JIPH-352; No. of Pages 7

ARTICLE IN PRESS

Journal of Infection and Public Health (2014) xxx, xxx—xxx

An overview of the present status of hospital waste management in Kerman, Iran Hamideh Bahrami a, Mohammad Malakootian b, Seyed Dawood Mousavi Nasab c, Nemat Jaafarzadeh d, Mehrdad Askarian e, Sarah Samadi b, Nayeb Ali Ahmadi f,∗ a

Department of Environmental Health Engineering, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran b Environmental Health Engineering Research Center, Department of Environmental Health, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran c Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran d Department of Environmental Health, School of Public Health, Ahwaz Jondishapour University of Medical Sciences, Ahwaz, Iran e Department of Community Medicine, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran f Department of Medical Lab Technology, and Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Received 22 January 2014 ; received in revised form 14 May 2014; accepted 11 July 2014

KEYWORDS Hospital waste; Management; Pollution; Environment; Kerman



Summary Introduction: The management of hospital waste is a notably important issue due to its potential contribution to environmental pollution and its undesirable effects on public health. Methods: This cross-sectional study was performed in eight hospitals in Kerman, Iran. Data and information from all of the hospitals were collected using a questionnaire and interviewing personnel. The purpose of this research was to determine different types of waste and to evaluate the waste management situation in Kerman. Results: The results showed that the waste composition in hospitals included general waste (71.37%), infectious waste (23.14%), pathological waste (0.58%), sharps (3.61%), pharmaceutical and chemical waste (0.93%) and pressured containers (0.37%). The generation rate varied from 2.45 to 5.26 kg/bed-day with a weight average of 3.43 kg/bed-day.

Corresponding author. Tel.: +98 2122718528. E-mail addresses: [email protected], [email protected] (N.A. Ahmadi).

http://dx.doi.org/10.1016/j.jiph.2014.07.007 1876-0341/© 2014 Published by Elsevier Limited on behalf of King Saud Bin Abdulaziz University for Health Sciences. All rights reserved.

Please cite this article in press as: Bahrami H, et al. An overview of the present status of hospital waste management in Kerman, Iran. J Infect Public Health (2014), http://dx.doi.org/10.1016/j.jiph.2014.07.007

JIPH-352; No. of Pages 7

ARTICLE IN PRESS

2

H. Bahrami et al. Conclusions: The findings of this research indicated that comprehensive plans and policies should be applied to improve the present status of hospital waste management in Kerman. © 2014 Published by Elsevier Limited on behalf of King Saud Bin Abdulaziz University for Health Sciences. All rights reserved.

Introduction An increase in the rate of urbanization and population has changed the quality and quantity of waste production. Environmental pollution has become a fundamental concern due to insufficient waste management systems, particularly in developing countries [1,2]. Additionally, poor healthcare waste management will result in increased charges in healthcare settings [3]. Thus, waste management is a very important issue [4,5]. One study reported that 1 kg out of every 4 kg of hospital waste was infectious [6]. Studies have shown poor waste management situations in some developing countries such as South Africa and Nigeria [7,8]. According to the documents of the World Health Organization (WHO), between 75% to 90% of hospital waste is non-risk or generally comparable to domestic waste, while the rest of hospital waste (10—25%) are infectious and may be a source of health risks [9]. A mixture of infectious and general waste can cause the entire waste to be potentially infectious [10]. Inappropriate waste management increases the risk of transmitting diseases such as Hepatitis B, Hepatitis C, and HIV, and increases the risk of blood born viruses, respiratory enteric infections, soft tissue infections and environmental pollution [11—13]. According to the WHO classification, health care waste is categorized into infectious waste, pathological waste, sharps, pharmaceutical waste, genotoxic waste, chemical waste, waste with a high content of heavy metals, pressurized containers and radioactive waste [9]. The aim of the present study was to determine the different types of hospital waste and the various components of hospital waste per capita and to assess the hospital waste management in eight hospitals in Kerman city, Iran.

Methods Study area Kerman is the capital city of Kerman Province and is located in the southeast of Iran in the vicinity of the

Loot and Dasht-e-Kavir deserts. Kerman mainland extends between the latitudes 30◦ 14 and 30◦ 19 north, and the longitudes 56◦ 58 and 57◦ 9 east covering an area city of 185 km2 . The population of Kerman is estimated to be approximately 515,114 [14]. In this cross sectional study, all the hospitals that agreed to be visited (N = 8) in Kerman were investigated over a period of 4 months from April to August in 2012. Data and information from all the hospitals were collected through a data collection form that was derived from the recommendations of the World Health Organization for the evaluation of hospital waste management in developing countries [9,15]. In each hospital, data (about the general information such as the number of wards and type of hospital, waste segregation, storage, treatment and final disposal practices) were collected by observing the process of waste management and interviewing the hospital authorities, the heads of the wards, the environmental health managers and personnel involved in the management of the hospital waste. Personnel and workers involved in the management of the hospital waste were trained to separate the waste. The segregated waste was weighed with a spring scale daily during a period of 8 weeks, distributed randomly over 4 month from April to August, 2012.

Waste classification Waste classification was performed according to the World Health Organization classification system as follows: infectious (laboratory cultures; waste from isolation wards; tissues (swabs) materials, or equipment that have been in contact with infected patients; and excreta), pathological (body parts; blood and other body fluids; and fetuses), sharps (needles; infusion sets; scalpels; knives; blades; and broken glass), pharmaceutical and chemical wastes (pharmaceuticals that are expired or no longer needed; items contaminated by or containing pharmaceuticals; laboratory reagents; film developer; disinfectants that are expired or no longer needed; and solvents) and pressurized containers (gas cylinders; gas cartridges; and aerosol cans) [9]. Due to the scant amount of

Please cite this article in press as: Bahrami H, et al. An overview of the present status of hospital waste management in Kerman, Iran. J Infect Public Health (2014), http://dx.doi.org/10.1016/j.jiph.2014.07.007

JIPH-352; No. of Pages 7

ARTICLE IN PRESS

Present status of hospital waste management in Kerman, Iran

3

pharmaceutical and chemical waste, they were collectively grouped in one category. Due to national and security reasons we could not access radioactive waste materials. The weight and composition of the waste from each hospital were recorded on separate data sheets. The quantity of hospital waste was presented in terms of kg/day and kg/bed-day. The generation rate of each hospital was calculated by dividing the weight of produced waste by the number of occupied beds in each hospital.

Statistical analysis The statistical significance of each difference observed between various hospitals, between two proportions, and between the various components of hospital waste per capita were evaluated by 2 tests, calculating the Z statistic, and one-way ANOVA analysis, respectively. Data analysis was performed using SPSS 16 software, and a P value of

WITHDRAWN: An overview of the present status of hospital waste management in Kerman, Iran.

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full...
569KB Sizes 0 Downloads 3 Views