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牙科诊所的废物管理:巴西贝洛奥里藏特的案例研究。

Waste management from dental clinics: A case study in Belo Horizonte, Brazil.

机构信息

Fundação Ezequiel Dias, Diretoria de Pesquisa e Desenvolvimento, Belo Horizonte, MG, Brazil.

Superintendência de Limpeza Urbana (SLU), Prefeitura Municipal de Belo Horizonte, MG, Brazil.

出版信息

Waste Manag. 2024 Dec 1;189:177-184. doi: 10.1016/j.wasman.2024.08.027. Epub 2024 Aug 28.

DOI:10.1016/j.wasman.2024.08.027
PMID:39208754
Abstract

Healthcare waste management is a critical aspect of public health and environmental protection, particularly in establishments such as dental clinics. This study examined the dental clinic waste (DCW) management processes in clinics within the city of Belo Horizonte, Brazil. Utilizing data from Healthcare Waste Management Plans (HCWMP) provided by the Urban Cleaning Superintendence, the study investigated waste generation, segregation, storage, collection, treatment, and final disposal practices. The results revealed that hazardous DCW represented a significant portion (26.5 %) of waste generated in dental clinics, exceeding the World Health Organization's recommended threshold. Biological waste (22.9 %), mainly consisting of cotton, gauze, and gloves contaminated with blood or body fluids, was the most generated hazardous waste group, followed by chemical (2.2 %) and sharps waste (1.3 %). Incineration was the predominant treatment method for hazardous DCW, raising concerns about environmental impacts and greenhouse gas emissions. Non-hazardous waste, primarily destined for landfills, had limited recycling rates (2.4 %), emphasizing the need for improved waste management strategies to minimize environmental impacts and increase circular economy. Challenges in DCW management included inadequate segregation practices, limited recycling initiatives, and incomplete HCWMPs lacking descriptions of waste management beyond establishment boundaries. Addressing these challenges requires comprehensive training programs, strengthened regulations, and increased environmental awareness among healthcare professionals. In conclusion, improving DCW management in dental clinics is crucial for mitigating occupational and environmental risks. Collective efforts are needed to enhance waste segregation, promote recycling, and ensure compliance with regulations, ultimately safeguarding public health and the environment.

摘要

医疗废物管理是公共卫生和环境保护的一个关键方面,特别是在牙科诊所等机构中。本研究考察了巴西贝洛奥里藏特市诊所的牙科诊所废物(DCW)管理流程。利用城市清洁监督机构提供的《医疗废物管理计划》(HCWMP)中的数据,研究调查了废物产生、分类、储存、收集、处理和最终处置做法。研究结果表明,危险的 DCW 占牙科诊所产生的废物的很大一部分(26.5%),超过了世界卫生组织推荐的阈值。生物废物(22.9%),主要由棉花、纱布和手套组成,这些物品被血液或体液污染,是产生的主要危险废物,其次是化学废物(2.2%)和锐器废物(1.3%)。焚烧是处理危险的 DCW 的主要方法,这引起了人们对环境影响和温室气体排放的关注。非危险废物主要送往垃圾填埋场,其回收利用率有限(2.4%),这强调了需要制定更好的废物管理策略,以尽量减少环境影响并增加循环经济。DCW 管理面临的挑战包括分类实践不足、回收举措有限以及 HCWMP 不完整,缺乏超出机构边界的废物管理描述。解决这些挑战需要全面的培训计划、加强法规以及提高医疗保健专业人员的环境意识。总之,改善牙科诊所的 DCW 管理对于减轻职业和环境风险至关重要。需要共同努力加强废物分类、促进回收利用,并确保遵守法规,最终保护公众健康和环境。

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