HOSPITAL WASTE MANAGEMENT IN A TERTIARY CARE ARMY HOSPITAL
Hospital Waste Management
This direct observational descriptive study was carried out in a tertiary care army hospital from 5th December 2003 to 19th December 2003 to assess its prevailing practices of health care waste management and to estimate hospital waste generated per bed per day. Presently the waste is being segregated and collected in different colour coded receptacles only at the nursing stations and carried in open unhygienic trolleys. The sanitary workers were not using protective devices while handling waste in the hospital. The waste generation was calculated by placing coloured receptacles in selected zones and constant observation for seven days each as mentioned above. Results showed that total waste generation was about 3.434 kg/bed/day (out of which 0.309 kg was infectious, 0.103 kg sharps and 3.022 kg non- infectious) and that final disposal of infectious and non-infectious waste was getting mixed-up while loading in the municipality carriage system. The awareness of sanitary workers regarding colour coding was fair but not up to the mark and they were also unaware of potential hazards of health care waste while handling it. Eighty one percent of sanitary workers were vaccinated against tetanus and typhoid but none of the 86 workers were vaccinated against Hepatitis B. Two single chambered, brick made, gas fired so called “incinerators” with enormously low temperature are being used for burning which are emitting smoke and obnoxious gases directly into the atmosphere, affecting the health of the people and environment. Liquid waste is thrown down the municipal sewerage system without any prior treatment, which is adding up to the water pollution. The study concluded that although some basic steps have been taken towards the effective waste management but still there is a long way to go. Several recommendations have been made to stream line the waste segregation, collection, transportation and final disposal along with the improvement in the awareness of sanitary workers about the potential hazards of health care waste and to get 100% vaccination against tetanus, typhoid and hepatitis B. In the end it is also recommended that national guidelines on hospital waste management must be practically implemented without any further delay.