Health care waste management possesses a leading place in the recent waste management researches. Health care facilities such as clinics, nursing homes and hospitals, households as well as medical laboratories, veterinary practices, research facilities, schools and first aid stations can generate this kind of waste. It is important to underline that if such products of health care activities such as pharmaceuticals, sharps, disinfectants, chemotherapy drugs will not be disposed of properly, they can cause a serious harm to the human health and environment (Wisconsin Department of Natural Resources).
I have chosen this topic because I consider that the mismanagement of health care waste, in particular hazardous waste, infectious waste, radioactive waste are very dangerous for the health in particular they can cause infectious diseases, inhalation hazards, environmental contamination, increase the risks of dermal contact with the harmful substances. Therefore, society, representatives of the health care entities, governmental bodies, volunteers as well as households should pay sufficient attention to this issue.
It is necessary for health care professionals to know that medical waste is divided into infectious waste, anatomical and pathological waste, pressurized containers, hazardous chemical and pharmaceutical waste, waste that contains heavy metals (Wisconsin Department of Natural Resources). Sharps, highly infectious waste, genotoxic/ cytotoxic waste, radioactive waste require additional attention and are considered to be the highly hazardous health care waste. It is necessary to underline that “the WHO estimates that over 23 million infections of hepatitis B, C and HIV occur yearly due to unsafe injection practices (reuse of syringes and needles in the absence of sterilization)” (HealthCare Waste Management).
I would like to put an emphasis on the fact that even small steps implemented in a sustainable manner can change the situation more successfully than sophisticated systems that do not work in the long run. With the aim to reduce risks and possible damages caused by improper health care waste management, simple measures that address waste management should be taken. First of all, these are related to safe handling and effective confinement of waste that could reduce health risks if they are applied on the constant base from the generation phase to the disposal phase (HealthCare Waste Management).
Health care professionals should be aware that separation of health care waste into the three categories – infectious waste, sharp and general waste – can be an efficient first step in dealing with potential health related risks to general public, supplementary services specialists, and health care professionals (HealthCare Waste Management).
It is rather essential to point out that, according to the World Health Organization, several types of health-care waste bring the highest risk to health. This is infectious waste that accounts for almost one fourth of all health care waste. Infectious waste, the disposal of which should be carried out in the most conscious way, includes sharps waste, pharmaceutical or chemical waste, body part waste, broken thermometers, radioactive and cytotoxic waste.
I was impressed by the statistical facts describing sharps waste as the most dangerous type of health care waste. If inadequately and unsafely managed, it disposes risks to the communities, waste handlers, and health-care workers. Contaminated syringes and needles are a threat for the HIV infections gaining and may be scavenged from dump sites and waste areas and be reused. According to the World Health Organization, 32 per cent of all new infections of hepatitis B virus were caused by the contaminated syringes. Two million HCV (hepatitis C) infections and 5 per cent of all new HIV infections that equals to 260 000 HIV infections had the same background.
Moreover, I would like to point out that the most striking fact in the health care waste management is related to the developing countries. It should be stated that after the assessment of such procedures in 22 developing countries by the World Health Organization, the number of health-care facilities that do not conduct proper heath care waste disposal varies in the range of 18 to 64 percent. This causes the reuse of syringes that can be found in everyday garbage, accidental needlestick injuries.
World Health Organization proposes short-term, medium-term and long-term measures as a part of the health care waste management strategy. Short-term measures include the use of the same plastic type for manufacturing all syringe components for easier recycling; choosing the PVC-free medical devices; development of recycling options; promotion and funding of new innovative technology or development of the alternatives to the small-scale incineration.
In a medium term, the World Health Organizations argues about the need of research in the field of the health effect of low levels of furan and dioxin related to the incineration and recycling of health care waste management. In the long run, it is necessary to invest in and promote the implementation of the non-incineration technologies used for the disposal of the hazardous medical waste, as well as support countries in creating a national guidance manual of the health-care waste management; “promotion of the principles of environmentally sound management of health-care waste as set out in the Basel Convention” (World Health Organization).
Regarding the practical example of health care waste management, such organization as PATH, an international nonprofit organization and a pioneer in developing innovative technologies, operates to improve the safety of handling and disposing the medical waste. The activists propose innovative decisions in three directions:
- Making needles reuse impossible with the help of autodisable syringes, development and production of which is funded by HealthTech program of the US Agency for International Development;
- Separating sharps from the general waste by using needle removers “de-fang” syringes.
- Keeping needles in special stickproof containers until they cannot be destroyed.
It is also necessary to underline that PATH draws society’s attention to the fact that the developing countries do not have the necessary facilities and training to implement and carry out reliable systems for health care waste disposal. Therefore, they need technical and educational support to face the issues related to the health care waste management.