The Definition and Management Risks of Medical Waste

Medical waste is known as any solid waste that is generated from health care facilities during diagnosis and the treatment process of humans and animals (Diaz and Savage, 2003). Medical waste can be classified into six categories: sharps, laboratory, animals, pathological radioactive, chemical, and residual after incineration or microwave treatment. Medical waste contains high amount of plastic, and is hazardous and infectious. Due to the potential risks of its management process, the cost of transportation of medical waste  is much higher than that of regular solid waste (Lee et al., 2003). Hepatitis B virus, hepatitis C virus, and human immunodeficiency virus were the three most commonly transmitted diseases to health care workers. Approximately 6 million out of the 35 million health care workers were infected by one of these three diseases, and more than 90% of the cases took place in developing counties (WHO, 2002). Some of the infectious wastes include blood-soaked bandages, discarded surgical gloves and instruments, glassware, removed body parts and organs, and needles that were used to give injections and draw blood. Many of these incidences were caused by uncontained needles from collected wastes (Diaz and Savage, 2003).

Over the past decades, medical waste has become a less significant problem due to the ongoing research on different ways to minimize the possible negative impacts that medical waste can bring to society. Separation techniques have been invented for this purpose: to correctly identify medical waste from health care facilities and separate the infectious materials that require expensive special care from other regular solid wastes (Lee et al., 2003). For instance, waste generated from hospital cafeteria is not medical waste because it is not hazardous and can be disposed through recycling, landfilling, or composting and therefore its cost is low. A study published in 2003 reveals that the cafeteria from hospital B at Massachusetts produced more waste than operating room and emergency room (Table 1) (Lee et al., 2003). After imposing separation techniques, there was a steady decrease in the amount of identified medical wastes (Garcia, 1999). The separation techniques successfully reduce the amount of materials that needed to be treated by incineration, a process that provides oxygen and temperature to convert combustible components into water vapor and carbon dioxide. Incineration emits toxic that are harmful to the human body such as acid gases, dioxins, furans, and heavy metals. The high plastic content creates the even greater potential of acid gas and dioxin emission (Lauber, 1987).

Table 1. Treatment and disposal characteristics of medical waste produced from different waste generation department in hospital B.
Table taken from Lee, 2004.

Another way of spilling medical waste is the accidental breakage of medical equipment. Mercury is a toxic pollutant that can severely harm fish’s central nervous system and causes symptoms such as paralysis, insomnia, and even death. Thermometers, gastroenterology, sphygmomanometers, and many other nonclinical equipment contain mercury. There was an average of 18 mercury spills every year in UCLA. To prevent future accidents, many facilities are encouraging to use more expensive alternatives to avoid toxic pollutants. Although this initiation could be expensive, the hazardous material unit can eventually save time and money by mitigating similar incidence (Environmental Best Practices for Health Care Facilities, 2002).

Figure 1. The percentage of different medical equipment that contain mercury from seven Northern Carolina hospitals. Figure taken from Environmental Best Practices for Health Care Facilities, 2002.

Figure 2. UCLA mercury spill frequency form 1997 to 1999. Figure taken from Environmental Best Practices for Health Care Facilities, 2002.

New methods are constantly developing to reduce medical wastes and pollution. Incineration was used to eradicate potential infection that can occur, but it emits toxic substances that are harmful to life. Separation technique was invented as a solution to reduce the use of incineration, but there are potential risks to its management process. The risks of medical waste cannot be completely eliminated, however, more research can still be done on this topic to improve the situation.

References

1. Environmental Best Practices for Health Care Facilities. (Nov 2002). Eliminating Mercury in Hospitals. Environmental Protection Agency. USA.
2. Diaz, L.F., Savage, G.M. (Dec 2003). Risks and Costs Associated with The Management of Infectious Wastes. WHO/WPRO. Philippines.
3. Garcia, R. (1999). Effective Cost-Reduction Strategies in the Management of Regulated Medical Waste. Association for Professionals in Infection Control and Epidemology, Inc. New York.
4. Lauber, J.D. (Feb 1987). New Perspectives on Toxic Emissions from Hospital Incinerators. The New York State Legislative Commission on Solid Waste Management Conference on Solid Waste Management & materials Policy. NY.
5. Lee, B.K., Ellenbecker, M.J., Moure-Ersaso, R. (Oct 2003). Alternatives for treatment and disposal cost reduction of regulated medical wastes. Elsevier. Universtiy of Ulsan from South Korea, and University of Massachusetts, USA.
6. WHO. (Jan 2002). The World Health Report 2002: Reducing Risks, Promoting Healthy Life. World Health Organization. Geneva, Switzerland.