There has been a growing awareness of the need for safe management of medical waste all over the world. Medical Waste are generated by all health sectors including hospitals, laboratories, diagnostic and research centers, dental and medical clinics, blood banks, mortuaries and autopsy centres, veterinary hospitals, industrial laboratories etc. Medical wastes which pose the greatest risk to human health are infectious waste (or hazardous medical waste) which constitutes 15 – 25 percent of total healthcare waste.
Infectious wastes may include all waste items that are contaminated with or suspected of being contaminated with body fluids such as blood and blood products, used catheters and gloves, cultures and stocks of infectious agents, wound dressings, nappies, discarded diagnostic samples, contaminated materials (swabs, bandages, and gauze), disposal medical devices, contaminated laboratory animals etc.
The quantity of waste produced in a hospital depends on the level of national income and the type of facility concerned. A university hospital in a high-income country can produce up to 10 kg of waste per bed per day, all categories combined.
Medical Waste in the GCC
Healthcare sector in the Gulf Cooperation Council continues to grow at a very rapid pace, which in turn has led to big increase in the quantity of waste generated by hospitals, clinics and other establishments. According to conservative estimates, more than 150 tons of medical waste is generated in GCC countries every day.
Saudi Arabia leads the pack with daily healthcare waste generation of more than 80 tons. As far as UAE is concerned, approximately 21.5 tons per day of medical waste are generated in the UAE, out of which 12 tons per day is produced by Abu Dhabi alone. Kuwait produces around 12 tons while Bahrain generates 7 tons of hazardous medical waste daily.
These figures are indicative of the magnitude of the problem faced by municipal authorities in dealing with medical waste disposal problem across GCC. The growing amount of medical wastes is posing significant public health and environmental challenges in major cities of the region. The situation is worsened by improper disposal methods, insufﬁcient physical resources, and lack of research on medical waste management.
Medical Waste Generation in Some GCC Countries
|Country||Medical Wastes (tons per day)|
Need for Medical Waste Management Strategy
Improper management of healthcare wastes from hospitals, clinics and other facilities in GCC countries pose occupational and public health risks to patients, health workers, waste handlers, haulers and general public. It may also lead to contamination of air, water and soil which may affect all forms of life. In addition, if waste is not disposed of properly, members of the community may have an opportunity to collect disposable medical equipment (particularly syringes) and to resell these materials which may cause dangerous diseases.
According to World Health Organization, hospital-associated infections (HAI) affect approximately 5% of hospitalized patients.The complexity of infectious healthcare waste problems and the recent rise in the incidence of diseases such as AIDS, SARS and Hepatitis B open up greater risk of contamination through mishandling and unsafe disposal practices.
Inadequate waste management can cause environmental pollution, growth and multiplication of vectors like insects, rodents and worms and may lead to the transmission of diseases like typhoid, cholera, hepatitis and AIDS through injuries from syringes and needles contaminated with human. In addition to health risks associated with poor management of medical waste, consideration must also be given to the impact on environment, especially to the risks of pollution of water, air and soil.
The situation is further complicated by the extreme climatic and environmental conditions of the region, which makes medical waste disposal in developing countries more challenging. Since medical waste is more dangerous than ordinary trash, it is imperative on governments and private companies in GCC countries to devise a successful hospital waste management program and make use of modern medical waste treatment technologies to avoid the spread of diseases and to protect the environment.
The main problem with medical waste is, that not all waste at present objected as 'medical waste' is in fact hazardous waste. On the contrary, estimations ans experiences in Europe are that only 50% of the 'medical waste' can be objected as 'hazardous waste'. Therefor this not-hazardous part can be collected and treated as normal municipal waste. The huge problem however is a problem of organization in the hospitals, clinics, vets and other sources of medical waste. Education, technical means as completely different waste bins, hermetically closed for the hazardous parts after filling of the bins and normal waste bags or bins for the non-hazardous waste have to be provided and educated. Second is, a good and safe storage facility (for the hazardous waste cooled) and transport scheme to the waste processing facility. In the Netherlands we have already 22 years ago decided that pyroyses-gasification of this hazardous part of the waste was the best, safest and economically best solution. Safe because the waste bins are not to be opened or shredded and can hermetically closed be fed to the feeding system of the installation. After the pyrolyses stage there is a gasification stage, providing the pyrolyses stage with developed heat. The process is controlled by computers, flammable hazardous waste is applied as 'regulator' of the process. So a smooth process is obtained, not only converting the hazardous part of the medical waste into syngas but also converting hazardous flammable liquid waste into syngas. The syngases are burned in an afterburner at temperatures of >1450 C and fed afterwards in a steamboiler, generating steam for electricity generation. The high temperature in the afterburner destroys not only the virus and bacteries, it is also a thermal cracking of the syngas and destroying also the chemical compound of the waste. Capacity 9000 tons/year and providing 1000 household fully of electricity. The emissions are much lower than the European Standards. The installation belongs to the top in Europe in thermal efficiency and can be objected as 'waste fired powerplant' according the European standards.
For further information: because of the Regulation BAT (Best Availble Technology to be applied) shredding and autoclaving in what form ever of medical waste is NOT allowed in the Netherlands, because of several reasons: – danger for spreading aerosols during the pressurized process – danger of spreading bacteries and virus during shredding – problems in desinfection of the shredder during break-downs and maintenance. – the availability of a sophisticated, safe centralized processing plant For more information we are always available. Kind regards, Melle B. van der Meulen Senior Consultant MHV Consultancy Ltd
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