MANAGEMENT OF MEDICAL WASTE IN HEALTH FACILITIES Prepared By : PASCHAL. N. NJOKA Presented By: Florence Atieno Aneya BIO-MEDICAL ENGINEERS Ministry of Medical Services, KENYA

HEALTH CARE WASTE MANAGEMENT INTRODUCTION Special in that it has high potential of waste infection and injury. Inadequate handling of Health care waste may have serious public Health consequences and impact on the environment. Hospital and Health-Care establishments have responsibilities and a “duty of care” for environment and public Health. HHC - also carry a responsibility to ensure that there are no adverse health and environmental consequences as a result of waste handling, treatment and disposal activities. This paper aims at transmitting the basic skill for development and implementation of health care waste management policy.

WHO Defines - DEFINATION Health care waste: As The total waste stream from a healthcare or research facility that include both potential risk waste and non-risk waste materials.

IMPORTANCE OF PROPER WASTE DISPOSAL Minimizes the spread of infection Reduces the risk of accidental injury to staff, patients, visitors and the community. Attract fewer insects, rodents and animal Reduces Adour Reduces the likelihood of contamination of the soil or ground water with chemicals or micro-organism. Help provide and aesthetically pleasing atmosphere

CLASSIFICATION OF HEALTH CARE WASTE Categories of waste RISK WASTE - 20% of HCW and include: - Infectious waste i.e. blood and blood products, body fluids Anatomical waste-Human tissue Sharp waste – Needles, Syringes, Scalpel blades Chemical waste-formaldehyde, photographic chemicals, solvent, organic chemicals Pharmaceutical waste Radioactive waste Genotoxic waste-include cystostatic drugs, vomit, urine, from patient treated with cytotoxic drugs Pressurized containers Waste with high content of heavy metals.

CATEGORIES OF WASTE (cont.) B) LOW RISK waste-80% of HCW Referred to as Communal waste – All social waste that does not contain high risk waste type e.g. bottles, office paper, boxes and packaging material.

KEY STEPS IN HCW MANAGEMENT SEGREGATION – Basically separation of waste by type where it is generated colour coding of waste. CATEGORIES EXAMPLES COLOUR OF BINLINERS Non-infectious Paper, plastic boxes Black Infectious Gloves, Dressing Yellow Highly Infectious Anatomical waste Red Chemical Formaldehyde, batteries Brown Radioactive Any solid, liquid with radioactive isotopes Yellow with radioactive label

KEY STEPS IN HCW MANAGEMENT(cont.) B)HANDLING AND STORAGE Collection – Removing waste bags and taking to storage or disposal area Weighing - Quantifying waste by volume or weight, labeling as to it source, and recording Storage - Not longer that 2-3 days in secure designated place. Organic waste should be disposed daily. C) CONTAINMENT

KEY STEPS IN HCW MANAGEMENT(cont.) D) TRANSPORT Movement of waste from one place to another, either on site or offsite After transport, clean the vehicle surfaces

KEY STEPS IN HCW MANAGEMENT(cont.) E) TREATMENT AND DISPOSAL Treatment – so as to render it non-hazardous Types of waste Recommended Treatment Recommended Procedure Microbiological waste e.g. culture, vaccine, specimen Autoclave As per instruction with the machine Pathological waste tissue, organs, blood Liming Dig pit- place lime-add waste- add more lime-add soil Infectious fluid chemical 0.5% Sodium Hypochlorite solution. Let sit for 15minutes

KEY STEPS IN HCW MANAGEMENT(cont.) ii) DISPOSAL METHODS Eliminating or transporting health waste from the facilities Disposal method include Bury – waste is placed into a pit and covered with earth. Burn – Placed in a pit and burned on a regular basis and ashes covered with earth. Encapsulate – Fill container with waste, add immobilizing material(cement, sand or clay) and seal the container. Best for vaccine disposal.

DISPOSAL METHOD(cont.) 4) Incinerate High temperature (>800°c) burning reducing volume of waste and eliminating pathogens Types of incinerators i) Demonfort incinerators-made of fire bricks and fire proof cement. ii) Diesel powered incinerator

INCENERATION(cont.) INCINERATOR OPERATION AND MANTAINANCE For an incinerator to be used properly, it must have the following: Clear operation procedure well posted near the equipment Trained operator Reliable segregation system Reliable transport system Ash pit to safely dump the incineration ash Regular maintenance and repair Adequate supply of fuel

LAWS RELATED TO WASTE MANAGENT EMCA 1999-Environment management control Act Biomedical Waste Regulations(Draft) Public Health Act-Cap 242 Basel Convention Global treaty that applies to international transportation of hazardous wastes. Stockholm Convention Global treaty to protect human health and environment from persistent organic pollutant(pop) specifically dioxins and furans. United Nations packaging requirements Guidelines for proper packaging and international transport of infectious substances. Defines both inner and outer packaging composition requirements

A Dirty Country Is A Dying Nation CONCLUSION A Dirty Country Is A Dying Nation (Mr. Lay 1842) THANK YOU! END