swaHealth care activities protect and restore health and save lives. But what about the waste and byproducts they generate? Of the total waste generated by healthcare activities, about 85% is general, nonhazardous waste which is equivalent to household waste. The remaining 15% are considered hazardous materials that may be infectious, chemical, or radioactive. Measures to ensure safe and environmentally friendly management of healthcare wastes can prevent adverse health and environmental impacts from such wastes, including unintended emissions of chemical or biological hazards. Healthcare waste contains potentially harmful microorganisms that can infect hospital patients, healthcare workers, and the general public. Other potential threats may include drugresistant microorganisms that spread from healthcare facilities into the environment. Adverse health outcomes associated with healthcare waste and byproducts include injuries caused by sharp objects; Exposure to pharmaceutical products, particularly antibiotics and cytotoxic drugs, and substances such as mercury or dioxins released into the surrounding environment during the handling or incineration of healthcare wastes; chemical burns arising in the context of disinfection, sterilization or waste treatment activities; Air pollution resulting from the release of particulate matter during medical waste incineration; Thermal injuries associated with open burning and operation of medical waste incinerators; radiation burns; and the spread of antimicrobial resistance through unsafe storage, treatment and disposal of pharmaceutical wastes. Many reasons exist for inadequate healthcare waste services.
These include limited legal frameworks (e.g., policies, regulation, guidelines), lack of awareness of health risks associated with healthcare waste, inadequate training in proper waste management, absence of waste management and disposal systems, inadequate financial and human resources. And include low priority. Many countries either do not have proper regulations or do not monitor and enforce them. Worldwide, an estimated 16 billion injections are administered each year. Not all needles and syringes are disposed of safely, creating risks of injury and infection and opportunities for reuse.
Injections using contaminated needles and syringes have declined significantly in low- and middleincome countries in recent years, partly due to efforts to reduce the reuse of injection equipment. Despite this progress, unsafe injections were still responsible for 33,800 new HIV infections, 1.7 million hepatitis B infections and 315,000 hepatitis C infections. A person who experiences a needlestick injury from a needle used on an infected source patient has a 30%, 1.8%, and 0.3% risk of becoming infected with HBV, HCV, and HIV, respectively.
Additional hazards arise during cleanup at waste disposal sites and during the handling and manual sorting of hazardous waste from healthcare facilities. These practices are common in many areas of the world, especially low- and middleincome countries. Waste handlers are at immediate risk of needlestick injuries and exposure to toxic or infectious substances. The treatment and disposal of healthcare waste can pose indirect health risks through the release of pathogens and toxic pollutants into the environment. Disposal of untreated healthcare wastes in landfills can lead to contamination of drinking, surface and groundwater if those landfills are not properly constructed.
Minimizing healthcare waste should be a priority. This will significantly reduce the amount of waste that needs to be handled and treated. Waste minimization actions include green purchasing and selecting products where shipping is minimized and have less and ecological packaging, switching to reusable products when safe and feasible, ordering pharmaceuticals only based on documented need / Involves obtaining and recycling common items including plastic, paper and cardboard. Treatment of healthcare effluents with chemical disinfectants can result in the release of chemical substances into the environment if those substances are not handled, stored and disposed of in an environmentally friendly manner.
Managing healthcare waste requires greater attention and diligence to avoid adverse health outcomes associated with poor practice, including exposure to infectious agents and toxins. Key elements of improving healthcare waste management are promoting practices that reduce the amount of waste generated and ensuring proper waste separation; To develop strategies and systems along with strong monitoring and regulation to progressively improve waste separation, destruction and disposal practices with the ultimate objective of meeting national and international standards.
Where possible, favor safe and environmentally friendly treatment of hazardous health care wastes (for example, autoclaving, microwaving, integrated steam treatment with internal mixing, and chemical treatment) over medical waste incineration; Creating a comprehensive system, responsibilities, resource allocation, and choosing safe and environmentally friendly management options to protect people from hazards when collecting, handling, storing, transporting, treating, or disposing of waste. Universal, longterm reform requires government commitment and support, although immediate action can be taken at the local level.
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Image Credit: KhasKhabar.