Health care waste

DEFINITION:

Healthcare waste (medical waste), refers to waste generated by health facilities such as hospitals, clinics, medical laboratories and research centers.

World Health Organization (WHO), defined it as a by-product of healthcare that includes sharps, non-sharp blood contaminated items, blood, body parts and tissues, chemicals, pharmaceuticals and radioactive materials.

RISKS AND HAZARDS OF HEALTHCARE WASTE

They include:

1. INFECTIOUS DISEASE TRANSMISSION:

- Exposure to infectious waste can lead to transmission of various diseases, such as hepatitis B and C, HIV/AIDs, Covid-19 and other viral, bacterial and parasitic infections.

This can occur through direct contact with contaminated materials, inhalation of air borne pathogens or indirect contact with contaminated environmental services or water sources.

- Improper disposal of infectious waste can also facilitate the spread of anti-microbial-resistance pathogens.

2. SHARPS’ INJURIES AND ACCIDENTS:

- Needle stick and other sharps injuries can expose healthcare workers waste handlers and the public to risk of contracting blood borne infections.

- Those injuries can also cause physical harm, such as cuts and puncture wounds, which can lead to infections and other complications.

- Improper storage transportation or disposal of sharps can increase the likelihood of such accidents.

.3. CHEMICAL EXPOSURE:

- Exposure to chemical wastes such as disinfectant, solvent and heavy metals can cause skin irritation, respiratory problems and even long term health effects, depending on the nature and concentration of the chemicals.

- Improper disposal of chemical waste can lead to environmental contamination affecting the health of nearby communities and ecosystems.

4. RADIATION HAZARDS:

- Radioactive waste from medical procedures, such as nuclear imaging or cancer treatment, can pose risk of radiation exposure if not handled and disposed properly.

- Exposure to ionizing radiations can increase the risks of cancer, genetic damage and other health problems.

- Improper disposal of radioactive waste can also lead to environmental contamination and long term radiation risks.

5. PSYCHOLOGICAL AND EMOTIONAL IMPACTS:

- Exposure to healthcare waste especially infectious or hazardous materials can cause psychological distress, anxiety and trauma particularly among healthcare workers and waste handlers

- Improper management of healthcare waste can also have a negative impact on the local community’s well being and perception of healthcare services.

6. ENVIRONMENTAL CONTAMINATION:

- Improper dumping or burning in open areas can lead to the contamination of soil, surface water and ground water.

- It can, as well, disrupt the ecosystems, contaminate food and water sources and potentially expose the surrounding and communities to hazardous substances.

7. OCCUPATIONAL EXPOSURE AND RISKS:

- Healthcare workers, waste handlers and other personnel involves in the management of healthcare wastes are at higher risk of exposure to various hazards, including needle stick injuries, chemical exposures and infectious disease.

- Lack of personal protective equipment (PPE), inadequate training and poor segregation and handling practices can increase the likelihood of occupational illnesses.

- Exposure to hazardous health care waste can lead to both short term and long term health effects such as skin irritation, respiratory problems and even chronic diseases.

8. COMMUNITY HEALTH IMPACTS:

- Improper disposal of healthcare waste can pose a direct risk to the health and well-being of local communities, particularly in areas where waste management infrastructure is inadequate or non-existent.

- It can lead to outbreak of disease in a community.

- It can as well have negative impact on the social and economic well-being of communities, affecting their livelihood, access to clean water and overall quality of life.

9. REGULATORY AND LEGAL IMPLICATIONS:

- The management of healthcare waste is heavily regulated and failure to comply with national and international guidelines and regulations can result in legal and financial penalties for healthcare facilities and waste management service providers.

- Non-compliance can also lead to the suspension or revocation of operating licenses, damaging the reputation and credibility of healthcare organizations.

10. REPUTATION AND PUBLIC TRUST.

Improper health care waste has a significant impact on the public’s perception and trust in health care system and associated institutions.

Incidences of environmental contamination, community health issues or occupational accidents related to healthcare waste can erode public confidence and damage the reputation of healthcare providers and waste management companies.

CLASSIFICATIONS OF HEALTHCARE WASTE

Healthcare waste can be categorized into the following:

General waste.

Infectious waste.

Pathological waste.

Sharps.

Pharmaceuticals.

Genotoxic waste.

Chemical waste.

Waste with high heavy metal content.

Pressurize containers.

Radioactive wastes.

GENERAL WASTE

This is also known as non-risk healthcare waste (HCW). It is comparable to domestic wastes. It is dealt with by municipal waste disposal system. They include waste generated from administrative, housekeeping functions of healthcare establishment as well as waste produced during maintenance of the premises.

They represent 7% t0 90% 0f the total amount of healthcare waste generated by medical institutions.

Types of General Waste

There are two types of general waste. They include;

A. RECYCLABLE WASTES: They include paper, cardboard, non-contaminated plastic or metal, cans or glass that can be recycled if recycling industries exist in the country.

B. BIODEGRADABLE WASTE: Examples are left over foods, garden waste that can be composted.

INFECTIOUS WASTE

This comprises all biomedical and healthcare waste known or clonically assessed by medical practitioners or vetenary surgeon to have the potential of transmitting infectious agents to humans or animals.

Waste of this kind is typically generated in the following places:

Isolation ward of hospitals.

Dialysis wards or centers for caring patients infected with hepatitis virus.

Pathology department.

Operating theaters.

Medical practices.

Laboratories which mainly treat patients suffering from infectious diseases.

Examples of infectious waste:

Culrues and stocks from laboratory.

Surgery and autopsies from infectious patient.

Blood from patients infected with HIV or viral hepatitis.

Feces from patients infected with typhoid fever enteritis cholera.

Respiratory tract secretions from patient infected with TB, andhrase, rabies, poliomyelitis.

Wastes from hemodialyzers (Example, dialyses equipments such as tubing and filters, disposable sheets, linen aprons, gloves or laboratory coats contaminated with blood.

Infected animal from lab.

Instruments in contact with infected patients or animals.

PATHOLOGICAL WASTES

These category of waste comprises non-infectious human body parts, organs and tissues. Example:

Tissues.

Removed organs.

Amputed body parts.

Human fetus.

Placenta.

Animal carcasses.

SHARPS.

Sharps are all objects and materials that are closely linked with healthcare activities and pose potential risk of injury and infection due to their puncture or cut property. Examples:

All types of needles.

Broken glasswares.

Ampoules.

Saw.

Knives.

Infusion set.

Scales,

Blades.

Lancets.

Nails.

Vials without contents. Etc.

PHARMACEUTICAL WASTES

This category of wastes comprises expired pharmaceuticals or pharmaceuticals that are unusable for other reasons (Example, call back campaign). Example:

Expired drugs.

Unused drugs.

Spilt drugs.

Contaminated pharmaceutical products.

Drugs vaccine. Etc.

GENOTOXIC WASTE

This refers to highly hazardous waste that may have mutagenic, teratogenic or carcinogenic properties.

TERATOGENIC OBJECT: This is any object that can dirupt the development of an embryo or halt the pregnancy.

CARCINOGENIC OBJECT: This means cancer-causing agent. They include:

- ______

- Cytostatic drugs.

- Vomit.

- Urines and feces from patient treated with hydrostatic drugs.

- Chemicals.

- Radioactive materials.

Hydrostatic wastes are generated from several sources and can include the following:

Contaminated material from drug preparation such as syringes, needles, vials; packaging

O.Gdered drugs, excess (left over) solutions, drugs returned from the wards.

Urine, feces and vomit from patients which may contain potentially hazardous amounts of administered cystostatic or of their metabolites and which should be considered genotoxic for at least 48hours and sometimes up to 1week after drug administration.

CHEMICAL WASTE

Chemcal wastes from healthcare may be hazardous or non hazardous. In the context of protecting health, it is hazardous if it has at least one of the following properties:

Toxic.

Corrosive (Example, acids pH < 2 and base >12).

Flammable.

Reactive (Explosive, water-reactive. Shock-sensitive).

Genotoxic (Example, cytostatic drugs),

Non-hazardous chemical waste consists of chemicals with none of the above properties. All discarded solid, liquid and gaseous chemicals from diagnostic and experimental work and from cleaning and disinfection are refered to as chemical waste.

Examples of hazaedous chemical waste:

Formaldehyde, glutaraldehyde

Photographic fixing and developing solutions.

Laboratory solvents.

Pesticides.

Mercury in thermometers and sphygmomanometer.

Disinfectants (Phenols and bleed).

Toxic cleaners, degreasers.

Examples Of Non-Hazardous Chemical Waste.

Saline solutions.

Glucose.

Amino acids.

Vitamins.

WASTES WITH HIGH CONTENT OF HEAVY METALS

They include batteries, broken thermometers, blood pressure gauges etc.

Pressurized Containers

They include; pressured cylinders, cartridges and aerosol cans containing residues.

Whether inert or potentially harmful, gas in pressurized containers should always be handled with care. Containers may explode if incinerated or accidentally punctured.

Radioactive Waste

This refers to waste produced from nuclear medicine treatments, cancer therapies and medical equipment that uses radioactive isotopes. Any pathological waste that is contaminated with radioactive material is usually treated as radioactive waste. It includes;

Liquids or gaseous materials from radioactive substances produced as a result procedures such as an invitro analysis or body tissue and fluid, invivo imaging and tumor localization.

Fecese/urine of patients under radiation therapy.

Residues of radiostapes studies in the laboratory.

All the above categories of healthcare wastes can be brandy grouped or classified into:

GENERAL OR NON-HAZARDOUS WASTE.

CHEMICAL OR RADIOACTIVE WASTE.

Pharmaceutical Waste.

Waste With High Content Of Heavy Metals.

Pressurized Containers.

Gene toxic Waste.

INFECTIOUS (HAZARDOUS WASTE).

Sharps.

Pathological Waste.

BENEFITS OF MEDICAL WASTE CLASSIFICATION

A. Decision Making: It is useful for deciding:

Treatment Approaches Of The Waste:

Steam disinfection: Infectious waste, blood or body fluids, microbiological waste.

Burial: Anatomical waste, human tissues.

Incineration with pollution control: Cytotoxic waste.

B. Waste Minimization Options:

- Recycling: Paper, glass, aluminium.

- Composting: Kitchen waste, yard waste.

- Materials recovery: Silver from X-ray waste.

C. Easy Identification Of Hazardous Or Infectious Waste: Helps in easy identification of hazardous or infectious waste from non hazardous or general waste. Hence, all the waste won’t be treated as hazardous or infectious, thereby reducing cost associated with its management.

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