Knowledge, attitude and practice of health-care waste management and associated health risks in the two teaching and referral hospitals in Kenya.

Hazardous health-care waste poses a great danger to public health and the environment if it is not properly managed. There is need for health-care workers involved in its management to understand the integral link between human health and environmental health. This study was done to identify gaps in knowledge, attitude and practice among the healthcare workers involved in its management hence endangering public health and polluting the environment. A self administered questionnaire was used in both Kenyatta National Hospital, Nairobi and Moi Teaching and Referral Hospital, Eldoret to clinicians, nurses, laboratory technologists and hospital attendants to identify the gaps with a focus on their knowledge, attitude and practice. It was found that health and safety in health-care waste management, was not included in most of the curricula for training the three healthcare professionals. Most of them acquired this through on-job training from seminars and informally through organized talks at work-places. The hospital attendants had also an opportunity to acquire the knowledge through organized training at work places. The training improved the workers' compliance to hepatitis B vaccinations and use of personal protective equipment when handling health-care waste. There was also reduction on injuries from health-care waste. This study therefore concludes that it is necessary for healthcare workers training curricula to include health and safety issues while managing hazardous health-care waste as well as establishes the need for healthcare institutions to conduct continuing education on health and safety in the management of health-care waste.

Health-care waste incineration and related dangers to public health: case study of the two teaching and referral hospitals in Kenya.

There are practically no low cost, environmentally friendly options in practice whether incineration, autoclaving, chemical treatment or microwaving (World Health Organisation in Health-care waste management training at national level, [2006] for treatment of health-care waste. In Kenya, incineration is the most popular treatment option for hazardous health-care waste from health-care facilities. It is the choice practiced at both Kenyatta National Hospital, Nairobi and Moi Teaching and Referral Hospital, Eldoret. A study was done on the possible public health risks posed by incineration of the segregated hazardous health-care waste in one of the incinerators in each of the two hospitals. Gaseous emissions were sampled and analyzed for specific gases the equipment was designed and the incinerators Combustion efficiency (CE) established. Combustion temperatures were also recorded. A flue gas analyzer (Model-Testos-350 XL) was used to sample flue gases in an incinerator under study at Kenyatta National Hospital--Nairobi and Moi Teaching and Referral Hospital--Eldoret to assess their incineration efficiency. Flue emissions were sampled when the incinerators were fully operational. However the flue gases sampled in the study, by use of the integrated pump were, oxygen, carbon monoxide, nitrogen dioxide, nitrous oxide, sulphur dioxide and No(x). The incinerator at KNH operated at a mean stack temperature of 746 °C and achieved a CE of 48.1 %. The incinerator at MTRH operated at a mean stack temperature of 811 °C and attained a CE of 60.8 %. The two health-care waste incinerators achieved CE below the specified minimum National limit of 99 %. At the detected stack temperatures, there was a possibility that other than the emissions identified, it was possible that the two incinerators tested released dioxins, furans and antineoplastic (cytotoxic drugs) fumes should the drugs be subjected to incineration in the two units.

Rapid analysis of polyolefin antioxidants and light stabilisers by supercritical fluid chromatography.

Nineteen commercial antioxidants and light stabilisers, with a wide range of relative molecular masses and boiling-points, present in polyolefins were analysed by packed column supercritical fluid chromatography on four different phases with CO2 or 10% MeOH-CO2 as the mobile phase and with UV detection. The technique is shown to yield short analysis times and sufficient resolution for a number of additives present in a given polyolefin.