Hospital waste is all waste generated from hospital activities in the form of solid, liquid and gas. The hospital as a health service facility is a gathering place for sick and healthy people,can be a source of disease transmission and allow for environmental pollution and health problems, as well as produce waste that can transmit disease.
Hospital waste is dangerous for the health of the environment, and for the community in the hospital and surrounding areas. Hospital waste if not managed properly and according to the rules can pollute the environment. To avoid these risks, it is necessary to manage waste in hospitals.
Waste Management Purpose
- Hospital waste management can be in accordance with applicable regulations.
- Protect patients, health workers, visitors and the community around the hospital from the spread of infection and injury.
- Dispose of hazardous materials (cytotoxic, radioactive, gas, infectious waste, chemical and pharmaceutical waste) safely.
- Prevent environmental pollution around
Hospitals must be able to reduce the amount of waste produced by reducing materials, reusing waste and recycling waste.
- Radioactive Waste; Radioactive waste is material that is contaminated with radioisotopes originating from medical use or radionucleide research. This waste can come from among others from nuclear medicine, radiological examination , radioimmunoassay, and bacteriology can be in solid, liquid, or gas form.
- Highly Infectious Waste Infectious waste is waste that is suspected to contain pathogenic materials (bacteria, viruses, parasites or fungi) in sufficient concentration or quantity to cause disease in susceptible hosts.
- Infectious Waste, Pathology and Anatomy; Pathological waste consists of tissue, organs, body parts, human fetuses and animal carcasses, blood and body fluids (anatomical waste) or subcategories of infectious waste.
- Cytotoxic; Cytotoxic waste is material that has been contaminated or may be contaminated with cytotoxic drugs during the compounding, transportation or therapeutic action of cytotoxics. Handling this waste requires proper absorbent and cleaning agent must always be available in the compounding room.
- Chemical and Pharmaceutical Waste; Pharmaceutical waste includes pharmaceutical products, drugs, vaccines and serums that are expired, unused, spilled, and properly disposed of.
Waste Management Process
The waste management process starts from identification, separation, labeling, transportation, storage to disposal/destruction.
1) Identification of waste types
In general, medical waste is divided into solid, liquid, and gas. While the solid medical waste category consists of sharp objects, infectious waste, pathological waste, cytotoxic waste, pressure tube waste, genotoxic waste, pharmaceutical waste, waste containing heavy metals, chemical waste, and radioactive waste.
2) Waste Separation Waste
separation begins at the beginning of the waste generated by separating waste according to its type. Place waste according to its type, including:
- Infectious waste; Waste contaminated with blood and body fluids is put in yellow plastic bags. Examples: laboratory samples , pathological waste (tissues, organs, body parts, autopsies, body fluids, blood products consisting of serum, plasma, platelets, etc.), diapers are considered infectious waste if they have been used by patients with gastrointestinal infections, menstruation and patients with infections transmitted by blood or other body fluids.
- Non-infectious waste; Waste that is not contaminated with blood and body fluids, put it in a black plastic bag. Example: household waste, food waste, office waste.
- Sharps waste; Waste that has a sharp surface, put it in a puncture-resistant container and water. Examples: needles, syringes, infusion tips, sharp-edged objects.
Waste transportation must use special trolleys that are strong, closed and easy to clean, must not be scattered, officers use PPE when transporting waste. The waste transport lift is different from the patient lift, if it is not
possible to set the waste transport time.
4). Temporary Waste Shelter
- Temporary Shelter (TPS) for waste before being transported to the final disposal site.
- Place the waste in a plastic bag and tie it tightly.
- Label the waste plastic bags.
- Every day waste is removed from the TPS at least 2 times a day.
- Transporting waste must use a special stroller.
- The stroller must be strong, easy to clean, covered with waste and no spillage.
- Use PPE when handling waste.
- TPS must be in an open area, accessible to vehicles, safe and always kept clean and dry.
5). Waste treatment
- Infectious waste is destroyed by incinerator.
- Non-infectious waste is taken to the final disposal site (TPA).
- Sharps waste is destroyed by incinerator. Liquid waste is discharged to spoelhoek.
- The waste of feces, urine, blood is disposed of to the disposal site/waste corner (spoelhoek).
6). Handling of Waste Sharps / Broken Glass
- Pay attention to aspects of K3RS (Occupational Safety and Health) .
- Do not bend or break sharp objects.
- Do not put sharps waste anywhere.
- Immediately dispose of sharps waste in a puncture-resistant and water-resistant container provided that cannot be opened again.
- Always throw away by the user / user.
- It is not allowed to re-cover used syringes (recapping).
- A special sharps container is placed near the action site.
- When handling broken glass waste, always use household gloves.
- Sharps Waste Storage Containers must: Leak-proof and puncture-resistant, Must have a handle that can be carried with one hand, Have a lid that cannot be opened again, The shape is designed to be used with one hand, Closed and replaced after part is filled with waste; Handling with medical waste
7). Sharps Disposal
- Sharps containers are medical waste and must be placed in a medical bag prior to incineration.
- Ideally all sharp objects can be incinerated, but if this is not possible they can be buried and limed with other waste.
- Whatever method is used, it must not present the possibility of injury.
- Destruction is carried out by a Permitted Third Party.
8). B3 waste
B3 Waste (Toxic and Hazardous Materials); such as: Liquid Radiological Chemical Waste, Used Oil, TL Lamp Waste, WWTP Sludge, Bateria, Cartridges, Expired Pharmaceutical Waste, Contaminated Packaging, Freon Tubes, etc.; then do as follows:
- The B3 waste in the unit is taken by the B3 waste officer every day at 08.00-12.00 WIB.
- Stored at TPS Special for Hazardous Waste
- Every 2 days it is transported and destroyed by a licensed 3rd party (complete with Manifest).
- Destruction is carried out by a Third Party with an Incinerator with a temperature above 1000 o C.
- B3 waste is always under monitoring.
Liquid Waste Management
Liquid waste must be collected in containers (containers) that are suitable for chemical and radiological characteristics, volume, and handling and storage procedures.
- The sewerage must use a closed, watertight, and sewage system must flow smoothly, and be separated from the rainwater channel.
- Hospitals must have their own wastewater treatment plant or together with surrounding buildings that meet the technical requirements, if there is no urban wastewater treatment system or it is not accessible.
- It is necessary to install a measuring device for liquid waste discharge to determine the discharge of the generated waste.
- Wastewater from the kitchen must be equipped with a grease catcher and the sewerage must be equipped/covered with a grill.
- Wastewater from laboratories and other medical installations (eg hemodialysis, operating rooms , etc.) that produces sewage must be treated at the Wastewater Treatment Plant (IPAL), in accordance with applicable regulations.
- The frequency of inspection of treated liquid waste (efflunt) is carried out once a month for self-monitoring and at least once every 3 months for picking tests in accordance with applicable regulations.