3. Transportation: Trollies and vehicle used for outside transport should be designed to facilitate least damage to structural integrity of WASTE .

10 WASTE should be transported only through the designed route. The WASTE handlers should use protection equipments. Procedures to be undertaken in case of fire should be well designed. (Out-house transportation). Proper documentation of the type and quantity of WASTE being transported should be maintained. Authorized personnel should only be allowed for transportation to avoid illegal reuse of needles and other kind of WASTE . 4. Treatment, Destruction and Disposal: Type of WASTE Treatment Procedure 1. Sharps 2. Culture and Stock Steam sterilisation or incineration or thermal/chemical deactivation 3. Blood & blood products Discharge to sanitary sewer system or approved septic system.


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