[Dental waste management in municipal health clinics in Belo Horizonte, Brazil]. / Gerenciamento de resíduos sólidos de odontologia em postos de saúde da rede municipal de Belo Horizonte, Brasil.

OBJECTIVE: To investigate whether municipal health clinics in the city of Belo Horizonte, Brazil, comply with the legal requirements for managing dental wastes. METHOD: We collected information from 54 of the city's 105 municipal health clinics that provide dental care. At each clinic we interviewed the clinic manager, one dental assistant, and one general assistant. Based on the requirements outlined in the Belo Horizonte Health Waste Management Manual, we assessed characteristics in the following three areas: (1) technical and operational (waste classification and characterization, minimization, segregation, pretreatment, conditioning, collection and internal and external transportation, and external storage); (2) general and organizational (inspection, amount of clinic space, environmental permits, floor plan showing waste-generating areas, and whether the clinic had a technical specialist responsible for managing the health wastes); and (3) human resources (employee vaccination records and oversight, occupational safety and occupational medicine program, environmental risk prevention program, medical oversight and occupational health program, hospital (clinic) infection control committee, and training in health waste management). RESULTS: The clinics produced an average of 270 liters of solid waste per day. None of the clinics surveyed had a plan for managing health wastes. The only requirements with which all the clinics complied were: segregation of needles and mercury, adequately identified cardboard containers used for disposal of cutting and piercing items, and daily internal collection and transportation of wastes. CONCLUSIONS: When the risks associated with each class of waste have not been established, all the wastes should be considered potentially dangerous. Further, a law by itself does not guarantee that the public's health will be protected. Before public agencies impose legal requirements, it is necessary to know if the agencies themselves are capable of enforcing those requirements. Any proposed waste management legislation should be based on scientific research.

Gerenciamento de resíduos sólidos de odontologia em postos de saúde da rede municipal de Belo Horizonte, Brasil / Dental waste management in municipal health clinics in Belo Horizonte, Brazil

Objective. To investigate whether municipal health clinics in the city of Belo Horizonte, Brazil, comply with the legal requirements for managing dental wastes. Method. We collected information from 54 of the city's 105 municipal health clinics that provide dental care. At each clinic we interviewed the clinic manager, one dental assistant, and one general assistant. Based on the requirements outlined in the Belo Horizonte Health Waste Management Manual, we assessed characteristics in the following three areas: (1) technical and operational (waste classification and characterization, minimization, segregation, pretreatment, conditioning, collection and internal and external transportation, and external storage); (2) general and organizational (inspection, amount of clinic space, environmental permits, floor plan showing wastegenerating areas, and whether the clinic had a technical specialist responsible for managing the health wastes); and (3) human resources (employee vaccination records and oversight, occupational safety and occupational medicine program, environmental risk prevention program, medical oversight and occupational health program, hospital (clinic) infection control committee, and training in health waste management). Results. The clinics produced an average of 270 liters of solid waste per day. None of the clinics surveyed had a plan for managing health wastes. The only requirements with which all the clinics complied were: segregation of needles and mercury, adequately identified cardboard containers used for disposal of cutting and piercingitems, and daily internal collection and transportation of wastes. Conclusions. When the risks associated with each class of waste have not been established, all the wastes should be considered potentially dangerous. Further, a law by itself does not guarantee that the public's health will be protected. Before public agencies impose legal requirements, it is necessary to know if the agencies themselves are capable of enforcing those requirements. Any proposed waste management legislation should be based on scientific research

Objetivo. Verificar a conformidade do processo de gerenciamento dos resíduos sólidos odontológicos pelas unidades básicas de saúde da rede municipal de Belo Horizonte frente à legislação vigente. Método. Foram avaliadas 54 unidades básicas de saúde das 105 unidades da rede municipal foram entrevistados o gerente, um atendente de consultório dentário e um auxiliar de serviços gerais. Com base nos requisitos estabelecidos pelo Manual de Gerenciamento de Resíduos de Serviços de Saúde de Belo Horizonte, foram avaliados os seguinte aspectos: técnicos e operacionais (classificação e caracterização dos resíduos, processos de minimização, segregação, tratamento prévio, acondicionamento, coleta e transporte internos e externos e abrigo externo); gerais e organizacionais (fiscalização, área construída, licenciamento ambiental, planta baixa com discriminação das áreas geradoras de resíduos e presença de responsável técnico); recursos humanos (registro e controle de vacinação dos trabalhadores, programa de segurança e medicina do trabalho, programa de prevenção de riscos ambientais, programa de controle médico e saúde ocupacional, comissão de controle de infecção hospitalar e treinamento em manejo de resíduos de serviços de saúde). Resultados. Cada unidade básica de saúde gerava uma média de 270 litros de resíduos por dia. Nenhuma possuía um plano de gerenciamento de resíduos de serviços de saúde. Os únicos itens em conformidade com a legislação em todas as unidades foram: as agulhas e o mercúrio eram segregados; eram utilizados recipientes de papelão resistente com simbologia adequada para acondicionamento dos resíduos perfurocortantes; e a coleta e transporte internos de resíduos eram feitos diariamente. Conclusão. Enquanto não forem estabelecidos os riscos reais de cada classe de resíduos, todas deveriam ser consideradas como potencialmente perigosas. Por outro lado, uma lei em vigor por si só não garante que a saúde da população preciso verificar até que ponto os órgãos públicos estão preparados para cumpri-las. A realização de pesquisas sobre gerenciamento de resíduos é importante para fundamentar a legislação