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BMC Public Health

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Open Access 01-12-2021 | Research

Current practices of waste management in teaching hospitals and presence of incinerators in densely populated areas

Authors: Salma Khalid, Najibul Haq, Zia-ul-Ain Sabiha, Abdul Latif, Muhammad Amjad Khan, Javaid Iqbal, Nowsher Yousaf

Published in: BMC Public Health | Issue 1/2021

Abstract

Background

Hospital waste management (HWM) practices are the core need to run a proper health care facility. This study encompasses the HWM practices in teaching hospitals of Peshawar, Pakistan and examine the enforcement of Pak HWM (2005) rules and risks through transmission of pathogens via blood fluids, air pollution during waste incineration and injuries occurring in conjunction with open burning and dumping.

Methods

A questionnaire based on World Health Organization (WHO) recommendations was used to survey the selected private and public teaching hospital (n = 16). Site visits and personnel observations were also included in the data. It was spatio-statistically analyzed using descriptive statistics, Krushkal-wallis and Fisher’s exact tests.

Results

The findings revealed that the lack of HWM practices in all surveyed hospitals (p > 0.05), besides statistical difference (p < 0.017) in waste generation/day. No proper segregation of waste from generation point to final disposal was practiced. However, the performance of private teaching hospitals (50%) was found better in terms of HWM personnel and practices. In surveyed hospitals, only nine hospitals (56.3%) were found with the incinerator facility while rest of the hospitals (43.7%) practiced open dumping. Moreover, operational parameters of the incinerators were not found satisfactory and located in densely populated areas and emitting hazardous gases.

Conclusion

Proper HWM practices are not being followed in the light of WHO guidelines. Hospital waste impose serious menace to healthcare workers and to nearby population. WHO issued documents for improving HWM practices but triggered no change in Pakistan. To improve the situation, insights in this context is need for enforcement of rules.

Available only for authorised users

Chartier Y. Safe management of wastes from health-care activities: World Health Organization; 2014.

Ross DE. Safeguarding public health, the core reason for solid waste management. England: Sage Publications; 2011.CrossRef

Ali M, Wang W, Chaudhry N. Management of wastes from hospitals: A case study in Pakistan. Waste Manag Res. 2016;34(1):87–90.CrossRef

Arab M, Baghbani RA, Tajvar M, Pourreza A, Omrani G, Mahmoudi M. Report: the assessment of hospital waste management: a case study in Tehran. Waste Manag Res. 2008;26(3):304–8. https://doi.org/10.1177/0734242X08093598.CrossRefPubMed

Taghipour, Mosaferi. The challenge of medical waste management: a case study in Northwest Iran-Tabriz. Waste Manag Res. 2009;27(4):328–35. https://doi.org/10.1177/0734242X08104132.CrossRefPubMed

WHO. Health-care waste. Fact sheet. 2018.

Almuneef M, Memish ZA. Effective medical waste management: it can be done. Am J Infect Control. 2003;31(3):188–92. https://doi.org/10.1067/mic.2003.43.CrossRefPubMed

Da Silva C, Hoppe A, Ravanello M, Mello N. Medical wastes management in the south of Brazil. Waste Manag. 2005;25(6):600–5. https://doi.org/10.1016/j.wasman.2004.03.002.CrossRefPubMed

Ganguly R, Vasistha P, Gupta AK. Design of an incinerator to treat combined biomedical wastes generated from four major hospitals in Chandigarh and Shimla City, India; 2017.

10.

Hayleeyesus SF, Cherinete W. Healthcare waste generation and management in public healthcare facilities in Adama, Ethiopia. J HealthPollut. 2016;6(10):64–73. https://doi.org/10.5696/2156-9614-6-10.64.CrossRef

11.

Hashmi S, Shahab S. Hospital and biomedical waste management. Community medicine and public health. 4th ed. Karachi: Time Publishers; 2003. p. 426–37.

12.

Khan, Fareedi F, Rashid B. Techno-economic disposal of hospital wastes in Pakistan. Pak J Med Res. 2006;45(2):41–5.

13.

Imdad S, Anwar S, Shoukat MS. Healthcare waste: evaluation of its generation rate and management practices in tertiary care hospitals of Lahore. Ann King Edward Med Univ. 2013;19(4):274.

14.

Van HT, Pham QH, Trinh MV, Bui HM. Treatment of medical solid waste using an air flow controlled incinerator. Pol J Chem Technol. 2020;22(1):29–34.CrossRef

15.

Liu F, Liu H-Q, Wei G-X, Zhang R, Liu G-S, Zhou J-H, et al. Detoxification of medical waste incinerator fly ash through successive flotation. Sep Sci Technol. 2019;54(1):163–72. https://doi.org/10.1080/01496395.2018.1481091.CrossRef

16.

Shen H-M, Wang Y-F, Chyang C-S, Yang H-Y. Incineration of pelletized Fly ash in a bench-scale fluidized bed combustor. Aerosol Air Qual Res. 2019;19(9):2115–29.CrossRef

17.

Deng D, Qiao J, Liu M, Kołodyńska D, Zhang M, Dionysiou DD, et al. Detoxification of municipal solid waste incinerator (MSWI) fly ash by single-mode microwave (MW) irradiation: addition of urea on the degradation of dioxin and mechanism. J Hazard Mater. 2019;369:279–89. https://doi.org/10.1016/j.jhazmat.2019.01.001.CrossRefPubMed

18.

Ma C-J, Gong-unn K. Chemical Property of the Fly Ash Collected at an Incinerator and its Effects on Near Ambient Particles. Asian J Atmospheric Environ (AJAE). 2019;13(2):136–43.

19.

Vasistha P, Ganguly R, Gupta AK. Biomedical waste generation and management in public sector Hospital in Shimla City. Environmental Pollution: Springer; 2018. p. 225–32.

20.

Porta D, Milani S, Lazzarino AI, Perucci CA, Forastiere F. Systematic review of epidemiological studies on health effects associated with management of solid waste. Environ Health. 2009;8(1):60. https://doi.org/10.1186/1476-069X-8-60.CrossRefPubMedPubMedCentral

21.

Ashworth DC, Elliott P, Toledano MB. Waste incineration and adverse birth and neonatal outcomes: a systematic review. Environ Int. 2014;69:120–32. https://doi.org/10.1016/j.envint.2014.04.003.CrossRefPubMed

22.

Gonzalez CA, Kogevinas M, Gadea E, Huici A, Bosch A, Bleda MJ, et al. Biomonitoring study of people living near or working at a municipal solid-waste incinerator before and after two years of operation. Arch Environ Health. 2000;55(4):259–67. https://doi.org/10.1080/00039890009603416.CrossRefPubMed

23.

Reis MF, Sampaio C, Brantes A, Aniceto P, Melim M, Cardoso L, et al. Human exposure to heavy metals in the vicinity of Portuguese solid waste incinerators–part 1: biomonitoring of Pb, cd and hg in blood of the general population. Int J Hyg Environ Health. 2007;210(3–4):439–46. https://doi.org/10.1016/j.ijheh.2007.01.023.CrossRefPubMed

24.

Kumar R, Somrongthong R, Ahmed J. Impact of waste management training intervention on knowledge, attitude and practices of teaching hospital workers in Pakistan. Pakistan J Med Sci. 2016;32(3):705–10. https://doi.org/10.12669/pjms.323.9903.CrossRef

25.

Ali MU, Wang W, Chaudhry N, Geng Y, Ashraf U. Assessing knowledge, performance, and efficiency for hospital waste management—a comparison of government and private hospitals in Pakistan. Environ Monit Assess. 2017;189(4):181.CrossRef

26.

Khan HMA, Zafar B, Mehmod R, Mushtaq S. Knowledge, attitude and practices of health care staff regarding hospital waste handling in tertiary care hospitals of Muzaffarabad, AJK, Pakistan. Int J Sci Reports. 2017;3(7):220.CrossRef

27.

Komilis D, Fouki A, Papadopoulos D. Hazardous medical waste generation rates of different categories of health-care facilities. Waste Manag. 2012;32(7):1434–41. https://doi.org/10.1016/j.wasman.2012.02.015.CrossRefPubMed

28.

Tesfahun E, Kumie A, Legesse W, Kloos H, Beyene A. Assessment of composition and generation rate of healthcare wastes in selected public and private hospitals of Ethiopia. Waste Manag Res. 2014;32(3):215–20. https://doi.org/10.1177/0734242X14521683.CrossRefPubMed

29.

Ali S, Mahmood U, Malik AU, Aziz F, Naghman RB, et al. Current hospital waste management practices in Pakistan: case study and curative measures. Public Health Prevent Med. 2015;1(3):125–9.

30.

Ansari S, Habiba U, Aslam F, Hussain A. Hospital waste management- tackling trash as a team. Waste Manag Res. 2013;31(7):733–8.CrossRef

31.

Arshad N, Nayyar S, Amin F, Mahmood KT. Hospital waste disposal: a review article. J Pharm Sci Res. 2011;3(8):1412.

32.

Asante B, Yanful E, Yaokumah B. Healthcare Waste Management; Its Impact: A Case Study Of The Greater Accra Region, Ghana. Int J Sci Technol Res. 2014;3(3):106–12.

33.

Mukhtar S, Khan H, Kiani Z, Nawaz S, Zulfiqar S, Tabassum N. Hospital waste management: execution in Pakistan and environmental concerns—a review. Environ Contam Rev (ECR). 2018;1(1):13–7.CrossRef

34.

Hospital waste management rules- Pakistan. Ministry of Environment, Government of Pakistan; 2005. 2005. http://wwwenvironmentgovpk/act-rules/rHWMRules2005PDF. Accessed 16 Jan 2018.

35.

De Titto E, Savino AA, Townend WK. Healthcare waste management: the current issues in developing countries. London: SAGE Publications Sage UK; 2012.

36.

Prüss-Üstün A, Townend W. Safe management of wastes from health-care activities: World Health Organization; 1999.

37.

Ali M, Kuroiwa C. Status and challenges of hospital solid waste management: case studies from Thailand, Pakistan, and Mongolia. J Mater Cycles Waste Manag. 2009;11(3):251–7. https://doi.org/10.1007/s10163-009-0238-4.CrossRef

38.

Sharma S, Chauhan S. Assessment of bio-medical waste management in three apex government hospitals of Agra. J Environ Biol. 2008;29(2):159–62.PubMed

39.

Munir S, Batool SA, Chaudhry MN. Characterization of hospital waste in Lahore, Pakistan. Chin Med J. 2014;127(9):1732–6.

40.

Khan MI, Khan EA, Irfan S, Muhammad A. Wastes Management Practices in Selected Public And Private Hospitals Of Peshawar, Khyber Pakhtunkhwa. J Med Stud. 2016;2(1):5–11.

41.

Rasheed S, Iqbal S, Baig LA, Mufti K. Hospital waste management in theTeaching hospitals of Karachi. JPMA. 2005;55:192.

42.

Zeeshan MF, Ibad AA, Aziz A, Subhani A, Shah A, Khan T, et al. Practice and enforcement of national Hospital Waste Management 2005 rules in Pakistan. Eastern Mediterr Health J. 2018;24(5):443–50.CrossRef

43.

Harhay MO, Halpern SD, Harhay JS, Olliaro PL. Health care waste management: a neglected and growing public health problem worldwide. Tropical Med Int Health. 2009;14(11):1414–7. https://doi.org/10.1111/j.1365-3156.2009.02386.x.CrossRef

44.

Mohamed L, Ebrahim S, Al-Thukair A. Hazardous healthcare waste management in the Kingdom of Bahrain. Waste Manag. 2009;29(8):2404–9. https://doi.org/10.1016/j.wasman.2009.02.015.CrossRefPubMed

45.

Ahmad I. Review of current waste management strategies at public and private sector hospitals of Islamabad; 2011.

46.

WHO. Water, sanitation and hygiene in health care facilities: status in low and middle income countries and way forward. 2015 9241508477.

47.

Hossain MS, Santhanam A, Norulaini NN, Omar AM. Clinical solid waste management practices and its impact on human health and environment–A review. Waste Manag. 2011;31(4):754–66. https://doi.org/10.1016/j.wasman.2010.11.008.CrossRefPubMed

48.

Mahwish I, Khan KU, Alam B, Ahad MZ, Malahat F. Critical evaluation of hospital waste management system in Pakistan and how it could be improved; recommendation for Pakistan environmental protection agency. Int J Appl Sci Eng Technol. 2013;1(1):12–6.

49.

Johnson KR, Braden CR, Cairns KL, Field KW, Colombel AC, Yang Z, et al. Transmission of mycobacterium tuberculosis from medical waste. Jama. 2000;284(13):1683–8. https://doi.org/10.1001/jama.284.13.1683.CrossRefPubMed

50.

Patil A, Shekdar A. Health-care waste management in India. J Environ Manag. 2001;63(2):211–20. https://doi.org/10.1006/jema.2001.0453.CrossRef

51.

Mujeeb Z, Lodi M. Prevalence of hepatitis B infection in health care workers. J Pak Med Assoc. 1994;44:265.PubMed

52.

Camacho-Ortiz A, Díaz-Rodríguez X, Rodríguez-López JM, Martínez-Palomares M, Palomares-de la Rosa A, Garza-Gonzalez E. A 5-year surveillance of occupational exposure to bloodborne pathogens in a university teaching hospital in Monterrey, Mexico. Am J Infect Control. 2013;41(9):e85–e8. https://doi.org/10.1016/j.ajic.2013.01.008.CrossRefPubMed

53.

Mol MP, Gonçalves JP, Silva EA, Scarponi CF, Greco DB, Cairncross S, et al. Seroprevalence of hepatitis B and C among domestic and healthcare waste handlers in Belo Horizonte, Brazil. Waste Manag Res. 2016;34(9):875–83. https://doi.org/10.1177/0734242X16649686.CrossRefPubMed

54.

Shiferaw Y, Abebe T, Mihret A. Sharps injuries and exposure to blood and bloodstained body fluids involving medical waste handlers. Waste Manag Res. 2012;30(12):1299–305. https://doi.org/10.1177/0734242X12459550.CrossRefPubMed

55.

Babanyara Y, Ibrahim D, Garba T, Bogoro A, Abubakar M. Poor medical waste management (MWM) practices and its risks to human health and the environment: a literature review. Int J Environ Ealth Sci Eng. 2013;11(7):1–8.

56.

WHO. Fundamentals of health-care waste management. United Nations Environment Programme/SBC National Health-Care Waste Management Plan, Guidance Manual; 2003. p. 7–23.

Title: Current practices of waste management in teaching hospitals and presence of incinerators in densely populated areas
Authors: Salma Khalid
Najibul Haq
Zia-ul-Ain Sabiha
Abdul Latif
Muhammad Amjad Khan
Javaid Iqbal
Nowsher Yousaf
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-021-11389-1

2024 ASCO Annual Meeting

Springer Medicine

Current practices of waste management in teaching hospitals and presence of incinerators in densely populated areas

Abstract

Background

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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