A Descriptive Study on the Compliance of the University of Santo Tomas Hospital regarding the handling, collection and storage of Pathogenic waste in accordance to the Health Care Waste Management Manual of Department of Health and the Procedural Manual Title III of Dao 92-29 “Hazardous Waste Management” of the Department of Environment and Natural Resources

Introduction Hospital waste Focus lies mainly on biological hazards caused by pathogenic waste Has considerable repercussions Human health Environment

In the Philippines DOH and DENR Have set guidelines regarding Handling Collection Storage of pathogenic waste But the degree to which hospitals follow these set of rules is not known

The University of Sato Tomas Hospital is a premier health care center should be committed in the service of public health whether it be through patient care or ensuring a clean healthy environment for their employees and the community

Research Question Does the University of Santo Tomas Hospital comply with the guidelines on handling, collection and storage of Pathogenic waste as written in the Health Care Waste Management Manual of the Department of Health and the Procedural Manual Title III of Dao 92-29 “Hazardous Waste Management” of the Department of Environment and Natural Resources?

General Objective To assess the compliance of University of Santo Tomas Hospital regarding the handling, collection and storage of Pathogenic waste in accordance to Health Care Waste Management Manual of Department of Health and the Procedural Manual Title III of Dao 92- 29 “Hazardous Waste Management” of Department of Environment and Natural Resources

Specific Objectives To describe the handling of Pathogenic Waste To describe the collection of Pathogenic Waste To describe the Storage of Pathogenic Waste To determine the compliance of UST hospital regarding the handling, collection and storage of Pathogenic waste in accordance to Health Care Waste Management Manual of Department of Health To determine the compliance of UST hospital regarding the handling, collection and storage of Pathogenic waste in accordance to the Procedural Manual Title III of Dao 92-29 “Hazardous Waste Management” of Department of Environment and Natural Resources

Significance Pathogenic Healthcare waste Identified as a major problem that negatively impacts both human health and the environment Little information available regarding the handling, collection storage and transport of pathogenic waste in USTH There are guidelines in place appraisal of the current situation regarding pathogenic waste management in the USTH is essential in order to evaluate whether or not these guidelines are followed, and if there are any areas that require improvement.

Methodology Descriptive Study Inclusion Criteria: Exclusion Criteria: Super Clean Services Exclusion Criteria: Waste Transporter Waste Treaters TSD facility

Methodology Data Collection Data Processing Semi Structured Interview of authorities and Personnel of Super Clean Services Visual inspection and Field investigation of collection, handling and storage of pathogenic waste Data Processing Flow Chart and narrative of collection, handling and storage of pathogenic waste

Infectious wastes from each ward and nurses station including those coming from pathology are collected Radioactive wasted are stored in a labeled room in the basement of USTH, then allowed to decay and are rinsed and disposed.   Wastes are either Autoclaved and disposed, or incinerated at their facility located in Cavite

The anatomic pathology specimen room located on the basement area of clinical division.

UST Hospital nurse’s station: wastes are segregated according to type Waste containers are color coded. Sharps are disposed in a puncture proof container then chemically disinfected, collected and buried

trained for 15 days hands-on on their proposed company of employment. A Superclean employee trained for 15 days hands-on on their proposed company of employment. Once accepted, another 3 days of refresher training on their place of work is done.

Waste baskets in each ward are color coded Waste baskets in each ward are color coded. Superclean employees would carry their “trolleys” shown on the first picture in which they use. In each floor, there are small areas in which they would get their water source and would also be used for storage of their cleaning materials.

Radioactive Wastes are stored in this room located on the basement on USTCD. These wastes are allowed to decay naturally according to the type of waste. These are then either chemically disinfected and rinsed, and then buried.

Critical Appraisal

Compliance of USTH in waste handling, collecting, storage and transport in accordance to DOH health care waste management manual

UST Hospital follows the health care waste management designed by the DOH able to minimize, segregate and identify properly waste materials Hazardous wastes are placed in clearly marked containers and in plastic bags Sharps are kept in a puncture proof containers made of high-density plastic, disinfected and buried Appropriate plastic bags are placed in all nurse stations and in each patient’s room and are color-coded

Aerosol containers are collected with general health care waste when completely empty Transportating waste inside the hospital premises is done with wheeled trolleys Workers transporting the waste are equipped with personal protective equipment

Anatomic wastes are stored in a room at the basement, collected then either incinerated or buried in a landfill Radioactive wastes are stored in a room at the basement, segregated according to its physical form and to half-life or potency and are allowed to decay naturally and buried

USTH is unable to Mark bags and containers for infectious waste with the international infectious substance symbol specify if highly infectious waste are treated immediately or if cytotoxic waste are collected in leak proof containers and are labeled Deposit in specified containers, packagings with obsolete or expired drug residues

Procedural Manual Title III of Dao 92-29 “Hazardous Waste Management” Compliance of UST hospital regarding the handling, collection and storage of Pathogenic waste in accordance to the Procedural Manual Title III of Dao 92-29 “Hazardous Waste Management” of Department of Environment and Natural Resources

USTH duly notifies the DENR on the type and quantity of waste produced and pays the Department the prescribed fees continues responsibility for waste generated until it has been disposed of The personnel are trained in emergency contingency plans and its implementation

Requirements for proper Hazardous Waste Management fails to have an appointed Pollution Control Officer Radioactive and pathologic wastes are stored in separate rooms in the basement where the area is prone to flooding, and is poorly ventilated. no assurance of security of the area or segregation of waste by pH drums of waste are not on raised pallets

However, USTH is compliant with accessibility in non-emergency cases, such as for inspection and monitoring enclosed with non-slippery floors that are impermeable to chemicals.

pre-transport or packaging and labeling of wastes does not conform to prescribed labeling guidelines on the size of labels and the use of internationally recognized symbols

Recommendations For the Hospital, the proponents recommends : storage facilities that are not prone to flooding and not freely accessible by non- authorized personnel segregation by proper labeling with the international infectious substance symbol prior to transport to storage facility should be implemented highly infectious waste should be treated immediately by the recommended method cytotoxic waste should be collected in leak proof containers and labeled

Personnel should also be given refresher courses and evaluation regarding handling, personal protection, emergency action plans at least yearly A Pollution Control Officer should also be appointed to closely handle Waste Management Waste Transport Record should be made, in compliance with the DENR manual, to help monitor conformity to recommendations.

Further study can be made on the knowledge and practices of personnel on handling of wastes

Thank you!