Coker Akinwale, Sangodoyin Abimbola, Sridhar Mynepalli, Booth Colin, Olomolaiye Paul, Hammond Felix
Department of Civil Engineering, Faculty of Technology, University of Ibadan, Ibadan, Nigeria.
Waste Manag. 2009 Feb;29(2):804-11. doi: 10.1016/j.wasman.2008.06.040. Epub 2008 Oct 2.
Quantification and characterization of medical waste generated in healthcare facilities (HCFs) in a developing African nation has been conducted to provide insights into existing waste collection and disposal approaches, so as to provide sustainable avenues for institutional policy improvement. The study, in Ibadan city, Nigeria, entailed a representative classification of nearly 400 healthcare facilities, from 11 local government areas (LGA) of Ibadan, into tertiary, secondary, primary, and diagnostic HCFs, of which, 52 HCFs were strategically selected. Primary data sources included field measurements, waste sampling and analysis and a questionnaire, while secondary information sources included public and private records from hospitals and government ministries. Results indicate secondary HCFs generate the greatest amounts of medical waste (mean of 10,238 kg/day per facility) followed by tertiary, primary and diagnostic HCFs, respectively. Characterised waste revealed that only approximately 3% was deemed infectious and highlights opportunities for composting, reuse and recycling. Furthermore, the management practices in most facilities expose patients, staff, waste handlers and the populace to unnecessary health risks. This study proffers recommendations to include (i) a need for sustained cooperation among all key actors (government, hospitals and waste managers) in implementing a safe and reliable medical waste management strategy, not only in legislation and policy formation but also particularly in its monitoring and enforcement and (ii) an obligation for each HCF to ensure a safe and hygienic system of medical waste handling, segregation, collection, storage, transportation, treatment and disposal, with minimal risk to handlers, public health and the environment.
对非洲一个发展中国家的医疗保健机构（HCFs）产生的医疗废物进行了量化和特征分析，以深入了解现有的废物收集和处置方法，从而为机构政策改进提供可持续的途径。这项在尼日利亚伊巴丹市进行的研究，对来自伊巴丹11个地方政府区域（LGA）的近400家医疗保健机构进行了代表性分类，分为三级、二级、一级和诊断性医疗保健机构，其中战略性地选择了52家医疗保健机构。主要数据来源包括现场测量、废物采样与分析以及问卷调查，而次要信息来源包括医院和政府部门的公共和私人记录。结果表明，二级医疗保健机构产生的医疗废物量最大（每家机构平均每天10238千克），其次分别是三级、一级和诊断性医疗保健机构。经特征分析的废物显示，只有约3%被视为传染性废物，并突出了堆肥、再利用和回收的机会。此外，大多数机构的管理做法使患者、工作人员、废物处理人员和民众面临不必要的健康风险。本研究提出的建议包括：（i）所有关键行为者（政府、医院和废物管理者）需要持续合作，实施安全可靠的医疗废物管理战略，不仅在立法和政策制定方面，而且特别是在其监测和执行方面；（ii）每个医疗保健机构有义务确保医疗废物处理、分类、收集、储存、运输、处理和处置的安全卫生系统，将对处理人员、公众健康和环境的风险降至最低。
