Proper waste management teeming from the tiny waste particles thrown by individuals including household waste to the massive wastes generated by hospitals, factories, demolition products, and drainage plays a vital role in minimizing the prevalence and transmission of any alteration of physical, mental, and social wellbeing. It is of utmost importance to prioritize the need for waste management and thereby follow it individually. Undoubtedly a small effort individually may result in a huge achievement collectively.
Focusing on health hazards Biomedical waste carries a higher potential for infection rather than other categories of waste. As per WHO Biomedical waste (BMW) is any waste produced during the diagnosis, treatment, or immunization of human or animal research activities pertaining thereto or in the production or testing of biological or in health camps The different categories of health care waste include
Infectious, pathological, pharmaceutical, genotoxic, chemical, pressurized containers, radioactive, Sharps
Infectious waste includes the waste that contains infective pathogens, resulting in disease incidence and progression, is defined as infectious healthcare waste; it comprises materials contaminated with blood and body fluids, human excreta, laboratory cultures, and microbiological products
Pathological waste is typically a smaller portion, part, or slice of any tissue, organ, or body part, taken from surgical or microbiological specimens from animal or human bodies
Pharmaceutical waste can be generated from many activities and locations in healthcare facilities, i.e. pharmacies, distribution centers, and hospitals. Expired and contaminated pharmaceutical products are considered pharmaceutical waste
Genotoxic waste include a genotoxic substance which may have carcinogenic properties such as cytotoxic drug and vomit or urine of patient undergoing these drugs
Waste that contains chemical substances, i.e. laboratory reagents, film developing reagents, expired/unused disinfectants, solvents, and waste containing heavy metals (batteries, broken thermometers, blood-pressure gauges, etc.) is considered chemical healthcare waste
Radioactive waste is a by-product of various nuclear technologies used in healthcare facilities, including nuclear medicine, radiotherapy, and reagents for research.
Pressurized containers include gas cylinders, aerosols, cans, etc
Radioactive waste is a by-product of various nuclear technologies used in healthcare facilities, including nuclear medicine, radiotherapy, and reagents for research. This waste contains radioactive substances, i.e. unused liquids from radiotherapy or laboratory research. Radioactive contaminated glassware, packages/absorbent paper, urine, and excreta from patients treated or tested with unsealed radionuclides also constitute a radioactive waste
Sharps waste is composed of used ‘sharps’ including used or unused hypodermic, intravenous, or other needles, auto-disable syringes, syringes with attached needles, infusion sets, scalpels, pipettes, knives, blades, and broken glasses
Used plastic water bottles, office paper, magazines, newspapers, food waste, and food packaging are considered non-hazardous healthcare solid waste the use of rapid test kits for identifying an infected person produces additional waste in the waste stream, as each kit is used only once.
The route of infection encircles sanitation workers, medical and paramedical staff, patients and visitors, pharmacists, and food providers in the hospitals. The chain of infection mainly revolves around these people via inhalation of dust particles containing germs, non-intact skin or mucous membrane, and ingestion of contaminated food or water. Consequently these result in a number of diseases caused by numerous viruses(HIV, Hepatitis B, A, C, Herpes), bacteria(Salmonella typhi, Vibrio Cholera, Clostridium tetani, Pseudomonas, Stretococci , Parasites(Plasmodium, Wucheria Bancrofti).
Segregation should be done at the point of generation of waste and put in color-coded bags.
The only key to minimization and effective management of health care waste is a genuine way of segregation, collection, storage, transportation, and treatment of waste. Segregation should be done at the point of generation of waste and put in color-coded bags.
Only designated vehicles have been used for transporting healthcare solid waste with a proper record of all details.
During collection, the waste bags should be tightly sealed when they are about three-quarters full. Waste should not be allowed to accumulate at the point of production. The use of one hand scoop technique while disposing of needles and syringes is mandatory in every medical practice waste should be stored in areas that are inaccessible to animals, birds, and insects and also should not be located close to food and water sources. The waste should be transported in vehicles that are not used for other purposes and the vehicles should be cleaned and disinfected daily. Only designated vehicles have been used for transporting healthcare solid waste with a proper record of all details. Load areas have been locked, disinfected, and separated from drivers in order to avoid the risk of infection.
The choice of a treatment system for health care waste matters the most. The method of disposal of healthcare waste depends on the particular hospital and its waste management facilities. Sterilization by autoclave or irradiation has been used before disposing of the segment of waste in a licensed landfill. In some hospitals, incineration on-site or in a special remote area has been used to dispose of the healthcare waste. Mobile incineration or autoclave systems have been provided to support the extra healthcare waste generated during the outbreak. Cement kilns and other industrial furnaces have been considered as alternative facilities for disposing of healthcare waste. Additional healthcare waste has been temporarily stored in selected areas that has been secured and isolated. – Disinfecting and sorting out healthcare waste facilitates sustainable management and allows their utilization for valuable purposes. The 5 R’s: Refuse, Reduce, Reuse, Repurpose, Recycle. The principle of this can be implemented where needed. In response to the pandemic, healthcare waste management strategies should include several additional measures in order to ensure appropriate containment for avoiding infection. As per the guidelines of the CDC (Centers for Disease Control and Prevention), in the United States of America (USA), healthcare waste generated by COVID-19 patients is considered the same as waste generated by other patients
Waste from confirmed COVID-19 patients, i.e. infectious waste, sharps, and pathological waste should be collected with safety measures and kept in special bags with proper markings.
Considering this pandemic Era of The Novel Corona Virus, it is a matter of great concern to prevent the rapid transmission of the disease by any means. COVID-19 has now been acknowledged as a Public Health Emergency of International Concern . The survival period of SARS-CoV-2 varies from a few hours to a few days, based on the substrate type and the environmental conditions. The survival periods of the COVID-19 virus following aerosolization on copper, cardboard, plastic, and stainless steel are 3 h, 4 h, 24 h, and 2–3 days respectively. The longer survival period of this novel COVID-19 virus poses an increased potency for its transmission. Sodium hypochlorite is considered effective for disinfection in this Covid 19 pandemic Temporary and permanent storage areas, containers, and healthcare waste bags should be sanitized to prevent the spread of the virus. Proper healthcare waste management may add value by reducing the spread of the COVID-19 virus and increasing the recyclability of materials instead of sending them to landfills. Waste from confirmed COVID-19 patients, i.e. infectious waste, sharps, and pathological waste should be collected with safety measures and kept in special bags with proper markings. Healthcare waste collectors should use PPE, as they are at higher risk of community transmission. Waste pickers are directly exposed to contaminated waste and are susceptible to infection as a result.
waste management team or committee should be formed in order to develop and implement a waste management plan.
Summing up, the effective management of waste is solely dependent on good healthcare waste management organization and strategies. The establishment of a waste management organization, allocation of staff, financial resources, implementation of plans, periodic training, monitoring, evaluation, and continuous improvement are also important for sustainably managing healthcare waste. A waste management team or committee should be formed in order to develop and implement a waste management plan. In low-income areas, there should be an infection control committee, with one person responsible for healthcare waste management in healthcare facilities Posters with illustration schemes for proper segregation can be affixed to walls in areas where multiple containers are located; these can serve as reminders to health workers about the purposes of using specific containers. Labeling with the International Biohazard symbol can act as a marker to aware people. It’s an urgent appeal to the people to look into this matter and think globally and act locally.
KAJOL SHAH
BP KOIRALA INSTITUTE OF HEALTH SCIENCES
