Local Government in Clinical Waste Management. Dr Trevor Thornton Deakin University

Transcription

1 Local Government in Clinical Waste Management Dr Trevor Thornton Deakin University

2 The problem of potentially biohazardous waste contaminating the environment is not mainly from hospitals but primarily due to improper disposal from homes and illegal settings. Biohazardous Waste Management: What the Physician Needs to Know, Report on the Council on Scientific Affairs, American Medical Association 2007

3 Some issues Data from Japan Main obstacle is cost ~ 31% of municipal governments report needlestick injuries from domestic waste Organics processors report sharps are becoming common in loads A study examining pathogens in landfills, has indicated that the risk from scavengers/vermin (birds and rats), distributing biohazardous waste containing pathogens is a real risk Nappies/incontinence pads and gastroenteritis from nursing homes

4 Hazards. workers in high-income countries involved in processing, treatment and disposal of wastes are more likely to be exposed to and contract a greater number of different forms of pulmonary disorders and infectious diseases than the general population World Health Organization (Review of Health Impacts from Microbiological Hazards in Health Care Waste, 2001),

5 Main Types Sharps Diabetics IV injections Needle piercing Dialysis waste ~2kg per treatment Cytotoxic waste Healthcare provision Forensic/property clean-up Pharmaceutical New and emerging diseases Epidemics

6 Issues Changes in healthcare delivery Community health Workplace health & safety Environmental How transported and managed

7 Management considerations Management is not just based on health considerations (ie., modes of infection) Must consider downstream management 2009 study demonstrated various pathogens surviving in clinical waste

8 Approaches United Kingdom requires that home generated healthcare waste must be managed only not, if a risk assessment conducted The World Health Organization has stated that there were between 500-7,300 waste workers (outside hospitals), injured by sharps of which, annually, 1-15 contracted Hepatitis B. A Statute in California defines home generated sharps waste and prohibits disposal in certain containers and they must be transported in sharps containers Local government has a role

9 Regardless It s a waste type that is growing in type, volume, source and frequency and requires management It cannot be ignored Is remediation easier than prevention of the issues

10 What s required Acceptance Managing for improvement, is impossible if not measured to understand National and uniform approaches Innovation mailing sharps (approved by US Postal Service)

11 Practically Advice on management options to residents Liaise with healthcare providers includes associations Consider drop-off or collection systems Educate waste management staff Consistency and safety use of BWI Code of Practice

12 BWI Recognised as peak industry group Government agencies consults with BWI Input into legislative/policy changes Best practice approach with regulatory acknowledgment Primary tool is Code of Practice Only National guideline Adopted by Victoria, Western Australia and South Australia governments Consistent definition No landfilling untreated biohazardous waste Management of wastes outside usual settings

13 Content Focus on Performance based Based on no manual handling once contained Definitions Containment (colours and signage) Home healthcare Waste minimisation Storage Transport Treatment systems OHS Education

14 In Conclusion Biohazardous waste growing in regards to sources and volumes Need for consistency specifically with definition Management strategies disjointed Consult with all stakeholders It is about ensuring that there is protection of the environment and human health Management does not have to be complicated