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CLINICAL WASTE MANAGEMENT IN MALAYSIA

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Nur Alynn

on 12 May 2015

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Transcript of CLINICAL WASTE MANAGEMENT IN MALAYSIA

Clinical Waste Generation
Source of Clinical Waste
Clinical Waste Segregation
Guidelines published by Malaysia Ministry of Health stated that:
Clinical waste should be deposited in yellow plastic bag that is lined in the bag holder provided by the concession company.
Infectious clinical waste should be deposited in the blue plastic bag.
Used sharps should be deposited in to a sharp container that is lined with the yellow plastic bag.
$1.25
Wednesday, May 13, 2015
Vol XCIII, No. 311
Introduction
Clinical Waste Collection and Transportation
In recent years, generation of waste from healthcare facilities(HCFs) has increased concern throughout the world.
Mismanagement of HCFs waste is potentially dangerous because it can spread diseases.
Impacts both directly and/or indirectly to healthcare staffs, patients and hospitals environment.
WHO requires clinical waste to be collected and transported daily and frequent.

CLINICAL WASTE MANAGEMENT IN MALAYSIA
Definition and Classification of Clinical Waste
Definition by Controlled Waste Regulations (1992)
Any waste which consists entirely or partly of human or animal tissue, blood or other body fluids, excretions, drugs or other pharmaceutical products, swabs or dressings or syringes, needles or other sharp instruments, being waste which unless rendered safe may prove hazardous to persons coming into contact with it.
Any other waste arising from medical, nursing, dental, veterinary, pharmaceutical or similar practice, investigation, treatment, care, teaching or research or the collection of blood from transfusion, being waste which may cause infection to any person coming into contact with it.
Clinical Waste

Pharmaceutical Waste

Sharps

Pathological Waste

Chemical Waste

Infectious Waste

Radioactive Waste
Non-clinical Waste

HCFs Waste

Principle sources: Hospitals and clinics providing acute services.
Operating Theatre
Maternity ward
Accident&Emergency
Mortuary
Intensive Care
Isolation Wards
Pharmacy
Pathology Laboratories
Other sources:
Ambulance services
Public health laboratories
Blood donation centers and blood banks
Doctors practice centers
Dentists
Veterinary surgeons
Immunization/vaccination clinics
Hospitals, clinics and nursing homes providing community care
Care of the elderly
Services related to mental health and learning disabilities
Clinical waste from households
Arise with establishment of home health and medical care services.
Medical devices and instruments used when treating patients at home.
Eg: Self-injecting diabetics and people changing colostomy bag at home
But waste generated from home health and medical services are still included in general household waste material.
Clinical waste generation determines the effectiveness of clinical waste management practices.
Quantities of waste generation rate in healthcare centers depends on:
Type of healthcare establishment
Availability of instrumentation
General condition of HCFs area
Ratio of disposable item in use
Number of patient care
Economic, social and cultural status of the patients
Healthcare staffs that are directly involve in clinical waste are:
Doctors
Medical assistant officer
Nurses
Concession Company
Responsible in supplying all equipment needed.
Examples of equipment are:
Yellow bin
Sharp container
Yellow and blue plastic bag
During collection, the collected waste is replaced with new
clinical waste bags and containers marked with international infectious substance symbol.

At the end of each shift, clinical wastes were collected and transported to a
temporary storage area by waste handlers

The waste handler have to carry all the
containers and trolley, collect the clinical waste at generation points and change the yellow bags and
containers at every location by their own.

Wheeled trolleys were used in collection process to the
temporary storage area.

Main Concession Company in Malaysia
Rules and Regulations
Environmental Quality (Scheduled Waste) 2005

This is because :-
Contain infectious agents
Genotoxic in nature that cause DNA damage or mutations
Toxic chemicals or dangerous
Radioactive
Consists of material that is sharp
Under Scheduled Waste 4
SW 403

discarded drugs containing psychotropic substances or containing substances that are toxic, harmful, carcinogenic, mutagenic or teratogenic.

SW 404

Pathogenic wastes, clinical wastes or quarantined materials.

SW 405

Waste arising from the preparation and production of pharmaceutical product.

Storage
Central storage sites – temporary only.
Clinical waste stored for 12 to 24 hours – not more than 48 hours.
Example : Hospital Tumpat
left lying outside the store.
Cold storage was used as a rest room for waste handlers.
Treatment
A landfill is defined as a system designed and constructed to contain discarded waste and to minimize releases of contaminants into the environment.
Concept behind land disposal – landfill is the ultimate fate of waste.
1. Landfill
2. Incinerator
Incineration process
Reception hall
ii. Waste pit (enough for 16-36 hours) (20000m3)
iii. Feed hopper
iv. Combustion grate (200-230kg/m2/j)
v. Combustion chamber
vi. Quench tank for bottom ash
vii. Heat recovery boiler
viii. Electrostatic precipitator
ix. Acid gas scrubbing equipment
x. Incineration stack

Incinerator
Typical Incineration for Waste Management

Autoclaving
Other alternative for the incinerator.
More costly.
Not suitable for chemical and hazardous substances.

Other Treatments Outside Malaysia
Medical waste autoclave

Other Treatments Outside Malaysia
Microwaves
Electromagnetic waves with frequencies between radio and infrared waves.
The waste must be wet.
The microwaves heat the clinical waste from the inside of the materials to their external surfaces.
Expensive and not affordable for the developing countries.

Conclusion
Clinical waste management in Malaysia mostly followed the required standards and regulations.
Proper storage, collection, transportation and disposal are key elements.

Suggestion
Broader aspects such as risk assessment should be conducted.
All hospitals need to involved in the study.
Conclusion and Suggestions
Full transcript