Medical waste has been a growing concern because of recent awareness in public regarding HIV, AIDS and Hepatitis B and exposure to discarded needles, syringes and other medical waste from municipal garbage bins and disposable sites. At the garbage dump sites there are several rag pickers trying to salvage any discarded material to sell and make a living. These rag pickers are exposed to the risk of injuries from contaminated needles and other sharp objects. Improper practice of hospital medical waste disposal affects not only medical people who come in contact with waste but Para-medical staff, labour staff, rag pickers and citizen at a large. Illness spreads due to improper medical waste management practice.
Ministry of Environment and forests, Government of India has laid down guidelines for handling of Bio-Medical Waste (management and handling) Rules 1998.
Steps in management of hospital waste
1) Segregation - Different categories of waste are sorted and placed in different containers and bags. Segregation should be done, as early as possible at the source itself.
2) Disinfection - Infectious hospital waste should be disinfected before it is disposed off. It is the process of destruction or removal of pathogen which gives rise to infection.
3) Storage - Medical waste requires to be stored on site until it is collected for transport to the site of ultimate disposal. Storage containers such as plastic bags (yellow, red, white, black), puncture proof containers are used to store medical waste.
4) Treatment and Disposal - Treatment renders waste, unrecognizable and may reduce its volume .It also makes it less hazardous
Labelling of hospital waste
1) The waste after segregation into its respective containers and bags must be labelled.
2) Labelling must be in letters along with international symbols.
3) The label must be multilingual
4) The label must be such that it should be wash resistant. It would be useful to use indelible ink for complete information on the label.
5) These bags must also be labelled with information relating to the address of generator the waste category, date of generation and must describe the waste.
6) The symbols to be used are international biohazard symbols.
Management of non infectious hospital waste
1) Non infectious waste will be treated like any routine household waste.
2) The collection will be done as per the disposal rules.
3) Like plastic .I.V. bottles, glass bottles, glass injection bulbs –segregated and stored at one place.
4) Tins or any other material will be stored as per the policy.
5) Bio degradable waste will be collected in black bags
6) Kitchen waste can be utilised in many different ways according to the quality of the waste.
Universal safety precautions to prevent hospital infections
1) Use gloves when handling blood. body fluids and collecting pathological specimens of the patients
2) Prevent needle stick injuries and injuries with other sharp instruments
3) Do not bent or recap needles
4) Do not leave sharps on beds or bedside
5) Use a container to carry needles, syringes, and other sharp instruments and items.
6) Dispose all sharps in puncture proof container and ensure safe disposal
7) Avoid spills of blood and body fluids.
8) Mask, eye protecting glasses and gowns must be used if splashes of blood and or body fluids are expected from patient.
9) Garbage must be disposed in proper polythene bags.
10) Clean all furniture, bed, and other articles within patients unit with 1% clicks solution
11) Equipment, instruments used on patients must be properly sterilised before use.
12) Dead body of HIV infected persons must be bagged in heavy duty polythene sheets before being handed over to the patients relatives.