医疗废物——全球健康面临的严重问题。

Healthcare Waste-A Serious Problem for Global Health.

作者信息

Janik-Karpinska Edyta, Brancaleoni Rachele, Niemcewicz Marcin, Wojtas Wiktor, Foco Maurizio, Podogrocki Marcin, Bijak Michal

机构信息

Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland.

Bed Management Unit, Agostino Gemelli IRCCS University Hospital Foundation, Via della Pineta Sacchetti 217, 00168 Rome, Italy.

出版信息

Healthcare (Basel). 2023 Jan 13;11(2):242. doi: 10.3390/healthcare11020242.

Abstract

Healthcare waste (HCW) is generated in different healthcare facilities (HCFs), such as hospitals, laboratories, veterinary clinics, research centres and nursing homes. It has been assessed that the majority of medical waste does not pose a risk to humans. It is estimated that 15% of the total amount of produced HCW is hazardous and can be infectious, toxic or radioactive. Hazardous waste is a special type of waste which, if not properly treated, can pose a risk to human health and to the environment. HCW contains potentially harmful microorganisms that can be spread among healthcare personnel, hospital patients and the general public, causing serious illnesses. Healthcare personnel are the specialists especially exposed to this risk. The most common medical procedure, which pose the highest risk, is injection (i.e, intramuscular, subcutaneous, intravenous, taking blood samples). The World Health Organization (WHO) estimates that around 16 billion injections are administered worldwide each year. However, if safety precautions are not followed, and needles and syringes are not properly disposed of, the risk of sharps injuries increases among medical staff, waste handlers and waste collectors. What is more, sharps injuries increase the risk of human immunodeficiency virus (HIV), hepatitis B and C viruses (HBV/HCV), tuberculosis (TB), diphtheria, malaria, syphilis, brucellosis and other transmissions. Disposing of medical waste in a landfill without segregation and processing will result in the entry of harmful microorganisms, chemicals or pharmaceuticals into soil and groundwater, causing their contamination. Open burning or incinerator malfunctioning will result in the emission of toxic substances, such as dioxins and furans, into the air. In order to reduce the negative impact of medical waste, waste management principles should be formulated. To minimize health risks, it is also important to build awareness among health professionals and the general public through various communication and educational methods. The aim of this paper is to present a general overwiev of medical waste, its categories, the principles of its management and the risks to human health and the environment resulting from inappropriate waste management.

摘要

医疗废物产生于不同的医疗保健机构,如医院、实验室、兽医诊所、研究中心和疗养院。据评估,大多数医疗废物对人类不构成风险。据估计,所产生的医疗废物总量中有15%是有害的,可能具有传染性、毒性或放射性。危险废物是一种特殊类型的废物,如果处理不当,会对人类健康和环境构成风险。医疗废物含有潜在有害微生物,可在医护人员、医院患者和普通公众中传播,引发严重疾病。医护人员是特别容易面临这种风险的专业人员。风险最高的最常见医疗程序是注射(即肌肉注射、皮下注射、静脉注射、采集血样)。世界卫生组织(WHO)估计,全球每年进行约160亿次注射。然而,如果不遵守安全预防措施,针头和注射器未得到妥善处理,医护人员、废物处理人员和废物收集人员发生锐器伤的风险就会增加。此外,锐器伤会增加感染人类免疫缺陷病毒(HIV)、乙型和丙型肝炎病毒(HBV/HCV)、结核病(TB)、白喉、疟疾、梅毒、布鲁氏菌病及其他疾病的风险。在未经分类和处理的情况下将医疗废物填埋会导致有害微生物、化学物质或药物进入土壤和地下水,造成污染。露天焚烧或焚烧炉故障会导致二恶英和呋喃等有毒物质排放到空气中。为了减少医疗废物的负面影响,应制定废物管理原则。通过各种沟通和教育方法提高卫生专业人员和公众的认识也很重要。本文旨在对医疗废物、其类别、管理原则以及不当废物管理对人类健康和环境造成的风险进行总体概述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e279/9858835/0c6e87ea4e86/healthcare-11-00242-g001.jpg

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