Healthcare waste management Flashcards
Healthcare waste are generated from
Diagnosis, treatment, management, and immunization of humans or animals
Research about diagnosis, treatment, management, and immunization of humans or animals
Producing or testing of biological materials
Waste originating from minor or scattered sources
Categories of Healthcare waste
general
infectious
pathological
sharps
pharmaceutical
genotoxic
chemical
waste with high heavy metal contents
pressurized containers
radioactive wastes
Other wise known as non risk infectious disease
Comparable to domestic waste
Dealt with municipal waste disposal system
From administrative and housekeeping functions of healthcare establishment
also wastes produced during maintenance of the premises
General Waste
2 types of general waste
recyclable and biodegradable waste
Examples of recyclable wastes
paper, cardboard, non contaminated plastic or metals, cans or glass that can be recycled
Examples of biodegradable HCW
left over food or garden waste that can be compostedd
all _______ and ______ are known to have the potential of transmitting infectious agents to humans or animals
medical and healthcare waste
infectious waste are generated from
isolation wards of the hospital
dialysis wards
centers for caring patients infected with hepatitis virus
pathology department
operating theater
medical practices
laboratory which mainly treat patients suffering from diseases
infectious wastes are suspected to contain _________ to cause disease to susceptible host
sufficient concentration of pathogens
susceptible hosts are the
Young, Adolescence, Pregnant, Immunocompromised
Examples of infectious waste
Bacterial stocks and culture
Fecal Samples
Wastes from Hemodialyzers
Blood
Respiratory Tract Secretions
Infected Lab Animal
used to identify bacterial colonies
bacterial tubes
anything that contains urine sample are considered
infectious
also known as the anatomical waste
this category of waste compromises human body parts, organs, and tissue
Pathological Waste
Examples of pathological wastes
Human fetus, Amputated body part, Removed organs, Animal carcasses, Placenta, Tissues
all objects and
materials that are closely
linked with health-care
activities and pose a potential
risk of injury and infection due
to their puncture or cut
property.
Sharps
Examples of sharps waste
needles, ampoules, broken glassware, saw, knives, infusion sets, scalpel blades, lancets, nails, vials without content
Comprised expired pharmaceutical or pharmaceuticals that are unusable for other reasons
Pharmaceutical wastes
examples of pharmaceutical wastes
expires, unused, spilt, contaminated pharmaceutical drugs, products, vaccine, and sera
bottles or boxes with pharmaceutical residue
gloves and masks used during handling,
and connecting tubing and drug vials
May include certain cytostatic
drugs, vomit, urine, feces from
patients treated with cytostatic
drugs, chemicals, and radioactive
material
genotoxic waste
Cytostatic wastes are generated
from several sources and can
include the following
contaminated materials from drug preparation and administration, such as syringes, needles, vials, packaging
examples of genotoxic wastes
outdated drugs
excess solutions
drugs returned from the wards
Urine, feces, and vomit from patients, which may contain potentially hazardous amounts of the administered cytostatic drugs
Urine, feces, and vomit of patients administered with cytostatic drugs should be considered genotoxic for at least ____ hours and sometimes up to _____ week after drug administration
48 hours and 1 week
waste from health care may be hazardous or
nonhazardous; in the context of protecting health,
Chemical waste
chemical waste is considered hazardous if :
toxic
corrosive - acids of ph is <2; base of ph is > 12
flammable
reactive - explosive, water reactive, shock sensitive
genotoxic
chemical waste is considered nonhazardous if
the waste consists of chemicals with none of the properties of a hazardous waste
Subcategory under hazardous chemical wastes
Highly toxic
Wastes with high heavy metal content
examples of Wastes with high heavy metal content
mercury spill
lead
arsenic
cadmium waste from discarded batteries
examples of pressurized container
Pressurized cylinders, cartridges, aerosol cans containing residues
Liquid/gaseous materials
contaminated with
radioactive substances
radioactive waste
Produced as a result of
procedures such as in vitro
analysis of body tissue and
fluid, in vivo imaging and
tumor localization
radioactive waste
examples of radioactive waste
Feces/urine of patients under
radiation therapy
Residues of radioisotope
studies in the laboratory
HEALTH CARE WASTE GENERATORS
hospital
infirmaries
birthing centers
drug manufacturers
laboratories and research center
institution
clinics
Laboratories and Research
Centers examples
- Medical and biomedical
laboratories - Nuclear medicine laboratories
- Medical research centers
- Biotechnology laboratories
- Blood banks and blood
collection services - Animal research and testing
- Dental prosthetic laboratories
- Drug testing laboratories
- HIV testing laboratories
examples of institution
- Drug rehabilitation center
- Schools of Radiologic
Technology - Training centers for
embalmers Medical Schools - Med Tech intern training
centers - Nursing Homes centers
- Dental Schools
- Mortuary and Autopsy
Centers
examples of clinics
- Medical
- Surgical
- Ambulatory
- Alternative medicine
- Dialysis
- Dental
- Health care centers
- Dispensaries
- Veterinary
The ______ is often characteristic of the type of
source.
composition of wastes
MEDICAL WARDS contain what type of waste
Mainly infectious waste and general waste
OPERATING AND SURGICAL WARDS contain what type of waste
general, pathological, anatomical, infectious waste, sharps
OTHER HEALTH CARE UNITS contain what type of waste
mostly general with small percentage of infectious, and sharps
LABORATORIES contain what type of waste
mainly pathological, highly infectious waste, sharps, plus some radioactive and chemical waste
PHARMACEUTICAL & CHEMICAL STORES contain what type of waste
mainly packaging, general waste, small quantities of pharmaceutical and chemical wastes
SUPPORT UNITS contain what type of waste
general wastes only
Preventing or reducing generation of waste with emphasis on
source reduction and recycling
minimization
benefits of minimization
- Source reduction
- Recyclable products
- Good management and control practices
BASIC STEPS IN
HANDLING WASTE
minimization
segregation
an important step to waste management
segregation
Reasons to take undertake waste segregation
- Minimizes the amount of waste that needs to be managed
as biohazardous or hazardous - Generates a solid waste stream through recycling or
composting - Reduced the number of toxic substances release to the
environment - Makes it easier to conduct assessments of the quantity
and composition of different waste streams
When handling HCW, sanitary
staff and cleaners should
always wear protective clothing
including
industrial aprons
boots
heavy duty gloves
ways to avoid accumulation of the waste
it must be collected on a regular basis
transported to a central storage area within hcf before being treated or removed
collection must follow specific routes through the HCF to reduce the passage pf loaded carts through wards and other clean areas
Refuse receptacle for general
waste with _____
plastic bag cover
Refuse receptacle for pathological
wastes lined ____
with heavy gauge
plastic bag and cover
for infectious
wards receptacle
Foot operated lid container
refuse receptacle lined with
heavy-gauge plastic bag
with cover;
Refuse receptacles for
sharps with _______
heavy gauge
plastic bag and cover
(plastic container)
For radioactive waste and
chemical waste receptacle
wooden box
storage area should be marked
“CAUTION:
BIOHAZARDOUS WASTE STORAGE AREA. UNAUTHORIZED
PERSONS KEEP OUT.”
storage area should be located :
within the establishment or research facility, away
from patient rooms, laboratories, hospital function/operation
rooms or any public access areas
REQUIREMENTS FOR STORAGE FACILITIES
- Must have an impermeable, hard-standing floor with good
drainage - Easy to clean and disinfect
- Must have water supply for cleaning purposes
- Allows easy access for staff in charge of handling the waste.
- Must have a lock to prevent access by unauthorized persons.
- Easy access for waste collection vehicle
- Protected from sun, rain, strong winds, floods, etc.
- Inaccessible to animals, insects, and birds
transport must be:
- Uses wheeled trolleys, containers, or carts
- Should be cleaned & disinfected daily
- All waste bag seals should be in-place and intact at the end of
transportation
Specifications for on site transport
- Easy to load & unload
- No sharp edges that can damage waste bags or containers
during loading/unloading - Easy to clean
HCW should be transported through:
the quickest or shortest
possible route and should be planned before the trip begins
- An efficient and effective collection system route should consider
the following:
- Collection schedule either by route or zone
- Revised routing plan should be established
- Logical planning of the route
HEALTH CARE WASTE
TREATMENT
TECHNOLOGIES/PROCESSES
a. Thermal
b. Chemical
c. Irradiation
d. Biological processes
e. Encapsulation
f. Inertization
Thermal decomposition of substance and materials in the absence of supplied molecular oxygen in the destructionchamber in which the said material is converted into gaseous,
liquid, or solid form.
Pyrolysis
Waste residues of thermal processes may be in form of
greasy aggregates or slugs, recoverable metals, carbon black
Waste residues of pyrolysis may be in form of
secure facility such as sanitary landfill
Thermal Processes
WET AND DRY THERMAL TREATMENT
wet thermal treatment
autoclave
Uses steam sterilization to render waste harmless
* Exposes shredded infectious waste to high temperature (121°C)
and high pressure (15 psi) for 30 minutes
* Has been used in hospitals for the sterilization of reusable
medical equipment
autoclave
Dry thermal treatment
Microwave
Incorporates some type of size reduction device
* Shredding of wastes is done either before or after disinfection
* Waste is exposed to microwaves that raises the temperature to
100°C for at least 30 minutes
* Microorganisms are destroyed by moist heat which irreversibly
coagulates and denatures enzymes and structural proteins
microwave
Chemicals like _______ are added to waste to kill or inactivate pathogens present in the healthcare waste
aldehydes, chlorine compounds, phenolic compound
Most suitable in treating blood, urine, and stool
chemical disinfection
Uses an enzyme mixture to
decontaminate health care waste
and the resulting by-product is put
through an extruder to remove
water for sewage disposal.
* Requires regulation of
temperature, pH, enzyme level,
and other variables.
* Composting and vermiculture as
biological processes for treating
and disposing of placenta waste as
well as food waste, yard trimmings
and other organic waste is also
recommended
biological processes
- Wastes containing potentially infectious microorganisms
(sewage sludge, biomedical wastes, wastewater) are treated
using irradiation systems which are currently being used in
waste treatment operations. - Sterilization is achieved by breaking down the DNA molecules
of the contaminated organism. - Ionizing radiation is very efficient at DNA disruption and
requires far less total energy than would be used in an
equivalent thermal process.
radiation technology or irradiaton
- Filling up of container with waste,
adding an immobilizing material,
and sealing the container - Uses either cubic boxes made of
high-density polyethylene or
metallic drums, that are three
quarters filled with sharps or
chemical or pharmaceutical
residues. - The boxes are then filled up with a
medium such as plastic foam,
bituminous sand, and cement
mortar
encapsulation
advantage of encapsulation
: Effective in reducing the
risk of scavengers gaining access to
the health care waste
- Mixing of the waste with cement and other substances before
disposal; Especially suitable for pharmaceutical wastes - For the inertization of pharmaceutical waste, the packaging
should be removed, the pharmaceuticals ground, and a
mixture of water, lime, and cement added.
inertization
typical proportion for the inertization mixture
65% pharmaceutical waste
15% lime
15% cement
5% water
FOUR BASIC WASTE DISPOSAL
TECHNIQUES
a. Flushing down the drain to the sewer system
b. Incineration
c. Landfill burial
d. Recycling
is a type of
disposal method in which municipal
solid wastes are burned at high
temperatures.
incineration or combustion
The process eventually converts them
into residues and gaseous products.
incineration
Used to be the method of choice in
treating health care waste but due to
the implementation of Clean Air Act, this
method is no longer allowed.
incineration
- An engineered method designed to keep
the waste isolated from the environment. - Appropriate engineering preparations
should be completed before the site can
accept waste.
landfill burial or sanitary landfill
is collecting
waste and processing it
into something new
recycling
Many items in the
hospital can be recycled
such as
organics, plastics, paper, glass and metal
