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Training on Medical Waste Management
in Collaboration with Al-Essa Medical & Scientific Equipment Co. W.L.L
Kuwait University Health Science Center 29 January – 1 February, 2012
Global Perspectives on Medical Waste Management
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Ed Krisiunas, MT (ASCP), MPH President WNWN International PO Box 1164 Burlington, Connecticut 06013 USA Tel.: +1-860-675-1217 Fax.: +1-860-675-1311 Mob.: +1-860-839-3993 Email: [email protected] [email protected] Skype: Boutiquewaste
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Presentation Outline
1. Global Perspective 2. Environmental Health and Safety Issues 3. Risk Assessment 4. Definitions of Medical Waste - WHO 5. Management of Waste in the Facility 6. Decontamination 7. Transport, Treatment / Disposal of Medical Waste 8. Practicing Safe Science video
Quiz!!!!!!
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Waste Management is a Process
Not a Technology.
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What’s in a Name / Definition??
• Biohazardous Waste
• Biomedical Waste
• Clinical Waste
• Healthcare Waste
• Hospital Waste
• Infectious Waste
• Medical Waste
• Regulated Medical Waste
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Chelsea
Arsenal
Tottenham
Lord’s
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HTM 07-01 NHS UK Is this what it really looks like???
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Most preferable
Least preferable
Prevent
ReduceReuse
RecycleRecover
TreatDispose
Waste Management Hierarchy
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Global Perspective – Actual Practices
Different Cultures but common themes to Waste Management
Caribbean
Armenia United States
Hong Kong
Lithuania China
South Africa
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International Healthcare Waste Guidelines
Healthcare Waste Guidelines and Regulations
Facility Healthcare Waste Management Plan
Global Level
National Level
Local Level
Unique to each Facility
Best Available Practices
Country Specific
General
Applicability of information on Healthcare Waste Management
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World Health Organization
Introduction to Legislation
International Agreements and Principles
• Basel Convention
• Polluter Pays Principle
• Precautionary Principle
• Duty of Care Principle
• Proximity Principle
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Basel Convention, 1989
• Coordinated by the United Nations Environment Programme (UNEP)
• Signed by more than 100 Nations (Parties)
• Controls transboundary movements of hazardous waste
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Polluter Pays
All waste producers are legally and
financially responsible for:
• safe handling
• environmentally sound disposal
• creating an incentive to produce less
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Precautionary Principle
Where risk is uncertain or unknown:
• Assume risk is significant
• Plan protection measures accordingly
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“Duty of Care” for Wastes
The “duty of care” principle stipulates that any person handling or managing hazardous substances or related equipment is ethically responsible for applying the utmost care.
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Proximity Principle
Treatment and disposal of waste takes place as near as possible to the point of production as is technically and environmentally possible
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Typical Waste breakdown in Healthcare Facilities Source: Technical Guidelines on the Environmentally Sound Management of Biomedical and Healthcare Wastes (Y1; Y3), Secretariat of the Basel Convention, 2003
Chemical/radioactive
(hazardous)5%
Infectious (hazardous)
10%
General non-infectious 85%
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01
23
45
67
89
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Country (increasing Gross National Income per capita→)
Ave
rage
kg
/ bed
-day
Total Healthcare Waste generation in Hospitals (in kg/bed-day)
Points represent reported averages; vertical lines are reported ranges of data. Low-income Countries: 1-Bangladesh (includes clinics), 2-Cambodia, 3-Lao PDR, 4-Nigeria, 5-Vietnam, 6-Pakistan, 7-India; Middle-income Countries: 8-Guyana, 9-Philippines, 10-Jordan, 11-Columbia, 12-Peru, 13-Thailand, 14-Iran, 15-Brazil (includes health centers and labs), 16-Turkey; High-income Countries: 17-Portugal, 18-Kuwait, 19-United States
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0
0.5
1
1.5
2
2.5
3
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Country (increasing Gross National Income per capita→)
Aver
age
kg /
bed-
day
Infectious Waste generation in Hospitals (in kg/bed-day)
Points represent reported averages; vertical lines are reported ranges of data. Low-income Countries: 1-Bangladesh (includes clinics), 2-Cambodia, 3-Nigeria (poor segregation), 4-Vietnam, 5-India; Middle-income countries: 6-Guyana, 7-Philippines, 8-Columbia, 9-Thailand, 10-Iran (poor segregation), 11-Bulgaria, 12-Brazil (includes health centers and labs-poor segregation); High-income Countries: 13-Taiwan (China), 14-Portugal, 15-Hong Kong (China), 16-Kuwait (poor segregation), 17-Italy, 18-United States