Hospital Waste Management in Rajshahi City

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Asian Journal of Innovative Research in Science, Engineering and Technology (AJIRSET)

Available online at: www.engineeringjournal.info

RESEARCH ARTICLE

Hospital Waste Management in Rajshahi City

Md. Ahsan Habib

1*

, Sayeda Kamrun Nahar

2

, Tanjila Tazrin

1

1Dept. of Civil Engineering, Rajshahi University of Engineering & Technology, Bangladesh. 2Dept. of Civil Engineering, Bangladesh University of Engineering & Technology, Bangladesh.

Abstract

A review of hospital waste management systems was performed to understand the knowledge and awareness of individuals involved in hospital waste generation, handling and disposal, and to quantify hospital wastes production and their various types in Rajshahi city. The purpose of the study is to provide direction for further study. Data were collected by field investigation and conducting interview in the selected hospitals. It was found that a variety of methods were used by the medical facilities to dispose their wastes including open dumping, land filling and incineration. The waste disposal practice was found to be quite unsafe, and both clinical and non-hospital wastes were found to be thrown together. There was insufficient awareness of the magnitude of the hospital waste issue by concerned individuals at different levels from director or divisional head to tokai (waste pickers). The results revealed that the present waste disposal system was unhygienic and unsafe. To manage hospital solid waste, use of single practices cannot solve the management problems. This study is to research and discuss about hospital solid waste management practices in Rajshahi city, so that; we can detect the main management problem of hospital solid waste. In addition, we also can plan a new and better practice of hospital solid waste for the future.

Keywords: Disposal, Labeling, Packaging, Segregation, Treatment.

Introduction

Nothing on earth is more international than disease”, said Paul Russel. Health and disease have no political or geographical boundaries. Hospitals have become complex institutions which were frequented by people from every walk of life in the society without any distinction between age, sex, race and religion [1]. Hospital waste management is among the critical concerns in the most of the cities in Asian countries as well as in Bangladesh. This is because hospital waste is always considered negative in term of aesthetic values, sanitary and environmental aspects and public health. The potential hazards of the hospital wastes, effect to human health and environment. Hospital waste management means the management of waste produced by hospitals using such techniques that will help to check the spread of diseases through it.

It is observed that the solid hospital wastes are being disposed of in the City

Corporation’s collection bins in and around the hospital premises. The waste is then collected by City Corporation’s vehicles and then transported to the open municipal dumping sites. Simply disposing it into dustbins, drains, and canals or finally dumping it to the outskirts of the city poses a serious public health hazard. Such disregard for protecting public health occurs due to lack of awareness, skill of the people and institutions engaged in hospital waste generation and disposal as well as due to lack of treatment facilities and system in the city.

The rapid increase of hospitals, clinics, diagnostic laboratories etc. in Rajshahi city exerts a tremendous impact on human health ecology. The present practice of improper handling of generated hospital wastes is playing a contributing role in spreading out the Hepatitis and HIV diseases (Iftekhar, 2004). The liquid and solid wastes containing hazardous materials

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are simply dumped into the nearest drain or garbage heap respectively where they are prone to contaminate the rag-pickers that sift through the garbage dumps. The chances of infection are very high to the cleaners, and to the general population. The improvement of waste management will have significant long-term impact on keeping the spread of infectious diseases to a minimum and result in a cleaner and healthy environment.

The prevention, segregation, handling, transport and disposal of waste must be properly managed so as to minimize the risks to the health and safety of staff, patients, the public and the safety of the environment.

Materials and Methods

Classification of Hospital

For the convenience of study the hospitals of Rajshahi city are classified based on the following ranges of capacity of beds:

 No. of beds: less than 50 (Small scale hospital).

 No. of beds: Greater than 50 and less than 100 (Medium Scale Hospital).

 No. of beds: Greater than 100 (Large Scale Hospital).

Data Collection

Data were collected by field investigation and conducting interview in the selected hospitals.

Analytical Procedure

Qualitative and quantitative data collected to analyze existing solid waste management situation from hospitals in Rajshahi City mostly analysis is used information from questionnaire interview field observation, investigation for this study. It contains  Types of hospital wastes from hospital.  Hospital waste management system for

inside and outside the hospital.

 Knowledge and awareness of hospital workers, doctors, nurses regarding to hospital waste.

Waste Segregation

From the questionnaires surveys we can know that segregation of waste is done before disposal. Although segregated waste is not recycling, they use the separate bags for different types of waste and they use the separated plastic bins for infectious, sharp waste and general waste. Proper separation has been introduced by public health ministry in Bangladesh but all of hospitals in Rajshahi City do not exactly follow this.

Figure 1: Segregation of waste

Color Coding System of Sample Hospital

For effective waste separation, in addition to identifying its source and persons responsible, color coding system is needed. However, partial color coding is followed in Rajshahi Medical College and Christian

Mission Hospital. Other hospital also follows the color coding system, but comparatively less. Generally three colors are used. Black is used for general waste, yellow color is used for infectious waste and red color is used for sharp waste.

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Figure 2a: Sharp waste and 2b Infectious waste

Table 1: Color coding for hospital wastes

Hospital Type of wastes Color of containers and bags

In all selected hospitals Infectious Waste General Waste Green/Black Yellow

Sharp Waste Red

Results

Table 2: Details of selected hospitals

No Hospital Name Bed Symbolic

Name (According to no. Size of Hospital of Beds)

Type of

Hospital Location

1 RajshahiMedicalCollegeHospital 530 A Large scale Govt. Laxmipur

2 ChristianMissionHospital 85 B Medium scale Specialist Kazihata

3 Al-Medina Clinic 15 C Small scale Private Laxmipur

4 Mohanogor Clinic 12 D Small scale Private Hetemkha

5 RajshahiDentalCollege - E Small scale Govt. Sodor Hospital

Road

6 Popular Diagonostic Centre - F Large scale Private Laxmipur

Table 3: Data collected from selected hospitals and clinics

Hospitals No. of

Beds Doctors Nurses Cleaners Amount of solid wastes generated per day (kg)(Average of 7 days data, which are presented in Appendix A.8, B.8, C.8, D.8, E.8

and Appendix F.8)

Hospital A 530 169 349 137 710

Hospital B 85 10 20 4 7

Hospital C 15 3 10 2 1.5

Hospital D 12 5 9 3 2

Hospital E - - - - 1

Hospital F - - - - 15

Table 4: Percentage of waste generated from selected hospitals and clinics

Name of the hospital Type of waste Quantity of waste % of waste

RajshahiMedicalCollageHospital Saline packet 193kg 27.18

Injection ampoule 80kg 12.27

Syringes with needles 225 kg 31.69

Catheter 51kg 7.18

Blood bag 44 kg 6.20

Cotton with blood 117 kg 16.48

ChristianMissionHospital Saline packet 1.5 kg 21.43

Saline set .690 kg 9.85

Injection ampoule .490 kg 7

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N.G tube .970 kg 13.86

Catheter 2.5kg 35.71

Al- Medina Clinic Saline bottle .300 kg 20

Saline bag .500 kg 33.33

Injection ampoule .150 kg 10

Saline set .300 kg 20

Blood bottle .250 kg 16.67

Mohanogor Clinic Saline bags .750 kg 37.5

Injection syringes .500 kg 25

Bottles .430 kg 21.5

Gloves .320 kg 16

RajshahiDentalCollege Injection syringes .450 kg 45

Saline bottle .550 kg 55

Popular Diagnostic Centre Plain tube 5 kg 33.33

EDTA tube 1kg 6.67

Urine pot 4.5 kg 30

Glass plate and ESR tube 4.5 kg 30

Figure 3: Waste percentages in Rajshahi Medical College Hospital

Figure 3 represents that in hospital A the percentage of saline packet is 27%,injection ampoule is 12%,syringes with needles are

32%,blood bag and catheter are very less amount that are 6% and 7%,cotton with blood is 16%.

Saline packet

21%

Saline set 10%

Injection ampoule

7% Syringes with

needles 12% N.G tube

14% Catheder

36%

Hospital B

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Figure 4 shows that in Christian Mission Hospital the percentage of saline packet is 21%,saline set is 10%, injection ampoule is

7%, syringes with ampoule is 12%.The large portion of waste is catheter and N.G tube that are 36% and 14%.

Saline bottle 20%

Saline bag 33%

Injection ampoule 10% Saline set

20%

Blood bottle 17%

Hospital C

Figure 5: Waste percentages in Al- Medina Clinic

Figure 5 shows the percentage of waste generated from Al-Medina Clinic. Here the percentage of saline bottle is 20%, saline bag

is large amount and it is 33%, injection ampoule is 10%, saline set and blood bottle are 20% and 17%.

Saline bags 37%

Injection syringes 25%

Bottles 22%

Gloves 16%

Hospital D

Figure 6 : Waste percentages in Mohanogor Clinic

Figure 6 describes the percentage of waste

generated in Mohanagar Clinic. Here saline bags are 37%, injection syringes are 25%, bottles are 22% and used gloves are 16%.

Injection syringes

45% Saline

bottle 55%

Hospital E

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Figure 7 represents that in Rajshahi Dental

College the percentage of injection syringes are 45% and saline bottles are 55%.

Figure 8: Waste percentages in popular diagnostic centre

Figure 8 gives an idea about the percentage of waste generated in Popular Diagnostic center. The percentage of plain tube is 33%, EDTA tube is 7% and urine pot, glass plate and ESR tube is almost same 30% [2-9].

Conclusion

Medical wastes pose a significant impact on health and the environment. There is not enough information on medical waste management technologies and impacts in developing countries. The proper hospital waste management system can help the control diseases can reduce community exposure to resistant bacteria, and could reduce HIV/AIDS and Hepatitis transmission from dirty needles and other improperly cleaned or disposed medical items.

 Protection of the personnel working in waste collection is very important. Clothing and special protection items are in most of the cases obligatory.

 Frequent training of the personnel is extremely important to ensure proper segregation and classification of the clinical waste and to keep them always updated with the new implementations.  Hospital waste may be stored before being

transported to treatment/disposal sites. They should not be allowed to accumulate in corridors, wards or other places accessible to un-authorized personnel or members of the public.

 Infectious waste, excluding sharps, should be collected in no more than one day a week, unless the waste is refrigerated.  Transport of clinical waste for on-site

transport must follow certain procedure to be optimized, such as steam-cleaning of used vehicles or disinfecting them following leakages or spills, and at regular intervals.

 Frequent and optimized clinical audits are essential to ensure a good practice of the clinical waste disposal.

References

1. Rudraswamy S, Sampath N, Doggalli N

(2013) Global Scenario of Hospital Waste Management.(https://www.researchgate.net/ publication/264905268_ISSN_2277386X_Ori ginal_Article_GLOBAL_SCENARIO_OF_H OSPITAL_WASTE_MANAGEMENT) 2. Mia MY, Ali MA, Rahman MA, Nazrin L,

Hossain MU (2012) Hospital Waste

Management in Tangail Municipality, J.Environ. Sci. & Natural Resources, 5(1):121-127.

3. Mato and Kaseva (1999) Critical review of industrial and medical waste practices in Dar es Salaam City”, Resources, Conservation and Recycling, 25:271-287. 4. Akter N, Chowdury A, Kazi NM (1998)

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Hospital Waste Disposal in Bangladesh with Special Reference to Dhaka City and its Environmental Evaluation. (http://citeseerx.ist.psu.edu/viewdoc/downloa d?doi=10.1.1.530.8191&rep=rep1&type=pdf) 5. Akter N (2000) Medical Waste Management:

A Review.(http://www.eng-consult.com/ben/papers/paper-anasima.pdf) 6. Mohankumar S, Ottaiveer KK (2011)

Hospital Waste Management and Environmental Problems in India, International Journal of Pharmaceutical & Biological Archives, 2(6):1621- 1626.

7. The Environmental Protection Department Hong Kong, Small Clinical Waste Producers, June (2010). “Code of Practice for the

Management of Clinical

Waste”.(http://www.epd.gov.hk/epd/clinicalw aste/file/doc06_en.pdf)

8. World Bank (2003) Health Facility Waste

management Study in

Bangladesh.(http://bmcpublichealth.biomedc entral.com/articles/10.1186/1471-2458-8-36) 9. Yousef Elg ita it, Sarshar M, Gee I

“Determining the Best Practice in Clinical

Waste Management”.

(http://www.ncbi.nlm.nih.gov/pmc/articles/P MC4791961/)

Figure

Figure 1: Segregation of waste

Figure 1:

Segregation of waste p.2
Figure 2a: Sharp waste and 2b Infectious waste

Figure 2a:

Sharp waste and 2b Infectious waste p.3
Figure 3: Waste percentages in Rajshahi Medical College Hospital  Figure 3 represents that in hospital A the

Figure 3:

Waste percentages in Rajshahi Medical College Hospital Figure 3 represents that in hospital A the p.4
Figure 4: Waste percentages in Christian Mission Hospital

Figure 4:

Waste percentages in Christian Mission Hospital p.4
Figure 4 shows that in Christian Mission  Hospital the percentage of saline packet is  21%,saline set is 10%, injection ampoule is

Figure 4

shows that in Christian Mission Hospital the percentage of saline packet is 21%,saline set is 10%, injection ampoule is p.5
Figure 6 : Waste percentages in Mohanogor Clinic  Figure 6 describes the percentage of waste

Figure 6 :

Waste percentages in Mohanogor Clinic Figure 6 describes the percentage of waste p.5
Figure 5: Waste percentages in Al- Medina Clinic  Figure 5 shows the percentage of waste

Figure 5:

Waste percentages in Al- Medina Clinic Figure 5 shows the percentage of waste p.5
Figure 7 represents that in Rajshahi Dental

Figure 7

represents that in Rajshahi Dental p.6

References