ABSTRACT
PURPOSE OF REVIEW: The healthcare sector has a substantial environmental footprint, and the delivery of anesthesia contributes significantly. Inhaled anesthetics themselves are potent greenhouse gases, unused intravenous medication exert toxic effects on the environment, and the increasing reliance on single-use devices has led to an ever-growing amount of solid waste produced in operating rooms. This review discusses many of these environmental impacts and suggests practices to mitigate the environmental footprint of anesthetic practice. RECENT FINDINGS: The choice of anesthesia maintenance has significant environmental implications, with nitrous oxide and desflurane having the highest carbon footprint of all anesthetic agents. Using low fresh gas flows and supplementing or replacing inhalational agents with propofol leads to a significant reduction in emissions. Many intravenous anesthetic agents pose a risk of environmental toxicity, and efforts should be made to decrease medication waste and ensure appropriate disposal of unused medications to minimize their environmental impacts. Additionally, consideration should be given to replacing single-use devices in the operating rooms with reusable alternatives that are often both environmentally and economically superior. And solid waste generated in the operating room should be segregated thoughtfully, as processing regulated medical waste is a highly energy-intensive process. SUMMARY: Significant opportunities exist to improve the environmental footprint of anesthesia practice, and with the rapidly worsening climate crisis, the importance of implementing changes is greater than ever.
Subject(s)
Operating Rooms , Humans , Anesthetics, Inhalation/adverse effects , Anesthetics, Inhalation/administration & dosage , Carbon Footprint , Medical Waste Disposal/methods , Medical Waste/adverse effects , Medical Waste/prevention & control , Environment , Anesthesia/adverse effects , Anesthesia/methods , Greenhouse Gases/adverse effectsSubject(s)
Carbon Footprint , Climate Change , Conservation of Natural Resources , Gastroenterology , Gastrointestinal Diseases , Medical Waste Disposal , Medical Waste , Disposable Equipment , Equipment Reuse , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/therapy , Humans , Medical Waste/adverse effects , RecyclingABSTRACT
OBJECTIVE: The aim of the study was to investigate the potential effects of waste anesthetic gas (WAG) on oxidative stress, DNA damage, and vital organs. METHODS: A total of 150 members of the staff at a hospital were assigned to an exposure group or control group. The 68 operating room (OR) staff in the exposure group were exposed to WAG, and the 82 non-OR staff in the control group were not exposed to WAG. Air samples were collected in the OR, and the sevoflurane concentrations in the samples were determined. Superoxide dismutase (SOD), glutathione peroxidase (GSH-px), and malondialdehyde (MDA) in plasma from the participants were determined to assess oxidative stress. Western blot analysis was used to detect γH2AX in peripheral blood to assess DNA damage. Hematopoietic parameters, liver function, kidney function, and changes in electrophysiology were assessed to identify the effects on the vital organs. RESULTS: The mean (±standard deviation) sevoflurane concentration in 172 air samples from 22 operating rooms was 1.11 ± 0.65 ppm. The superoxide dismutase activity and vital organ parameters (lymphocyte, hemoglobin, and total protein concentrations and heart rate) were significantly lower (P < 0.05) in the exposed group than the control group. The malondialdehyde, total bilirubin, and creatinine concentrations and QT and QTc intervals were significantly higher (P < 0.05) in the exposed group than the control group. There were no significant differences between the glutathione peroxidase activities and γH2AX concentrations for the exposed and control groups. CONCLUSIONS: Long-term occupational exposure to waste anesthetic gas may affect the antioxidant defense system and probably affects vital organ functions to some extent. No correlation between DNA damage and chronic exposure to WAG was observed.
Subject(s)
Anesthetics/adverse effects , Occupational Exposure/adverse effects , Oxidative Stress/drug effects , Adult , Air Pollutants/adverse effects , Air Pollutants/analysis , Anesthetics/analysis , Case-Control Studies , China , Cross-Sectional Studies , DNA Damage , Female , Gases , Humans , Inhalation Exposure/adverse effects , Inhalation Exposure/analysis , Male , Medical Waste/adverse effects , Middle Aged , Occupational Exposure/analysis , Operating Rooms , Organs at Risk/physiology , Oxidative Stress/genetics , Sevoflurane/adverse effects , Young AdultABSTRACT
BACKGROUND: The risk of hepatitis B virus infection among medical waste handlers who undergo collection, transportation, and disposal of medical wastes in the health institutions is higher due to frequent exposure to contaminated blood and other body fluids. There is limited evidence on the seroprevalence of hepatitis B among medical waste handlers in eastern Ethiopia. The study was aimed at studying the seroprevalence of Hepatitis B Virus and associated risk factors among medical waste collectors at health facilities of eastern Ethiopia. METHODS: A facility-based cross-sectional study was conducted among randomly selected medical waste collectors from public health facilities in eastern Ethiopia from March to June 2018. A pre-tested and well-structured questionnaire was used to collect data on socio-demographic characteristics and hepatitis B infection risk factors. A2.5ml venous blood was also collected, centrifuged and the serum was analyzed for hepatitis B surface antigen using the instant hepatitis B surface antigen kit. Descriptive summary measures were done. Chi-square and Fisher exact tests were used to assess the risk of association. Multivariate logistic regression was conducted with 95% CI and all value at P-value < 0.05 was declared statistically significant. RESULTS: From a total of 260 (97.38%) medical waste collectors participated, HBV was detected in 53 (20.4%) of the participants [95%CI; 15.8, 25.6]. No significant differences were observed in the detection rates of HBV with respect to socio-demographic characteristics. In both bivariate and multivariable logistic regression analysis, being unvaccinated (AOR = 6.35; 95%CI = [2.53-15.96], P = 0.001), history of blood transfusion (receiving) (AOR; 3.54; 95%CI; [1.02-12.24], P = 0.046), history of tattooing (AOR = 2.86; 95%CI = [1.12-7.27], p = 0.03), and history of multiple sexual partner (AOR = 10.28; 95%CI = [4.16-25.38], P = 0.001) remained statistically significantly associated with HBsAg positivity. CONCLUSION: This cross-sectional study identified that HBV infection is high among medical waste collectors in eastern Ethiopia. Immunization and on job health promotion and disease prevention measures should be considered in order to control the risk of HBV infection among medical waste collectors in eastern Ethiopia.
Subject(s)
Hepatitis B/epidemiology , Housekeeping, Hospital/statistics & numerical data , Medical Waste Disposal/statistics & numerical data , Occupational Exposure/statistics & numerical data , Personnel, Hospital/statistics & numerical data , Adult , Community Health Centers/statistics & numerical data , Cross Infection/blood , Cross Infection/epidemiology , Cross Infection/etiology , Cross-Sectional Studies , Educational Status , Ethiopia/epidemiology , Female , Health Knowledge, Attitudes, Practice , Hepatitis B/blood , Hepatitis B/etiology , Hepatitis B Surface Antigens/blood , Hepatitis B virus/isolation & purification , Hepatitis B virus/physiology , Hospitals, Public/statistics & numerical data , Humans , Male , Medical Waste/adverse effects , Medical Waste/statistics & numerical data , Middle Aged , Occupational Exposure/analysis , Public Facilities/statistics & numerical data , Risk Factors , Seroepidemiologic Studies , Socioeconomic Factors , Surveys and Questionnaires , Young AdultABSTRACT
It is currently a critical period for the prevention and control of the COVID-19 pandemic. Since the medical waste disposal could be an important way to control the source of infection, standardization, and strict implementation of the management of COVID-19 related medical waste should be with careful consideration to reduce the risk of epidemic within hospitals. This study illustrates the practice of medical waste disposal responding to the 2019-2020 novel coronavirus pandemic.
Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Infection Control/standards , Medical Waste Disposal/standards , Medical Waste/adverse effects , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Betacoronavirus/pathogenicity , COVID-19 , Hospitals, General/standards , Humans , SARS-CoV-2ABSTRACT
Since the 1960s, plastic has been used in the production of medical equipment and products that improve patient comfort, safety, and treatment. Yet an unwelcome challenge has emerged in the years since: how to safely dispose of this material without negatively affecting human health and the environment. Working with medical devices and supplies that are constructed using plastics, nurses are at the forefront of this issue and must identify solutions, collaborate with other health care workers, and lead efforts to establish more sustainable options. This series is in collaboration with the Alliance of Nurses for Healthy Environments (https://envirn.org).
Subject(s)
Conservation of Natural Resources , Medical Waste/adverse effects , Plastics , Waste Management , Delivery of Health Care , Humans , Nursing Staff/organization & administrationABSTRACT
BACKGROUND: Hepatitis B virus (HBV) infection is a significant occupational hazard in health care settings and represents a public health concern. The aim of this study was to investigate the association between medical waste handling and HBV infection by conducting a meta-analysis of available evidence. METHODS: Pooled odds ratios (ORs) and confidence intervals (CIs) of the included studies were calculated, using the random-effects model, for medical waste handlers versus non-medical waste handlers. Publication bias was detected using the regression test for funnel plot asymmetry, and quality assessment was conducted according to the Newcastle-Ottawa Scale. RESULTS: Nine cross-sectional studies, published between 1992 and 2018, were included. Medical waste handling was associated with higher odds of HBV infection compared to non-medical waste handling (pooled ORâ¯=â¯2.88; 95% CI, 1.40-5.93; I2â¯=â¯61.36%; P value for heterogeneityâ¯=â¯.008). Subgroup analysis showed higher odds of HBV infection in studies conducted in Africa (pooled ORâ¯=â¯3.61; 95% CI, 1.19-11.00). Most studies were of poor to fair quality; yet, little evidence of publication bias was detected (P value for publication biasâ¯=â¯.983). No single study showed a substantial impact on the pooled results. CONCLUSIONS: The present meta-analysis supports the suggestion that medical waste handling is associated with HBV infection. This association was shown to be more obvious in African health care settings.
Subject(s)
Hepatitis B/etiology , Medical Waste/adverse effects , Medical Waste/statistics & numerical data , Africa , Cross-Sectional Studies , Hepatitis B/virology , Hepatitis B virus/pathogenicity , Humans , Risk FactorsABSTRACT
A possible tool to reduce nosocomial infections is to identify unknown sources of contamination and then to provide a measure for controlling the related infections. In this study, solid hospital waste was considered a potential source of contamination, and a strategy to reduce the potential risk of pathogen contamination was tested. This paper describes a novel technique for waste management in healthcare settings with a view to facilitating infection prevention and control. We explored the innovative use of sodium dichloroisocyanurate (NaDCC) by investigating the microbicidal activity of chlorine, which derives from the hydrolysis of NaDCC mediated by humidity, and by testing its effect on the inhibition of microorganism growth. NaDCC was inserted in a solid hospital waste bin containing also Lauria-Bertani agar plates, with different dilutions of a known titre of three different microorganisms, namely Escherichia coli, Staphylococcus aureus and Aspergillus brasiliensis. The plates were incubated in the container with or without the antimicrobial agent (control, CNT) at room temperature for 5 days. The number of colony-forming units (CFUs) present on each plate was then counted. Microorganisms capable of proliferating in the CNT waste bin were not able to grow in the presence of NaDCC. Furthermore, the molecular chlorine which developed and was released in the waste bin under the experimental conditions (T=20°C, t=5 days) was quantified using iodometric titration. NaDCC hydrolysis, mediated by humidity, has a strong and long-lasting microbicide effect. The proliferation of tested bacteria and fungi is totally inhibited. These results demonstrate the effectiveness of NaDCC in controlling and/or inhibiting microbial proliferation and support its possible use in the treatment of hospital waste to control the spread of nosocomial contamination.
Subject(s)
Cross Infection/prevention & control , Disinfectants/pharmacology , Environmental Microbiology , Hazardous Waste , Medical Waste Disposal/methods , Medical Waste , Refuse Disposal/methods , Solid Waste , Triazines/pharmacology , Aspergillus/drug effects , Colony Count, Microbial , Cross Infection/transmission , Escherichia coli/drug effects , Hazardous Waste/adverse effects , Humans , Medical Waste/adverse effects , Medical Waste Disposal/instrumentation , Molecular Structure , Refuse Disposal/instrumentation , Solid Waste/adverse effects , Staphylococcus aureus/drug effects , Triazines/chemistry , VolatilizationABSTRACT
Hospital effluents contain myriad of mutagens and genotoxins capable of increasing DNA damage in aquatic biota. African mudfish, Clarias gariepinus, are exposed to genotoxins when cultured in swamps and derelict water bodies often contaminated by effluents. Moreover, its DNA is susceptible to xenobiotic-induced lesions since it lacks L-gulonolactone oxidase and hence cannot synthesize L-ascorbic acid. This study investigated 96-h acute toxicity and protective effects of dietary ascorbic acid (AA) against micronucleus (MN) and abnormal nuclear (NAs) formation in C. gariepinus exposed to sub-lethal concentrations of hospital effluent. Six concentrations (0.5-3.0%) of the effluent were selected to determine the 96-h acute toxicity of the effluent in C. gariepinus, after range finding test. Fish were exposed to sub-lethal concentrations (0.08-1.30%) of the 96 h LC50. Two other groups were exposed to the 96 h LC50 (1.30%) of the effluent +50 and +100 mg/kg of dietary ascorbic for 7 days, and MN and NAs assessed in peripheral erythrocytes. The 96 h LC50 (1.30%) was 1.18 times more toxic than the 24 h LC50 (1.54%), indicating that the toxicity of the effluent increased with exposure duration. MN, nuclear bud, enucleated, fragmented nucleus (apoptosis), and necrotic erythrocytes significantly increase in effluent treated fish. Dietary AA reduced MN from 6.35-fold (1.30% treated group) to 3.72-fold (1.30% + 50 mg AA) and 3.54-fold (1.30% + 100 mg AA). Also, AA reduced total NAs from 2.26-fold (1.30%) to 1.40-fold (1.30% + 50 mg AA) and 1.06-fold (1.30% + 100 mg AA) compared to the control. Heavy metals and physicochemical parameters analyzed in the tested effluent possibly induced the mortality and cytogenotoxicity in C. gariepinus, and this was ameliorated by dietary AA.
Subject(s)
Ascorbic Acid/pharmacology , Catfishes , Cell Nucleus Shape/drug effects , Medical Waste/adverse effects , Micronuclei, Chromosome-Defective , Water Pollutants, Chemical/toxicity , Animal Feed/analysis , Animals , Cell Nucleus , Diet/veterinary , Dietary Supplements , Erythrocytes/drug effects , Hospitals , Micronucleus Tests , Oxidative Stress/drug effectsABSTRACT
Introduction With the growing number of oral targeted therapies being approved for use in cancer therapy, the potential for long-term administration of these drugs to cancer patients is expanding. The use of these drugs in the home setting has the potential to expose family members and caregivers to them either through direct contact with the drugs or indirectly by exposure to the parent compounds and/or their active metabolites in contaminated patients' waste. Methods A systematic literature review was performed and the known adverse health effect of 32 oral targeted therapeutics is summarized. In particular, the carcinogenicity, genotoxicity, and embryo-fetal toxicity, along with the route of excretion were evaluated. Results Carcinogenicity testing has not been performed on most of the oral targeted therapeutics and the genotoxicity data are mixed. However, the majority of these drugs exhibit adverse reproductive effects, some of which are severe. Currently, available data does not permit the possibility of a health hazard from inappropriate handling of drugs and contaminated patients waste to be ignored, especially in a long-term home setting. Further research is needed to understand these issues. Conclusions With the expanding use of targeted therapies in the home setting, family members and caregivers, especially those of reproductive risk age, are, potentially at risk. Overall basic education and related precautions should be taken to protect family members and caregivers from indirect or direct exposure from these drugs. Further investigations and discussion on this subject are warranted.
Subject(s)
Antineoplastic Agents/adverse effects , Medical Waste/adverse effects , Molecular Targeted Therapy/adverse effects , Neoplasms/drug therapy , Safety , Administration, Oral , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/metabolism , Carcinogens , Caregivers , Family , Fetus/drug effects , Humans , Mutagens , TeratogensABSTRACT
BACKGROUND: Large amounts of expired and unused medications accumulate in households. This potentially exposes the public to hazards due to uncontrolled use of medications. Most of the expired or unused medications that accumulate in households (household medical waste) is thrown to the garbage or flushed down to the sewage, potentially contaminating waste-water, water resources and even drinking water. There is evidence that pharmaceutical active ingredients reach the environment, including food, however the risk to public health from low level exposure to pharmaceuticals in the environment is currently unknown. In Israel, there is no legislation regarding household medical waste collection and disposal. Furthermore, only less than 14 % of Israelis return unused medications to Health Maintenance Organization (HMO) pharmacies. METHODS: In this study, we investigated world-wide approaches and programs for household medical waste collection and disposal. RESULTS: In many countries around the world there are programs for household medical waste collection. In many countries there is legislation to address the issue of household medical waste, and this waste is collected in hospitals, clinics, law enforcement agencies and pharmacies. Furthermore, in many countries, medication producers and pharmacies pay for the collection and destruction of household medical waste, following the "polluter pays" principle. CONCLUSIONS: Several approaches and methods should be considered in Israel: (a) legislation and regulation to enable a variety of institutes to collect household medical waste (b) implementing the "polluter pays" principle and enforcing medical products manufactures to pay for the collection and destruction of household medical waste. (c) Raising awareness of patients, pharmacists, and other medical health providers regarding the health and environmental risks in accumulation of drugs and throwing them to the garbage, sink or toilet. (d) Adding specific instructions regarding disposal of the drug, in the medication label and leaflet. (e) Examining incentives for returning medications to pharmacies. (f) Examining drug collection from deceased in retirement homes and hospitals.
Subject(s)
Medical Waste Disposal/methods , Pharmaceutical Preparations , Drug Storage , Global Health , Health Knowledge, Attitudes, Practice , Humans , Israel , Medical Waste/adverse effects , Medical Waste Disposal/legislation & jurisprudenceABSTRACT
Infection with the hepatitis B and C viruses may occur through contact with infected body fluids, including injury with infected sharps. Collectors of domestic or healthcare wastes are potentially exposed to these infections. The aim of this article is to investigate the risk factors associated with the prevalence of hepatitis B and C viruses (HBV and HCV) infection among domestic and healthcare waste workers in Belo Horizonte, Brazil. A cross-sectional study of hepatitis B and C infection was conducted from November 2014 to January 2015, through blood sample collection and interviews about socio-demographic factors with 61 workers exposed to healthcare waste ('exposed') and 461 exposed only to domestic wastes ('unexposed'). The prevalence of antibodies to HCV (Anti-HCV) antibodies was 3.3% in 'exposed' workers and 0.9% in 'unexposed', and of antibody to hepatitis B core antigen (Anti-HBc) was 9.8% and 5.6% in 'exposed' and 'unexposed' workers, respectively. Only 207 (44.9%) of those exposed to domestic waste and 45 (73.8%) of those handling healthcare waste were effectively immunised against hepatitis B virus (HBV). Exposures to domestic waste and to healthcare wastes were associated with similar risks of infection with HBV. The risk of hepatitis C virus (HCV) infection was marginally higher among healthcare waste workers compared with domestic waste workers, probably because of needlestick accidents owing to deficient sharps management systems. Immunisation against hepatitis B and screening tests to ensure the success of vaccination should be a condition for recruitment for both groups of waste workers.
Subject(s)
Allied Health Personnel , Hepacivirus/isolation & purification , Hepatitis B virus/isolation & purification , Hepatitis B/epidemiology , Hepatitis C/epidemiology , Occupational Exposure , Adult , Allied Health Personnel/statistics & numerical data , Brazil/epidemiology , Cross-Sectional Studies , Female , Hepatitis B/virology , Hepatitis C/virology , Humans , Male , Medical Waste/adverse effects , Medical Waste Disposal , Middle Aged , Prevalence , Risk Factors , Seroepidemiologic Studies , Waste ManagementABSTRACT
Los residuos sanitarios representan un peligro potencial para los trabajadores sanitarios. Dado el alto riesgo de infección en los accidentes laborales, la gestión correcta de los residuos sanitarios minimiza el riesgo y mejora las condiciones laborales y ambientales. Objetivos. Identificar el nivel de conocimiento que tienen los profesionales sanitarios, en relación con la clasificación y gestión avanzada de los residuos sanitarios (RS) y valorar de forma global la gestión de los mismos. Metodología. Estudio descriptivo transversal con 178 participantes (auxiliares, enfermeras, médicos y técnicos de laboratorio), de 3 hospitales de la provincia de Barcelona. Se utilizó un cuestionario de elaboración propia, que analizabalas variables laborales, el conocimiento y la valoración global de la gestión de los RS. Resultados. El nivel medio de conocimiento sobre los RS delos auxiliares, las enfermeras, los médicos y los técnicos de laboratorio, en una escala de 1 (valor mínimo) a 15 (valor máximo), es de 10.59, 10.61, 8.92 y 8.39, respectivamente. La valoración global que hacen los auxiliares, las enfermeras, los médicos y los técnicos de laboratorio de la gestión de los RS en una escala de 1 (valor mínimo) y 5 (valor máximo), es de 2.89, 2.93, 2.88, 2.94, respectivamente. Conclusiones. Los resultados sugieren que las enfermeras y los auxiliares tienen un nivel de conocimiento aceptable con respecto a la gestión correcta de los RS. En cambio, los médicos y técnicos de laboratorio tienen un nivel de conocimiento inferiorsobre la segregación y eliminación adecuada de los RS. En cuanto a la valoración global, se obtienen valores aceptables, y muy similares, entre las diferentes categorías de profesionales estudiadas, en relación con la gestión correcta de los RS en los centros asistenciales donde realizan su actividad laboral (AU)
The sanitary waste represents a potential hazard for health workers. Given the high risk of infection in labor accidents, the correct management of sanitary waste minimizes this risk and improves labor and environment conditions. Objective. The current study was aimed at identifying the knowledge that health workers have about classification and management of sanitary waste. Methodology. The current study is a descriptive, cross-sectional study of 178 health workers (physicians, nurses, nurse assistants, lab technicians) of 3 hospitals in Barcelona. Results. Using a score from 1 (minimum) to 15 (maximum) to assess the knowledge, the average value for nurse assistants, nurses, physicians and lab technicians was 10.59, 10.61, 8.92 and 8.39, respectively. The global assessment of sanitary waste management (using a score from 1 to 5) was 2.89, 2.93, 2.88 and 2.94, respectively. Conclusions. These results suggest that nurses and nurse assistants have a good level of knowledge about the management of sanitary waste. By contrast, physicians and laboratory technicians have a lower level of knowledge compared to nurses and nurse asistants in relation to segregation and disposal of sanitary waste. Concerning the global assessment, the level is good, without differences between the different categories of health workers (AU)
Subject(s)
Female , Humans , Male , Waste Management/ethics , Waste Management/instrumentation , Medical Waste/adverse effects , Medical Waste/classification , Nursing Staff, Hospital/education , Nursing Staff, Hospital/supply & distribution , Public Health/methods , Waste Management/methods , Waste Management/standards , Medical Waste/analysis , Medical Waste/prevention & control , Nursing Staff, Hospital/psychology , Nursing Staff, Hospital/standards , Public Health , Spain/ethnologyABSTRACT
The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO's recommended standards.
Subject(s)
Medical Waste Disposal/standards , Medical Waste/adverse effects , Hospitals/statistics & numerical data , Medical Waste Disposal/methods , TanzaniaABSTRACT
The annual production of waste in health care institutions (HCI) tends to increase because of the growth of health care provision for population. Among the many criteria for selecting the optimal treatment technologies HCI is important to provide epidemiological and chemical safety of the final products. Environmentally friendly method of thermal disinfection of medical waste may be sterilizators of medical wastes intended for hospitals, medical centers, laboratories and other health care facilities that have small and medium volume of processing of all types of waste Class B and C. The most optimal method of centralized disposal of medical waste is a thermal processing method of the collected material.
Subject(s)
Incineration , Medical Waste Disposal , Medical Waste , Chemical Safety/standards , Conservation of Natural Resources/methods , Disinfection , Environmental Pollution/analysis , Environmental Pollution/prevention & control , Humans , Medical Waste/adverse effects , Medical Waste/analysis , Medical Waste/classification , Medical Waste Disposal/methods , Medical Waste Disposal/standards , RussiaABSTRACT
Mercury, one of the most toxic heavy metals, is ubiquitous in environment. The adverse health impact of mercury on living organisms is well known. The health care facilities are one of the important sources of mercury release into the atmosphere as mercury items are extensively used in hospitals. To assess the awareness about mercury toxicity and the knowledge of proper handling and disposal of mercury-containing items in health care set-up, a questionnaire-based survey was carried out amongst doctors (n = 835), nurses (n = 610) and technicians (n = 393) in government hospitals, corporate hospitals and primary health care centres in the Indian states of Delhi, Uttar Pradesh and Haryana. The study was conducted using a tool-containing pretested structured multiple-choice questionnaire. Analysis of the results using STATA 11.1 software highlighted that overall awareness was more in corporate sector. However, percentage range of knowledge of respondents irrespective of health care sector was only between 20 and 40%. Despite the commitment of various hospitals to be mercury free, mercury containing-thermometer/sphygmomanometer are still preferred by health professionals. The likely reasons are availability, affordability, accuracy and convenience in use. There is an urgent need for source reduction, recycling and waste minimization. Emphasis must be laid on mercury alternative products, education and training of health personnel and public at large, about correct handling and proper clean up of spills.