OPENING LECTURE : INTRODUCTION TO HEALTHCARE WASTE MANAGEMENT Dr Mohammed Ali Al-Zahrani

إدارة النفايات الصيدلانية والكيميائية الخطرة

INTRODUCTION

What is Healthcare Waste ? (100 %) Non-Risk Waste ( 80 %) Risk Waste ( 20 %) Risk Waste Waste Quantities Business ? Non-risk Waste Risk Waste Non -Risk Waste

Healthcare Waste in KSA The healthcare market in the KSA can be divided as follows :   HOSPITALS Ministry of Health – 27,279 Beds Private Sector – 8,766 Beds Other Governmental Sectors – 9,169 Beds Total = 45,214 Beds At average of 1.13 kg/bed/day - Total quantity of HCW = 51 tons per day = 18,615 tons / year 2. PHC’s & CLINICS At average of 0.08 kg/visitor/day – Total quantity = 7,626 tons / year TOTAL = 26,421 tons/ year = 71,893 kg / day

CATEGORIES OF HEALTHCARE WASTE Infectious Sharps Genotoxic Pressurised Containers Pathological Pharmaceutical Wastes Chemical Wastes Radioactive Wastes

Definition , classification and segregation

Hospital Waste Management & Treatment Healthcare Waste (100 %) Non-Risk Waste ( 80 –85 %) Risk Waste ( 20 %) Refuse ( 40-45 %) Recyclable ( 40 %) Medical Waste ( 14,5 %) Chemical Waste ( 5 %) Other Waste ( 0,5 %) Infectious w. Sharps Pathological w. Chemical waste Pharmaceuticals Heavy Metal Radioactive w. Genotoxic w. Pressur.Cont.

Risk Waste – Medical Waste ( 20 %) Division in accordance with a WHO / GCC Management System: Infectious waste Pathological waste Sharps Pharmaceutical waste Genotoxic waste Chemical waste Wastes with high heavy metal content Pressurized containers Radioactive waste Medical Waste ( 14,5 %)

Risk Waste – Infectious waste Division in accordance with a Waste Management System: Waste which need special attention for collection and treatment out of infectious preventive reasons. Infectious waste Origin: Blood and blood products, items contaminated with blood, serum or plasma and all contaminated waste from the diagnosis and treatment of patients with infectious diseases e.g. AIDS, Hepatitis, CJD, Cholera, Typhus, Dysentery, Tuberculosis, Meningitis, Diphtheria, Rabies,etc.

Risk Waste – Pathological waste Division in accordance with a Waste Management System: Pathological waste Pathological waste Origin: Body part, organs, placentas, fragments of tissues and stored blood from the surgery, pathology, blood bank, etc. Disposal: The organs or any part of human body should be kept in refrigeration until handled according to Islamic Fatwa No. 8099 dated 21 Safer 1405 H.

Risk Waste – Hospital waste Division in accordance with a Waste Management System: Sharps Sharp waste Origin: Sharp waste from the diagnosis and treatment of patients which can break the skin like needles, infusion sets, blades, knives, broken glass, etc. collection: The waste must be collected under consideration of hygienic and health and safety standards at work. Used packing material must be puncture proof !!!

Risk Waste – Pharmaceuticals Division in accordance with a Waste Management System: Pharmaceuticals but not cytotoxic medicines Pharmaceuticals Origin: Dispensary, drugstore, Laboratory, etc. Disposal: Pharmaceuticals should be collected separately and should be treated to avoid misuse.

Risk Waste – Chemical Waste ( » 2 0 %) Chemical Waste ( » 5 %) Origin: Generated in laboratories, X-ray, Research departments, etc. but also in wards, technical department. Disposal/Treatment: Treatment, collection and disposal under consideration of the characteristic of the chemicals

Risk Waste – Other Chemical waste Division in accordance with a Waste Management System: Acid Waste Alkaline Waste Solvents Inorganic laboratory chemicals Organic laboratory chemicals Chemical waste Origin: Laboratory, Research, etc. Disposal/Treatment: This chemicals should be collected, transported and treated according to their chemical characteristics.

Risk Waste – Photo Chemicals Division in accordance with a Waste Management System: Fixing bathes, Bleaching-fixing bathes Mercury, Cadmium, etc. Amalgam, etc. Heavy Metals Origin: Laboratory, X-Ray, Dental Department, Wards, Technical department, etc. Disposal: Photo Chemicals should be de-silvered and vaporized; Mercury, Amalgam must be separately collected and can be recycled. Batteries, fluorescent lamps, etc. can be treated in treatment plants.

Risk Waste – Radioactive and Cytotoxic waste Division in accordance with a Waste Management System: Genotoxic Waste Radioactive Waste Pressurized Containers Radioactive W. Genotoxic W. Containers Origin: Cancer treatment, Nuclear medicine, Laboratory, Research, Engineering department, etc. Disposal/: Genotoxic waste can be treated by special waste incineration (> 1200°C), radioactive waste can be interim stored, pressurized containers are not allowed to be incinerated in any way.

Packaging Producer Take the direct responsibility for the segregation and packaging process. Segregate in the production sites. Use coded bags and containers.

Receptacle for highly infectious waste Puncture proof Liquid proof Irreversible closable Autoclavable, without PVC UN, local approved Easy to handle Coded

Cleaning and supply staff often do not know the real significance. Labelling The internationally valid symbol for infectious substances has to be used in all cases when healthcare waste is being handled. The hospital has to guarantee that all bags and containers are labelled with this sign. Experience from many hospitals is that not all of the staff is aware that the symbol is important for any person dealing with healthcare waste. Cleaning and supply staff often do not know the real significance.

Classification, Waste-Number, Kind of waste, Responsible German Sample: Standard labels for receptacles Classification, Waste-Number, Kind of waste, Responsible Disposal company, Receptacle number, Waste generator