Health Care Waste Management Flashcards
According to WHO/UNICEF 2015: Only 24 countries had adequate systems in place for the safe disposal of health care wastes
true
Facts on Health Care Waste (WHO)
__% generated non-hazardous wastes
75-90%
Facts on Health Care Waste (WHO)
___% Considered hazardous and may be infectious, toxic, or radioactive
10-25%
0.5 kg hazardous wastes per hospital bed per day
High-income countries
0.2 kg hazardous wastes per hospital bed per day
Low-income countries
Facts on Health Care Waste (Philippines)
____% - Hazardous health care wastes
30.37%
Facts on Health Care Waste (Philippines)
____% - general wastes
69.63%
Philippines hospitals (per hospital bed per day)
____kg infectious sharps and pathological wastes
0.34kg
Philippines hospitals (per hospital bed per day)
____kg general wastes
0.39kg
Health Care Waste Generators
Hospitals and medical centers
Infirmaries
Birthing homes
Drug manufacturers
Mortuary and autopsy centers
Clinics and other health-related facilities
Laboratories and research centers
Institutions
All wastes suspected to contain pathogens or toxins in sufficient concentration that may cause disease to a susceptible host
Infectious Wastes
Includes discarded materials or equipments used for diagnosis, treatment, and management of patients with infectious diseases.
Infectious wastes
Tissue sections and body fluids or organs derived from biopsies, autopsies, or surgical procedures sent to the laboratory for examination.
Pathological and Anatomical Waste
Subgroup referring to recognizable body parts usually from amputation procedures
Anatomic waste
Waste items that can cause cuts, pricks, or puncture wounds.
It is considered the MOST DANGEROUS health care waste because of their potential to cause both injury and infection
Sharps
Discarded chemicals generated during disinfections and sterilization procedures
Includes wastes with high content of heavy metals and their derivatives
Chemical Wastes
Chemical are considered hazardous when they are:
Toxic - with health and environmental hazards
Corrosive - acid of pH <2.0 and bases of pH >12.0
Flammable - with a flash point below 60*C
Reactive - explosive with water
Expired, split, and contaminated pharmaceutical products, drugs, and vaccines including discarded items used in handling pharmaceuticals
Pharmaceutical Waste
Wastes exposed to radionuclides including radioactive diagnostic materials or radiotherapeutic materials
Radioactive Waste
Wastes that have not been in contact with communicable or infectious agents, hazardous chemicals, or radioactive substances, and do not pose a hazard
Non-hazardous/general Waste
Who are being exposed in health care wastes?
Medical staff, in-patients, out-patients, visitors, etc etc
Short periods in large quantities
Acute exposure
Prolonged periods in minute quantities
Chronic Exposure
Adverse Health Outcomes such as
Sharp-inflicted injuries
Toxic exposure to pharmaceutical products
Antibiotics and cytotoxic drugs
Mercury and dioxins
Chemical burns
Air pollution
Thermal injuries
Radiation burns
May lead to blood-transmissible diseases
May be released to the surrounding during the handling or incineration of these wastes
From disinfection, sterilization, or waste treatment activities
Release of particulate matter during medical waste incineration
In conjunction with open burning and the operation of medical waste incinerators
Waste in landfills can lead to the contamination of drinking, surface, and ground waters if not properly constructed
true
When incinerated, Chlorine generates what?
Dioxins and furans - CARCINOGENIC
Use modern incinerators operating at what *C?
850C to 1100C
Disposal through incineration is NOT allowed in the Philippines
true
Alternatives to incineration to minimized the formation and release of chemicals or hazardous emissions
Autoclave, microwave, steam treatment integrated with internal mixing
Health care Waste Management Hierarchy
From most preferred to Least preferred
Avoidance
Reduction
Reuse
Recycling
Treatment
Safe disposal
The most important step in the proper management of health care wastes
Waste minimization
green procurement policy’s two aspects:
Waste prevention and waste reduction
Resource Development
Safely reusing, recycling, and recovering wastes
For wastes that cannot be safely reused, recycled, or recovered,
End of Pipe Approach
Two aspects of End of Pipe Approach
Treatment and disposal
Process of changing the biological and chemical characteristics of waste to minimize its potential to cause harm
Waste Treatment
Discharging, depositing, placing, or releasing any health care waste into air, land, or water
Waste Disposal
Strong leakproof bin with cover labelled “infectious” with biohazard symbol
Pathological and Anatomical Waste BIN
Yellow plastic that can withstand autoclaving with 0.009mm thickness and labelled “infections waste” with a tag indicating source and weight of waste and date of collection
Pathological and Anatomical Waste Liner
Puncture-proof container with wide mouth and cover labeled “sharps” with biohazard symbol
Sharps BIN
Sharps Liner
Not applicable
Labeled Chemical waste
Chemical waste bin
For liquid chemical waste, inside the bin is a disposal bottle made of
Amber-colored glass with at least 4 liters capacity that is strong, chemical resistant, and leak-proof
Yellow with black band plastic with 0.009 mm thickness and labelled “Chemical Waste” with a tag indicating source and weight of waste and date of collection
Chemical Waste Liner
Strong leakproof bin with cover labelled
“Pharmaceutical Waste” for expired drugs and drug containers
“Cytotoxic Waste” for cytotoxic, genotoxic, and antineoplastic
Pharmaceutical Waste Bin
Yellow with black band plastic with 0.009 mm thickness and labelled “Pharmaceutical Waste” with a tag indicating source and weight of waste and date of collection
Pharmaceutical Waste liner
Radiation-proof repositories, leak-proof, and lead-lined container labeled with name of radionuclide and date of deposition with radioactive symbol
Radioactive waste bin
Orange plastic with 0.009 mm thickness and labelled “Radioactive” with a tag indicating name of radionuclide and date of deposition
Radioactive waste liner
Optional recycle symbol for recyclable non-hazardous waste
Varying sizes depending on the volume of waste
General waste Bin
Black or colorless plastic for non-biodegradable
Green for biodegradable
With 0.009 mm thickness with a tag indicating source, weight of waste, and date of collection
GENERAL WASTE LINER
Highly infectious waste must be
disinfected at source
Anatomical waste should be disposed through
safe burial or cremation
Pathological waste must be__ if not collected or treated within 24 hours
refrigerated
Sharps must be ____ or ____ before they are transported to the landfill
shredded or crushed
Chemical and pharmaceutical wastes shall be
segregated and collected separately
Radioactive waste has to be _________ to background radiation levels
decayed
All waste bins must be properly covered to prevent
cross contamination
Aerosol containers can be collected with
general wastes
Thermal decomposition of health care wastes in the absence of supplied molecular oxygen in the destruction chamber where the said waste is converted into gaseous, liquid, or solid form.
Pyrolysis
Use of steam sterilization to render
waste harmless
Autoclave
Incorporates some type of size reduction device
Shredding of wastes is done before disinfection
Microwave
waste is exposed to microwaves that raise the temperature to
100*C for at least 30 mins
Chemical like sodium hypochlorite,
hydrogen peroxide, peroxyacetic acid,
and heated alkali are added to health care wastes to kill or inactivate present pathogen
Chemical disinfection
Uses an enzyme mixture to decontaminate health care wastes
Resulting by-product is put through an extruder to remove water for wastewater disposal
Suited for large applications
Biological Process
Filling of containers with waste, adding and immobilizing material, and sealing the containers
Process uses either cubic boxes made of high-density polyethylene or metallic drums, that are three-quarters filled with sharps or chemicals, or pharmaceutical residues
Encapsulation
Suitable for pharmaceutical waste that involves the mixing of waste with cement and other substances before disposal
The packaging is removed, the pharmaceuticals are grounded,
and a mixture of water, lime, and cement is added.
Inertization