Environmental Health Department, High Institute of Public Health, Alexandria University, Egypt.
J Environ Manage. 2010 Jan-Feb;91(3):618-29. doi: 10.1016/j.jenvman.2009.08.012.
This study investigated the hospital waste management practices used by eight randomly selected hospitals located in Damanhour City of El-Beheira Governorate and determined the total daily generation rate of their wastes. Physico-chemical characteristics of hospital wastes were determined according to standard methods. A survey was conducted using a questionnaire to collect information about the practices related to waste segregation, collection procedures, the type of temporary storage containers, on-site transport and central storage area, treatment of wastes, off-site transport, and final disposal options. This study indicated that the quantity of medical waste generated by these hospitals was 1.249tons/day. Almost two-thirds was waste similar to domestic waste. The remainder (38.9%) was considered to be hazardous waste. The survey results showed that segregation of all wastes was not conducted according to consistent rules and standards where some quantity of medical waste was disposed of with domestic wastes. The most frequently used treatment method for solid medical waste was incineration which is not accepted at the current time due to the risks associated with it. Only one of the hospitals was equipped with an incinerator which is devoid of any air pollution control system. Autoclaving was also used in only one of the selected hospitals. As for the liquid medical waste, the survey results indicated that nearly all of the surveyed hospitals were discharging it in the municipal sewerage system without any treatment. It was concluded that the inadequacies in the current hospital waste management practices in Damanhour City were mainly related to ineffective segregation at the source, inappropriate collection methods, unsafe storage of waste, insufficient financial and human resources for proper management, and poor control of waste disposal. The other issues that need to be considered are a lack of appropriate protective equipment and lack of training and clear lines of responsibilities between the departments involved in hospital waste management. Effective medical waste management programs are multisectoral and require cooperation between all levels of implementation, from national and local governments to hospital staff and private businesses.
本研究调查了位于贝海耶省达曼胡尔市的八所随机选定医院所采用的医院废物管理实践,并确定了其废物的日总产量。根据标准方法确定了医院废物的理化特性。通过问卷调查收集了与废物分类、收集程序、临时储存容器类型、现场运输和中央储存区、废物处理、场外运输和最终处置选择有关的信息。本研究表明,这些医院产生的医疗废物数量为 1.249 吨/天。近三分之二是类似于家庭废物的废物。其余(38.9%)被认为是危险废物。调查结果表明,所有废物的分类没有按照一致的规则和标准进行,一些医疗废物与家庭废物一起处理。用于固体医疗废物的最常用处理方法是焚烧,由于与之相关的风险,目前不被接受。只有一家医院配备了没有任何空气污染控制系统的焚烧炉。仅在一家选定的医院使用了高压灭菌法。至于液态医疗废物,调查结果表明,几乎所有被调查的医院都将其排放到城市污水系统中,而没有进行任何处理。研究结论认为,达曼胡尔市当前医院废物管理实践中的不足之处主要与源头有效分类不足、收集方法不当、废物储存不安全、缺乏适当管理的财政和人力资源以及废物处置控制不力有关。需要考虑的其他问题是缺乏适当的防护设备以及缺乏培训以及参与医院废物管理的部门之间的明确责任分工。有效的医疗废物管理计划是多部门的,需要从国家和地方政府到医院工作人员和私营企业各级实施的合作。