1. MANAGEMENT OF MEDICAL WASTE IN HEALTH FACILITIES
Prepared By : PASCHAL. N. NJOKA
Presented By: Florence Atieno Aneya
BIO-MEDICAL ENGINEERS
Ministry of Medical Services, KENYA

2. HEALTH CARE WASTE MANAGEMENT INTRODUCTION
Special in that it has high potential of waste infection and injury.
Inadequate handling of Health care waste may have serious public Health consequences and impact on the environment.
Hospital and Health-Care establishments have responsibilities and a “duty of care” for environment and public Health.
HHC - also carry a responsibility to ensure that there are no adverse health and environmental consequences as a result of waste handling, treatment and disposal activities.
This paper aims at transmitting the basic skill for development and implementation of health care waste management policy.

3. WHO Defines - DEFINATION
Health care waste:
As The total waste stream from a healthcare or research facility that include both potential risk waste and non-risk waste materials.

4. IMPORTANCE OF PROPER WASTE DISPOSAL
Minimizes the spread of infection
Reduces the risk of accidental injury to staff, patients, visitors and the community.
Attract fewer insects, rodents and animal
Reduces Adour
Reduces the likelihood of contamination of the soil or ground water with chemicals or micro-organism.
Help provide and aesthetically pleasing atmosphere

5. CLASSIFICATION OF HEALTH CARE WASTE
Categories of waste
RISK WASTE - 20% of HCW and include:
- Infectious waste i.e. blood and blood products, body fluids
Anatomical waste-Human tissue
Sharp waste – Needles, Syringes, Scalpel blades
Chemical waste-formaldehyde, photographic chemicals, solvent, organic chemicals
Pharmaceutical waste
Radioactive waste
Genotoxic waste-include cystostatic drugs, vomit, urine, from patient treated with cytotoxic drugs
Pressurized containers
Waste with high content of heavy metals.

6. CATEGORIES OF WASTE (cont.)
B) LOW RISK waste-80% of HCW Referred to as Communal waste – All social waste that does not contain high risk waste type e.g. bottles, office paper, boxes and packaging material.

7. KEY STEPS IN HCW MANAGEMENT
SEGREGATION – Basically separation of waste by type where it is generated
colour coding of waste.
CATEGORIES
EXAMPLES
COLOUR OF BINLINERS
Non-infectious
Paper, plastic boxes
Black
Infectious
Gloves, Dressing
Yellow
Highly Infectious
Anatomical waste
Red
Chemical
Formaldehyde, batteries
Brown
Radioactive
Any solid, liquid with radioactive isotopes
Yellow with radioactive label

8. KEY STEPS IN HCW MANAGEMENT(cont.)
B)HANDLING AND STORAGE
Collection – Removing waste bags and taking to storage or disposal area
Weighing - Quantifying waste by volume or weight, labeling as to it source, and recording
Storage - Not longer that 2-3 days in secure designated place.
Organic waste should be disposed daily.
C) CONTAINMENT

9. KEY STEPS IN HCW MANAGEMENT(cont.)
D) TRANSPORT
Movement of waste from one place to another, either on site or offsite
After transport, clean the vehicle surfaces

10. KEY STEPS IN HCW MANAGEMENT(cont.)
E) TREATMENT AND DISPOSAL
Treatment – so as to render it non-hazardous
Types of waste
Recommended Treatment
Recommended Procedure
Microbiological waste e.g. culture, vaccine, specimen
Autoclave
As per instruction with the machine
Pathological waste tissue, organs, blood
Liming
Dig pit- place lime-add waste- add more lime-add soil
Infectious fluid
chemical
0.5% Sodium Hypochlorite solution. Let sit for 15minutes

11. KEY STEPS IN HCW MANAGEMENT(cont.)
ii) DISPOSAL METHODS
Eliminating or transporting health waste from the facilities
Disposal method include
Bury – waste is placed into a pit and covered with earth.
Burn – Placed in a pit and burned on a regular basis and ashes covered with earth.
Encapsulate – Fill container with waste, add immobilizing material(cement, sand or clay) and seal the container. Best for vaccine disposal.

12. DISPOSAL METHOD(cont.)
4) Incinerate
High temperature (>800°c) burning reducing volume of waste and eliminating pathogens
Types of incinerators
i) Demonfort incinerators-made of fire bricks and fire proof cement.
ii) Diesel powered incinerator

13. INCENERATION(cont.) INCINERATOR OPERATION AND MANTAINANCE
For an incinerator to be used properly, it must have the following:
Clear operation procedure well posted near the equipment
Trained operator
Reliable segregation system
Reliable transport system
Ash pit to safely dump the incineration ash
Regular maintenance and repair
Adequate supply of fuel

14. LAWS RELATED TO WASTE MANAGENT
EMCA 1999-Environment management control Act
Biomedical Waste Regulations(Draft)
Public Health Act-Cap 242
Basel Convention
Global treaty that applies to international transportation of hazardous wastes.
Stockholm Convention
Global treaty to protect human health and environment from persistent organic pollutant(pop) specifically dioxins and furans.
United Nations packaging requirements
Guidelines for proper packaging and international transport of infectious substances.
Defines both inner and outer packaging composition requirements

15. A Dirty Country Is A Dying Nation
CONCLUSION
A Dirty Country Is A Dying Nation
(Mr. Lay 1842)
THANK YOU!
END