Report: Healthcare waste characterization in Chittagong Medical College Hospital,Bangladesh

Abstract

Healthcare waste management (HCWM) options are inconsistent in Bangladesh. One of the first critical steps in the process of developing a reliable waste management plan requires a comprehensive understanding of the quantities and characteristics of the waste that needs to be managed. This study took into consideration both the quantity and quality of the generated waste to determine the generation rates and physical properties of healthcare waste (HCW) in Chittagong Medical College Hospital (CMCH) and also to estimate the amount of infectious and non-infectious waste generated in different wards. CMCH, the second largest hospital in Bangladesh, comprises 34 wards, 12 of which were selected randomly. Waste materials were collected from these wards and then segregated and weighed. Waste generation per day was found to be 73.22 kg/ward, 1.28 kg/bed and 0.57 kg/patient. A total of 2490 kg of HCW was produced each day in CMCH (37% being infectious and the rest being non-infectious waste). Infectious waste was 27.07 kg per ward, 0.47 kg per bed and 0.21 kg per patient and the non-infectious waste was 46.15 kg per ward, 0.81 kg per bed and 0.36 kg per patient per day. HCW comprised eight categories of waste materials with vegetable/food waste being the largest component (50.21%) and varied significantly (P < 0.05) among the 12 different wards studied. The greatest amount of HCW was recorded (154 kg) in Orthopaedics followed by 96.66 kg in the Medicine Unit-3 and the smallest amount was recorded in Casualty (8.79 kg). The amount of HCW was positively correlated with the number of occupied beds (r_xy = 0.79, P < 0.01). There is no structured form of medical waste treatment in CMCH and most waste materials are dumped in open areas for natural degradation or re-sold by scavengers. It is essential to develop a national policy and implement a comprehensive action plan for HCWM that will provide environmentally sound technological measures to improve HCWM in Bangladesh.

Keywords

healthcare waste waste generation infectious waste non-infectious waste wmr 1338—9

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References

Agarwal, R. (1998) Medical waste Disposal. Issues, Practices and Policy. An Indian and International Perspective. Seminar on Health and the Environment. Centre for Science and Environment . New Delhi, India.

Ahmed, R. (1997) Hospital Waste Management in Pakistan. UWEP, Gouda.

Akter, N. (2000) Medical Waste Management: A Review, Environmental Engineering Program, School of Environment, Resources and Development. Asian Institute of Technology, Thailand, 25 pp.

Akter, N. , Acott, R.E. & Chowdhury, S.A. (1998) Medical Waste Disposal at BRAC Health Centres: An Environmental Study. BRAC Research, Research and Evaluation Division, 75 Mohakhali C/A, Dhaka 1212.

Alam, A.K.M.M. , Saha, S.K. & Rahman, M.M.S. (2002) Aspects of solid waste management - a case study at Nirala Residential Area, Khulna. In: Ahmed, M.F. , Tanveer, S.A. and Badruzzaman, A.B.M. (eds.), Bangladesh Environment , pp. 698-711. Bangladesh Poribesh Andolon (BAPA), Dhaka-1207, Bangladesh.

Almuneef, M. & Memish, Z. (2003) Eective medical waste management: it can be done . American Journal of Infection Control, 31, 188-192.

Appleton, J. & Ali, M. (2000) Healthcare or health risk? Journal of Waste Management, April. 29-31.

Asaduzzaman, M. & Hye, S.A. (1997) When Both Market and State Fail: The Crisis of Solid Waste Management in Urban Bangladesh. In Crisis in Governance. A Review of Bangladesh's Development 1997. Centre for Policy Dialogue. University Press Limited. Dhaka, Bangladesh.

BAN & HCWH. (1999) Medical Waste in Developing Countries. An Analysis with a Case Study of India, and a Critique of the Basel -TWG Guidelines. Basel Action Network (BAN) Secretariat, Asia Pacific Environmental Exchange, Seattle, WA, USA.

10.

Bdour, A. , Altrabsheh, B. , Hadadin, N. & Al-Shareif, M. (2007) Assessment of medical wastes management practice: a case study of the northern part of Jordan. Waste Management, 27, 746-759.

11.

Bostoen, K. (1997) Landfilling healthcare waste: sustainable method of disposal or threat to public health? MSc Thesis, W EDC .

12.

Coad, A. (1994) Managing Medical Waste in Developing Countries . HO/ PEP/RUD/94.1, Geneva.

13.

Coad, A. & Cristen, J. (1999) How are we Managing our Healthcare Wastes? SKAT, Switzerland.

14.

Chowdhury, S.T. (2006) Medical waste: A danger to public health. The Daily Star, 5 (590) Downloaded from http://www.thedailystar.net/2006/01/25/d601252501116.htm.

15.

Diaz, L.F. , Savage, G.M. & Eggerth, L.L. (2005) Alternatives for the treatment and disposal of healthcare wastes in developing countries. Waste Management , 25, 626-637.

16.

Diaz, L.F. , Eggerth, L.L. , Enkhtsetseg, S. & Savage, G.M. (2007) Characteristics of healthcare wastes. Waste Management, (in press).

17.

Galtier, L. & Bekaert, C. (2002) Healthcare waste management on an international scale. In: Appropriate Environmental and Solid Waste Management and Technologies for Developing Countries, vol. 1, pp. 289-294. ISWA, Istanbul.

18.

Karademir, A. (2004) Health risk assessment of PCDD/F emissions from a hazardous and medical waste incinerator in Turkey. Environment International Journal, 30, 1027-1038.

19.

Lee, C.C. & Huffman, G.L. (1996) Medical waste management/incineration. Journal of Hazardous Materials, 48, 1-30.

20.

Mohee, R. (2005) Medical wastes characterization in healthcare institutions in Mauritius. Waste Management, 25, 575-581.

21.

MOHFW (Ministry of Health and Family Welfare) ( 2004) Environmental Assessment and Action Plan for the HNP Sector Program (2005- 2010), 36 pp. MOHFW, Government of Peoples Republic of Bangladesh.

22.

Morshed, M.G. , Rahman, A.K.M.A. , Saifullah, A.S.M. & Hossain, M.A. (2004) Quantitative study on medical waste in Chittagong Medical College Hospital. The Healer, 2, 27-34.

23.

Noman, M.A. (2007) Quantitative and qualitative study on medical waste management practice in Comilla Medical College Hospital, 59 pp. Institute of Forestry and Environmental Sciences, University of Chittagong, Bangladesh.

24.

Pruss, A. , Giroult, E. & Rushbrook, P. (1999) Safe Management of Wastes from Healthcare Activities . World Health Organization, Geneva .

25.

Rahman, H. & Ali, M. (2000) Healthcare Waste Management (HCWM) in developing countries. In Proc. of the 26th conference on Water, Sanitation and Hygiene: Challenges of the Millennium, pp.198- 201. WEDC.

26.

Rahman, H.M. , Ahmed, S.N. & Shehabullha, M. (1999) A study on hospital waste management in Dhaka City. In Proc. of the 25th WEDC Conference on Integrated Development for Water Supply and Sanitation , Addis Ababa Ethiopia.

27.

Rashid, S. (1996) Medical Waste Disposal in Dhaka City: A Survey . North-South University. Dhaka , Bangladesh.

28.

Rushbrook, Ph. , Chandra, C. & Gayton, S. (2000) Starting Healthcare Waste Management in Medical Institution, Practical Approach. Healthcare Practical Information Series No. 1. World Health Organization, Geneva .

29.

Sabour, M.R. , Mohamedifard, A. & Kamalan, H. (2007) A mathematical model to predict the composition and generation of hospital wastes in Iran. Waste Management , 27, 584-587.

30.

Sadeghi, A. (2002) Evaluation, Collection and Disposal of Mashhad's Hospital Wastes.

31.

Sarker, M.S.K.A. , Haque, M.A. & Khan, T.A. (2006) Hospital waste management in Sylhet City, Bangladesh . ARPN Journal of Engineering and Applied Sciences, 2, 32-40.

32.

Shinee, E. , Gombojav, E. , Nishimura, A. , Hamajima, N. & Ito, K. (2007) Healthcare waste management in the capital city of Mongolia. Waste Management. (in press).

33.

Silva, C.E.D. , Hoppe, A.E. , Ravanello, M.M. & Mello, N. (2005) Medical wastes management in the south of Brazil . Waste Management, 25, 600-605.

34.

Sujauddin, M. , Huda, S.M.S. & Hoque, A.T.M.R. (2007) Household solid waste characteristics and management in Chittagong, Bangladesh. Waste Management (in press).

35.

WHO. (2004) Safe Health Care Waste Management. Policy Paper. WHO, Geneva, Downloaded from www.healthcarewaste.org . (Accessed 10 February 2008)