Tesfahun Esubalew, Kumie Abera, Legesse Worku, Kloos Helmut, Beyene Abebe
1School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Waste Manag Res. 2014 Mar;32(3):215-20. doi: 10.1177/0734242X14521683. Epub 2014 Feb 13.
In many developing countries, the inadequacy of data regarding the quantity and composition of healthcare waste is one of the major reasons for improper healthcare waste management. We investigated the generation rate and composition of healthcare wastes in six public and three private hospitals. We conducted healthcare waste composition and characterization measurements for seven consecutive days in the selected hospitals following the protocol described by the World Health Organization (WHO). The results revealed that the total generation rate of healthcare wastes of hospitals ranged from 0.25 to 2.77 kg/bed/day with a median value of 1.67 kg/bed/day for inpatients to 0.21-0.65 in kg/patient/day with a median value of 0.31 kg/patient/day for outpatients. The waste generation rate in private hospitals (median 3.9 kg/bed/day) was significantly greater (Kruskal-Wallis test, P < 0.05) than in government hospitals (median 1.5 kg/bed/day). The median values of percent hazardous waste estimated for private and government hospitals were 63.4% and 52.2%, respectively. These figures are about three times greater than the threshold values recommended by the WHO. This situation might be attributed to the improper practice of healthcare waste segregation by health professionals and auxiliary health workers due to inadequate risk perception and lack of enforced public health regulations. The study revealed that the generation rate and proportion of hazardous waste significantly varies between public and private hospitals and number of patients treated per day.
在许多发展中国家,医疗废物数量和成分数据的不足是医疗废物管理不当的主要原因之一。我们调查了六家公立医院和三家私立医院的医疗废物产生率及成分。按照世界卫生组织(WHO)描述的方案,我们在选定的医院连续七天进行了医疗废物成分和特性测量。结果显示,医院医疗废物的总产生率为住院患者0.25至2.77千克/床/天,中位数为1.67千克/床/天;门诊患者为0.21至0.65千克/患者/天,中位数为0.31千克/患者/天。私立医院的废物产生率(中位数3.9千克/床/天)显著高于政府医院(中位数1.5千克/床/天)(Kruskal-Wallis检验,P<0.05)。私立医院和政府医院估计的危险废物百分比中位数分别为63.4%和52.2%。这些数字约为WHO建议阈值的三倍。这种情况可能归因于卫生专业人员和辅助卫生工作者因风险认知不足和公共卫生法规执行不力而在医疗废物分类方面的不当做法。研究表明,公立和私立医院之间以及每天治疗的患者数量之间,危险废物的产生率和比例存在显著差异。