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1.
Artigo em Inglês | MEDLINE | ID: mdl-35955091

RESUMO

The development of COVID-19 in China has gradually become normalized; thus, the prevention and control of the pandemic has encountered new problems: the amount of infectious medical waste (IMW) has increased sharply; the location of outbreaks are highly unpredictable; and the pandemic occurs everywhere. Thus, it is vital to design an effective IMW reverse logistics network to cope with these problems. This paper firstly introduces mobile processing centers (MPCs) into an IMW reverse logistics network for resource-saving, quick response, and the sufficient capacity of processing centers. Then, a multi-participant-based (public central hospitals, disposal institutions, the logistics providers, and the government) collaborative location and a routing optimization model for IMW reverse logistics are built from an economic, environmental perspective. An augmented ε-constraint method is developed to solve this proposed model. Through a case study in Chongqing, it is found that for uncertain outbreak situations, fixed processing centers (FPCs) and MPCs can form better disposal strategies. MPC can expand the processing capacity flexibly in response to the sudden increase in IMW. The results demonstrate good performance in reduction in cost and infection risk, which could greatly support the decision making of IMW management for the government in the pandemic prevention and control.


Assuntos
COVID-19 , Doenças Transmissíveis , Resíduos de Serviços de Saúde , Gerenciamento de Resíduos , Surtos de Doenças/prevenção & controle , Humanos , Pandemias/prevenção & controle , Gerenciamento de Resíduos/métodos
2.
Waste Manag ; 150: 13-19, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35780577

RESUMO

Microwave sterilization technology is an environmentally friendly non-incineration disposal method for medical waste. The core sterilization technology of "microwave sterilization, steam makes the system heat up quickly" was adopted to build a microwave sterilization screw conveyor system that can continuously and dynamically type microwave sterilization. The platinum resistance temperature sensor is used to measure the temperature of the steam at the outlet of the system and the temperature of the material at the outlet. The microwave sterilization process for medical waste was studied on the microwave sterilization test platform, and the influence and regularity of three factors on the microwave sterilization effect were explored and the microwave sterilization process was optimized using the orthogonal test method. Bacillus subtilis var. black spore (ATCC 9372) was used as the detection object of microwave sterilization effect, and the sterilization rate was calculated by the total number of colonies after culture. The results show that, microwave sterilization time has the greatest influence on sterilization effect, the greater the microwave power, the longer the sterilization time, the higher the water content, the higher the sterilization rate. The orthogonal test results show that the optimal process parameters of the microwave sterilization system are the microwave power of 22 kW, the sterilization time of 480 s, and the moisture content of 90%, the sterilization rate is 99.9996%, the sterilization effect is good. When the microwave power is 25 kW or 28 kW, the sterilization time is 480 s or 600 s, and the water content is 90%, the sterilization rate is 100%. Considering the germicidal effect, equipment cost, saving power consumption, shortening the germicidal process time and other comprehensive factors, this process parameter can obtain the best benefit. It can be seen that the use of microwave sterilization technology to treat medical waste is fast and efficient, and does not produce dioxins and other harmful substances, safe and environmental protection, simple operation, excellent sterilization effect.


Assuntos
Resíduos de Serviços de Saúde , Desinfecção/métodos , Resíduos de Serviços de Saúde/análise , Micro-Ondas , Vapor , Esterilização/métodos , Tecnologia , Água
3.
Sante Publique ; 33(5): 729-739, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35724107

RESUMO

INTRODUCTION: Public hospitals in Africa are experiencing major organizational dysfunctions, which are particularly acute in waste management. The opening of a new reference hospital in Niamey offers the opportunity to study the implementation of an innovative waste management system. PURPOSE OF RESEARCH: The objective of this study was to document the agents’ representations, practices, and construction of waste management standards in a new tertiary hospital in Niamey. We sought to study the implementation of innovative materials in waste management and the progressive construction of protocols, habits, and levers of adaptation. This research was carried out using a socio-spatial approach and essentially mobilized the tools of qualitative investigation. RESULTS: Our study highlighted that a hospital waste management culture is progressively established, thanks to an effort to plan activities, to promote the sector, the activities and the emergence of a profession organized around waste management. However, the distinct waste management sectors are struggling to stabilize due to the differentiated statuses and perceptions of the agents. Finally, the success of hospital waste management depends on waste collection at the city level. CONCLUSIONS: The Niamey referral hospital is intended to be an infrastructure of excellence, a showcase for neighboring countries. In this respect, our study shows that it is crucial to invest in planning, the enhancement of the profession and the recognition of all the agents involved in waste management.


Assuntos
Resíduos de Serviços de Saúde , Gerenciamento de Resíduos , Hospitais , Humanos , Níger , Encaminhamento e Consulta , Gerenciamento de Resíduos/métodos
4.
Gynecol Oncol ; 166(1): 162-164, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35597685

RESUMO

OBJECTIVE: As healthcare expenditures continue to rise, identifying mechanisms to reduce unnecessary costs is critical. The objective of this study is to estimate the annual cost of wasted indocyanine green (ICG) used for sentinel lymph node mapping in patients with endometrial cancer. METHODS: Using the Surveillance, Epidemiology, and End Results program database and Premier database, we determined the annual number of cases in which sentinel lymph node mapping with ICG would be used and the median cost of ICG to institutions and patients, respectively. We assumed that gynecologic oncologists use 2-4 mL (20-40%) of the currently available ICG vial kit (25 mg per 10 mL) per case. Estimated waste was then calculated using cost as a measure of institutional waste and charge as excess cost transferred to patients or payers. RESULTS: An estimated 45,864 cases of localized endometrial cancer were identified and eligible for sentinel lymph node (SLN) mapping. The mean total cost associated with ICG was 99.20 and the mean charge was $483.64. The estimated excess annual cost to hospitals was $2,729,825 to $3,639,767. Similarly, using mean charge data, the annual cost of wasted drug for patients and payers was $13,308,999 to $17,745,332. CONCLUSIONS: The annual cost of wasted ICG due to its current manufactured vial size exceeds $2 million for hospitals and $13.3-$17.7 million for patients. We suggest ICG vials should be packaged in a 10 mg vial kit (2-4 mL sterile solution) to avoid drug waste and the financial impact to institutions and patients.


Assuntos
Neoplasias do Endométrio , Resíduos de Serviços de Saúde , Linfonodo Sentinela , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Verde de Indocianina , Linfonodo Sentinela/patologia , Biópsia de Linfonodo Sentinela/métodos
5.
Sante Publique ; Vol. 33(5): 729-739, 2022 Mar 11.
Artigo em Francês | MEDLINE | ID: mdl-35485130

RESUMO

INTRODUCTION: Public hospitals in Africa are experiencing major organizational dysfunctions, which are particularly acute in waste management. The opening of a new reference hospital in Niamey offers the opportunity to study the implementation of an innovative waste management system. PURPOSE OF RESEARCH: The objective of this study was to document the agents’ representations, practices, and construction of waste management standards in a new tertiary hospital in Niamey. We sought to study the implementation of innovative materials in waste management and the progressive construction of protocols, habits, and levers of adaptation. This research was carried out using a socio-spatial approach and essentially mobilized the tools of qualitative investigation. RESULTS: Our study highlighted that a hospital waste management culture is progressively established, thanks to an effort to plan activities, to promote the sector, the activities and the emergence of a profession organized around waste management. However, the distinct waste management sectors are struggling to stabilize due to the differentiated statuses and perceptions of the agents. Finally, the success of hospital waste management depends on waste collection at the city level. CONCLUSIONS: The Niamey referral hospital is intended to be an infrastructure of excellence, a showcase for neighboring countries. In this respect, our study shows that it is crucial to invest in planning, the enhancement of the profession and the recognition of all the agents involved in waste management.


Assuntos
Resíduos de Serviços de Saúde , Gerenciamento de Resíduos , Hospitais , Humanos , Níger , Encaminhamento e Consulta , Gerenciamento de Resíduos/métodos
6.
Sci Total Environ ; 832: 155072, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35398414

RESUMO

Biomedical wastes (BMWs) are potentially infectious to the environment and health. They are co-dependent and accumulative during the ongoing coronavirus disease-2019(COVID-19) pandemic. In India the standard treatment processes of BMWs are incineration, autoclaving, shredding, and deep burial; however, incineration and autoclaving are the leading techniques applied by many treatment providers. These conventional treatment methods have several drawbacks in terms of energy, cost, and emission. But the actual problem for the treatment providers is the huge and non-uniform flow of the BMWs during the pandemic. The existing treatment methods are lacking flexibility for the non-uniform flow. The Government of India has provisionally approved some new techniques like plasma pyrolysis, sharp/needle blaster, and PIWS-3000 technologies on a trial basis. But they are all found to be inadequate in the pandemic. Therefore, there is an absolute requirement to micromanage the BMWs based on certain parameters for the possible COVID-19 like pandemic in the future. Segregation is a major step of the BMW management. Its guideline may be shuffled as segregation at the entry points followed by collection instead of the existing system of the collection followed by segregation. Other steps like transportation, location of treatment facilities, upgradation of the existing treatment facilities, and new technologies can solve the challenges up to a certain extent. Technologies like microwave treatment, alkaline hydrolysis, steam sterilization, biological treatment, catalytic solar disinfection, and nanotechnology have a lot of scopes for the treatment of BMWs. Hi-tech approaches in handling and transportation are found to be fruitful in the initial steps of BMW management. End products of the treated BMWs can be potentially fabricated for the application in the built environment. Some policies need to be re-evaluated by the health care facilities or government administrations for efficient BMW management.


Assuntos
COVID-19 , Resíduos de Serviços de Saúde , Humanos , Incineração , Pandemias , SARS-CoV-2
7.
J Wound Care ; 31(Sup4): S24-S30, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35404716

RESUMO

OBJECTIVE: Conventional skin graft fixation uses a tie-over bolus dressing with splint fixation. However, splints are highly uncomfortable and contribute considerably to medical waste. Previous study has shown positive results using hydrofiber for skin graft fixation. The aim of this study was to assess the effectiveness of using adhesive hydrofiber foam for skin graft fixation. METHOD: In this retrospective study, patients reconstructed with split-thickness skin graft that was fixated only with adhesive hydrofiber foam from April 2017 until April 2019 were included. RESULTS: A total of 44 patients took part, of whom 32 were male and 12 female, with a mean age of 56±19 years. The mean operative time was 77.5±91 minutes. The average defect size was 42±37cm2. The mean skin graft take was 97±5%. The mean length of hospital admission after skin grafting until discharge was 8.5±9.2 days. Excluding those patients undergoing other procedures at the same time as the skin graft gave a total of 34 patients. Their mean operative time was 32±20 minutes, and mean length of hospital stay after skin grafting was 4.0±4.7 days. CONCLUSION: Adhesive hydrofiber foam for skin graft fixation was technically very easy to apply, resulting in a waterproof, non-bulky, secure dressing. Splints were not required. Patients were allowed to mobilise. This method resulted in increased patient comfort and decreased medical waste. From these findings, we believe that this is an extremely simple and effective method of skin graft fixation.


Assuntos
Resíduos de Serviços de Saúde , Transplante de Pele , Adesivos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Transplante de Pele/métodos , Cicatrização
8.
Rev. Enferm. Atual In Derme ; 96(38): 1-19, Abr-Jun. 2022.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1379128

RESUMO

Objetivo: Analisar na literatura científica evidências sobre o perfil e a prevalência dos acidentes com materiais perfurocortantes entre a equipe de enfermagem. Métodos: trata-se de umascoping review,a busca dos artigos foi realizada nas bases de dados: PubMed/MEDLINE, CINAHL, LILACS e Web of Sciencee a amostra final foi composta por 27 estudos. Resultados: Identificou-se uma alta prevalência de acidentes causados por materiais perfurocortantes entre profissionais de enfermagem, sendo a categoria mais acometida entre os trabalhadores da saúde, especialmente técnicos e auxiliares de enfermagem. Houve predominância de ferimentos causados por agulhas, principalmente durante a realização de procedimentos invasivos e descarte de material, sendo que reencapar agulhas foi uma prática frequente. Conclusões: Fatores individuais e institucionais podem agravar as chances de acidentes. Destaca-se a necessidade de ações de educação permanente sobre precauções padrão, uso adequado de equipamentos de proteção individual, bem como odescarte correto entre a equipe de enfermagem.


Objective: To analyze evidence in the scientific literature on the profile and prevalence of accidents with sharps among the nursing team.Methods:this is a scoping review, the search for articles was performed in the following databases: PubMed/MEDLINE , CINAHL, LILACS and Web of Science and the final sample consisted of 27 studies.Results: A high prevalence of accidents caused by sharps was identified among nursing professionals, being the most affected category among health workers, especially technicians and nursing assistants. There was a predominance of injuries caused by needles, especially during invasive procedures and material disposal, and recapping needles was a frequent practice. Conclusions:Individual and institutional factors can aggravate the chances of accidents. The need for continuing education actions on standard precautions, proper use of personal protective equipment, as well as correct disposal among the nursing staff is highlighted.


Objetivo: Analizar evidencias en la literatura científica sobre el perfil y prevalencia de accidentes con cortopunzantes entre el equipo de enfermería. Métodos:se trata de una revisión de alcance, la búsqueda de artículos se realizó en las siguientes bases de datos: PubMed/MEDLINE, CINAHL, LILACS y Web of Science y la muestra final estuvo constituida por 27 estudios. Resultados:Se identificó una alta prevalencia de accidentes por cortopunzantes entre los profesionales de enfermería, siendo la categoría más afectada entre los trabajadores de la salud, especialmente los técnicos y auxiliares de enfermería. Predominaron las lesiones causadas por agujas, especialmente durante procedimientos invasivos y descarte de material,y el reencapuchado de agujas fue una práctica frecuente. Conclusiones:Factores individuales e institucionales pueden aumentar las posibilidades de accidentes. Existe la necesidad de acciones de educación continua sobre las precauciones estándar, el uso adecuado de los equipos de protección personal, así como la eliminación correcta entre el equipo de enfermería.


Assuntos
Humanos , Masculino , Feminino , Literatura de Revisão como Assunto , Acidentes de Trabalho , Enfermagem , Ferimentos Penetrantes Produzidos por Agulha , Resíduos de Serviços de Saúde
9.
PLoS One ; 17(4): e0266888, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35482740

RESUMO

BACKGROUND: Biomedical wastes (BMWs) generated from medical laboratories are hazardous and can endanger both humans and the environment. Highly infectious biomedical wastes are produced at an unacceptably high rate from health laboratories in developing countries with poor management systems, such as Ethiopia. The purpose of this study was to assess the rate of biomedical waste generation, management practices, and associated factors in public healthcare medical laboratories in Addis Ababa, Ethiopia. MATERIALS AND METHODS: From July 13 to September 25, 2020, a health institution-based cross-sectional study was conducted in 6 hospital laboratories and 20 health centres laboratories in Addis Ababa, Ethiopia. Data on socio-demographic characteristics, knowledge and practice of biomedical waste management and generation rate were collected d in health facilities using pre tested data collection tools. SPSS version 20 was used to manage the data. To identify independent predictors of the dependent variable, descriptive statistics, Pearson correlation, linear, and logistic regression analysis were used. The strength of the association was determined using an odds ratio with a 95% confidence interval. RESULTS: In this study, the mean ± SD daily generation rate of biomedical wastes was 4.9 ± 3.13 kg/day per medical laboratory. Nineteen medical laboratories (74.3%) had proper biomedical waste management practice, which is significantly associated with professionals' knowledge of biomedical waste management policies and guidelines, the availability of separate financial sources for biomedical waste management, and the level of training of professionals. CONCLUSION: The study found that medical laboratories in Addis Ababa's public healthcare facilities generate a significant amount of biomedical waste. Nearly two-thirds of hospitals performed proper waste segregation, collection, storage, and treatment procedures for biomedical waste generated in their laboratories. However, there was a poor transportation and disposal method. As a result, paying special attention and implementing the current national guidelines for biomedical waste management is recommended.


Assuntos
Eliminação de Resíduos de Serviços de Saúde , Resíduos de Serviços de Saúde , Estudos Transversais , Etiópia , Humanos , Laboratórios , Eliminação de Resíduos de Serviços de Saúde/métodos
10.
BMJ Open ; 12(3): e056037, 2022 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-35301210

RESUMO

INTRODUCTION: Medical waste management (MWM)-related factors affecting the health of medical waste handlers (MWHs) and their health risks in low and middle-income countries (LMICs) are an important public health concern. Although studies of MWM-related factors and health risks among MWHs in LMICs are available, literature remains undersynthesised and knowledge fragmented. This systematic review will provide a comprehensive synthesis of evidence regarding the individual, system and policy-level MWM-related factors that affect MWHs' health and their experiences of health risks in LMICs. METHODS AND ANALYSIS: All qualitative studies published in peer-reviewed journals between 1 July 2011 and 30 June 2021 with full texts available and accessible will be included in the review. Seven specific electronic databases (eg, Scopus, Ovid MEDLINE, EMBASE, Global Health, CINAHL, ProQuest and PsycINFO) will be searched. Two authors will review the citations and full texts, extract data and complete the quality appraisal independently. A third reviewer will check discrepancies when a consensus cannot be reached on differences between the two reviewers. Data extraction will be conducted using the Joanna Briggs Institute standardised data extraction form for qualitative research. The quality of articles will be assessed using a Critical Appraisal Skills Programme checklist. Results from eligible articles will be synthesised into a set of findings using the thematic framework analysis approach and will be reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement. ETHICS AND DISSEMINATION: This review is based on published articles, which does not require ethical approval because there is no collection of primary data. Findings from this review will be published in a peer-reviewed journal and presented at relevant public health conferences. This protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO). PROSPERO REGISTRATION NUMBER: CRD42020226851.


Assuntos
Resíduos de Serviços de Saúde , Gerenciamento de Resíduos , Países em Desenvolvimento , Humanos , Pesquisa Qualitativa , Literatura de Revisão como Assunto , Revisões Sistemáticas como Assunto
11.
Sci Total Environ ; 829: 154692, 2022 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-35318056

RESUMO

The massive generation of medical waste (MW) poses a serious risk to the natural environment and human health. The pyrolysis technique is proposed as a potential treatment for MW to tackle the associated environmental issues and produce value-added products. In this work, medical waste pyrolysis has been conducted at various temperatures using a fixed bed reactor with a 20 °C·min-1 heating rate and nitrogen was used as a career gas with a flow rate of 100 ml·min-1. In addition, the effect of temperature on products yield and chemical composition of MW pyrolysis have been investigated. The maximum yield of 57.1% for liquid oil was observed from the mixed MW pyrolysis at 500 °C. The gas and char yield were found between 26.5-37.3% and 24.2-12.4%, respectively, for the pyrolysis temperature of 450 °C to 600 °C. According to GC analysis, the concentration of the main gaseous products such as CH4, H2, and C2H4 was increased with increasing temperature, while CO and CO2 experienced a decreasing trend. The results of GC-MS analysis revealed that the main components of MW pyrolysis oil were aromatic hydrocarbons, cyclic hydrocarbons, aliphatic hydrocarbons, alcohol, carboxylic acids, and their derivatives. The aromatic and cyclic hydrocarbons content increased up to 38.2% at a pyrolysis temperature of 600 °C. As pyrolysis oil tends to have more long-chain hydrocarbons therefore carbon distributions from C7 to C35 were observed. The ultimate analysis of oil and char revealed that the increased temperature enhanced the carbon content up to 78.6% and 68.0%, respectively. Furthermore, the higher heat values of 41.8, 24.4, and 52.7 MJ·kg-1 were reported for oil, char, and gas, respectively.


Assuntos
Resíduos de Serviços de Saúde , Pirólise , Carbono , Gases , Temperatura Alta , Humanos , Hidrocarbonetos , Temperatura
12.
Sci Total Environ ; 827: 154416, 2022 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-35276163

RESUMO

Disposal of medical waste (MW) must be considered as a vital need to prevent the spread of pandemics during Coronavirus disease of the pandemic in 2019 (COVID-19) outbreak in the globe. In addition, many concerns have been raised due to the significant increase in the generation of MW in recent years. A structured evaluation is required as a framework for the quantifying of potential environmental impacts of the disposal of MW which ultimately leads to the realization of sustainable development goals (SDG). Life cycle assessment (LCA) is considered as a practical approach to examine environmental impacts of any potential processes during all stages of a product's life, including material mining, manufacturing, and delivery. As a result, LCA is known as a suitable method for evaluating environmental impacts for the disposal of MW. In this research, existing scenarios for MW with a unique approach to emergency scenarios for the management of COVID-19 medical waste (CMW) are investigated. In the next step, LCA and its stages are defined comprehensively with the CMW management approach. Moreover, ReCiPe2016 is the most up-to-date method for computing environmental damages in LCA. Then the application of this method for defined scenarios of CMW is examined, and interpretation of results is explained regarding some examples. In the last step, the process of selecting the best environmental-friendly scenario is illustrated by applying weighting analysis. Finally, it can be concluded that LCA can be considered as an effective method to evaluate the environmental burden of CMW management scenarios in present critical conditions of the world to support SDG.


Assuntos
COVID-19 , Resíduos de Serviços de Saúde , Eliminação de Resíduos , Gerenciamento de Resíduos , Animais , COVID-19/epidemiologia , Humanos , Estágios do Ciclo de Vida , Pandemias/prevenção & controle , Resíduos Sólidos/análise , Desenvolvimento Sustentável
13.
Environ Sci Pollut Res Int ; 29(33): 50780-50789, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35239117

RESUMO

In this study, the hospital waste generation rates and compositions in Delhi were examined temporally and spatially during the first COVID-19 wave of April 2020. A total of 11 representative hospitals located in five districts were considered. The pre-COVID hospital waste generation rates were relatively consistent among the districts, ranging from 15 to 23 tonne/month. It is found that the number of hospital beds per capita may not be a significant factor in the hospital waste quantity. Strong seasonal variations were not observed. All districts experienced a drastic decrease in generation rates during the 1-month lockdown. The average rates during the COVID period ranged from 12 to 24 tonne/month. Bio-contaminated and disposable medical product wastes were the most common waste in Delhi's hospitals, representing 70-80% by weight. The changes in waste composition were however not spatially consistent. The lockdown appeared to have had a higher impact on hospital waste generation rate than on waste composition. The findings are important as the design and operation of a waste management system are sensitive to both waste quantity and quality. Waste records at source helped to minimize waste data uncertainties and allowed a closer examination of generation trends.


Assuntos
COVID-19 , Eliminação de Resíduos de Serviços de Saúde , Resíduos de Serviços de Saúde , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Hospitais , Humanos , Índia/epidemiologia , Resíduos de Serviços de Saúde/análise , Pandemias
14.
PLoS One ; 17(2): e0262741, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35192618

RESUMO

The ongoing Covid-19 pandemic has generated an immense amount of potentially infectious waste, primarily face masks, which require rapid and sanitary disposal in order to mitigate the spread of the disease. Yet, within Africa, large segments of the population lack access to reliable municipal solid waste management (SWM) services, both complicating the disposal of hazardous waste, and public health efforts. Drawing on extensive qualitative fieldwork, including 96 semi-structured interviews, across four different low-income communities in Blantyre, Malawi and Durban, South Africa, the purpose of this article is to respond to a qualitative gap on mask disposal behaviours, particularly from within low-income and African contexts. Specifically, our purpose was to understand what behaviours have arisen over the past year, across the two disparate national contexts, and how they have been influenced by individual risk perceptions, established traditional practice, state communication, and other media sources. Findings suggest that the wearing of cloth masks simplifies disposal, as cloth masks can (with washing) be reused continuously. However, in communities where disposable masks are more prevalent, primarily within Blantyre, the pit latrine had been adopted as the most common space for 'safe' disposal for a used mask. We argue that this is not a new behaviour, however, and that the pit latrine was already an essential part of many low-income households SWM systems, and that within the Global South, the pit latrine fulfils a valuable and uncounted solid waste management function, in addition to its sanitation role.


Assuntos
COVID-19/epidemiologia , Máscaras , Resíduos de Serviços de Saúde , Pandemias , Saúde Pública , SARS-CoV-2 , Saneamento , Humanos , Malaui/epidemiologia , Pobreza , África do Sul/epidemiologia
15.
Chemosphere ; 297: 134022, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35202672

RESUMO

This study investigates the Covid-19 driven indiscriminate disposal of PPE wastes (mostly face mask and medical wastes) in Chittagong metropolitan area (CMA), Bangladesh. Based on the field monitoring, the mean PPE density (PPE/m2± SD) was calculated to be 0.0226 ± 0.0145, 0.0164 ± 0.0122, and 0.0110 ± 0.00863 for July, August, and September 2021, respectively (during the peak time of Covid-19 in Bangladesh). Moreover, gross information on PPE waste generation in the city was calculated using several parameters such as population density, face mask acceptance rate by urban population, total Covid-19 confirmed cases, quarantined and isolated patients, corresponding medical waste generation rate (kg/bed/day), etc. Moreover, the waste generated due to face mask and other PPEs in the CMA during the whole Covid-19 period (April 4, 2020 to September 5, 2021) were calculated to be 64183.03 and 128695.75 tons, respectively. It has been observed that the negligence of general people, lack of awareness about environmental pollution, and poor municipal waste management practices are the root causes for the contamination of the dwelling environment by PPE wastes. As a result, new challenges have emerged in solid waste management, which necessitates the development of an appropriate waste management strategy. The ultimate policies and strategies may help to achieve the SDG goals 3, 6, 11, 12, 13, and 15, and increase public perception on the use and subsequent disposal of PPEs, especially face masks.


Assuntos
COVID-19 , Resíduos de Serviços de Saúde , Bangladesh/epidemiologia , COVID-19/epidemiologia , Humanos , Equipamento de Proteção Individual , Plásticos , SARS-CoV-2
16.
Artigo em Inglês | MEDLINE | ID: mdl-35162400

RESUMO

The coronavirus (COVID-19) pandemic has created a global medical emergency. The unforeseen occurrence of a pandemic of this magnitude has resulted in overwhelming levels of medical waste and raises questions about management and disposal practices, and environmental impacts. The amount of medical waste generated from COVID-19 since the outbreak is estimated to be 2.6 million tons/day worldwide. In Australia, heaps of single-use gowns, facemasks/face shields, aprons, gloves, goggles, sanitizers, sharps, and syringes are disposed everyday as a result of the pandemic. Moreover, the establishment of new home/hotel quarantine facilities and isolation/quarantine centres in various Australian states and territories have increased the risks of transmission among people in these facilities and the likelihoods of general waste becoming contaminated with medical waste. This warrants the need to examine management and disposal practices implemented to reduce the transmission and spread of the virus. This study reviews the various management and disposal practices adopted in Australia for dealing with medical waste from the COVID-19 pandemic and their impacts on public health and the environment. To achieve the aims of this study, prior studies from 2019-2021 from various databases are collected and analysed. The study focuses on generation of medical waste from COVID-19, management and disposal methods, current problems/challenges and environmental and public health impacts. Considering the enormous risks involved and the significance of appropriate handling and disposal of medical waste from COVID-19, this study provides insights on short and long term responses towards managing COVID-19 waste in Australia. The study contributes to Australia's efforts against the transmission and spread of COVID-19 and provides recommendations for the development of workable and sustainable strategies for mitigating similar pandemics in the future.


Assuntos
COVID-19 , Resíduos de Serviços de Saúde , Eliminação de Resíduos , Gerenciamento de Resíduos , Austrália/epidemiologia , Meio Ambiente , Humanos , Pandemias/prevenção & controle , SARS-CoV-2 , Resíduos Sólidos/análise
17.
PLoS One ; 17(1): e0259207, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35073321

RESUMO

COVID-19 greatly challenges the human health sector, and has resulted in a large amount of medical waste that poses various potential threats to the environment. In this study, we compiled relevant data released by official agencies and the media, and conducted data supplementation based on earlier studies to calculate the net value of medical waste produced in the Hubei Province due to COVID-19 with the help of a neural network model. Next, we reviewed the data related to the environmental impact of medical waste per unit and designed four scenarios to estimate the environmental impact of new medical waste generated during the pandemic. The results showed that a medical waste generation rate of 0.5 kg/bed/day due to COVID-19 resulted in a net increase of medical waste volume by about 3366.99 tons in the Hubei Province. In the four scenario assumptions, i.e., if the medical waste resulting from COVID-19 is completely incinerated, it will have a large impact on the air quality. If it is disposed by distillation sterilization, it will produce a large amount of wastewater and waste residue. Based on the results of the study, we propose three policy recommendations: strict control of medical wastewater discharge, reduction and transformation of the emitted acidic gases, and attention to the emission of metallic nickel in exhaust gas and chloride in soil. These policy recommendations provide a scientific basis for controlling medical waste pollution.


Assuntos
Poluição do Ar/prevenção & controle , COVID-19/epidemiologia , Poluição Ambiental/prevenção & controle , Resíduos de Serviços de Saúde/análise , Redes Neurais de Computação , Gerenciamento de Resíduos/métodos , Águas Residuárias/análise , Poluição do Ar/análise , COVID-19/economia , China/epidemiologia , Cloretos/análise , Meio Ambiente , Poluição Ambiental/análise , Gases/análise , Humanos , Incineração/métodos , SARS-CoV-2/patogenicidade , Gerenciamento de Resíduos/estatística & dados numéricos
18.
Semina cienc. biol. saude ; 43(1): 15-26, jan./jun. 2022. ilus
Artigo em Português | LILACS | ID: biblio-1354396

RESUMO

Introdução: os Resíduos de Serviços de Saúde (RSS) têm sido uma fonte de preocupação para os gestores hospitalares, pois necessitam atender às exigências legais; nos últimos anos houve mudanças no Brasil com a publicação da atual Resolução de Diretoria Colegiada (RDC) 222/18, que normatiza o gerenciamento interno dos resíduos. Objetivo: comparar a RDC 306/04 com a RDC 222/18 quanto ao gerenciamento de Resíduos de Serviços de Saúde, bem como apresentar as implicações da legislação em vigência. Material e Método: trata-se de uma pesquisa exploratória e descritiva, de abordagem qualitativa do tipo documental; para tal, criou-se um roteiro de análises baseado nas etapas de gerenciamento dos RSS; os resultados foram apresentados em tabelas por grupos (A, B, C, D e E) que foram as categorias documentais para a comparação da legislação RDC 306/04 com a RDC 222/18. Resultados: observou-se importantes mudanças na lei atual, com impacto para os gestores e profissionais que atuam em hospitais, como o descarte de bolsas de sangue e peças anatômicas caracterizadas como A1, liberação de descarte de equipamentos de proteção individual (EPIs) como resíduos do Grupo D comum, seringas e agulhas podem ser desconectadas quando tiverem o dispositivo de segurança, novos critérios para descarte de oito grupos de medicamentos, entre outras. Discussão: as mudanças citadas necessitam ser incorporadas nos planos de gerenciamento, planejamento de novos fluxos de segregação de resíduos e aquisição de novos coletores que em médio prazo podem contribuir na redução de custo financeiro, e diminuição dos impactos ambientais desses resíduos quando descartados de forma segura. Conclusão: ao comparar as duas legislações, o presente estudo contribui para direcionar as adequações necessárias, a fim de atender a atual legislação, com informações diretas para orientar novos critérios de classificação, acondicionamento, tratamento e destinação final para o gerenciamento seguro dos resíduos nos serviços de saúde.


Introduction: Waste from Health Services (RSS) has been a source of concern for hospital managers, as they need to meet legal requirements; in recent years there have been changes in Brazil with the publication of the current Resolution of the Collegiate Board 222/18, which regulates the internal management of waste. Objective: to compare Resolution of the Collegiate Board 306/04 with Resolution of the Collegiate Board 222/18 regarding the management of RSS, as well as present the implications of the legislation in force. Material and Method: this is an exploratory and descriptive research, with a qualitative approach of the documentary type; for this, an analysis script was created based on the steps of managing the RSS; the results were presented in tables by groups (A, B, C, D and E) which were the document categories for the comparison of legislation Resolution of the Collegiate Board 306/04 with Resolution of the Collegiate Board 222/18. Results: important changes were observed in the current law, with an impact on managers and professionals working in hospitals, such as the disposal of blood bags and anatomical parts characterized as A1, release of disposal of Personal Protective Equipment as waste from Group D common, syringes and needles can be disconnected when they have the safety device, new criteria for disposing of eight groups of drugs, among others. Discussion: the aforementioned changes need to be incorporated into management plans, planning new waste segregation flows and acquisition of new collectors that in the medium term can contribute to reducing the financial cost, and reducing the environmental impacts of these wastes when disposed of safely. Conclusion: by comparing the two legislations, this study contributes to direct the necessary adjustments, in order to meet the current legislation, with direct information to guide new classification, packaging, treatment and final disposal criteria for the safe management of waste in the services of health.


Assuntos
Humanos , Saúde , Gerenciamento de Resíduos , Serviços de Saúde , Resíduos de Serviços de Saúde , Coletores , Custos e Análise de Custo , Agulhas
19.
Rev. Enferm. Atual In Derme ; 96(37): 1-13, Jan-Mar. 2022.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1378262

RESUMO

Objetivo: descreveras etapas do gerenciamento dos resíduos de serviços de saúde de um hospital público do Maranhão, considerando o ambiente/investigando os profissionais. Métodos:estudo transversal descritivo, com visitas às enfermarias e postos de enfermagem, cada local observado durante umahora (com cincoréplicas) seguindo um roteiro pré-estabelecido e com aplicação de questionário semiestruturado com a equipe de enfermagem. Resultados:os postos de enfermagem apresentaram maior quantidade de geraçãode resíduos perfurocortantes, com destaque para agulhas e seringas; o Descartex apresentava localização e posição adequada e segura, mas com volume excedido; resíduos infectantes, biológicos e de lixo comum, foram acondicionados em sacos plásticos segundoo normatizado. A frequência de coleta e limpeza estava de acordo com a normatização, embora as lixeiras estivessem sem tampa e pedal. O transporte foi realizado em containersadequados embora o tempo de remoção dos resíduos até o armazenamento externo estivesse em desacordo com o estabelecido. 88% dos técnicos e 100% dos enfermeiros relataram que há diferença no manejo dos diferentes grupos de resíduos, tendo como resíduos mais gerados os perfurocortantes, máscaras, luvas e papel. 94% dos técnicos e todos os enfermeiros afirmaram existir a etapa de segregação. 36,3% dos técnicos e 20% dos enfermeiros afirmaram já terem sofrido algum acidente ocupacional envolvendo resíduos perfuro cortantes. Conclusões: Observou-se maior produção dos resíduos biológicos,perfurocortantese comuns, com determinados pontos em desacordo com a legislação normativa, ressaltando a necessidade dos profissionais da equipe de enfermagem conhecerem as etapas do gerenciamento dos resíduos.


Objective: to describethe stages of waste management from health services in a public hospital in Maranhão, considering the environment/investigating professionals. Methods:descriptive cross-sectional study, with visits to the wards and nursing stations, with each location being observed for onehour (with fivereplicas) following a pre-established script and applying a semi-structured questionnaire with the nursing team. Results:the nursing stations showed a greater amount of generation of sharp waste, especially needles and syringes; Descartex had an adequate and safe location and position, but with excess volume; infectious, biological andcommon garbage residues were packed in plastic bags in accordance with regulations. The frequency of collection and cleaning was in accordance with regulations, although the bins had no lid and pedal. Transport was carried out in suitable containers, although the time from waste removal to external storage was not in accordance with what was established. 88% of technicians and 100% of nurses reported that there is a difference in the management of different groups of waste, with sharps, masks, gloves and paper as the most generated waste. 94% of technicians and all nurses stated that there was a segregation stage. 36.3% of the technicians and 20% of the nurses said they had already suffered an occupational accident involving sharp waste. Conclusions:There was agreater production of biological, sharp and common waste, with certain points at odds with normative legislation, highlighting the need for nursing staff professionals to know the stages of waste management.


Objetivo: describir las etapas de la gestión de residuos de los servicios de salud en un hospital público de Maranhão, considerando el medio ambiente/investigando a los profesionales. Métodos:estudio descriptivo transversal, con visitas a las salas y puestos de enfermería, cada local observado durante una hora (con cinco repeticiones) siguiendo un guión preestablecido y aplicación de un cuestionario semiestructurado con el equipo de enfermería. Resultados:los puestos de enfermería tuvieron mayor generación de residuos cortopunzantes, especialmente agujas y jeringas; Descartex tenía una ubicación y posición adecuada y segura, pero con volumen rebasado; Los residuos infecciosos, biológicos y de desecho común fueron empacados en bolsas plásticas de acuerdo a normatividad. La frecuencia de recogida y limpieza fue conforme a la normativa, aunque las papeleras no tenían tapa ni pedales. El transporte se realizó en contenedores adecuados, aunque el tiempo desde la retirada de los residuos hasta el almacenamiento externo no se ajustaba a lo establecido. El 88% de los técnicos y el 100% de las enfermeras informaron que existe diferencia en el manejo de los diferentes grupos de residuos, siendo los punzantes, mascarillas, guantes y papel los residuos más generados. El 94% de los técnicos y todos los enfermeros manifestaron que hubo una etapa de segregación. El 36,3% de los técnicos y el 20% de los enfermeros afirmaron haber sufrido ya un accidente de trabajo con residuos cortantes. Conclusiones:Hubo una mayor producción de desechos biológicos, cortopunzantes y comunes, con ciertos puntos en desacuerdo con la legislación normativa, destacando la necesidad de que los profesionales del equipo de enfermería conozcan las etapas de la gestión de desechos.


Assuntos
Humanos , Masculino , Feminino , Enfermagem , Gerenciamento de Resíduos , Política Nacional de Vigilância Sanitária , Resíduos de Serviços de Saúde , Equipe de Enfermagem
20.
Int J Environ Health Res ; 32(1): 155-167, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32183563

RESUMO

In this study, an integration of multi-criteria evaluation, geographic information system, and remote sensing techniques were used for site selection of medical waste landfills in Kermanshah, Iran. Also, an environmental risk assessment for the selected site has been conducted in order to minimize the possible hazardous. The GIS and remote sensing were used for acquiring and preparing layers and maps and the multi-criteria evaluation was used for setting aim, criteria selection, criteria weighting, and final decision making. The results showed that only 1.2% of the study area is scored high-suitable, while 90% of the area is considered unsuitable that makes this region critical for preservation. After further assessment and field visits, a suitable site was selected for landfilling. Environmental risk assessment showed that the selected site poses a low-level of risks to the environment and surrounding areas and this is because various environmental and health aspects have been considered in the site selection process.


Assuntos
Resíduos de Serviços de Saúde , Eliminação de Resíduos , Técnicas de Apoio para a Decisão , Sistemas de Informação Geográfica , Irã (Geográfico) , Resíduos Sólidos , Instalações de Eliminação de Resíduos
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