Udofia Emilia Asuquo, Gulis Gabriel, Fobil Julius
Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, University of Ghana, Legon, Ghana.
Department of Community Health, School of Public Health, University of Ghana, Legon, Ghana.
BMC Public Health. 2017 May 18;17(1):464. doi: 10.1186/s12889-017-4366-9.
Solid medical waste (SMW) in households is perceived to pose minimal risks to the public compared to SMW generated from healthcare facilities. While waste from healthcare facilities is subject to recommended safety measures to minimize risks to human health and the environment, similar waste in households is often untreated and co-mingled with household waste which ends up in landfills and open dumps in many African countries. In Ghana, the management of this potentially hazardous waste stream at household and community level has not been widely reported. The objective of this study was to investigate household disposal practices and harm resulting from SMW generated in households and the community.
A cross-sectional questionnaire survey of 600 households was undertaken in Ga South Municipal Assembly in Accra, Ghana from mid-April to June, 2014. Factors investigated included socio-demographic characteristics, medication related practices, the belief that one is at risk of diseases associated with SMW, SMW disposal practices and reported harm associated with SMW at home and in the community.
Eighty percent and 89% of respondents discarded unwanted medicines and sharps in household refuse bins respectively. A corresponding 23% and 35% of respondents discarded these items without a container. Harm from SMW in the household and in the community was reported by 5% and 3% of respondents respectively. Persons who believed they were at risk of diseases associated with SMW were nearly three times more likely to report harm in the household (OR 2.75, 95%CI 1.15-6.54).
The belief that one can be harmed by diseases associated with SMW influenced reporting rates in the study area. Disposal practices suggest the presence of unwanted medicines and sharps in the household waste stream conferring on it hazardous properties. Given the low rates of harm reported, elimination of preventable harm might justify community intervention.
与医疗机构产生的固体医疗废物相比，家庭中的固体医疗废物（SMW）被认为对公众构成的风险极小。虽然医疗机构的废物受到建议的安全措施管制，以尽量减少对人类健康和环境的风险，但家庭中的类似废物往往未经处理，并与生活垃圾混合，最终在许多非洲国家进入垃圾填埋场和露天垃圾场。在加纳，家庭和社区层面这种潜在危险废物流的管理情况尚未得到广泛报道。本研究的目的是调查家庭处置做法以及家庭和社区产生的固体医疗废物所造成的危害。
2014年4月中旬至6月，在加纳阿克拉的加南区市政议会对600户家庭进行了横断面问卷调查。调查的因素包括社会人口特征、与药物相关的做法、认为自己有患与固体医疗废物相关疾病风险的看法、固体医疗废物处置做法以及报告的在家中和社区与固体医疗废物相关的危害。
分别有80%和89%的受访者将不需要的药品和锐器丢弃在家庭垃圾桶中。相应地，分别有23%和35%的受访者在没有容器的情况下丢弃这些物品。分别有5%和3%的受访者报告了家庭和社区中固体医疗废物造成的危害。认为自己有患与固体医疗废物相关疾病风险的人报告家庭中受到危害的可能性几乎是其他人的三倍（比值比2.75，95%置信区间1.15 - 6.54）。
认为自己会受到与固体医疗废物相关疾病伤害的看法影响了研究区域内的报告率。处置做法表明家庭废物流中存在不需要的药品和锐器，使其具有危险特性。鉴于报告的危害发生率较低，消除可预防的危害可能需要社区干预。
