Transcript handling and disposal of medical waste

HANDLING AND DISPOSAL
OF HEALTH CARE WASTE
OBJECTIVES
At the end of this course, the student should be able to
 Define medical waste
 Discuss the various categories of individual at risk of
infection due to mishandling of medical waste
 Outline the stages in the management of medical
waste
 Discuss the importance of colour coding in medical
waste management.
 WHO estimates that, in 2000, injections with
contaminated syringes caused 21 million hepatitis B
virus (HBV) infections, two million hepatitis C virus
infections and 260 000 HIV infections worldwide.
Many of these infections were avoidable if the
syringes had been disposed of safely .
 In developing countries, additional hazards occur
from scavenging at waste disposal sites and the
manual sorting of hazardous waste from health-care
establishments. The waste handlers are at
immediate risk of needle-stick injuries and exposure
to toxic or infectious materials.
Poor management of health care waste poses public
health risks; they may be scavenged and reused or
children may play with them.
Management of Health Care Waste
 Poor management of health care waste potentially
exposes health care workers, waste handlers,
patients and the community at large to infection,
toxic effects and injuries and risks polluting the
environment.
 It is essential that all waste materials are segregated
at the point of generation, appropriately treated and
disposed of safely (WHO, 2013)
Management of Health Care Waste
Medical waste is all waste material generated at
health care facilities such as hospital, clinics,
blood banks, medical research facilities and
laboratories.
It is any waste generated in the diagnoses, treatment
or immunization of human beings or animals, in
the testing of biologicals.
E.g.
 blood-soaked bandages
 culture dishes and other glassware
 discarded surgical gloves
Management of Health Care Waste
 discarded surgical instruments
 discarded needles used to give shots or draw blood
(e.g., medical sharps)
 cultures, stocks, swabs used to inoculate cultures
 removed body organs (e.g., tonsils, appendices,
limbs)
 discarded lancets
Management of Health Care Waste
 All staff have a responsibility to handle and
dispose of waste in a manner that poses
minimal hazard to clients, visitors, other
health care workers and the community at
large.
 Proper disposal of waste:
1. Minimizes the spread of infections and
reduces the risk of accidental injury to s
Management of Health Care Waste
2. Helps provide an aesthetically pleasing
atmosphere
3. Reduces odours
4. Attracts fewer insects and animals
5. Reduces the likelihood of contamination of the soil
or ground water with chemicals or microorganisms
Management of Health Care Waste
Three (3) kinds of waste are generated in the health
facilities:
1. General Waste: non-hazardous waste that poses
no risk of injury or infection. E.g. paper, boxes,
packaging materials, bottles, food related trash etc.
2. Medical Waste: these are materials generated in
the diagnosis, treatment or immunization of
clients. They include:
 Blood and blood products as well as other
body fluids; materials containing blood or body
fluids e.g bandages and surgical sponges
materials containing blood or body fluids e.g
bandages and surgical sponges
Management of Health Care Waste
 Organic waste/pathological waste such as
human tissue, body parts, placentas and products of
conception.
 Sharps such as hypodermic suture needles, scalpel
blades, blood tubes, glass slide, vials and ampoules.
Management of Health Care Waste
3. Hazardous Waste/Toxic Waste: these are
chemical waste that is potentially toxic or
poisonous e.g. expired drugs and vaccines,
cleaning products, disinfectants, cytotoxic drugs
and radioactive compounds.
Components Of Medical Waste Management
Health care waste management system comprises of
the following components:
1.
Collection and segregation
2. Transportation
3. Storage
4. Treatment
5. Final disposal
Components Of Medical Waste Management
 Collection and Segregation: different types of
waste require different methods of disposal; hence it
is important that waste is sorted or separate waste
into the various categories at the point of generation
for effective disposal.
 For effective sorting of waste in the health facilities,
colour coding system is adopted so that each type of
waste is placed immediately (or at the point of waste
generation) into the appropriate colour-coded
container.
colour coding system waste bins: waste is sorted at the
point of waste generation into the appropriate colourcoded bin.
The Approved Colour Codes For Ghana Health
Service Medical Waste Management
Category
Category
General waste
Container and Colour Code
Container and Colour Code
Black plastic bag and bin
Sharps
Yellow puncture resistant containers
other infectious
waste
Yellow plastic bags and or bins
Pharmaceutical
and chemical
containers
Brown plastic bags and or bin
Management of Health Care Waste
Containers for collecting health care waste should :
 Be non transparent
 Be impervious
 Be leak proof
 Have close fitted lids
 Have sufficient strength to prevent easy damage
during handling or use.
Storage: storage takes place from the time of
generation of waste until collection for final disposal.
Waste is stored both internally and externally.
Internal storage occurs when waste is temporarily
placed at the site of generation pending
transportation to external storage site. During
internal storage:
 Waste should not be kept for more than 24 hours
 Waste bins should be emptied when 2/3 full (or daily
if not 2/3 full) and bins cleaned and disinfected
 Do not put your hands in the waste bins to remove
anything from it once waste is dropped into it.
NB: every unit/ward should have appropriate and
adequate number of waste bins with lids placed at
vantage points protected from rain and pests.
 External storage refers to the site where waste is
stored until it is transported for treatment or final
disposal. The external storage site should be fenced
and locked to protect from humans and animals. The
floor should be smooth, impervious and easy to clean.
 Transportation: health care waste must be
transported directly to disposal or treatment site
within the shortest possible time. Vehicles (e.g. wheel
barrow) used for transportation should be such that
scattering of waste is prevented; they must also be
odour and leak proof.
 Treatment: the recommended treatment options are:
 Incineration
 Sterilisation by autoclave or dry heat
 Chemical disinfection
 Final Disposal of Waste
Disposal of Solid Waste: the best disposal methods
for treated health care waste are controlled disposal
at sanitary landfills or burial. Sharps,
pharmaceutical as well as pathological waste must be
incinerated
Disposal of Liquid Waste: guidelines for disposal
of liquid waste include the following:
 Carefully pour liquid waste down a sink dedicated for
the purpose, drain, water closet or latrine; otherwise,
bury it in a pit along with slid waste.
 Rinse the sink, drain or toilet thoroughly with water
to remove residual waste, still avoiding splashing
 Clean these areas with a disinfectant cleaning
solution at the end of each day or more frequently if
heavily used or soiled
 Decontaminate the containers that held the liquid
waste by filling with or soaking it for 10minutes in
0.5% chlorine solution before washing.
 Wash your hands after handling liquid waste and
decontaminate and wash gloves.
 Other wastes
 Placenta or body parts should be incinerated or
buried in a safe area:
 Chemical wastes should be treated as for liquid waste
 Genotoxics should be disposed of in consultation
with experts.
USE AND DISPOSAL OF SHARPS
 Sharps include needles, scapels blades, scissors,
lancets etc.
 In health care settings, injuries from these sharps are
the nunber-one cause of infections in staff from
bloodborne pathogens. All staff who touch sharps are
at risk of infection. The following are some of the
activities through which injuries from sharps can
occur:
 During recapping, bending, or breaking of
hypodermic needles
 When carrying unprotected sharps
 When sharps are kept at unexpected places e.g. in
linen
 During procedures in they use many sharps, cannot
see their hands or when they are working in small
confined places
 When they handle or dispose of waste that contains
used sharps
 When clients move suddenly during injections.
Safe Handling of Sharps
 To reduce the risk or injuries from sharps (needles,
lancet, scapel blades etc.), sharps especially syringes
should not be recapped, burnt or cut.
 Place sharps in the sharps containers (puncture
resistant containers) placed at convenient places.
 The sharps containers should be disposed when ¾
full.
Safety Box for Sharps
ANY QUESTIONS?