The WHO Health Care Waste Management website starts at http://www.healthcarewaste.org/en/115_overview.html
Healthcare activities lead to the production of waste that can have adverse health effects. Although most of this waste is not more dangerous than regular household waste, some types of healthcare waste represent a higher risk to health: these include infectious waste (15% to 25% of total healthcare waste) among which aresharps waste (1%), body part waste (1%),chemical or pharmaceutical waste (3%), andradioactive and cytotoxic waste or broken thermometers (less than 1%).
Sharps waste, although produced in small quantities, is highly infectious. Poorly managed, they expose healthcare workers, waste handlers and the community to infections. Contaminated needles and syringes represent a particular threat and may be scavenged from waste areas and dump sites and be reused. WHO has estimated that, in 2000, injections with contaminated syringes caused:
Epidemiological studies indicate that a person who experiences one needle-stick injury from a needle used on an infected source patient has risks of 30%, 1.8%, and 0.3% respectively to become infected with HBV, HCV and HIV. In 2002, the results of a WHO assessment conducted in 22 developing countries showed that the proportion of healthcare facilities that do not use proper waste disposal methods ranges from 18% to 64%.
HCWM options may themselves lead to risks to health and no perfect readily achievable solution to manage HCW exists. Healthcare waste, whether generated at smaller rural clinics or larger facilities, can be managed where adequate well-operated infrastructures exist.
However, the volumes of waste generated within large facilities and targeted public efforts (e.g., immunization campaigns) are more challenging, particularly in developing countries where resources may be limited. In these difficult situations for which waste disposal options are limited, small-scale incinerators have been used and are still used as an interim solution. However, small-scale incinerators often operate at temperatures below 800 degrees Celsius. This may lead to the production of dioxins, furans or other toxic pollutants as emissions and/or in bottom/fly ash. Transport to centralised disposal facilities may also produce hazards to healthcare handlers, if not safely managed.
Health-care waste management rapid assessment tool
In many (mainly low income) countries, improper management of wastes generated in health care facilities causes direct health impacts on the community, the personnel working in health care facilities, and on the environment. In addition, pollution due to inadequate treatment of waste can cause indirect health effects to the community.
Health-care wastes (HCW) include sharps (syringes, disposable scalpels, blades, etc.), non-sharps (swabs, bandages, disposable medical devices, etc.), blood and anatomic waste (blood bags, diagnostic samples, body parts, etc.), chemicals (solvents, disinfectants, etc.), pharmaceuticals, and others, and may be infectious, toxic, create injuries or be radioactive.
This rapid assessment tool is a part of an overall strategy developed by WHO which aims at reducing the disease burden caused by poor health care waste management (HCWM) through the promotion of best practices and the development of safety standards.
Download the rapid assessment tool
The WHO Health Care Waste Management site is at http://www.healthcarewaste.org
Health Care Without Harm Medical Waste Management pages start at http://www.noharm.org/all_regions/issues/waste/
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