Specificobjectives are ü Toidentify the types of medical waste in DCC area ü Tofind out the sources of medical waste in DCC areaü Tocalculate the amount of generated medical waste in DSCC areaü Toassess the existing waste management practice in DSCC area Review of LiteratureIntroductionInliterature the terms ‘Healthcare Waste’, ‘Infection waste’ and’Medical/hospital waste’ they have similar meaning or so close meaning whichsignificantly slows up and evaluate thedifferent of countries (Muduli & Barve, 2012).
Safe healthy management is requiredremaining to huge financial which is responsible generation in all sourceswhich increasing gradually for last 10 years, management sectors and disposalwhich causes environmental problems (Aziz, 2011) .Thefitness structure which is under pressure of arranges the Health Care Waste insuch a way as to keep away from the gratuitously in high risky levels ofEnvironmental damages. Healthcareservices are working to the social of cleaner and safe environment. Tohandle healthcare waste optimally, healthcare should provide all levels ofmedical product’s life cycle, by looking at the medical products up stream anddown-stream activities (Gabela and Knight, 2010). Asuitable handling of Health Care Waste can reduce the hazard in both of indoorand outdoor of healthcare centers. There are four key steps of Health CareWaste Management: 1.
Separation on the generation point 2. Transportation ofwaste and disposal site 3. Treatment and 4. Final disposal (World Bank, 2000). Definition of key terms The definition of the medical waste is differ intoworldwide and organizations as well, based on different sorts of waste (Akter,Rahman, and Sharmin, 2005).
Medicalwaste also has traditionally been defined as waste production from healthcarecenters and related actions that reduces the hazardous of infection accordingto health policies. NorthernIreland, 2003, “Any other waste arising from medical, nursing, dental,veterinary, pharmaceutical orsimilar practice, investigation, treatment, care, teaching or research, or thecollection of blood for transfusion, being waste which may cause infection toany person coming into contact with it” (Elgitait, Sarshar and Gee, 2009). Theterm “medical waste” covers all wastes produced in health-care or diagnosticactivities”.
Ingeneral medical waste generated from the diagnostic, healing veterinary andhuman medicine, and highly medical waste which is defined “any solid or liquidwaste that is generated in the diagnosis, treatment or immunization of humanbeings or animals, in research pertaining there to, or in production or testingof biological” (BAN, 1999). According to World Bank, 2000, “healthcare waste isdefined the entire waste stream form healthcare facilities, laboratories, emergencyrelief donations. Aofficial definition by EPA is “any kind of waste of a solid, liquids, orgaseous or semisolid its quantity, concentration, physical or chemicalcharacteristic may (1) cause orsignificantly contribute to an increase in mortally or an increase in seriousirreversible or incapacitating reversible illness; or (2) pose a substantialpresent or potential hazard to human health or the environment when improperlytreated, stored, transported or disposed of, or otherwise managed”(Vesilined,Worrell and Reinhart, 2008). Accordingto World Health Organization (WHO), 2013, “the term of medical waste with all akinds of waste with is generated within research centers, laboratories relatedto medical process, In addition, it includes the equal types waste initiatefrom minor and scattered sources, including waste produced in the course ofhealth care undertaken in the home (e.
g. home dialysis, self-administration ofinsulin, recuperate care).” Medical wastemanagement definition MedicalWaste Management defines the management of waste generated by medical orhospitals by using such practice that will help you to check the spreading thediseases though it (Elgitait, Sarsharand Gee, 2009). The healthcare wasteincludes all categories that generated by healthcare like general hospitals,private clinics, dialysis centers, medical centers and dispensaries. The wastehandling is defined as a collecting, transporting processing and disposes it(Aziz, 2011).Initialhandling, collecting, transporting, disposing and observe of waste collectivelycalled waste management (Tabasi and Marthandan, 2013).
According to Rushbrook,”Good management of healthcare waste in hospitals means the effectiveseparation of waste, handling and disposal of eiach sorted waste category. Thiscannot be reach without the commitment of manager and incentive of medicalstaff. Categories ofmedical waste and typesTypesof medical waste There are different items of medical waste like Sharps, contaminatedsyringes, animal and human tissues, drugs and medicine which produced asdifferent ways from healthcare services (Abbasi, 2013).
Inbetween 75-90% of the waste produced by healthcare providers is similar to dogmatic waste and often called”non Hazardous” and the remaining 10-25 of health waste is considered to”Hazardous” that may cause a different diversity of environmental and health risks(WHO, 2013). Figure1Types of medical wastes (WHO, 2013) Types of medical waste according to WHO, 2013: ü Sharp waste: used needles, syringes, infusion setsscalpels, pipettes, knives, blades andbroken glasses. ü Infectious waste: blood and others of body fluids,lab cultures and microbiological stocks, waste from isolation wards useddressing.ü Pathological waste: human and animal tissues,organs and fluids, body parts, fetuses, placentas, unused blood.ü Pharmaceutical waste with toxic waste: unwanteddrugs expired or no longer needed drugs, toxic waste which maycontain substances with genotoxic/cytotoxic properties.ü Chemical waste: Chemicals from lab anddiagnostic work, cleaning materials.ü Radioactivewaste: Radioactive substances from radiotherapy and lab work.ü Pressurizedcontainers: Gas cylinders, cartridge and aerosol cans.
ü Highheavy metal content: Batteries, broken thermometers, blood pressure gauges.ü Non-hazardousorGeneral healthcare waste: Paper, cardboard and plastics, discarded food wastefrom kitchen, metal, glass, textiles, plastics/polythene and wood. Types of Health Care Waste a)Sharp WasteIn healthcareservices there is different items are used like needles, scalpels, or blades,knives, infusion sets, saws, broken glass and pipettes. These items are usuallyconcentrated highly hazardous and infections. Because of their sharpness whichcan cut or puncture wounds and hence, should be treated as if they werepotentially infected. b)Infectious wasteInfectious wasteis material suspected to contain pathogens (bacteria, viruses, parasites orfungi) in sufficient concentration or quantity to cause disease in susceptiblehosts.
These include cultures and stocks of infectious agents from laboratorywork; waste from surgery and autopsies on patients with infectious diseases,e.g. tissues and materials or equipment that have been in contact with blood orother body fluids, waste from infected patients in isolation wards, e.g.excreta, dressings from infected or surgical wounds, cloths heavily coveredwith human blood or other body fluids; waste that has been in contact withinfected patients undergoing hemodialysis, e.g. dialysis equipment, such astubing and filters, disposable towels, gowns, aprons, globes, and laboratorycoats; infected animals from laboratories; any other instruments or materialsthat have been in contact with infected persons or animals. c)Pathological waste:Pathological wasteconsist of human tissues, organs, body parts, blood, body fluids, and othersimilar wastes from surgery, biopsies, and autopsies on patients withinfectious diseases.
It also includes human fetuses and infected animalcarcasses.d) Pharmaceuticalwaste:Pharmaceuticalwaste includes expired, unused, spilt and contaminated pharmaceutical products,prescribed and proprietary drugs, vaccines and sera that are no longerrequired, and due to their chemical or biological nature, need to be disposedof carefully. The category also includes discarded items such as bottles, vialsand boxes containing pharmaceutical residues, gloves, masks and connectingtubes. In addition sometimes this waste item includes toxic drugs such asgenotoxic and cytotoxic drugs should be disposed of very carefully and after disposalthis should be given special attention.e)Chemical waste: Chemical wasteconsists of discarded solid, liquid and gaseous chemicals, such as solvents, filmdeveloper from diagnostic and experimental work and form cleaning anddisinfecting procedures, chemical waste also includes toxic, corrosive,flammable, explosive, or carcinogenic, reactive and oxidizing and considered tobe hazardous.f)Radioactive waste:Radioactive wastesare materials contaminated with radionuclides. They are produced as a result ofprocedures such as in vitro analysis of body tissue and fluid, in vivo organimaging and tumor localization and various investigative such as x-ray andtherapeutic practice.
g)Pressurized containers:Various types ofgas are used in healthcare and are often stored in pressurized cylinders cartridgesand aerosol cans. Many of these, once empty or of no further use (although theymay still contain residues), are reusable, but certain types-notably aerosolcans-must bedisposed of. h)Waste with high content of heavy metals:These types ofwastes are highly toxic. Mercury wastes are typically generated by spillage frombroken clinical equipment, but their volume is decreasing with the substitutionof solid state electronic-sensing instruments, such as batteries, brokenthermometers, blood pressure gauges, etc.
Sources of healthcare wasteAccording to WHO,(2013) the primary sources of medical waste are given as follows:· University, General and district hospitals· Clinics· Emergency medical care services· Healthcare centers and dispensaries· Research laboratories/dialysis center· Blood banks and blood collection services· Nursing homes for the elderlyAssociatedRiskGeneral,non-hazardous waste from HCE poses the same hazards as general solid waste, butmedical or clinical waste poses significantly increased hazardous. The mostobvious of these is the transmission of infectious diseases (e.g. Hepatitis Band HIV/AIDS) through direct contact with infected waste items such as usedneedles, discarded dressings and human tissues or fluids. Non-direct risksinclude disease transmission by vectors and pollution of water sources and theenvironment. Less common potential risks include the risk of cancer, burns andskin irritation from radioactive waste or toxic chemicals (Harvey, Baghri andReed,)