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加纳北部塔马利中央医院的医疗废物管理。加纳新冠疫情出现之前的一项评估。

Healthcare waste management in the Tamale Central Hospital, northern Ghana. An assessment before the emergence of the COVID-19 pandemic in Ghana.

作者信息

Abanyie Samuel Kojo, Amuah Ebenezer Ebo Yahans, Douti Nang Biyogue, Amadu Casmid Charles, Bayorbor Manaf

机构信息

Department of Environment, Water and Waste Engineering, University for Development Studies, Tamale, Ghana.

Department of Environmental Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

出版信息

Environ Chall (Amst). 2021 Dec;5:100320. doi: 10.1016/j.envc.2021.100320. Epub 2021 Oct 12.

Abstract

Healthcare waste (HCW) poses several environmental and public health challenges. However, much attention has not been given to its management. The present study sought to assess the healthcare waste management (HCWM) practices in the Tamale Central Hospital (TCH) by characterizing and measuring the quantities of waste generated and the associated implications. Observation of the value chain of healthcare waste management, waste quantification using a weighing scale (Top-pan-spring balance), and semi-structured interviews were used in the data collection. The study revealed that, except for sharps, there was no segregation of infectious and non-infectious waste, and healthcare waste was not treated before final disposal. The study showed that a daily record of 5.1 kg of sharps, 24.46 kg of infectious waste and 59.45 kg of general waste was generated. The maternity ward produced more general waste (14 kg), whereas the theatre generated the highest infectious waste (5.70 kg) and sharps (0.8 kg) daily. Generally, the maternity ward recorded the highest daily waste generation of 17.9 kg. The waste treatment method available in the hospital was incineration. However, the incinerator was found to be dysfunctional. Thus, an improvised method (dug pit) was used irrespective of the associated health and environmental implications. The study also revealed that the hospital did not quantify the amount of solid waste that was generated. Inadequate finance and lack of supervision were linked to the problem of poor healthcare waste management in the study area. Also, 82% of the workers mentioned that there was poor HCW segregation at the departments whereas 76% of the patients who received healthcare at the facility were unsatisfied with the HCWM practices. A strong linear relationship in the responses made was recorded. The healthcare waste management index showed that the HCWM practice at the facility was unsatisfactory as it was medium-ranked. The study, therefore, recommends that the hospital considers constructing an on-site waste treatment facility, segregate and quantify waste for effective allocation of resources for treating healthcare waste.

摘要

医疗废物对环境和公众健康构成了诸多挑战。然而,其管理工作并未得到足够重视。本研究旨在通过对塔马利中心医院(TCH)产生的废物量进行特征描述和测量以及评估相关影响,来评定该医院的医疗废物管理(HCWM)实践情况。数据收集采用了观察医疗废物管理价值链、使用秤(顶盘弹簧秤)进行废物量化以及半结构化访谈等方法。研究表明,除了锐器外,感染性和非感染性废物没有进行分类,医疗废物在最终处置前也未得到处理。研究显示,每日产生的锐器为5.1千克、感染性废物为24.46千克、普通废物为59.45千克。产科病房产生的普通废物最多(14千克),而手术室每日产生的感染性废物(5.70千克)和锐器(0.8千克)最多。总体而言,产科病房记录的每日废物产生量最高,为17.9千克。医院可用的废物处理方法是焚烧。然而,发现焚烧炉存在功能故障。因此,不顾及相关的健康和环境影响,采用了一种临时方法(挖坑)。研究还表明,医院没有对产生的固体废物量进行量化。资金不足和缺乏监管与研究区域医疗废物管理不善的问题有关。此外,82%的工作人员提到各科室医疗废物分类不佳,而在该机构接受治疗的患者中有76%对医疗废物管理实践不满意。记录的回答之间存在很强的线性关系。医疗废物管理指数表明,该机构的医疗废物管理实践不令人满意,因为其排名中等。因此,该研究建议医院考虑建设一个现场废物处理设施,对废物进行分类和量化,以便有效分配资源来处理医疗废物。

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