Medical waste management at three hospitals in Jenin district, Palestine.

Medical wastes are considered hazardous because they may possess infectious agents and can cause unsafe effects on the environment and human health. This study is to analyze and evaluate the current status of medical waste management at Jenin's district in light of medical waste control regulations recommended by the World Health Organization. The results demonstrated that the average hazardous healthcare waste generation rate ranges from 0.54 to 1.82 kg/bed/day with a weighted average of 0.78 kg/bed/day. There was no established waste segregation of healthcare waste types in all hospitals, and these wastes were finally disposed of in a centralized municipal sanitary landfill, namely Zahrat Al-Finjan. The results suggest that there is a need for activation and enforcement of medical waste laws. This can be achieved through cooperation among key actors: Ministry of Health, Environmental Quality Authority, Ministry of Local Government, and Non-Governmental Organizations working in related fields. Additional remediation measures proposed to tackle the problematic areas of medical waste management in Jenin's district hospitals are addressed. Some recommendations to minimize potential health and environmental risks of medical waste are also introduced.

Human placentophagy: a review.

Placentophagy or placentophagia, the postpartum ingestion of the placenta, is widespread among mammals; however, no contemporary human culture incorporates eating placenta postpartum as part of its traditions. At present, there is an increasing interest in placentophagy among postpartum women, especially in the United States. The placenta can be eaten raw, cooked, roasted, dehydrated, or encapsulated or through smoothies and tinctures. The most frequently used preparation appears to be placenta encapsulation after steaming and dehydration. Numerous companies offer to prepare the placenta for consumption, although the evidence for positive effects of human placentophagy is anecdotal and limited to self-reported surveys. Without any scientific evidence, individuals promoting placentophagy, especially in the form of placenta encapsulation, claim that it is associated with certain physical and psychosocial benefits. We found that there is no scientific evidence of any clinical benefit of placentophagy among humans, and no placental nutrients and hormones are retained in sufficient amounts after placenta encapsulation to be potentially helpful to the mother postpartum. In contrast to the belief of clinical benefits associated with human placentophagy, the Centers for Disease Control and Prevention recently issued a warning due to a case in which a newborn infant developed recurrent neonatal group B Streptococcus sepsis after the mother ingested contaminated placenta capsules containing Streptococcus agalactiae. The Centers for Disease Control and Prevention recommended that the intake of placenta capsules should be avoided owing to inadequate eradication of infectious pathogens during the encapsulation process. Therefore, in response to a woman who expresses an interest in placentophagy, physicians should inform her about the reported risks and the absence of clinical benefits associated with the ingestion. In addition, clinicians should inquire regarding a history of placenta ingestion in cases of postpartum maternal or neonatal infections such as group B Streptococcus sepsis. In conclusion, there is no professional responsibility on clinicians to offer placentophagy to pregnant women. Moreover, because placentophagy is potentially harmful with no documented benefit, counseling women should be directive: physicians should discourage this practice. Health care organizations should develop clear clinical guidelines to implement a scientific and professional approach to human placentophagy.

Aerotransporte de pacientes con alto riesgo de contaminación por enfermedad infecciosa, a propósito de tres casos / High risk infections patients Air Medevec. Our experience after 3 medical cases

Las tropas españolas destacadas en operaciones internacionales en áreas tropicales con enfermedades infecciosas emergentes pueden verse en situación de riesgo de contagio, a lo que se suma el potencial uso de armas biológicas en los actuales conflictos de guerra desigual. Este riesgo puede hacerse extensivo a toda la población bajo responsabilidad española. Esta situación hizo que la Sanidad Militar Española y, en el caso que se presenta, la Unidad Médica de Aeroevacuación (UMAER) actualizase sus procedimientos de defensa NBQ en vigor desde el inicio de las misiones de las Fuerzas Armadas en territorio africano. Se reforzó la respuesta a la amenaza biológica en dichos ambientes tropicales y se trabajó y entrenó en la posibilidad de transporte aéreo de pacientes con enfermedades infecciosas transmisibles para su tratamiento definitivo en territorio nacional. Este artículo es un informe de lo sucedido durante estas misiones. Es un reconocimiento a todas las personas involucradas y sus esfuerzos

Spanish troops deployed on international operations all over African tropical areas can be exposed to high-risk situations due to severe infectious diseases that can affect the population under their responsibility as well as to the possible use of biological weapons in current international conflicts. In this situation the Spanish Unified Defense Medical Command and, in this particular case, the Spanish Unit Medical Evacuation (UMAER) updated their NBC defense procedures since the beginning of these missions of Spanish armed forces in Africa. Initially the response capability to this biological threat was reinforced in these territories, and afterwards training was carried out for the possibility of MEDEVAC missions of patients with infectious diseases in order to receive definitive treatment on national territory. This article is a report of what happened during these missions. It is recognition of all people involved and their efforts

[Approaches of European and Russian legislation in the field of management of medical waste].

A comparative analysis of Russian and European legislation concerning to the waste management has been performed. There were revealed principal differences in Russian and European legislation in methodology of the waste classification. In Europe, there is no methodology for breaking up waste into hazard classes, and for the denomination of the danger there are used hazard lists which fail to give information about the extent of their danger. Medical waste in the European legislation are not selected into the separate category as being included in terms of articles and lists in the annexes to the directives or other legal acts. There are considered requirements of the Russian and European legislation in the area of the landfill waste burial. In the frameworks of the proposals for the implementation of international experience in the waste management there was drafted the project of Sanitary rules on hygiene requirements to the arrangement and the contents of landfills for residential solid waste, which includes requirements concerning not only residential solid waste, but also medical waste.

Health care waste management practice in Nepal.

UNLABELLED: The management of health care waste has become an urgent need to safeguard the public health from adverse effects caused due to improper management of healthcare waste. Healthcare waste management continues to present an array of challenges for developing countries, including Nepal. As the demand for healthcare facilities increases, there is also an increase in waste generation from these facilities. This situation requires an organized system of healthcare waste management to curb both public and occupational health risks. The aim of this paper is to explore the current situation of health care waste management practices in Nepal and its possible impacts on human health as well as recommend the best practices. KEYWORDS: health impact; legislation; risk and non-risk health care waste; waste management practice.

Tem algo podre no lixo?: A coleta do lixo em hospitais públicos de Brasília / Is there anything rotten in the garbage?: the waste sorting in public hospitals of Brasília

Este trabalho aborda a coleta de materiais recicláveis produzidos em hospitais do serviço de saúde pública do Distrito Federal (DF). O trabalho teve o objetivo de descobrir qual o destino dos materiais recicláveis que são gerados nesses locais, num cenário normativo em que é determinada a cada estabelecimento a elaboração de um Plano de Gerenciamento de Resíduos Sólidos de Saúde (PGRSS) - para tratar do manejo dos resíduos a fim de minimizar e racionalizar a sua produção, e proporcionar o seu encaminhamento seguro -, e que também obriga os órgãos públicos, daquela unidade federativa, a fazer a coleta seletiva de materiais recicláveis em suas dependências e a destinar estes materiais às associações ou cooperativas de catadores de materiais recicláveis, constituída por trabalhadores de baixa renda. Para alcançar o objetivo proposto foram feitas pesquisas nas legislações da esfera federal e do Distrito Federal, e material bibliográfico que tratam tanto dos resíduos sólidos, como da coleta seletiva e dos catadores de materiais recicláveis. Para completar a pesquisa foi feito um trabalho de campo em que foram realizadas entrevistas semi-estruturadas, com funcionários de hospitais públicos do DF, na Superintendência de Limpeza Urbana (SLU/DF), no Núcleo de Resíduos da Gerencia de Hotelaria da Secretaria de Estado de Saúde (NR/GH/SES/DF), na Central de Cooperativas dos Catadores de Material Recicláveis do Distrito Federal, e na empresa Capital Recicláveis Ltda.. Assim foram dadas explicações do que é e como funciona o PGRSS, a coleta seletiva de materiais recicláveis e o mercado de recicláveis, numa economia capitalista. Os resultados obtidos revelam que a implementação do PGRSS ainda é precária e os materiais recicláveis não são destinados aos catadores...

This work approaches the collection of recyclable materials, which are producedin hospitals that belong to the Federal District's public health system. The work aims at discovering the destination of the recyclables that are generated at those places, within a normative context, in which the elaboration of a Health Solid Waste Management Plan(PGRSS) is determined to each establishment - to deal with the handling of solid waste in order to minimize and rationalize its production, as well as to provide this safe delivery -, and that also obliges public agencies of the Federal District to ensure the waste sorting, in their buildings and to direct these materials to recycling collectingassociations or cooperatives, comprised by low-income workers. To reach this goal, researches in the legislations and bibliographic materials that approach solid waste, waste sorting and recycling collectors have been carried out in both federal and Federal District's spheres...

XVIII Congreso Español de Toxicología / No disponible

No disponible

Regulatory compliance in the dental office.

Dentists in the private sector, as well as their academic counterparts, must comply with a variety of federal, state, and local regulations. The scope of this regulation ranges from specifying who may engage in the practice of dentistry to the disposition of extracted teeth. In this review, some requirements imposed by various regulatory agencies are described. Because of the importance of state and local oversight, each clinician must determine what state and local requirements exist for them. A number of states have enacted various regulations that are more stringent than the federal versions. It is necessary, therefore, to seek appropriate local counsel regarding applicable statutes and regulations.

Determination of the best appropriate management methods for the health-care wastes in Istanbul.

Health-care waste management has been a significant problem in most economically developing countries as it is in Turkey. Most of the time, the main reason for the mismanagement of these wastes is the lack of appropriate legislation and effective control; other reasons are: financial strains and a lack of awareness. Being aware of the significance of the subject, in this paper the management of the health-care wastes in Istanbul, as a Metropolitan City of Turkey, was analyzed to create an integrated health-care waste management system in the city. Within the scope of the study, the existing situation and management practices such as the amount of the health-care wastes generated, segregation procedures, collection, temporary storage and transportation of the wastes within and outside of the institution were examined. Deficiencies, inconsistencies and improper applications were revealed. The existing Turkish Medical Wastes Control Regulation and institutional structure of the health-care waste management body were reviewed. After the evaluation and comparison with the requirements of other national and international organizations, items to be changed/added in the Regulation were identified. At the end of the study, the best management methods for the Istanbul City were determined and started to be applied at the institutions. After this study, the existing Regulation has been changed. The modified Regulation was published in 2005 and implementation has started. It is expected that by the application and implementation of the research outcomes, the management of health-care wastes in Istanbul and then in all over Turkey will be improved. The results obtained can also be used in most economically developing countries where there are similar environmental problems and strict budgets.

[Safe management of waste generated in health care institutions especially with infectious waste]. / Zasady bezpiecznego postepowania z odpadami w zakladach swiadczacych uslugi medyczne ze szczególnym uwzglednieniem odpadów zakaznych.

Health care institutions generate variable waste, including infectious. Since the microorganism can survive on non alive surfaces for up to dozen or so mouth infectious medical waste can be real health risk for patients and personnel. Then it is very important to prepare and introduce the plan of waste management. It must be done by the adequate team. The members of this committee should be representatives from all departments. The plan of management waste from health can institutions include the segregation of waste and management (collecting, storage, transport, neutralization).

[Biosafety and biosecurity in the medical laboratory. Update and trends]. / Biosiguranta si biosecuritatea în laboratorul medical. Actualitati si tendinte.

Biosafety includes the protective measures against the risks of contamination with pathogen germs in the laboratories that handle pathogens, or stock or manipulate potentially contaminated products, or perform microbiological tests for medical or scientific research purposes, as well as the means of protecting the environment and the human collectivities against hazard contaminations that have as starting point these laboratories. Besides, lately, a new notion emerged, that of biosecurity, which refers to the sum of measures designed to protect workers, environment and population against the loss, theft, use and release in the environment of pathogenic biological agents. The work overviews the present concerns for the regulation of these two notions and the way in which a system for the management of the biological risks in a laboratory that handles pathogens should be documented and implemented. The need for the continuous professional training of the staff and for the establishment of individual and collective responsibilities for preventing biosafety incidents and trespassing biosecurity rules are as well emphasized. The main biosafety measures are pointed out and a series of considerations regarding biosafety and bioterrorism in correlation with the medical laboratory are as well mentioned.

Vulnerabilidade dos geradores de resíduos de saúde frente às Resoluções n. 358 Conama e RDC n. 306 Anvisa / Vulnerability of Health Waste Generators in Light of CONAMA 358 and ANVISA RDC 306 Resolutions

No Brasil a questão dos resíduos de saúde passou a ter destaque após promulgação das resoluções n. 358 Conama – Conselho Nacional do Meio Ambiente e n. 306 Anvisa – Agência Nacional de Vigilância Sanitária a nível federal que atribuem aos geradores dos chamados resíduos contaminados de saúde a responsabilidade pelos serviços de coleta, transporte, tratamento e destinação final. Tal responsabilidade despertou muita discussão e questionamentos em todo o país, pois o serviço era realizado pelo estado sem grandes custos para os geradores. Com a divulgação das resoluções surgiram no mercado inúmeras empresas especializadas na prestação de tal serviço. Neste contexto observa-se a vulnerabilidade dos geradores diante do poder das resoluções e das empresas prestadoras de serviço. Assim o estudo analise a vulnerabilidade do gerador e relata mobilização das varias categorias de profissionais da saúde no município de Londrina para o comprimento das legislações e sair da posição de vulnerabilidade. Formou-se uma Organização da Sociedade Civil de Interesse Público - Oscip que gerenciará as questões dos resíduos de saúde. Para solucionar as questões emergências, foi contratada uma empresa, outra Oscip, que realizara a coleta, tratamento, e destino final dos resíduos. Paralelamente ações de educação ambiental, são realizadas, com o objetivo de diminuir a geração de resíduos. Deste modo, conclui-se que a mobilização das várias categorias do setor saúde foi produtiva para solução de uma situação de conflito e vulnerabilidade, onde o caráter social e educação ambiental foram palavras-chave.

Managing hazardous waste in the laboratory.

This article offers an introduction to the federal U.S. Environmental Protection Agency (EPA) regulations as they relate to hazardous wastes generated by clinical and anatomic pathology laboratories. Traditionally, the EPA has targeted "heavy" industries such as manufacturing for compliance auditing, but it recently turned an eye toward health-care facilities since they are identified as important sources of hazardous waste generation. Enforcement of EPA regulations within health-care facilities presents the challenge of a new labyrinth of definitions, rules, and compliance methods for laboratorians who have already made it through other regulatory agency mazes, including the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards, the College of American Pathologists (CAP) checklists, and the Occupational Safety and Health Administration (OSHA) standards.

Legal regulation of clinical waste in the community.

The European Union has led the way in regulating the management of waste and has compelled member states, including the United Kingdom, to introduce legislation to ensure that risks to public health and the environment from waste is minimized. Waste management is now highly regulated and it is essential that district nurses comply with the regulations when disposing of waste produced in the course of treating patients. This article describes how the health and safety, waste and carriage legislation governs how district nurses handle clinical and hazardous waste in the community.