Healthcare waste management Flashcards by MORASCALLO MARY CHRISTINE

Healthcare waste are generated from

Diagnosis, treatment, management, and immunization of humans or animals
Research about diagnosis, treatment, management, and immunization of humans or animals
Producing or testing of biological materials
Waste originating from minor or scattered sources

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Categories of Healthcare waste

general
infectious
pathological
sharps
pharmaceutical
genotoxic
chemical
waste with high heavy metal contents
pressurized containers
radioactive wastes

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Other wise known as non risk infectious disease
Comparable to domestic waste
Dealt with municipal waste disposal system
From administrative and housekeeping functions of healthcare establishment
also wastes produced during maintenance of the premises

General Waste

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2 types of general waste

recyclable and biodegradable waste

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Examples of recyclable wastes

paper, cardboard, non contaminated plastic or metals, cans or glass that can be recycled

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Examples of biodegradable HCW

left over food or garden waste that can be compostedd

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all _______ and ______ are known to have the potential of transmitting infectious agents to humans or animals

medical and healthcare waste

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infectious waste are generated from

isolation wards of the hospital
dialysis wards
centers for caring patients infected with hepatitis virus
pathology department
operating theater
medical practices
laboratory which mainly treat patients suffering from diseases

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infectious wastes are suspected to contain _________ to cause disease to susceptible host

sufficient concentration of pathogens

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susceptible hosts are the

Young, Adolescence, Pregnant, Immunocompromised

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Examples of infectious waste

Bacterial stocks and culture
Fecal Samples
Wastes from Hemodialyzers
Blood
Respiratory Tract Secretions
Infected Lab Animal

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used to identify bacterial colonies

bacterial tubes

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anything that contains urine sample are considered

infectious

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also known as the anatomical waste
this category of waste compromises human body parts, organs, and tissue

Pathological Waste

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Examples of pathological wastes

Human fetus, Amputated body part, Removed organs, Animal carcasses, Placenta, Tissues

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all objects and
materials that are closely
linked with health-care
activities and pose a potential
risk of injury and infection due
to their puncture or cut
property.

Sharps

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Examples of sharps waste

needles, ampoules, broken glassware, saw, knives, infusion sets, scalpel blades, lancets, nails, vials without content

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Comprised expired pharmaceutical or pharmaceuticals that are unusable for other reasons

Pharmaceutical wastes

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examples of pharmaceutical wastes

expires, unused, spilt, contaminated pharmaceutical drugs, products, vaccine, and sera
bottles or boxes with pharmaceutical residue
gloves and masks used during handling,
and connecting tubing and drug vials

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May include certain cytostatic
drugs, vomit, urine, feces from
patients treated with cytostatic
drugs, chemicals, and radioactive
material

genotoxic waste

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Cytostatic wastes are generated
from several sources and can
include the following

contaminated materials from drug preparation and administration, such as syringes, needles, vials, packaging

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examples of genotoxic wastes

outdated drugs
excess solutions
drugs returned from the wards
Urine, feces, and vomit from patients, which may contain potentially hazardous amounts of the administered cytostatic drugs

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Urine, feces, and vomit of patients administered with cytostatic drugs should be considered genotoxic for at least ____ hours and sometimes up to _____ week after drug administration

48 hours and 1 week

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waste from health care may be hazardous or
nonhazardous; in the context of protecting health,

Chemical waste

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chemical waste is considered hazardous if :

toxic corrosive - acids of ph is <2; base of ph is > 12 flammable reactive - explosive, water reactive, shock sensitive genotoxic

chemical waste is considered nonhazardous if

the waste consists of chemicals with none of the properties of a hazardous waste

Subcategory under hazardous chemical wastes Highly toxic

Wastes with high heavy metal content

examples of Wastes with high heavy metal content

mercury spill lead arsenic cadmium waste from discarded batteries

examples of pressurized container

Pressurized cylinders, cartridges, aerosol cans containing residues

Liquid/gaseous materials contaminated with radioactive substances

radioactive waste

Produced as a result of procedures such as in vitro analysis of body tissue and fluid, in vivo imaging and tumor localization

radioactive waste

examples of radioactive waste

Feces/urine of patients under radiation therapy Residues of radioisotope studies in the laboratory

HEALTH CARE WASTE GENERATORS

hospital infirmaries birthing centers drug manufacturers laboratories and research center institution clinics

Laboratories and Research Centers examples

* Medical and biomedical laboratories * Nuclear medicine laboratories * Medical research centers * Biotechnology laboratories * Blood banks and blood collection services * Animal research and testing * Dental prosthetic laboratories * Drug testing laboratories * HIV testing laboratories

examples of institution

* Drug rehabilitation center * Schools of Radiologic Technology * Training centers for embalmers Medical Schools * Med Tech intern training centers * Nursing Homes centers * Dental Schools * Mortuary and Autopsy Centers

examples of clinics

* Medical * Surgical * Ambulatory * Alternative medicine * Dialysis * Dental * Health care centers * Dispensaries * Veterinary

The ______ is often characteristic of the type of source.

composition of wastes

MEDICAL WARDS contain what type of waste

Mainly infectious waste and general waste

OPERATING AND SURGICAL WARDS contain what type of waste

general, pathological, anatomical, infectious waste, sharps

OTHER HEALTH CARE UNITS contain what type of waste

mostly general with small percentage of infectious, and sharps

LABORATORIES contain what type of waste

mainly pathological, highly infectious waste, sharps, plus some radioactive and chemical waste

PHARMACEUTICAL & CHEMICAL STORES contain what type of waste

mainly packaging, general waste, small quantities of pharmaceutical and chemical wastes

SUPPORT UNITS contain what type of waste

general wastes only

Preventing or reducing generation of waste with emphasis on source reduction and recycling

minimization

benefits of minimization

1. Source reduction 2. Recyclable products 3. Good management and control practices

BASIC STEPS IN HANDLING WASTE

minimization segregation

an important step to waste management

segregation

Reasons to take undertake waste segregation

* Minimizes the amount of waste that needs to be managed as biohazardous or hazardous * Generates a solid waste stream through recycling or composting * Reduced the number of toxic substances release to the environment * Makes it easier to conduct assessments of the quantity and composition of different waste streams

When handling HCW, sanitary staff and cleaners should always wear protective clothing including

industrial aprons boots heavy duty gloves

ways to avoid accumulation of the waste

it must be collected on a regular basis transported to a central storage area within hcf before being treated or removed collection must follow specific routes through the HCF to reduce the passage pf loaded carts through wards and other clean areas

Refuse receptacle for general waste with _____

plastic bag cover

Refuse receptacle for pathological wastes lined ____

with heavy gauge plastic bag and cover

for infectious wards receptacle

Foot operated lid container refuse receptacle lined with heavy-gauge plastic bag with cover;

Refuse receptacles for sharps with _______

heavy gauge plastic bag and cover (plastic container)

For radioactive waste and chemical waste receptacle

wooden box

storage area should be marked

“CAUTION: BIOHAZARDOUS WASTE STORAGE AREA. UNAUTHORIZED PERSONS KEEP OUT.”

storage area should be located :

within the establishment or research facility, away from patient rooms, laboratories, hospital function/operation rooms or any public access areas

REQUIREMENTS FOR STORAGE FACILITIES

1. Must have an impermeable, hard-standing floor with good drainage 2. Easy to clean and disinfect 3. Must have water supply for cleaning purposes 4. Allows easy access for staff in charge of handling the waste. 5. Must have a lock to prevent access by unauthorized persons. 6. Easy access for waste collection vehicle 7. Protected from sun, rain, strong winds, floods, etc. 8. Inaccessible to animals, insects, and birds

transport must be:

* Uses wheeled trolleys, containers, or carts * Should be cleaned & disinfected daily * All waste bag seals should be in-place and intact at the end of transportation

Specifications for on site transport

1. Easy to load & unload 2. No sharp edges that can damage waste bags or containers during loading/unloading 3. Easy to clean

HCW should be transported through:

the quickest or shortest possible route and should be planned before the trip begins

* An efficient and effective collection system route should consider the following:

* Collection schedule either by route or zone * Revised routing plan should be established * Logical planning of the route

HEALTH CARE WASTE TREATMENT TECHNOLOGIES/PROCESSES

a. Thermal b. Chemical c. Irradiation d. Biological processes e. Encapsulation f. Inertization

Thermal decomposition of substance and materials in the absence of supplied molecular oxygen in the destructionchamber in which the said material is converted into gaseous, liquid, or solid form.

Pyrolysis

Waste residues of thermal processes may be in form of

greasy aggregates or slugs, recoverable metals, carbon black

Waste residues of pyrolysis may be in form of

secure facility such as sanitary landfill

Thermal Processes

WET AND DRY THERMAL TREATMENT

wet thermal treatment

autoclave

Uses steam sterilization to render waste harmless * Exposes shredded infectious waste to high temperature (121°C) and high pressure (15 psi) for 30 minutes * Has been used in hospitals for the sterilization of reusable medical equipment

autoclave

Dry thermal treatment

Microwave

Incorporates some type of size reduction device * Shredding of wastes is done either before or after disinfection * Waste is exposed to microwaves that raises the temperature to 100°C for at least 30 minutes * Microorganisms are destroyed by moist heat which irreversibly coagulates and denatures enzymes and structural proteins

microwave

Chemicals like _______ are added to waste to kill or inactivate pathogens present in the healthcare waste

aldehydes, chlorine compounds, phenolic compound

Most suitable in treating blood, urine, and stool

chemical disinfection

Uses an enzyme mixture to decontaminate health care waste and the resulting by-product is put through an extruder to remove water for sewage disposal. * Requires regulation of temperature, pH, enzyme level, and other variables. * Composting and vermiculture as biological processes for treating and disposing of placenta waste as well as food waste, yard trimmings and other organic waste is also recommended

biological processes

* Wastes containing potentially infectious microorganisms (sewage sludge, biomedical wastes, wastewater) are treated using irradiation systems which are currently being used in waste treatment operations. * Sterilization is achieved by breaking down the DNA molecules of the contaminated organism. * Ionizing radiation is very efficient at DNA disruption and requires far less total energy than would be used in an equivalent thermal process.

radiation technology or irradiaton

* Filling up of container with waste, adding an immobilizing material, and sealing the container * Uses either cubic boxes made of high-density polyethylene or metallic drums, that are three quarters filled with sharps or chemical or pharmaceutical residues. * The boxes are then filled up with a medium such as plastic foam, bituminous sand, and cement mortar

encapsulation

advantage of encapsulation

: Effective in reducing the risk of scavengers gaining access to the health care waste

* Mixing of the waste with cement and other substances before disposal; Especially suitable for pharmaceutical wastes * For the inertization of pharmaceutical waste, the packaging should be removed, the pharmaceuticals ground, and a mixture of water, lime, and cement added.

inertization

typical proportion for the inertization mixture

65% pharmaceutical waste 15% lime 15% cement 5% water

FOUR BASIC WASTE DISPOSAL TECHNIQUES

a. Flushing down the drain to the sewer system b. Incineration c. Landfill burial d. Recycling

is a type of disposal method in which municipal solid wastes are burned at high temperatures.

incineration or combustion

The process eventually converts them into residues and gaseous products.

incineration

Used to be the method of choice in treating health care waste but due to the implementation of Clean Air Act, this method is no longer allowed.

incineration

* An engineered method designed to keep the waste isolated from the environment. * Appropriate engineering preparations should be completed before the site can accept waste.

landfill burial or sanitary landfill

is collecting waste and processing it into something new

recycling

Many items in the hospital can be recycled such as

organics, plastics, paper, glass and metal

Healthcare waste management Flashcards

(86 cards)