THE amount of municipal solid waste will rise from the current 1.3 billion tons per year to 2.2 billion tons per year by 2025. That’s the estimate of a World Bank study. “Much of the increase will come in rapidly growing cities in developing countries,” it said.
Hospitals make only a relative small contribution to the waste mountain as a whole. In an article written by Richard E. Struempler, which appeared in Health and Lifestyle, each hospitalized patients generates approximately 7 kilos of hospital waste per day.
Compared with any other form of garbage, hospital waste pose more danger because of their infectious and toxic character. About 15 percent of the total hospital waste by weight is considered infectious waste, according to Struempler. In addition, the cost of disposing infectious waste is five to 20 times that of other hospital waste.
In the case-study report, “Hospital Waste Management in the Philippines,” hospital waste are classified into the following:
1 Pathological waste: These consist of tissues, organs, body parts, human fetuses and animal carcasses; and most blood and body fluids.
2 Infectious waste: This contains pathogens in sufficient concentration or quantity that exposure to it could result in disease. This category includes cultures and stock of infectious agents from laboratory work, waste from surgery and autopsies on patients with infectious diseases, waste from infected patients in isolation wards, waste that had been in contact with infected patients undergoing hemodialysis (e.g. dialysis equipment such as tubing and filters, disposable towels, gowns and aprons, gloves and laboratory coats) and waste that had been in contact with animals inoculated with an infectious agent or suffering from an infectious disease.
3 Sharps objects: These include needles, syringes, scalpels, saws, blades, broken glass, nails and other items that could cause a cut or puncture.
4 Pharmaceutical waste: These include pharmaceutical products, drugs, and chemical that had been returned from wards, spilled, outdated or contaminated, or are to be discarded because they are no longer required.
5 Radioactive waste: These include solid, liquid, and gaseous waste contaminated with radionuclides generated from vitro analysis of body tissues and fluids, in vivo body organ imaging and tumor localization, and therapeutic procedures.
6 Chemical waste: These comprise discarded, solid, liquid, and gaseous chemicals, for example from diagnostic and experimental work, and cleaning, housekeeping and disinfecting product.
Health problems that may arise from hospital waste come in two forms: acute exposure or chronic exposure. Acute exposure means exposure up to 14 days, while chronic exposure is for much longer periods, including years.
According to medical scientists, the risk of infection depends on the survival of the germs present in the hospital waste.
To survive, pathogenic viruses need the same milieu as in human cells. “Neither waste nor soil provide this milieu, and microorganisms are broken down there within a few hours,” informed Dr. Winfried Schmidt, a German researcher who has been working on an environmentally- and hygienically-sound concept for the disposal of hospital waste.
But there’s a risk of infection if someone comes into direct contact with infectious microorganisms as a result of injury by puncture, cut or abrasion. “Infection will follow if a large number of infectious germs find their way into the body, either through this injury or through the mouth,” Schmidt explained.
A survey conducted by the Presidential Task Force on Waste Management in the late-1990s found that over 90 percent of the 64 hospital surveyed “dispose of their general waste through the city or municipal refuse disposal system.” General waste include packing materials and non-infectious rubbish.
In its report, the task force said that 56 hospitals disposed of their general waste through the city or municipal refuse disposal system, 11 burned their waste inside the hospital compound, and four buried their garbage within the hospital premises.
The report also noted that most of the surveyed hospitals treated their radioactive waste before disposing them. “Chemical waste [non-hazardous and hazardous] are disposed of in sinks or water closets through hospital septic tanks, pit and sewer lines,” the report said.
But what alarmed the task force was the fact that most of the disposal sites of the hospital waste “are all open dumps with the prevalence of scavenging.” It added that majority of the hospital dispose of their infectious waste with the general wastes without disinfection.
“The work for sanitation is tied to health,” the report noted. “If these facts fail to put across the message that health has been all but neglected here, I don’t know what will.”
The seriousness of the garbage problem caught the attention of then-President Fidel V. Ramos. In fact, he directed the Department of Health to ensure the hospitals’ strict compliance with waste-disposal management standards. He also urged the local government units to deal with the problem in their respective areas.
Republic Act 6969, or The Toxic Substances and Hazardous and Nuclear Wastes Control Act of 1990, stresses the need to control and regulate the management of toxic waste, from all sources.
Administrative Order Number 29 of the Department of Environment and Natural Resources, the implementing rules and regulation of the law, covers hazardous hospital wastes since these categorize infectious waste as hazardous.
The law, likewise, outlines rules, responsibilities, and instructions for waste handlers, and provides a system to keep track of hazardous waste.
So, what’s the best way of disposing hospital waste? Perhaps, through incineration? Schmidt thinks otherwise. “It [incineration] does not solve the [hospital waste] problem, but merely defers it: toxic emissions and ash residues, which have to be disposed of separately, create new pollution,” he pointed out.