Better management of medical wastes

Experts are disturbedthat the non-coordination of Healthcare Waste (HCW) Management System, especially in the area of segregation, collection, storage, treatment and disposal put Nigerians at risk of biohazards such as hazardous waste chemicals, needles, scalpels, etc.

While contaminated needles and syringes poses a public health threat as the failure to dispose of them safely may lead to dangerous recycling and repackaging which lead to unsafe reuse, improper handling and disposal of healthcare waste portends a higher risk of diseases like hepatitis and HIV/AIDS.

While the Federal Executive Council approved a new National Healthcare Waste Management Policy for Nigeria in September 2012, and a national steering committee that ensures effective implementation expected, the policy is yet to be embraced by all states of the federation.

While wastes are buried without prior treatment and human body parts such as placenta and amputated limbs either disposed with the general waste or returned to the patient for disposal, Abah noted that used swabs and dressings as well as pharmaceutical wastes are disposed with general waste, a situation that portends huge medical danger.

Health experts believe that the absence of waste segregation at health facility implies that the estimates of various categories of waste may not be precise. Dumping and open burning at facility premises poses health risks to patients and people residing close to healthcare facilities. The HCW may contain a large proportion of plastics. When burnt, dioxin is a major air pollutant of concern from chlorinated polymer. Hazardous healthcare Waste poses potential risk of injury or infection to all those exposed to it.

The need for institutional support and guidance aimed at ensuring that health workers follow a standard procedure in the management of HCW waste at the institutional level has been identified.Without a clear policy, there is likely to be very little attempt at waste segregation, waste minimization and adequate treatment and disposal.  The World Health Organization(WHO) stipulates that segregation of HCW waste be done at the source of production.But without a HCW management manual and hospital policy on HCW management health workers are not likely to show any meaningful responsibility in this area.

A clear policy on medical waste management should be put in place both at the institutional and national levels to reduce the health risks associated with medical wastes.

Presently, Nigeria is a signatory to the Basel Convention on control of trans-boundary movements of hazardous wastes and disposal. The Basel Convention regulates trans-boundary movements of hazardous and other wastes applying the ‘prior informed consent’ procedure (shipments made without consent are illegal).

Unlike many other hazardous wastes, there is currently no international convention that directly covers medical waste management, so categorization systems vary from country to country. However, waste is usually categorized according to the risk it carries. The majority of medical waste – around 75 to 85 percent — is similar to normal municipal waste and of low risk unless burned.The remainder is composed of more hazardous types of medical wastes, including infectious and sharps wastes, chemical and radioactive wastes, and hospital waste water.

Burning medical waste, health experts say, releases a number of hazardous gases and compounds, including hydrochloric acid, dioxins  as well as the toxic metals lead, cadmium, and mercury. The disposal of biodegradable waste produces greenhouse gas emissions, including methane, which is twenty-one times more potent than carbon dioxide.