Hospital waste: can we reduce the environmental impact of a large university hospital?

Introduction: As technology advances, society must reflect on the destination of materials which are no longer needed. Hospital waste requires special attention due to the associated risk of disease transmission and biological accidents. Also, it tends to increase proportionally to the economic development and is associated with increased use of disposable material. The purpose of this study is to analyze the management of hospital waste at the Hospital de Clínicas de Porto Alegre (HCPA) and to evaluate the effectiveness and feasibility of the measures adopted by the institution to mitigate the impact of its waste on the environment. Methods: Observational study with field research. Hospital waste management is divided into generation, disposal, storage and final destination. Results: Between 2010 and 2015, the HCPA produced 21.4 tons of biological and sharps waste, 23,000 liters of chemical waste and 113,9 tons of solid waste per month. The main improvements include the implementation of a inspection of the hospital's waste bins every 2 months, a reduction from 29.42% to 2.79% in the rate of inappropriate disposal of hazardous waste, a 313% increase in investments in staff training, the expansion and adaptation of external areas for temporary storage of hospital waste and the collection of more than 1 ton of waste generated by the local community (sharps, X-ray films, kitchen oil, batteries), as well as the establishment of contracts which will guarantee the appropriate treatment of all types of health care waste. Conclusions: These results demonstrate that mitigating the impact of hospital waste on the environment is possible and should encourage the adoption of similar measures at other institutions (AU)

Os portos na nova economia global: uma proposta de gestão ambiental estratégica para a promoção da sustentabilidade e da saúde em cidades portuárias / Ports in the new global economy a proposal of strategic environmental management to promote health and sustainability in port cities

O desenvolvimento portuário tem desdobramentos diretos nos municípios onde estão inseridos, a bibliografia sobre o tema indica que os processos históricos que definem a gênese das cidades suportam, em muitos casos, o desenvolvimento dos portos ao redor do mundo. Esses processos foram analisados nesta tese, visando pontuar os reflexos da econômica global, dos fluxos de bens e mercadorias no desenvolvimento dos espaços portuários e como o atual momento do sistema capitalista cria espaços artificiais, desconexão da territorialidade e desequilíbrios de toda ordem, incluindo àqueles ambientais. A hipótese norteadora desta tese versou sobre a possibilidade de gerir aspectos ambientais e reduzir impactos ambientais oriundos dos portos a partir do emprego da metodologia da gestão adaptativa, pautada nos Padrões Abertos para a Prática da Conservação, tendo como caso de análise a cidade e o porto de Santos. Desta forma, o objetivo geral foi testar parcialmente essa metodologia internacional de gestão aplicada à relação porto-cidade, com especial atenção aos aspectos que comprometem a qualidade de vida e a saúde da população. Os resultados coletados, apesar de parciais, permitiram atestar que o método dos Padrões Abertos para a Prática da Conservação tem grande viabilidade no desenvolvimento de projetos de gestão ambiental, contribuindo para o desenvolvimento de um Planejamento Ambiental Estratégico, com definição de estratégias e ações pautadas em mecanismos de avaliação contínua do atendimento ao planejamento e melhoria dos aspectos e impactos ambientais da atividade portuária. Compete às pesquisas futuras o desafio da implementação e monitoramento de ações, análise de dados produzidos, avalição de atividades e o compartilhamento de lições apreendidas para a plena aplicação da metodologia. Enquanto modelo de gestão, a proposta desenvolvida poderá ser aplicada em outros portos ao redor do mundo e, em especial aos brasileiros

The development of ports carries direct implications for the cities they are located in. The bibliography of theme-related works indicates that the historical processes that define the genesis of cities often include worldwide port development. Such processes were analyzed in this thesis in order to show how global economy and the flow of goods and merchandise influence the development of port areas and how the current phase of capitalism creates artificial spaces, disconnection of territoriality, and imbalances of all sorts, including those concerning environment. The guiding hypothesis of this thesis concerns the possible management of environmental aspects and the reduction of environmental impacts arising from ports by employing the adaptive management methodology, based on the Open Standards for the Practice of Conservation. The case to be analyzed is the city and port of Santos. Therefore, the general aim was to partially test this international management methodology applied to the port-city relationship, with special emphasis on the aspects that compromise the populations health and quality of life. The results collected, although partial, enabled us to prove that the method related to the Open Standards for the Practice of Conservation is truly viable for the development of environmental management projects and contributes to developing a Strategic Environmental Planning, with the definition of strategies and actions based on mechanisms to continually assess the responses to the planning and improvement of port-related environmental aspects and impacts. It is up to future research projects to take on the challenge of implementing and monitoring actions, analyzing data produced, assessing activities, and sharing lessons learned to fully apply the methodology. As a management model, the proposal developed may be applied to other ports all over the world and especially the Brazilian ones

Modelo de gestão da fauna silvestre nativa vitimada para as Secretarias de Saúde, Meio Ambiente e Segurança Urbana: Prefeitura de São Paulo / Model of management of victimized native wildlife for the Secretariat of Health, Environment and Urban Security

Introdução - A pressão antrópica provoca alterações no ambiente e perda de biodiversidade que aproximam os homens dos animais silvestres e aumentam os fatores de risco à saúde das populações. Os animais vitimados são resgatados ou apreendidos e depositados em centros de triagem para serem libertados ou permanecerem até virem a óbito ou serem transferidos para outra instituição. Objetivo - Constituir a vigilância pela biodiversidade faunística, a partir da formulação de políticas públicas e da criação e integração de serviços de manejo de animais silvestres. Metodologia Levantamento de dados; mapeamento e georreferenciamento das ocorrências envolvendo animais silvestres. Aplicação de questionários em Centros de Triagem de Animais Silvestres. Pesquisa-ação para a formulação de instrumento legal e a criação de serviços integrados de manejo de animais silvestres. Estudo sobre a Febre Maculosa Brasileira e a biodiversidade. Abordagem sobre o comércio ilegal de animais silvestres. Resultados Os Centros de Triagem de Animais Silvestres não estão estruturados. Os animais vitimados são resgatados e tratados pela Prefeitura de São Paulo. Houve a integração dos serviços de manejo de animais silvestres na Prefeitura de São Paulo e a implantação do Serviço de Resgate de Animais Silvestres. Foi formulada Minuta de Lei que cria o Programa Vigilância pela Biodiversidade Faunística VigiBio-Fauna, institui o Conselho Municipal de Tutela Compartilhada de Animais Silvestres e a Tutela-cidadã. Conclusões: O VigiBio-Fauna decorre de um processo iniciado em 1988 e que culmina na gestão descentralizada, integrada e participativa da fauna silvestre no Município de São Paulo; constituindo um avanço a inserção da gestão da fauna silvestre na Saúde Pública. O entendimento de que o manejo de animais silvestres vitimados está relacionado à área de saúde, e não apenas ao do meio ambiente, traria uma nova visão na abordagem do problema.

Introduction - The anthropic pressure causes changes in the environment and biodiversity loss that approaches men to wild animals which increases the risk factors for public health. The victimized animals are rescued or seized and deposited in wild animal centers to be released, to remain until death or to be transferred to another institution. Objective - To build the Surveillance by Fauna-Biodiversity, from the formulation of public policies and the creation and integration of wild animal management Services. Methodology Data collection; mapping and georeferencing data from occurrences involving wild animals. Questionnaires to wild animal governmental centers. Action research for the formulation of legal instrument and the creation of an integrated of wild animal management Services. Study on the Brazilian Spotted Fever and the biodiversity. Approach on illegal wildlife trade. Results - The national wild animal centers are not structured. The victimized animals are rescued and treated by the São Paulo City Hall. There was the integration of wildlife management Services in the São Paulo City Hall and the implementation of a Wild Animal Rescue Service. It was formulated a Draft Law establishing the Fauna- Biodiversity Surveillance Program - VigiBio-Fauna, establishing the Shared Trusteeship Municipal Council of Wild Animals and the Trusteeship-citizen. Conclusion: The VigiBio-Fauna stems from a process initiated in 1988 and culminating in a decentralized, integrated and participatory management of the São Paulo Citys wildlife, constituting an advance the insertion of Public Health, the wildlife management. The understanding that the management of victimized wild animals is related to health, not just to the environmental area, would bring a new vision in addressing the problem.

Diseño e implementación de un sistema de gestión ambiental en un departamento de Hemodiálisis / Design and implementation of an environmental management system in a department of hemodialysis

La ocurrencia de infecciones con hepatitis B, C y VIH/SIDA, entre otras enfermedades contagiosas, en el Departamento de Hemodiálisis de los servicios de Nefrología, es un problema grave de salud en el país. El Hospital de Morón no era la excepción a esta problemática debido a diferentes causas que iban desde su ineficiente y antiguo diseño constructivo, hasta violaciones en la disciplina de trabajo, el desconocimiento por el personal de las buenas prácticas en bioseguridad e higiene ambiental y el manejo incorrecto de los desechos hospitalarios. Con el fin de superar estas deficiencias se planteó como objetivo diseñar e implementar un sistema de gestión ambiental, a partir de una revisión ambiental inicial, como solución a la ocurrencia de enfermedades infecciosas. El diseño e implementación de dicho sistema permitió realizar una serie de inversiones y medidas que dieron como resultado final la mejoría de la calidad de vida de los pacientes y trabajadores. Desde la implementación del sistema no se reportan casos incidentes de hepatitis B y C(AU)

The occurrence of infections with hepatitis B, C and HIV / AIDS, among other infectious diseases in the Hemodialysis Department of Nephrology services is a serious health problem in the country. Morón Hospital was no exception to this problem due to various reasons ranging from their inefficient and old construction design, to violations of work discipline, lack of knowledge by staff of best practices in biosafety and environmental hygiene and mishandling of medical waste.To overcome these deficiencies the aim raised was to design and implement an environmental management system, from an initial environmental review as a solution to the occurrence of infectious diseases. The design and implementation of this system allowed a series of investments and actions that finally resulted the improved quality of patients life and workers. Since the system implementation are not reported incident cases of hepatitis B and C(AU)

Diseño e implementación de un sistema de gestión ambiental en un departamento de Hemodiálisis / Design and implementation of an environmental management system in a department of hemodialysis

La ocurrencia de infecciones con hepatitis B, C y VIH/SIDA, entre otras enfermedades contagiosas, en el Departamento de Hemodiálisis de los servicios de Nefrología, es un problema grave de salud en el país. El Hospital de Morón no era la excepción a esta problemática debido a diferentes causas que iban desde su ineficiente y antiguo diseño constructivo, hasta violaciones en la disciplina de trabajo, el desconocimiento por el personal de las buenas prácticas en bioseguridad e higiene ambiental y el manejo incorrecto de los desechos hospitalarios. Con el fin de superar estas deficiencias se planteó como objetivo diseñar e implementar un sistema de gestión ambiental, a partir de una revisión ambiental inicial, como solución a la ocurrencia de enfermedades infecciosas. El diseño e implementación de dicho sistema permitió realizar una serie de inversiones y medidas que dieron como resultado final la mejoría de la calidad de vida de los pacientes y trabajadores. Desde la implementación del sistema no se reportan casos incidentes de hepatitis B y C.

The occurrence of infections with hepatitis B, C and HIV / AIDS, among other infectious diseases in the Hemodialysis Department of Nephrology services is a serious health problem in the country. Morón Hospital was no exception to this problem due to various reasons ranging from their inefficient and old construction design, to violations of work discipline, lack of knowledge by staff of best practices in biosafety and environmental hygiene and mishandling of medical waste.To overcome these deficiencies the aim raised was to design and implement an environmental management system, from an initial environmental review as a solution to the occurrence of infectious diseases. The design and implementation of this system allowed a series of investments and actions that finally resulted the improved quality of patients life and workers. Since the system implementation are not reported incident cases of hepatitis B and C.

Estrategias medioambientales para la arquitectura hospitalaria. Un compromiso contemporáneo / Environmental strategies for the hospital architecture. A contemporary commitment

A través de este trabajo se trata de dar una visión sistemática sobre la arquitectura hospitalaria incorporando la óptica medioambiental, aplicado estrategias que permiten reducir las emisiones y los consumos, integrando la arquitectura con otras disciplinas tradicionalmente más vinculadas a la ingeniería (AU)

Through this work seeks to provide a systematic view on hospital architecture incorporating environmental perspective, implemented strategies to reduce emissions and consumption, integrating the architecture with other disciplines traditionally associated with engineering (AU)

Premisas de la implementación del sistema de gestión ambiental del Instituto Nacional de Higiene, Epidemiología y Microbiología de Cuba / Introduction steps of environmental management system of the Cuban Hygiene, Epidemiology and Microbiology National Institute

El Instituto Nacional de Higiene, Epidemiología y Microbiología de Cuba decidió el diseño de un Sistema de Gestión Ambiental, para lo cual se utilizó la metodología de las NC ISO 14000, así como también de la ISO 14031 sobre gestión ambiental. Para el diagnóstico ambiental inicial se tomó como base la metodología para la ejecución de los diagnósticos ambientales y la verificación del cumplimiento de los indicadores de la Resolución CITMA 135/2004, utilizando los aspectos que se adecuaban a las características de la institución. Se identificaron los aspectos ambientales asociados al centro y los impactos que estos provocan en el medio ambiente circundante. Se definió la política ambiental de la institución y mediante revisión bibliográfica se identificaron los requisitos legales y las regulaciones aplicables a las actividades y servicios de la institución, y se evaluó el acceso que los interesados tenían a estos.

Cuban Hygiene, Epidemiology and Microbiology National Institute designed a Environmental Management System using the NC ISO 14000 methodologies, as well as from ISO 14031 on environmental management. Initial environmental diagnosis was based on methodology for the carrying out of environmental above, and fulfillment verification of CITMA 135/2004 Resolution indicators, using features fitting features institution. We identified environmental features associated with Center, and their impacts on surrounding environment. We defined the environmental policy of Institution, and through a bibliographic review we identified the legal requirements and regulations applicable to activities and services of Institution, and we assessed the access of interested in it.

Premisas de la implementación del Sistema de Gestión Ambiental del Instituto Nacional de Higiene, Epidemiología y Microbiología de Cuba / Introduction steps of Environmental Management System of the Cuban Hygiene, Epidemiology and Microbiology National Institute

El Instituto Nacional de Higiene, Epidemiología y Microbiología de Cuba decidió el diseño de un Sistema de Gestión Ambiental, para lo cual se utilizó la metodología de las NC ISO 14000, así como también de la ISO 14031 sobre gestión ambiental. Para el diagnóstico ambiental inicial se tomó como base la metodología para la ejecución de los diagnósticos ambientales y la verificación del cumplimiento de los indicadores de la Resolución CITMA 135/2004, utilizando los aspectos que se adecuaban a las características de la institución. Se identificaron los aspectos ambientales asociados al centro y los impactos que estos provocan en el medio ambiente circundante. Se definió la política ambiental de la institución y mediante revisión bibliográfica se identificaron los requisitos legales y las regulaciones aplicables a las actividades y servicios de la institución, y se evaluó el acceso que los interesados tenían a estos(AU)

Cuban Hygiene, Epidemiology and Microbiology National Institute designed a Environmental Management System using the NC ISO 14000 methodologies, as well as from ISO 14031 on environmental management. Initial environmental diagnosis was based on methodology for the carrying out of environmental above, and fulfillment verification of CITMA 135/2004 Resolution indicators, using features fitting features institution. We identified environmental features associated with Center, and their impacts on surrounding environment. We defined the environmental policy of Institution, and through a bibliographic review we identified the legal requirements and regulations applicable to activities and services of Institution, and we assessed the access of interested in it(AU)

Programa de Gestión Ambiental del Instituto Nacional de Higiene, Epidemiología y Microbiología / Environmental Management Program of the National Institute of Hygiene, Epidemiology and Microbiology

En el marco del sistema de gestión ambiental del Instituto Nacional de Higiene, Epidemiología y Microbiología, se formuló un Programa de Gestión Ambiental para dar solución a los problemas detectados en el diagnóstico inicial, teniendo como principio fundamental la planificación de todas las acciones de forma gradual y con un grado de prioridad determinado por las posibilidades reales de cumplimiento a corto, mediano y largo plazo. Fueron definidos 11 objetivos, 14 metas y 40 acciones, los cuales forman parte del Programa de Gestión Ambiental desarrollado. La experiencia adquirida en la elaboración del programa puede ser transferida a otras unidades de ciencia y técnica del sector de la salud.

In the framework of the Environmental Management System of the National Institute of Hygiene, Epidemiology and Microbiology, an Environmental Management Program was formulated to solve the problems detected in the initial diagnosis, considering as the fundamental principle the planning of all actions in a gradual way and with a priority level determined by the real possibilities of fulfillment on a short, medium, and long term. 11 objectives, 14 goals, and 40 actions, which are part of the Environmental Management Program, were defined. The experience acquired in the development of this program may be transferred to other science and technique units of the health sector.

Programa de Gestión Ambiental del Instituto Nacional de Higiene, Epidemiología y Microbiología / Environmental Management Program of the National Institute of Hygiene, Epidemiology and Microbiology

En el marco del sistema de gestión ambiental del Instituto Nacional de Higiene, Epidemiología y Microbiología, se formuló un Programa de Gestión Ambiental para dar solución a los problemas detectados en el diagnóstico inicial, teniendo como principio fundamental la planificación de todas las acciones de forma gradual y con un grado de prioridad determinado por las posibilidades reales de cumplimiento a corto, mediano y largo plazo. Fueron definidos 11 objetivos, 14 metas y 40 acciones, los cuales forman parte del Programa de Gestión Ambiental desarrollado. La experiencia adquirida en la elaboración del programa puede ser transferida a otras unidades de ciencia y técnica del sector de la salud(AU)

In the framework of the Environmental Management System of the National Institute of Hygiene, Epidemiology and Microbiology, an Environmental Management Program was formulated to solve the problems detected in the initial diagnosis, considering as the fundamental principle the planning of all actions in a gradual way and with a priority level determined by the real possibilities of fulfillment on a short, medium, and long term. 11 objectives, 14 goals, and 40 actions, which are part of the Environmental Management Program, were defined. The experience acquired in the development of this program may be transferred to other science and technique units of the health sector(AU)

Técnica de implatanción de los sistemas de gestión ambiental en las UCO, s / No disponible

No disponible