Medical Waste Management

Feliks Leybovich12/20/2012

Medical care is vital for our life, health and well being. The waste generated from medical activities can be

hazardous, toxic. Diseases like cholera, plague, skin infection, hepatitis ,

AIDS (HIV), pose grave public health risks. Environmental pollution. Institutional/Organizational set up, training and

motivation. Great research & awareness have increased recently.

Introduction

‘Medical Waste’ means any solid and/or liquid waste including

its container and any intermediate product, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research or in the production or testing.

Any waste which consists entirely or partly of human or animal tissue, blood or other body fluids, excretions, drugs or other pharmaceutical products, dressings or syringes, needles or other sharp instruments.

Sources: Arising from medical, nursing, dental, pharmaceutical or similar practice, investigation, treatment, care, teaching or research or the collection of blood from transfusion.

Definition

Risk Involved

Microorganisms Enterobacteria Mycobacterium

tuberculosis Streptococcus Human

Immunodeficiency Viruses

Infections Gastroentic

infections Respiratory infection Skin infection Acquired

Immunodeficiency Disorder

Public hospitals produce more healthcare waste than

private hospitals. Mismanagement of Waste and lack of segregation of

waste. North America produces 7–10 kg of healthcare waste per

bed/day, South America produces 3kg . Western Europe produces 3–6 kg, Eastern Europe 1.4–2 kg, In Asia, richer countries produce 2.5 kg per bed/daily, and poorer countries 1.8–2 kg per bed/daily.

Generation

Worldwide Waste

Generation South Africa Algeria Brazil Jordan Greece Bangladesh China

0.60 kg/bed/day 0.70 kg/bed/day 2.63 kg/bed/day 6.10 kg/bed/day 8.4 kg/bed/day 1.71 kg/bed/day 1.22 kg/bed/day

Risks to healthcare staffs, the public and the environment.

Codes of practices and guidelines for handling and disposal

Problematic due to its enormous volume of generation, serious threat for the human health as well as disposal cost.

Clinical waste cannot mix with non-clinical waste.

workers are not educated enough and most of them have not had any special training on the management of clinical waste.

Do not have appropriate colour coded bags or containers for sorting the different types of waste.

Handling & Transportation

Recommended Labelling and Color

Coding

Segregate Storage in Separate Containers (at the Point of Generation).

Certification.

Common/Intermediate Storage Area.

Storage of Waste

Incineration Autoclaving Microwave Chemical disinfecting Irradiation

Treatment Technologies

According to the EPA 90% of

medical waste is incinerated Very effective and secondary

benefit of powering boilers in the facility

Strict regulations regarding air emissions

Incinerator Ash is generally landfilled

Incineration

Applied heat, pressure,

and sometimes steam for sterilization.

Often followed by compaction process, and eventually reaches landfills

Many landfills are reluctant to accept the waste due to concerns that it still is infectious

Autoclaving

On-site installation or mobile

treatment vehicles in US First the waste is shredded

and then it is mixed with water.

Microwaving is applied internal heat (autoclaving is external heat)

According to the EPA not recommended for treatment of pathological waste

Microwaving

Industrial Microwaving Belt

Primarily through the use

of chlorine products Waste is first shredded

and mixed with water According to the EPA,

chemical disinfection is the most appropriate way to treat liquid medical waste

Chemical Disinfecting

Exposure of Waste to Cobalt source Gamma Radiation inactivates all microbes Special treatment sites are required (No

Mobile or in house process) High capital cost Operators’ safety risk in irradiation plant is an

issue Does not sterilize pathological wastes

Irradiation

Comparison of Treatment

Technologies

Metro Health Hospital, Wyoming,

MI: Divert and Purchase Reprocessing Medical Devices

Spectrum Health: Medical Plastics Recycling

Germany Waste Act: 1991

Case Studies

Metro Health Hospital, Wyoming, MI:

Divert and Purchase Reprocessing Medical Devices

What Reprocess many

previously single-use devices

Including: harmonic scalpels, orthopedic burrs, and orthopedic cannulas/trocars

Benefits Cost savings of $235,803

from purchasing reprocessed SUDs between 2008 and 2010

1.84 tons of waste �avoided due to reprocessing in 2010.

Avoided $900 in �regulated medical waste disposal fees in 2010.

Spectrum Health: Medical

Plastics Recycling

Plastics plastic casing� hard plastic from devices paper lined with plastic plastic from surgical gowns outer casings of syringes soft plastics from glove

wrappers rigid saline bottles wash basins, and surgical

preparation kits

Benefits 42,000 pounds of blue wrap

diverted to recycling in 2010 100 bags per day diverted �

from OR Recycling cost half as much �

as general waste Increases staff satisfaction �

relative to reducing environmental impact of the OR

Retailers and producers required to take back

a certain percentage of packaging materials Duales System Deutschland (DSD) collects all

the packaging with a Green Dot Licenses this symbol for the products they

recycle Reimbursement will be given to companies

only after recycling occurs and quotas are met

German Waste Act: 1991

Targets for collection, sorting and recycling

packaging materials in 1996

Questions?

Thank You