Wastes Domestic waste Industrial waste Domestic waste subject to special control Figure 1. Classification of waste under Japanese law Industrial waste.

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Presentation transcript:

Wastes Domestic waste Industrial waste Domestic waste subject to special control Figure 1. Classification of waste under Japanese law Industrial waste subject to special control

Back ground In recent years, home-visit nursing care services have become widespread in Japan. Since the home- care waste resulting from home-visit nursing care is legally categorized as domestic waste (figure. 1). Municipalities are responsible for its disposal under Japanese waste management law. However, in fact, many municipalities do not accept the disposal of injection needles. Furthermore, regarding infusion bags, root, etc., which are generally thought not to be infectious. Visiting nurses carry back the waste that is not accepted by the municipalities, and the safety of such waste is left to the care of the nurses.

Object I conducted a questionnaire survey to figure out the problems involved in the infectious waste recovery at home-visit nursing stations, by means of a visit (automobile, bicycle, public transportation, and walk). Methods From among the home-visit nursing stations registered at the National Association for Home-visit Nursing Care, 1,965 stations were selected at random, and questionnaires were sent to them.

Descriptive questionnaires were sent to 1,965 home-visit nursing stations. 1,308 stations responded to the questionnaire. 26 stations were closed. 5 stations performed only psychiatric services. Excluded from further analysis. 1,277 stations were used for analysis. Figure 2. Study design Results

AutomobileNon-automobile n Opening year* ± ±0.1 Full-time nurse 3.78± ±0.05 Part-time nurse 2.92± ±0.07 Number of visits of total a month 372.9± ±17.7 Table 1. Basic characteristics of the station 1 1 Values are means ± SE; *p < 0.05, significant differences between two station groups.

Nurses at 1308 (66.6%) stations replied to the questionnaire, 657 stations did not reply, and 26 stations closed down. Five stations performed only psychiatric services and thus did not dispose of HMC waste. Analysis of the remaining 1277 stations was made (Figure 2). Stations were classified by visit (Automobile and non-Automobile). On average, Automobile stations had been in existence longer than non-Automobile stations (Table 1). This difference was statistically significant (p < 0.05).

Table 2. Waste recovery status and problems AutomobileNon- automobile I carry the home care waste from patient’s home to my station.* 920 (80.8)99 (71.7) I always have to carry the waste about with me after the first visit. 512 (45.0)67 (48.6) I am afraid of getting injured by the waste. 343 (30.1)31 (22.5) I worry about bad odor from waste.*** 341 (29.9)15 (10.9) I worry about heavy waste.*** 28 (2.5)11 (8.0) Values are observation and (percent in each category); ***p < 0.001, *p<0.05, significant differences between two station groups.

More automobile-station nurses recovered medical waste from patients’ homes than did non- automobile-station nurses (p < 0.05, Table 2). They were also more likely to afraid of getting injured by the waste (Table 2). Automobile-station nurses were more concerned with bad odor from waste (p < 0.001, Table 2). Non-automobile-station nurses were more concerned with the physical weight of transported waste (p < 0.001, Table 2).

Grant This study was supported by the Japan ministry of environment (Grant in aid for scientific research of promote a recycling-oriented society (No ; ). Conclusion As measures to cope with these difficulties, it is necessary to provide the nurses with containers for medical waste suited to home-visit nursing care and tools to reduce for bad odor from waste.