MANAGEMENT OF MEDICAL WASTE

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MANAGEMENT OF MEDICAL WASTE

Prepared By:Nihan Isbil

Gökçe AlpayBengi Berker

Burcu Yalçınkaya

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Objectives

In our presentation, we’d like to inform you about:

What is medical waste? Sources of medical wastes Who’s collecting medical wastes? Methods for treatment The treatment methods and application in Turkey Ways to improve the current applications.

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What is Medical Waste?

This symbol is the “International Biohazard Symbol”. It is also known as “Trifoil”.

Biohazard materials include “Medical Waste.”

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Any solid or liquid waste which is generated in the

Diagnosis, Research, Treatment Immunization

of human being or animals are called as Medical Waste.

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Medical Waste can’t be considered as general waste.

Since the medical wastes are infectious, bio-hazardous and they could lead to the spread of diseases; they should be collected separately from commercial and residential wastes.

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Medical wastes have a risk of transmitting:

Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) Other agents that are associated with

blood-borne diseases.

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Chemical composition of the medical wastes consists of:

50 % of Carbon, 20 % of Oxygen, 6 % of Hydrogen, Many other trace elements.

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Sources of Medical Waste

Hospitals and Clinics, Bio-technology Institutes, Laboratories, Medical Research Facilities, Nursing Homes, Diagnostic Laboratories

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Examples for Medical Waste

Blood or body fluid, Cultures and stocks of agents, Discarded vaccines, culture dishes and devices

used at those actions; Blood products such as serum, plasma,

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Pathological wastes, such as tissues, organs, body parts, and body fluids that are removed during surgery and autopsy,

Discarded needles, scalpel blades, those have come contact with infectious agents,

Radioactive materials, Used operation room clothes, Dialysis wastes.

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Wastes from normal veterinarian activities and from farms or ranches,

Paper towels, which didn’t contact with the infectious agents and does not contain fluid blood,

Are not considered as Medical Waste.

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Generation Rate of Medical Waste in Turkey

For example; medical waste generation rate depends on:

o The type of the facility, o The treatment methods and the materials used during those actions

According to the survey that is run throughout Turkey, the most medical waste production is in Istanbul (about 34 tons per day); which contributes 17% of the total waste production. In contrast, Tunceli has the least waste production rate which is approximately 32 kilograms per day.

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Regulations & Applications Of Medical Waste Management

The aim of Management of Medical Wastes Regulation:

To protect human-beings and environment from the hazardous wastes from their

generation to final disposal.

x NO YES

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The Ministry of Environment and Forests has published “Regulation on Control of Medical Wastes” on 1993.

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According to the regulation; management consists of 6 steps:a. Separate collection at the source,b. Remove from the source in different containers,c. Storing temporarily until collection,d. Collection of wastes with proper licensed medical

waste vehicles and transferring to the disposal site,

e. Treatment or destruction of wastes by incineration,

f. Tracking period.

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Steps

Seperation @ Source

Storing temporarily until collection

Collection of wastes with proper licensed medical waste vehicles

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Packages

The potential infectious medical wastes must be coded with color red.

The packing should be strong enough to withstand during handling, storage and transportation.

The packages must have 150 microns thickness.

Also the packaging should be moisture resistant, insect proof.

18Applications For Medical Waste Treatment In World-wide & In Turkey

The most used method for treatment of medical waste is Autoclaving and Incineration.

Besides those methods, also new technologies are used to improve existing ones; like Microwave & Chemical Disinfections, Plasma Technology.

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Applications For Medical Waste Treatment In World-wide & In Turkey

Medical Waste Incinerators burn trash and infectious medical waste.

Autoclaving is the usage of superheated, pressurized steam; so that medical waste can be harmlessly buried in landfills.

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Advantages & Disadvantages of Methods

Incineration

Advantages DisadvantagesVolume & Weight Reduction High Investment & Operation

CostsHeat Recovery for Large Systems High Maintenance CostFits for Every Type of Waste Air Pollution

Expensive EquipmentHazardous Fly Ash

Autoclaving

Advantages DisadvantagesLow Investment Cost Appearance & Volume Remain

StillLow Operating Cost Not Suitable for All Waste TypesLow Hazard Residue Possible Air Pollution

Ergonomic Concerns

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Applications For Medical Waste Treatment In Turkey

The treatment method used in Turkey is Incineration.

In Istanbul, ISTAC is responsible for collection of medical wastes.

There’re 16 licensed medical waste collection vehicles in Istanbul.

Medical wastes collected from the hospitals and different health care facilities, are brought the Kemerburgaz Odayeri Landfill Facility.

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Applications For Medical Waste Treatment In Turkey

At the gates, the trucks are controlled by 4 radio-activity detectors, in order to locate the radioactivity in the truck if exists.

The incinerator system in Odayeri has a daily capacity of 24 tones. All of the system is controlled by PLC System.

The wastes are incinerated at temperatures of 1000°C to 1200°C. By incineration, 95% reduction in volume and 75% reduction in mass is obtained.

Also electricity is obtained from the incineration activity and is used in the complex.

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Researches – Government Hospital

Our group visited the “Silivri Devlet Hastanesi”.

There’s only one employee for medical waste collection. He said he is obligated to wear special clothes which

are in color orange. Also he has to wear gloves, caps, plastic yellow boots and masks.

There’s a main container that is used for collection of medical wastes from very unit. Wastes are collected in every morning and every evening.

The collected wastes are stored in a storage room which is constructed according to the regulation rules.

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Researches – Government Hospital

İSTAÇ collects the wastes two times in a week. The wastes wait in the storage room about 3 days. The vehicles are sent to the hospital at evenings.

They’re not interested in what is done to wastes at İSTAÇ, they said that they’re just collecting and sending the wastes.

They’re using the red medical waste packages.

They’re very careful about separate collection of medical wastes from residential wastes.

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Researches – Clinic Laboratory

Also, we visited Kızıltoprak Referans Clinic Laboratory. They gave us the following information:

“Since we are a small facility, there’s not much medical waste generation. Because of that reason, İSTAÇ visits us once in two weeks.”

They collect their wastes in an red container without any usage of red packages. When we asked the reason, the manager said that “There’s no harmful waste generation in our facility. So, we don’t need to use packages.”

But the bad thing is that, the container is put into the street. There’s no special place for the container.

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Comments & Recommendations for İSTAÇ

According to our impression at the hospitals and at the technical trip, we saw that İSTAÇ is well-working about medical waste management.

İSTAÇ collects all of the medical waste and brings them to Odayeri for incineration.

But in clinics or local health care centers, generated waste is not that hazardous or pathologic. Instead of incinerate all of the wastes, those kinds of low or non-hazardous wastes can be collected separately and they can be sterilized by autoclaving and could send to the landfills.

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Autoclaves

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An incinerator example.

Incineration

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The major disadvantage of incineration is emissions of toxic materials like mercury and dioxin. So, by reducing the amount of waste to be incinerated, we can also reduce the air pollution from those materials. By autoclaving, we can eliminate the generation of dioxin.

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Besides autoclaving and incineration there’re also new technologies. Historical systems can be replaced with those technologies. İSTAÇ can investigate those technologies and use for medical waste treatment.

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Comments & Recommendations for Waste Generators

Since the collection from source and temporarily storage part belong to hospitals; there should be controllers who are working for government or for İSTAÇ. They should be controls on a regular basis. According to the hospitals we’ve talked and the investigations we’ve made there’s no such a regular-basis control.

Here’s some examples for the bad collection:

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With Our Recommendations we Achieve

Less environmental impactWaste minimizationStrict conformation to the regulations

Recycle & reuse of wastesReducing the air pollutant release.

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Thank You for Listening...

MANAGEMENT OF MEDICAL WASTE

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