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Study of Clinical Waste Management at Rajshahi Medical College Hospital (rmch) in Bangladesh

Md. Shamim Al Razib
Department of Civil Engineering, Rajshahi University of Engineering & Technology, Rajshahi, Bangladesh

Nazmul Hasan
Department of Civil Engineering, Rajshahi University of Engineering & Technology, Rajshahi, Bangladesh

Abstract/ Executive Summary:

The management of clinical waste is of great importance due to its infectious and hazardous nature that can cause risks on environment and public health. The study is conducted to evaluate clinical waste management practices and to determine the amount of waste generated at Rajshahi Medical College Hospital (RMCH) in Bangladesh. A survey is driven to collect information about the practices related to waste segregation, collection procedures, type of temporary storage containers, on-site transport and primary dumping point, treatment of wastes, off-site transport, and final disposal options. This study indicates that the quantity of medical waste generated by RMCH is 156 kg/day. Almost half of the waste was similar to domestic waste and 20% of the waste is considered to be hazardous waste. The survey result shows that segregation of all wastes is not conducted according to consistent rules and standards where some quantity of medical waste is disposed of with domestic wastes. The most frequently used treatment method for solid medical waste is incineration which is not done regularly at RMCH and the position of the incinerator is not acceptable. Clinical wastes pose a significant impact on health and environment. From this study it can be said that there is an urgent need for raising awareness and education on medical waste issues. For further study, it is needed to collect more information on impacts, disposal and management to draw a clear conclusion. Need to collect information and examples from developed country or the country which has sound medical waste management system.

Keywords: Solid Waste Management, Segregation, Incineration, Rajshahi Medical College Hospital (RMCH), Hazardous Waste, Domestic Waste, Clinical Waste

Location: Rajshahi Medical College Hospital (RMCH) in Bangladesh

Start Date:

End Date:

Program Area: Risk Management in Agriculture

Commodity: Waste

Objectives:

The objectives of this research are to collect information on the collection, treatment, handling, hauling, and disposal of medical wastes and quantify hospital wastes production in Rajshahi Medical College Hospital. Similarly determine the composition of generated clinical wastes in Rajshahi Medical College Hospital and also determine the level of knowledge and awareness of individuals involved in the medical waste management.

Methodology:

This study is mainly based on data collection. The relevant data for this study were mainly collected from the published and unpublished sources. The data were analyzed to address the central issues of hospital waste management with relation to the generation of wastes in different sources. In order to fulfill the aims and objectives, the project tasks were structured as data collection and data analysis. Sekaran (2009) defined a research design as a master plan specifying the methods and procedures which are used to guide and conduct a research. It is a strategic plan for a research project including the methods of data collection and analysis to be employed and showing how the research strategy addresses specific aims and objectives of the study. In this study we have just measured the amount of the waste is being generated in each ward. It was done by following a procedure. We have divided the hospital waste into some basic category. Then the waste transferred from ward to the primary disposal point is measured according to the category. After that by analyzing the data the waste production per bed is measured. It is also measured that what types of waste produced and quantity. 2.2. About Rajshahi Medical College Hospital (RMCH) The public hospital RMCH is located in the northern part of Bangladesh. The capacity of the Rajshahi Medical College Hospital is 2148 beds. The total no of doctors, nurses and cleaners are 169, 349, and 137 respectively. The average no. of inpatients and outpatients per day are 200-220 and 200-210 respectively. Total amount of waste generated is 200-350 kg/day of which amount of hazardous waste is 50-60 kg/day. The toxic and hazardous waste of RMCH is incinerated in its own incinerator. The RMCH is directly connected with Rajshahi City Corporation (RCC) in regard to Solid waste disposal. 2.3. Segregation and Measurement of Hospital Waste By asking question to the waste collector and during visiting each ward we have seen that segregation of waste is done before disposal. Although segregated waste is not recycled, they use the separate bags for different types of waste and they use the separated plastic bins for infectious, sharp waste and general waste. But in general there is no systematic segregation of waste before disposal. There are several types of solid Hospital waste. It is not possible to segregate all types of waste as it takes so much time to segregate & some clinical waste (blood, needle) are very hazardous so it is not possible to weight those. We have taken fifteen types of solid hospital waste in consideration further we differentiate Solid Hospital waste into some basic types- Sharps, Pathological waste, Pharmaceutical waste and others waste. Sharps can be further divided into two typesSyringe and Needle. Pathological waste can be divided into four types- Cotton, blood bag, hand gloves and bandage, pharmaceutical waste can be divided into three types- glass bottle, drug shard and saline. After segregation process the waste is taken into a box or sometimes in polythene to measure the weight of the segregated waste. The weight is taken in kg up to two decimal. The weight of the box and the poly bag is taken for the accurate measurement of the weight. As the weight meter is an electric machine so first it is checked that if the machine is charged properly. If the machine is charged properly then the machine has been calibrated. In weight measuring machine weight is taken shown in figure 1 (a), (b) and (c). Weight meter have shown the exact reading of the weight of waste in the digital screen.

Source of Information: International Journal of Environmental Protection and Policy, 2017; 5(2): 26-31 ISSN: 2330-7528 (Print); ISSN: 2330-7536 (Online)

Article Link (Online Journal): http://www.sciencepublishinggroup.com/j/ijepp

Funding Source:

Total Budget (Tk.) :

Achievement/Findings:

Medical waste poses a great impact on human health and our environment. There is lack of proper technical support from the government in this sector and needs more investment. At a regular interval workshop might be arranged to increase awareness among the waste managing authority of the Hospital. It has been also seen from the study that there is a lack of man power, technical knowledge, and investment in the hospital. So it may say that, Proper waste management strategy is needed to ensure health and environmental safety. The storage, collection, transportation, and disposal systems are improper. So authority should take special concern about this. And also Consideration needs to be given to the generation and minimization, source separation and segregation, identification and labeling, handling and storage, safe transportation and treatment. Infectious waste, excluding sharps should be collected in no more than one day a week, unless the waste is refrigerated. The sharps receptacles are exchanged at regular intervals of three months. Arrangements should be made to routinely transport waste from ward level to a storage area pending collection by a waste contractor. The problems confronting the hospitals include lack of instructions on the aspects of clinical waste segregation and practices by nurses and intermingling of clinical waste with general waste. It is no doubt that problem in improper segregation of clinical waste and general waste is a common problem in clinical waste management worldwide. However, it is still important to keep the segregation process according to the standard and guidelines as to ensure the safety and health of the people and environment.

Knowledge Management: Journal