1. 1 HCW Working Group Annette Pruess World Health Organization Protection of the Human Environment (PHE)

2. 2 Content of my presentation Strategy –Participation of relevant WHO programmes –External review group –External partners Ongoing activities Available products

3. 3 Strategy Developing the evidence base science + monitor progress Prepare guidance material assist in choices Achieve safety and availability of options information source development Support the development of country plans networks pilot projects

4. 4 Products Fact Sheet N° 253 October 2000 WASTES FROM HEALTH-CARE ACTIVITIES Health-care activities - for instance, immunizations, diagnostic tests, medical treatments, and laboratory examinations - protect and restore health and save lives. But what about the wastes and by-products they generate? From the total of wastes generated by health-care activities, almost 80% are general waste comparable to domestic waste. The remaining approximate 20% of wastes are considered hazardous materials that may be infectious, toxic or radioactive. The wastes and by-products cover a diverse range of materials, as the following list illustrates (percentages are approximate values):

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6. 6 Network Knowledge network Compilation of information and others...

7. 7 Database Contains a number of technical options –on segregation, transport, treatment and disposal Characteristics Contact information Source Comments Technical drawing and construction requirementss Links to resource material Country info Interactive exchange

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10. 10 Interactivity This data base also enables members of the peer review group to enter comments “on-line” straight within the data base. A similar mechanism will be available for people to give us there feed-back regarding the technical options they have tested or even enter options they know of and which isn’t in the data base yet…

11. 11 Decision-making guide Targeted at primary health care centres Tool for guiding in decisions for the best options in a given situation Core part: decision trees

12. 12 Peri-Urban with Access to Landfill (DRAFT) Waste Minimization Infectious Non- Sharps in Bags/ Containers Sharps, in Sharps Boxes Non-Infectious Informal Recycling Onsite Treatment Large Disinfection Unit Available with Required Resources Disinfection by Onsite Treatment Device (Autoclaving, Microwaving, etc.) Landfill Segregation Availability of Resources for Incineration Burial Pit on Premises Municipal Waste Stream Yes Large Disinfection Unit Available with Required Resources Disinfection by Onsite Treatment Transportation Available Offsite Landfill No Yes Acceptable Operating Conditions for Incineration Incinerator Yes No Ash Yes Densely Populated Area (People Living < 50 m) Transportation Available Transport to Larger Facility with Treatment Facility Available Space on Facility Premises for Burial Burial Pit on Premises Disinfect with Bleach Landfill No Yes No Yes No Acceptable Operating Conditions for Incineration Yes Incineration Burial Pit on Premises YesNo Ability and Resources to Separate Biodegradable Organic Materials Space Available to Compost Organics Ability and Resources to Compost Organics Composting No Yes Densely Populated Area (People Living < 50 m) Available Space on Facility Premises for Burial Yes No Disinfect Landfill No Yes Availability of Resources for Incineration

13. 13 Forthcoming... Database Rapid Assessment Tool (RAT) National Action Plan (NAP) Guide on disposal of blood Decision-making guide for PHC