Knowledge, Attitude, and Practices about Biomedical Waste Management among Healthcare Personnel: A Cross-sectional Study

Navigating Challenges in Biomedical Waste Management in India: A Narrative Review

Biomedical waste management (BMWM) in India poses significant challenges that demand thorough examination and strategic interventions. As the country's healthcare sector expands rapidly, proper management of biomedical waste becomes increasingly critical to safeguarding public health and environmental integrity. Biomedical waste, encompassing industrial waste, hospital waste, and waste from other healthcare facilities, poses a heightened risk of infection and injury compared to any other form of waste. A lack of understanding regarding safe medical waste disposal practices can be hazardous to one's health as well as the environment. To improve waste management practices in the country, we can suggest effective strategies and recommendations by developing a deeper understanding of the current situation. To manage medical waste effectively, healthcare professionals must be knowledgeable about and have experience with this process. This evaluation study provides a comprehensive overview of current BMWM methods in India, shedding light on the benefits, drawbacks, challenges, and areas for improvement in the healthcare waste management system. Several important facets of BMWM were highlighted by the literature research, including waste segregation, treatment techniques, and disposal options, as well as compliance and regulatory frameworks.

Predictors of biomedical waste management practices among staff nurses of a tertiary care teaching hospital in India

BACKGROUND

Inappropriate handling of biomedical waste (BMW) may pose serious threats to the health of patients and hospital personnel. Among all healthcare workers, staff nurses play a vital role in BMW management (BMWM). Thus, the present study aimed to determine the predictors of BMWM practices among staff nurses of a tertiary care teaching hospital in India.

MATERIALS AND METHODS

A prospective cross-sectional study was conducted among 150 staff nurses, working at a tertiary care teaching hospital in South India, from July to August 2018. Data were collected using a pretested, semi-structured, and self-administered questionnaire after taking their written informed consent. Regression analysis was carried out to identify the predictors of satisfactory BMWM practice status.

RESULTS

Of the total 150 staff nurses, most of them were young females with a work experience of ≤ 5 years. Concerning knowledge scores, most staff nurses (63.3%) belonged to the moderate category, whereas a few (24%) were in the high category. Also, most of them (62.7%) were in the high category of attitude scores. For practice scores, half of the participants were in moderate and high categories, each. Female gender, attended training status, and moderate and high knowledge scores were significantly associated with satisfactory BMWM scores in unadjusted analysis. After adjusting for other independent variables, all these three factors were found significantly associated with satisfactory BMWM practice scores.

CONCLUSION

The present study shows that the female gender, attending training in BMWM, and having a moderate and high knowledge of BMWM were significant predictors of satisfactory BMWM practice among staff nurses. Thus, all hospitals must periodically train their staff nurses to strengthen their BMWM practices. Safe BMWM leads to environmental protection and safeguards the health of patients, hospital personnel, and the public.

Healthcare Workers' Knowledge about the Segregation Process of Infectious Medical Waste Management in a Hospital

Any hospital's primary goal is to restore human health and save lives through health services provided to patients, but at the same time, hazardous wastes are produced. Inconsistent management of unsafe wastes might cause adverse effects and other issues for workers, the environment, and public health. Segregation is considered the critical stage in successful medical waste management. Mixing hazardous medical waste with non-hazardous medical waste will be avoided by correctly applying practices at the segregation stage. This study aimed to assess personnel's knowledge about infectious medical waste and segregation practices used at six wards in Nicosia General Hospital. An analytical cross-sectional study was conducted, and data were collected through a structured self-administered questionnaire. The Statistical Package of Social Science (SPPS) version 25 was used with a minimum statistical significance of α = 0.05. The study population was nurses, nurse assistants, ward assistants, and cleaners working at the study wards. Out of 191 questionnaires, 82 were received, with a response rate of 42.93%. Most participants were female (72%) and nurses (85.4%). Participants had moderate knowledge about infectious medical waste management and good knowledge regarding segregation practices applied in their ward. Segregation was not carried out as it should have been, since most participants stated that infectious medical waste was mixed with non-hazardous medical waste. The number of correct answers the participants gave regarding the colour-coding of different medical waste categories was 67.5%, and only four answered correctly to all questions. Although participants knew segregation practices and the colour-coding process applied to medical waste, they did not use them satisfactorily. They applied methods regarding segregation without specific training, knowledge and guidance. Due to the issue's importance, training programs must be implemented and performed.

The Efficient Disposal of Biomedical Waste Is Critical to Public Health: Insights from the Central Pollution Control Board Guidelines in India

Biomedical waste (BMW), encompassing hazardous medical materials, poses environmental and public health risks if not correctly managed. The Central Pollution Control Board (CPCB) in India is a statutory organization that oversees BMW disposal standards, aimed at mitigating these hazards. BMW mismanagement is a major problem and potentially poses threats to the environment as well as public health. During the coronavirus disease 2019 (COVID-19) pandemic, increased use of personal protective equipment (PPE) and other medical equipment was witnessed which led to a marked raised BMW generation. To ensure proper and optimized BMW management, CPCB established guidelines and rules to be followed by the medical facilities as well as the common BMW treatment facilities (CBWTFs). The challenges in implementing proper waste management practices were lack of awareness and inadequate infrastructure. Strategies for better BMW management were proposed, including color-coded bins, improved infrastructure, advanced technology, and awareness campaigns. Highlighting CPCB's vital role, this emphasizes healthcare facilities' proactive role in implementing and evolving regulations for sustainable BMW disposal, ensuring both public health and environmental well-being through compliance and responsible waste management partnerships.

Knowledge of Staff Nurses on Health Hazards related to Biomedical Waste Disposal in a Tertiary Care Hospital

Objective

The study aimed to assess staff nurses' knowledge of the health concerns connected with biomedical waste disposal.

Materials and Methods

The descriptive study was performed with a sample of 50 staff nurses from a tertiary hospital. The semi-structured questionnaire was made to be used when interviewing participants. It has information about the person's age in years, religion, monthly family income, family type, marital status, previous biomedical waste management education exposure, and the source of information.

Results

Participants were between the ages of 20 and 60. Only five 20-30-year olds are moderately knowledgeable. Out of 50 nurses, 41 (82%) had an adequate level of knowledge, 9 (18%) had a moderate level of knowledge on biomedical waste management, and none of them had too inadequate knowledge.

Conclusions

The proper handling of biomedical waste necessitates that all hospital staff undergo extensive training on the collection, sorting, transportation, and storage of waste in color-coded bins before disposal and treatment.

Analysis of cognizance and practices of biomedical waste management principle rules among health professional workers in a teaching hospital with special emphasis on COVID-19 pandemic: A critical appraisal on the current state and way forward

BACKGROUND

Hospital-generated waste materials commonly labeled as "Biomedical waste" (BMW) is a kind of remnant that includes infectious and non-infectious materials and their appropriate disposals are controlled as per the guidelines of Biomedical Waste Management (BMWM) Amendment Rules, 2018, Government of India. Periodic assessment on BMWM among healthcare workers (HCWs) is mandated to ensure quality assurance, which may be helpful during pandemic times.

MATERIALS AND METHODS

The study was conducted with ethical clearance by using a validated questionnaire (using Cronbach's α) covering knowledge, attitude, and practices (KAP) derived based on recent BMWM 2018 guidelines. The responses in context to KAP were checked by the study conductors, appropriate statistical analysis was done and discussed at end of each session.

RESULTS

Nearly 279 HCWs participated in the study and cast their responses. Knowledge and attitude domain on BMWM showed statistical significance whereas varied responses were observed with practices among the health professional workers with health professional physicians having an edge over other HCWs involved in the processes with varying attrition factors.

CONCLUSIONS

The present study proves novelty by extensively analyzing KAP among HCWs on BMWM in general with special emphasis on laboratory biosafety norms. The study emphasizes that BMWM should be a continuous process and that all HCWs handling BMW must undergo regular training and assessment with questionnaire surveys. Multi-tasking and cumulative efforts must be formulated to attain translational synergy in the stream of KAP of BMWM, which could be attained by incorporating BMWM in the health science curriculum.

Knowledge, Attitude and Practice of Personnel Involved in Bio Medical Waste Handling about COVID-19 & Its Bio-Medical Waste Management: A Descriptive Analysis

Background: The COVID-19 pandemic has led to an increased amount of biomedical waste, worsening the already strained biomedical waste management system in India. As biomedical waste handlers are the core of biomedical waste handling, their knowledge, attitude, and practices regarding sorting, segregation, transport, and storage of the waste are of prime concern. This study aims to evaluate the knowledge, attitude and practices of personnel involved in biomedical waste handling about COVID-19 and its biomedical waste management at All India Institute of Medical Sciences Mangalagiri. Design: Cross-sectional survey. Setting: AIIMS Mangalagiri and common bio-medical waste treatment facility at Guntur. Participants- Personnel involved in bio-medical waste handling Methodology: The study enrolled a total of 139 participants from December 2020 to January 2021. A convenient sampling technique was used and a questionnaire was administered by face-to-face interview. Results: The study showed that half of the participants had favorable knowledge about bio-medical waste management (average score 5.08 and range 1-9). Two-thirds of the respondents felt that handling COVID-19 waste is necessary to contain the infection. Conversely, the practices regarding COVID-19 and its biomedical waste management were not in conformity with attitudes and knowledge. Fewer participants knew the exact sequence of donning (15.80%) and doffing (31.70%). Majority of participants (72.7%) desired a hands-on training for handling biomedical waste. Conclusion: Participants have good knowledge and attitudes regarding COVID-19 bio-medical waste management, but are not adhering to it. This explains the need for comprehensive training programs for all those involved in bio-medical waste management of COVID-19.

Biomedical waste disposal practices among healthcare workers during COVID-19 pandemic in secondary and tertiary care facilities of Tamil Nadu

Purpose

The ongoing COVID-19 crisis has drastically changed the practice of biomedical waste (BMW) generation and management. Studies venturing into the facility level preparedness at various levels of healthcare delivery during pandemic situation is the need of the hour. Hence, we did this study to assess the BMW disposal practices amongst secondary and tertiary health facilities during COVID-19 pandemic in Tamil Nadu.

Materials and methods

This cross-sectional survey was conducted amongst doctors, nurses and allied healthcare staffs across various departments in 18 public health facilities across six districts of Tamil Nadu. Multivariable logistic regression analysis was done based on the random-intercept model to assess the determinants of BMW disposal practices. The effect size was reported as adjusted odds ratio (aOR) with 95% confidence interval (CI).

Results

In total, 2593 BMW disposal observations were made. During nearly three-fourth of the observations (73%), the BMW was disposed of appropriately. Nurses (aOR ​= ​1.54; 95%CI: 1.06–2.23) and doctors (aOR ​= ​1.60; 95%CI: 1.05–2.45), healthcare workers in Paediatrics department (aOR ​= ​1.77; 95%CI: 1.13–2.76), healthcare workers in inpatient department (aOR ​= ​2.77; 95%CI: 1.95–3.94) and injection outpatient department (aOR ​= ​2.69; 95%CI: 1.59–4.47) had significantly better odds of having appropriate BMW disposal practices.

Conclusion

Our study shows that nearly during three-fourth of the observations, healthcare workers performed appropriate BMW disposal practices. However, measures should be taken to achieve 100% compliance by healthcare workers especially the target groups identified in our study by allocating appropriate resources and periodically monitor the BMW disposal practices.

A QUALITATIVE STUDY ON THE BIOLOGICAL HAZARDS ASSOCIATED WITH MORTUARY WORK: THE GHANAIAN PERSPECTIVE

BACKGROUND

Workplace safety and health are significant public health concerns for maintaining a low-risk environment. In Africa and Ghana, most mortuaries are not well resourced, nor do they follow the universal standard precautions for infection prevention. As a result, it exposes mortuary attendants to numerous biological hazards that threaten their health and well-being and cause anxiety of contracting infectious diseases while attending to corpses.

OBJECTIVES

The study sought to explore the biological hazards to which mortuary attendants in Ghana are exposed in three selected regions.

METHODS

Qualitative research approach was used together with an exploratory, descriptive design. Semi-structured interviews were conducted to comprehend the biological hazards among mortuary attendants. Purposive sampling was used, and saturation was reached with nineteen participants.

RESULTS

The study revealed that most mortuary attendants were exposed to infections through direct contact with bodily fluids. Exposure to potentially contaminated syringes and needles due to non-adherence to universal standard precautions for corpse handling and the poor condition of storage systems as well as work environment were found to facilitate the risk of infection.

CONCLUSION AND RECOMMENDATION

This study shows that mortuary attendants are exposed to biological hazards like HIV and other blood-borne diseases, making them hesitant to work and have difficulty concentrating on their jobs. The study recommends the urgent provision of functioning cold rooms to preserve the integrity of the corpses, PPE, and adequate training of mortuary attendants on universal standard precautions to enhance safe and therapeutic working environments.

Assessment of Awareness and Practices of Biomedical Waste Management among Health Care Professionals at a Teaching Hospital in Uttar Pradesh

Improper waste management practices are a serious problem that involves not only the hospital staff but society at large. To improve biomedical waste (BMW) management, it is important to evaluate the current practices in BMW management (BMWM), identify the gaps, and address them. With this backdrop, this research was done to assess the awareness of BMW management practices among the healthcare professionals in a teaching hospital. This is a hospital-based observational study with assessment of 112 doctors, 230 nurses, and 158 waste handlers. The healthcare workers (HCW) were evaluated regarding awareness, and different practices of BMWM with a self-structured questionnaire. An overall score of ≥50% in each section was considered satisfactory regarding awareness and practices for BMWM. Data were analyzed statistically using SPSS Ver.21 software. Regarding the awareness on various aspects of BMWM, doctors had maximum level of awareness at 68.6% (60.0% – 77.2%), followed by nurses at 69.3% (63.3%-75.3%) and waste handlers at 55.9% (48.2% – 63.6%). Overall nurses showed maximum awareness of existing practices at 74.0% followed by doctors at 70.2% and waste handlers were at 53.8%. To optimize BMWM, it is important to raise awareness on best practices while evaluating the current practices. Gaps in knowledge and skills need to be identified and closed. Ongoing information, education and communication for health care professionals are pivotal in improving BMWM practices.

To assess the knowledge, attitude and practices in biomedical waste management among health care workers in dedicated COVID hospital in Bangalore

Background

In this pandemic of COVID-19, the highest amount of infective material, biomedical waste is generated in hospitals and it is frequently handled by the healthcare workers irrespective of cadres. Hence the awareness of healthcare workers in regards with biomedical waste (BMW) management is crucial in this pandemic. This study is therefore conducted to assess the knowledge, attitude and practices in BMW management among health care workers in our institution.

Results

A total of 280 subjects consisting of doctors, nursing staff and group D workers were included in the study after obtaining informed consent. The knowledge among healthcare workers was satisfactory, but comparatively group D workers were lagging behind. Overall they all have a good attitude towards BMW management but practices on BMW management needs improvement mostly among group D workers.

Conclusions

There have to be regular training programmes on biomedical waste management and its hazards for all the healthcare workers including group D workers. Along with educational intervention, strict implementation of biomedical waste management guidelines with its monitoring at all levels is also very much essential.

Generation of infectious waste during the COVID-19 pandemic: The case of a Brazilian hospital

Coronavirus-19 disease (COVID-19) acquired pandemic status in March 2020. The new virus has caused serious implications in the healthcare services management, including several sectors, among them the generation of waste. Healthcare wastes (HCW) generation increased along pandemic representing a health problem due to potentially infected ones. From this perspective, the study sought to analyse the challenges and changes imposed by COVID-19 in the HCW management in a large public hospital from Brazil. For this purpose, data about the Contingency Plan prepared by the hospital and HCW generation from 2017 to 2020 were used, analysed by statistical methods. When dealing with the Contingency Plan, the Brazilian hospital adopted measures similar to other hospitals around the world as described by the literature, such as: adoption of new protocols, specific team assigned to manage actions and training of professionals and suspension of elective surgeries. Regarding the generation of HCW, there was a significant increase in the mass of biological waste with a high risk of infection. The waste of this group increased from March 2020, coinciding with the start of care for the patients infected by COVID-19. The contribution of this type of waste to total generation jumped from approximately 0.2% in previous years to almost 5% in 2020. In addition, a reduction in the average of total waste generated in kilogrammes per bed per day from 2017 to 2019 was indicated compared to the 2020. COVID-19 pandemic led to major challenges for hospitals that had to care for patients infected with the SARS-CoV-2 virus, including new protocols, changing the work shifts and training the teams in the new procedures. The biological waste with a high risk of infectiousness also increased 30 times.

Waste management in an Italian Hospital's operating theatres: An observational study

BACKGROUND

Each day operating theatres produce lots of waste. The wrong segregation represents both an environmental and economic problem, which is reflected in increased disposal cost and in a loss of resources.

AIM

To examine waste segregation by medical and nonmedical healthcare personnel in an Italian hospital's operating theatres.

METHODS

We used an observational tool, according to the local regulations and validated by a panel of experts.

RESULT

Fifty-seven percent of waste were disposed of incorrectly, of these 71% could have been recycled and 1% recovered. The preoperative phase had the greatest production of waste (48%) and the highest percentage of incorrect differentiation (72%). Sixty-six percent of waste handled as "undifferentiated" could have been recycled. Waste managed as hazardous that could have been recycled, reused or otherwise segregated stood at 54%. Hazardous waste was managed incorrectly in 5% of the disposals.

CONCLUSION

The lack of a variety of bins for waste segregation and improper classification by personnel appear to be the cause of the incorrect segregation, which should be error free.

Adherence to safety practices and risks associated with health care waste management at an academic hospital, Pretoria, South Africa

Background

Adequate knowledge on hazards of healthcare waste and proper handling methods can result in its safe disposal and protection of workers and communities. The study assessed perceptions of healthcare workers on the adherence and risks associated with the practices of healthcare waste management.

Methods

A total of 126 questionnaires were administered in selected wards at an academic hospital to establish training and knowledge on legislations regarding healthcare waste and health hazards associated with such waste.

Results

Sixty nine percent (69.0%) of participants had received training on healthcare waste handling. The highest number of cleaning staff (85.7%) received training from work while 34.8% of the doctors also received training from work. Only 44.1% of the nurses had knowledge about policies on healthcare waste. The majority of the participants (82.0%) had knowledge on the risks associated with handling of healthcare waste. However, only 20.0% of the participants re-capped needles after use and of these 43.5% were doctors. Most of the nurses (64.0%) had been exposed to needle pricks.

Conclusion

Even though 82.0% of the participants believed there were enough management practices enforced with regards to the healthcare waste, it was recommended that there should be more education on the handling of healthcare waste.

Health-Care Waste Management in Public Sector of Tripura, North-East India: An Observational Study

Background:

Hospitals generate variety of waste which is hazardous to patients, health workers, community, and environment. Proper health-care waste management (HCWM) requires infrastructure, trained workforce, law and supervision. More than 80% of the population of Tripura depends on the public health-care system but the knowledge and practice of health-care workers regarding HCWM in the public sector of Tripura is not clear.

Objectives:

The objective was to assess the knowledge and practice of health-care workers regarding HCWM and to take an account of the existing HCWM facilities in the public sector of Tripura.

Study Design:

This was a facility-based, cross-sectional study.

Materials and Methods:

This study was conducted during 1^st November 2015 to 16^th October 2017 among 544 health-care workers working in thirty health institutions chosen by stratified random sampling. Data entry and analysis was performed using SPSS software version 15.0.

Results:

Overall, 37.68% of the respondents had fair knowledge regarding HCWM, 8.27% received in-service training on HCWM, 66.17% were immunized against hepatitis B and > 90% of the respondents knew about segregation of waste at source but knowledge regarding the use of colored bins for this purpose varied widely across different categories of participants. Housekeeping staff were ignorant about most of these issues. The importance of disinfecting the waste before disposal was known to 83.63% of the workers. Proper HCWM was practiced by 39.15% and segregation of waste at source into colored bins was followed by 23.3% of the respondents. The study revealed both waste management facilities and display of waste management policy as poor. Technical qualification and in-service training were identified as the statistically significant determinants of knowledge and practice of HCWM (P < 0.05).

Conclusion:

HCWM scenario including knowledge of health-care workers in Tripura is lacking. Installing proper waste management facilities, raising technical qualification at recruitment and in-service training may improve the situation.

Effectiveness of education program on hospital waste management

Purpose

The purpose of this paper is to assess the effectiveness of Kuwait Infection Control Directorate educational program in improving knowledge, attitude and practices (KAP) of environmental service workers (ESWs) regarding the management of infectious and sharps waste.

Design/methodology/approach

An interventional educational pre-test/post-test study was conducted over seven months, on a sample of 102 ESWs in Farwaniya General Government Hospital, Kuwait. Educational sessions and practical training using the KAP approach were applied during the intervention phase. The KAP of the participants were assessed using a questionnaire and observation checklist in the pre- and post-intervention phases.

Findings

Improvement in all aspects of the KAP regarding infectious and sharps waste management was observed among the participants after implementation of the intervention, with a statistically significant difference between pre- and post-test results (p<0.01).

Originality/value

The applied multi-component educational program in the current study can be successfully implemented for ESWs in all government hospitals in Kuwait and other countries with similar settings.

Workplace accidents among hospital cleaning professionals at a hospital in the city of Maranhão, Brazil

The goal of this study was to investigate the prevalence and factors associated with workplace accidents among hospital cleaning professionals. This is a cross-sectional, analytical study of a sample of 199 cleaning workers at six hospitals in São Luís, Maranhão, Brazil. We first ran a univariate analysis, and later the Poisson regression analyzes with robust variance were used, with hierarchized modeling of the data in order to estimate the prevalence ratios (PR) between the independent variables and the outcome (workplace accidents). The prevalence of workplace accidents is 13.57%, 81.48% of them with sharps. At the end of the multivariate analysis the following were found to be associated with workplace accidents: age between 18 and 30, not having a high-school degree, on the job for 2 to 5 years, inadequate segregation of health service waste (HSW), training only on admission, failure to consider the health hazards of hospital waste and failure to use personal protective equipment (PPE). Our findings reinforce the importance of continued health education, stressing periodic training and the use of PPE.

Knowledge, attitude, and practices of Bio-medical Waste Management rules, 2016; Bio-medical Waste Management (amendment) rules, 2018; and Solid Waste Rules, 2016, among health-care workers in a tertiary care setup

INTRODUCTION

Biomedical waste poses physical, chemical, radiological, and microbiological risks to the public and health-care workers (HCWs) for current and future generations.

AIM

The aim was to gauge the depth of understanding amongst HCWs on biomedical waste management (BMWM).

MATERIALS AND METHODS

A predesigned questionnaire on knowledge, attitude, and practices on BMWM Rules, 2016 (Principle), and 2018 (Amendment), Solid Waste Rules, 2016, and health hazards in HCW was distributed to all participants.

RESULTS

Only 68% of the participants knew that the most important step in waste management is waste segregation. Eighty-two percent of the HCWs working in this setup knew of the different color-coded bins used for segregation. However, awareness was lacking with respect to health hazards associated with improperly segregated and disposed off biomedical waste as only 49% answered the questions on the hazards of waste correctly. Laboratory waste handling was found to be the least understood area of the newer guidelines.

CONCLUSIONS

Training aspects of health-care waste management should be strengthened so that the current, existing, and future regulations are practiced diligently and uniformly. Periodic evaluation and assessment should become routine to enforce adherence to waste management.

Knowledge and practice of waste management among hospital cleaners

Background

Poor knowledge and practice of waste management among hospital cleaners is a significant occupational and public health risk which could be improved by better training.

Aims

To assess private hospital cleaners' knowledge and practice of hospital waste management and the association with training.

Methods

A cross-sectional study using an interviewer-administered structured questionnaire was undertaken. The questionnaire was designed to record demographics, assess knowledge and assess self-reported practice and training by private hospital cleaners in Etiosa in Nigeria. Results were analysed with SPSS20 using chi-squared tests.

Results

Ninety-eight hospital cleaners out of 135 participated (response rate 73%), of whom 81% reported that they had received training. Forty-nine per cent had good knowledge, while 90% self-reported good practice. Statistical analysis showed a significant negative association between training and knowledge (χ2 = 11.1, P < 0.01). There was no significant association between knowledge and practice.

Conclusions

This group of cleaners reported good practice but knowledge was negatively associated with training. This may be related to the nature of training. The study found a knowledge gap, exposing these hospital cleaners to occupational risks which appropriate training has the potential to prevent. Collaboration to produce effective training programmes is recommended.

Keeping in pace with the new Biomedical Waste Management Rules: What we need to know!

Biomedical Waste Management Rules were first implemented in our country on 20th July 1998. Thereafter, the rules have undergone periodic updates and amendments in the years 2003 and 2011. Latest Biomedical Waste Management Rules, 2016, and (Amendment) Rules, 2018, were an update and simplification of BMW disposal as compared with the previous version, keeping in pace with the changes in the requirements of the health-care setup. Although exhaustive, numerous medical devices/products/kits did not find any mention even in the latest amendment of the rules. Thus, this article aims to bring out the key points to be known by all health-care workers and the gray areas which require clarification and inclusion in the rules for a completeness of the said rules.

Disposal Practice of Unfit Medicines in Nongovernmental Hospitals and Private Medicine Outlets Located in Mwanza, Tanzania

Introduction

For a medicine to qualify as safe and effective and to be of good quality, it should be properly labelled, stored, and transported. If a medicine is not handled properly, it ends up being unfit. Improper disposal of unfit medicines contributes to the appearance of their metabolites in the environment.

Methods

A descriptive cross-sectional study was designed to capture quantitative data. The study was conducted in Mwanza region, Tanzania. The study population comprised nongovernmental hospitals and private medicines outlets in the region. The sample size was 111 facilities. This study was conducted between October 2013 and May 2014. The questionnaire was used to assess experience and challenges of dealing with unfit medicines. A review of waste management records was done to capture data of past disposal for unfit medicines. The coded data were analyzed using Statistical Package for Social Sciences (Version 20.0) computer analysis software. Comparison of proportions between groups was performed using Pearson's chi square.

Results

The majority of facilities (41.4%) used methods such as the pouring of unfit medicines into the sink and into the dustbin. About 60.4% of facilities were found with unfit medicines at the time of survey. Majority of unfit medicines found were antibiotics (64.1%). Almost 10% of health facilities maintained a register book for recording unfit medicines.

Conclusion

There was improper disposal of unfit medicines in health facilities studied, whereby commonly reported methods of disposal were pouring into the sink and putting into the street dustbin. In private medicines outlets, there was poor storage management practice as some of the unfit medicines were left unpacked into boxes or separated from the usable medicines and not properly labelled.

Determining a conceptual framework for safe and sustainable health-care waste management (SSHCWM) implementation in health-care facilities

Purpose

This paper aims to explore current sustainable facilities management knowledge and practice, focussing specifically on sustainable waste management implementation in health-care facilities with an aim to conceptualize a framework for assessing performance and impact of successful implementation of safe and sustainable health-care waste management on health-care provision.

Design/methodology/approach

This paper used a review of existing literature in relation to health-care waste management in the context of sustainable facilities management and facilities management performance and forms a basis for further research.

Findings

The growing significance of the strategic role of facilities management is established. Building on this recognition, a conceptual framework for assessing both implementation of sustainable facilities management practice in the context of waste management in health-care facilities and its impact on health-care provision is proposed.

Originality/value

This paper conceptualizes a framework for optimizing safe and sustainable waste management implementation in health-care facilities and assessing its impact on the bottom-line of health-care provision.

Application of the DPSEEA Model to Healthcare Waste Management

The use of health indicators is indispensable for understanding the complex relationship between the environmental and health fields. For the proposition of environmental health indicators, the Brazilian Ministry of Health (MH) recommends using a model proposed by the World Health Organization. This model is composed of the following elements: Driving Force, Pressure, State, Exposure, Effect, and Action; it is called the DPSEEA model. The objective of this study is to propose the application of this model in healthcare waste (HCW) management. This study was performed by documentary research using two data sources: a) technical reports on research on HCW from the last 15 years (outpatient, dental, hospital, veterinary, university, and primary care unit) at the University of Caxias do Sul, Brazil; and b) the MH manual entitled "Environmental Health: Basic Guide for the Construction of Indicators". The results show that the model is relevant because it makes it possible to analyse a particular context, proposing indicators and defining specific actions for the case of this study, to monitor and improve methods of managing HCW. The results also show that the proposed model is an important analytical tool for both medical waste management and planning actions that will minimize risks, particularly chemical and biological, resulting in environmental health and protection.

Knowledge and Practice of Health Workers about Healthcare Waste Management in Public Health Facilities in Eastern Ethiopia

Healthcare waste management (HWM) problems are growing with an ever-increasing number of hospitals, clinics, diagnostic laboratories, etc in Ethiopia. Health workers are one of the key personnel who are responsible for the proper management of healthcare wastes at any health facilities. However, this performance will depend the level of knowledge and practice regarding waste management. A facility based cross-sectional study design was applied on 400 health workers. All public health institutions inside Jigjiga town were included and the study participants were randomly selected from each health facility. Data were collected using pre-tested and self administered questionnaire. The collected data was analyzed using SPSS version 20. Multivariable logistic regression model was used to identify factors associated with knowledge and practice of health workers. Out of those involved in this study, 47.7% and 42.3% of respondents had good knowledge and good practice on healthcare waste management, respectively. Health workers in the age group of 35-44 years, nurses, midwifes, medical laboratory, were significantly associated with knowledge of health workers. On the other hand, only educational status was significantly associated with practice. In this study, both knowledge and practice of health workers about healthcare waste management was poor. To enhance both the knowledge and practice of health workers, on job training is recommended.

Dataset on the knowledge, attitude, and practices of biomedical waste management among Tehran hospital׳s healthcare personnel

The data of this research was the investigation of knowledge, attitude and practices of biomedical waste management among healthcare staff and performed in some general hospitals in Tehran, Iran. In this descriptive data, 162 participants were chosen according to stratified sampling method and a self-made questionnaire was used for data collection. Also, Kruskal-wallis test, Mann -Whitney U tests and Spearman correlation coefficient were used to analyze the data in R software, version 3.4.4. The weighted mean of data showed that the knowledge level in staff is “Low” and their activity level is “Moderate”. Also, the data of the statistical analysis revealed that there is no significant difference between male and female health care personnel in knowledge, attitude and practices. However, the results of Kruskal-Wallis test showed that there was no significant difference between the views of hospital staff in occupational and educational groups about knowledge and attitude and their relationship with the history of passing the health course, while the difference in practices level was significant (P < 0.0001). Furthermore, the relation between attitude and practices level of participants with different work experience were not significant.

Current perspectives on biomedical waste management: Rules, conventions and treatment technologies

Unregulated biomedical waste management (BMWM) is a public health problem. This has posed a grave threat to not only human health and safety but also to the environment for the current and future generations. Safe and reliable methods for handling of biomedical waste (BMW) are of paramount importance. Effective BMWM is not only a legal necessity but also a social responsibility. This article reviews the current perspectives on BMWM and rules, conventions and the treatment technologies used worldwide. BMWM should ideally be the subject of a national strategy with dedicated infrastructure, cradle-to-grave legislation, competent regulatory authority and trained personnel. Improving the management of biomedical waste begins with waste minimisation. These standards, norms and rules on BMWM in a country regulate the disposal of various categories of BMW to ensure the safety of the health-care workers, patients, public and environment. Furthermore, developing models for the monitoring of hospital health-care waste practices and research into non-burn eco-friendly sustainable technologies, recycling and polyvinyl chloride-free devices will go in long way for safe carbon environment. Globally, greater research in BMWM is warranted to understand its growing field of public health importance.

Occupational blood exposures in health care workers: incidence, characteristics, and transmission of bloodborne pathogens in South Korea

BACKGROUND

Health care workers (HCWs) are at high risk for occupational blood exposures (OBEs) and transmission of bloodborne pathogens. This study elucidated the incidence rate and epidemiological characteristics of OBEs among HCWs and investigated the pathogen transmission rate for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV).

METHODS

Self-reported OBEs from January 1, 2011 to December 31, 2015 were obtained from the electronic recording system. OBE incidence densities per 100 person-years and per 100 bed-years were calculated with a 5-year trend analysis. OBE characteristics and pathogen transmission rates were evaluated.

RESULTS

Among 10,452 HCWs and 1072 average yearly beds, 1076 OBEs were reported. OBE incidence rate was 5.6 cases per 100 person (full-time equivalent)-years and 20.3 per 100 bed-years. Incidence rate decreased and was significantly associated with a decrease of beds served per HCW. Housekeeping showed the highest OBE rate (14.8%) followed by doctors (8.5%) and nurses (6.2%). OBEs occurred in wards, emergency rooms, and operating rooms (38.1%, 13.3% and 12.2%, respectively) via percutaneous (86.7%) and mucocutaneous exposures (13.2%). Of OBEs associated with HBV (n = 133), HCV (n = 126), and HIV (n = 25), only one led to an infection (HCV; transmission rate of 0.8%). Neither HBV nor HIV infection occurred.

CONCLUSIONS

OBE incidence rate in a Korean university hospital was 5.6 cases per 100 person-years and 20.3 per 100 bed-years and was related to HCW workload and work proficiency. Though the actual bloodborne pathogen transmission rate was low, efforts to prevent OBE should be made for hospital safety.

Health care waste management in community-based care: experiences of community health workers in low resource communities in South Africa

Background

In South Africa, community health workers (CHWs) working in community-based care (CBC) programmes provide care to patients most of whom are living with HIV/AIDS and tuberculosis (TB). Although studies have shown that the caregiving activities provided by the CHWs generate health care waste (HCW), there is limited information about the experiences of CHWs on health care waste management (HCWM) in CBC. This study explored HCWM in CBC in Durban, South Africa from the perspectives CHWs.

Methods

We used three ethnographic approaches to collect data: focus group discussions, participant observations and informal discussions. Data was collected from 85 CHWs working in 29 communities in the Durban metropolis, South Africa. Data collection took place from July 2013 to August 2014.

Results

CHWs provided nursing care activities to patients many of whom were incontinent or bedridden. Some the patients were living with HIV/AIDS/TB, stroke, diabetes, asthma, arthritis and high blood pressure. These caregiving activities generate sharps and infectious waste but CHWs and family members did not segregate HCW according to the risk posed as stipulated by the HCWM policy. In addition, HCW was left with domestic waste. Major barriers to proper HCWM identified by CHWs include, lack of assistance from family members in assisting patients to use the toilet or change diapers and removing HCW from homes, irregular waste collection by waste collectors, inadequate water for practicing hygiene and sanitation, long distance between the house and the toilets and poor conditions of communal toilets and pit latrines. As a result of these barriers, HCW was illegally dumped along roads or in the bush, burnt openly and buried within the yards. Liquid HCW such as vomit, urine and sputum were disposed in open spaces near the homes.

Conclusion

Current policies on primary health care (PHC) and HCWM in South Africa have not paid attention to HCWM. Findings suggest the need for primary health care reform to develop the competencies of CHWs in HCWM. In addition, PHC and HCWM policies should address the infrastructure deficit in low resource communities. In order for low-and-middle-income-countries (LMICs) to develop effective community health worker programmes, there is a need for synergies in PHC and HCWM policies.

Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior

Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation). Results. For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers' segregation behavior, but intention emerged as the strongest and most significant (r = 0.524, P < 0.001). The theory of planned behavior model explained 52.5% of the variance in health workers' segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion. Generally, health workers' health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers' health care waste segregation behaviors.

Awareness about biomedical waste management and knowledge of effective recycling of dental materials among dental students

AIMS AND OBJECTIVES

Biomedical waste management has become a concern with increasing number of dental practitioners in India. Being health care professionals, dentists should be aware regarding safe disposal of biomedical waste and recycling of dental materials to minimize biohazards to the environment. The aim of the present study was to assess awareness regarding biomedical waste management as well as knowledge of effective recycling and reuse of dental materials among dental students.

MATERIALS AND METHODS

This cross-sectional study was conducted among dental students belonging from all dental colleges of Bhubaneswar, Odisha (India) from February 2016 to April 2016. A total of 500 students (208 males and 292 females) participated in the study, which was conducted in two phases. A questionnaire was distributed to assess the awareness of biomedical waste management and knowledge of effective recycling of dental materials, and collected data was examined on a 5-point unipolar scale in percentages to assess the relative awareness regarding these two different categorizes. The Statistical Package for Social Sciences was used to analyzed collected data.

RESULTS

Forty-four percent of the dental students were not at all aware about the management of biomedical waste, 22% were moderately aware, 21% slightly aware, 7% very aware, and 5% fell in extremely aware category. Similarly, a higher percentage of participants (61%) were completely unaware regarding recycling and reusing of biomedical waste.

CONCLUSION

There is lack of sufficient knowledge among dental students regarding management of biomedical waste and recycling or reusing of dental materials. Considering its impact on the environment, biomedical waste management requires immediate academic assessment to increase the awareness during training courses.

Hospital housekeepers: Victims of ineffective hospital waste management

Improper waste management exposes hospital housekeepers to biological risk. The objectives of this study were to identify the frequency and profile of exposure incidents, classify the role of sharps waste, and compare the first and last occurrences for hospital housekeepers with multiple exposure incidents. A retrospective epidemiological study using Brazilian records from 1989 to 2012 was conducted. Data analyzed included hospital treatment records and the state notification database. Probabilistic linkage was performed using LinkPlus and data analysis using SPSS. There were 996 (11.6%) injuries, with 57 (6.1%) workers reporting multiple occurrences, for a total of 938 workers. These were primarily needlestick injuries (98.5%), involving blood (85.6%), caused by hypodermic needles (75.1%), and improper sharps disposal (70.8%). The number of workers completing vaccination after their first injury and before their last injury was statistically significant. Additional efforts to prevent and manage exposure incidents are needed.

Impact of waste management training intervention on knowledge, attitude and practices of teaching hospital workers in Pakistan

Objective:

To evaluate the sustainability and effectiveness of training as an intervention to improve the knowledge, attitude and practices of hospital workers on health care waste management.

Method:

We conducted this quasi-experimental study in two tertiary care teaching hospitals in Rawalpindi in October 2013. Training, practical demonstrations and reminders on standard waste management were given to 138 hospital workers in one hospital and compared with 137 workers from the control hospital. We collected data 18 months after intervention through a structured questionnaire to assess the impact of the intervention. We used paired t-test to compare the scores on knowledge, attitude and practices at baseline and first follow up and final impact assessment. Chi square test was used to compare group variables between intervention and control groups.

Results:

After 18 months since intervention the mean scores on knowledge attitude and practices differed statistically significantly since baseline and intervention group had statistically significantly better knowledge positive attitudes and good health care waste management practices (p < 0.001). Health care and sanitary workers in intervention group scored statistically significantly higher (p < 0.001).

Conclusion:

Trainings of health and sanitary workers on health care waste management guidelines were sustainable among the intervention group after 18 months which shows the positive impact of our intervention. It is recommended that the trainings as intervention be included in the overall policies of the public and private sector hospitals in Pakistan and other similar settings.

Sustentabilidade ambiental nos processos de medicação realizados na assistência de enfermagem hospitalar

Resumo Objetivo Foram analisadas ações sustentáveis realizadas pela equipe de enfermagem de uma unidade de terapia intensiva durante os processos de medicação e proposto intervenções para a melhoria da sustentabilidade ambiental na área hospitalar. Métodos Estudo antes e depois usando a metodologia Lean Seis Sigma aplicada em uma unidade de terapia intensiva. A amostra foi composta por 648 processos de medicação realizados pela equipe de enfermagem. Os dados foram coletados por meio de roteiros de observação e analisados quantitativamente. Resultados Os resultados pós-intervenções incluíram a redução dos materiais como sacos plásticos (37,1%), redução de sobras de anti-inflamatórios hormonais (67,1%), aumento na remoção de etiquetas de sacos plásticos para serem reciclados (146,9%) e descarte correto de resíduos (32,2%) com diferença estatística significante (p ≤0.05). Conclusão As estratégias de intervenções implementadas a partir da análise do problema, validação e priorização das ações teve influência positiva na redução, reciclagem e disposição correta dos resíduos com benefícios para a instituição, meio ambiente e a saúde humana.

Management of Biomedical Waste: An Exploratory Study

BACKGROUND

Dental operatories pose a threat due to the high chances of infection transmission both to the clinician and the patients. Hence, management of dental waste becomes utmost importance not only for the health benefit of the dentist himself, but also people who can come into contact with these wastes directly or indirectly. The present study was conducted to find out the management of biomedical waste in private dental practice among 3 districts of Karnataka.

MATERIALS AND METHODS

The study population included 186 private practitioners in 3 districts of Karnataka (Coorg, Mysore, Hassan), South India. A pre-tested self-administered questionnaire was distributed to assess the knowledge and practices regarding dental waste management. Descriptive statistics was used to summarize the results.

RESULTS

Out of 186 study subjects, 71 (38%) were females and 115 (62%) were males. The maximum number of participants belonged to the age group of 28-33 years (29%). Undergraduate qualification was more (70%). 90 (48%) participants had an experience of 0-5 years. Chi-square analysis showed a highly significant association between participant who attended continuing dental education (CDE) program and their practice of dental waste management.

CONCLUSION

Education with regards to waste management will help in enhancing practices regarding the same. In order to fill this vacuum CDE programs have to be conducted in pursuance to maintain health of the community.

Impacts of health education on knowledge and practice of hospital staff with regard to Healthcare waste management at White Nile State main hospitals, Sudan

OBJECTIVES

The present study aims at assessing nursing and sanitation staff knowledge and practice regarding Healthcare Waste (HCW) management before and after the implementation of an educational intervention program at the main hospitals of the White Nile State in Sudan.

METHODOLOGY

Quasi-experimental study design was applied to assess the impact of an intervention program on knowledge and practice regarding HCW management. The same questionnaire used in the pre-test was used immediately after the end of the intervention program and then again three months later for a second post-test.

RESULTS

The results showed that the majority of nursing and sanitation staff had fair knowledge regarding HCW management before the educational intervention program (17% good, 58% fair, and 25% poor). After implementation of the educational program, the majority had good knowledge (56% good, 34% fair, and 10% poor) in the immediate post-test, and also in the post-test three months later (59% good, 35% fair, and 6% poor). More than half the nursing and sanitation staff had fair level of practice before the educational intervention program (42% good, 55% fair, and 3% poor). After the implementation of the intervention program, the immediate post-test showed a similar result (45% good, 54% fair, and 1% poor), while the post-test three months later showed that the majority demonstrated good practice level (55% good, 42% fair, and 3% poor).

CONCLUSION

The nursing and sanitation staff at the main hospitals of the White Nile State in Sudan recorded significant improvement in their knowledge and practice with regard to HCW management immediately after the educational intervention program and three months later.

Analysis of Information, Impact and Control of HIV amongst Dental Professionals of Central India

BACKGROUND

Dental health care providers may be exposed to a variety of microorganisms via blood, oral or respiratory secretions. Though the risk of transmission of Human Immunodeficiency Virus (HIV) in dental settings is low, the consequences of being infected are life threatening. Therefore, high standards in infection control and waste management are required in controlling occupational contagion and cross infection.

AIM

To obtain comprehensive information about the HIV related information, its impact on the health care provider's attitude towards treating patients living with HIV/AIDS (PLWHA), infection control & waste disposal practices among dental professionals of Malwa region of Madhya Pradesh; situated in Central India.

MATERIALS AND METHODS

A cross-sectional survey was conducted among 320 private dental practitioners. Data was collected using a pretested, self administered 40 item questionnaire and statistically analysed.

RESULTS

The response rate was 81.25%. Over all 50.76% dentists were graded as having good knowledge of HIV. Unfortunately, their willingness to treat these patients remained low. In all 39.23% dentist were willing to render care to PLWHA. Junior dentists expressed less hesitation with regard to acceptance of risk patients than other dentists. Over 65% of the respondents reported adherence to universal precautions. The most alarming observation was that dentists were not following safe waste management practices.

CONCLUSION

Dental professionals continue to indicate a reluctance to treat patients with HIV/AIDS or those in high- risk groups. The results suggest need to have a comprehensive motivational program and implementing ways to ensure access and availability of safe dental care for PLWHA. The desire to get training on how to handle PLWHA illustrates that receptiveness to change exists.

Non-Communicable Chronic Diseases: Winning on Facts but Losing on Passion

Abstract-For the past ten years, there has been an extensive analytical effort attempting to convince policy makers to invest in the prevention and treatment of non-communicable chronic diseases (NCDs) in low- and middle-income countries. From an analytical perspective, it has been an impressive decade of data gathering and presentations culminating in the United Nations high-level meeting on NCDs in September 2011. On the other hand, funding for NCDs has remained at very low levels compared to the burden of disease associated with NCDs. An important question, therefore, becomes why has all this important analytical work so far been unable to generate significantly more additional funding for NCDs? There are many possible explanations for the lack of appreciable additional funding, but perhaps the most important reason is a lack of passion or grass roots advocacy for preventing and treating NCDs by the general public. Until the politicians and policy makers see some urgency from the general public, the funding situation is unlikely to fundamentally change. However, there are many different actions that can be taken by researchers and funders while the funding levels remain low. In addition, many highly cost effective programs should be highlighted.

Applying Nightingale charts to evaluate the heterogeneity of biomedical waste in a Hospital

OBJECTIVES:

to evaluate the heterogeneity of biomedical waste (BW) using Nightingale charts.

METHOD:

cross-sectional study consisting of data collection on wastes (direct observation of receptacles, physical characterisation, and gravimetric composition), development of a Management Information System, and creation of statistical charts.

RESULTS:

the wastes with the greatest degree of heterogeneity are, in order, recyclable, infectious, and organic wastes; chemical waste had the most efficient segregation; Nightingale charts are useful for quick visualisation and systematisation of information on heterogeneity.

CONCLUSION:

the development of a management information system and the use of Nightingale charts allows for the identification and correction of errors in waste segregation, which increase health risks and contamination by infectious and chemical wastes and reduce the sale and profit from recyclables.

Evaluation of knowledge, practices, and possible barriers among healthcare providers regarding medical waste management in Dhaka, Bangladesh

Background

Improper handling of medical wastes, which is common in Bangladesh, could adversely affect the hospital environment and community at large, and poses a serious threat to public health. We aimed to assess the knowledge and practices regarding medical waste management (MWM) among healthcare providers (HCPs) and to identify possible barriers related to it.

Material/Methods

A cross-sectional study was carried out during June to September, 2012 including 1 tertiary, 3 secondary, and 3 primary level hospitals in Dhaka division, Bangladesh through 2-stage cluster sampling. Data were collected from 625 HCPs, including 245 medical doctors, 220 nurses, 44 technologists, and 116 cleaning staff who were directly involved in MWM using a self-administered (researcher-administered for cleaning staff), semi-structured questionnaire.

Results

Nearly one-third of medical doctors and nurses and two-thirds of technologists and cleaning staff had inadequate knowledge, and about half of medical doctors (44.0%) and cleaning staff (56.0%) had poor practices. HCPs without prior training on MWM were more likely to have poor practices compared to those who had training. Lack of personal protective equipment, equipment for final disposal, MWM-related staff, proper policy/guideline, and lack of incinerator were identified as the top 5 barriers.

Conclusions

Strengthening and expansion of ongoing educational programs/training is necessary to improve knowledge and practices regarding MWM. The government should take necessary steps and provide financial support to eliminate the possible barriers related to proper MWM.

Biological risk among hospital housekeepers

Although not directly responsible for patient care, hospital housekeepers are still susceptible to accidents with biological material. The objectives of this study were to establish profile and frequency of accidents among hospital housekeepers, describe behaviors pre- and postaccident, and risk factors. This was a cross-sectional study with hospital housekeepers in Goiania, Brazil. Data were obtained from interviews and vaccination records. The observations were as follows: (1) participating workers: 94.3%; (2) incomplete hepatitis B vaccination: 1 in 3; and (3) accident rate: 26.5%, mostly percutaneous with hypodermic needles, and involved blood from an unknown source; roughly half occurred during waste management. Upon review, length of service less than 5 years, completed hepatitis B vaccination, and had been tested for anti-HBs (hepatitis B surface antigen) influenced frequency of accidents. These findings suggest that improper disposal of waste appears to enhance the risk to hospital housekeepers. All hospital workers should receive continued training with regard to waste management.

Evaluation of an education and training intervention to reduce health care waste in a tertiary hospital in Spain

BACKGROUND

In recent decades there has been a significant increase in waste generation. Training interventions in advanced health care waste management can improve the segregation of regulated medical waste and reduce volume and costs.

METHODS

We carried out a quasi-experimental intervention study with before and after training session analysis to compare waste segregation. Descriptive analysis of the segregated health care waste and an evaluation of the quality of segregation were done. A comparison of monthly average waste to assess the effectiveness of the educational intervention was performed.

RESULTS

After the intervention, there was a significant reduction in the monthly average health care waste volume of 6.2%. Statistically significant differences in the infectious waste and genotoxic/pharmaceutical waste weight segregated before and after the intervention (P < .05) were found. Because of the health care waste weight reduction and the improvement of waste classification, a savings cost of €125,205 was achieved.

CONCLUSIONS

The health care waste management training improves biomedical waste segregation at the hospital, reducing the health care waste volume and costs as an added value.

Status of biomedical waste management in nursing homes of delhi, India

INTRODUCTION

Improper management of biomedical waste (BMW) poses a risk for health and environment. Healthcare workers have an important responsibility to properly segregate and train the staff in its disposal.

OBJECTIVE

To study the awareness, attitude and practices of health care workers in biomedical waste management and to observe the appropriateness of the same in the private nursing homes in Delhi, India.

MATERIALS AND METHODS

A cross-sectional study was conducted among private nursing homes in Delhi. In both south and east zones, 116 nursing homes were selected by random sampling method. Data was collected using a validated questionnaire of WHO. Data was analysed using SPSS software (version 16). Chi-square or fisher tests were used and accepted statistically significant if p-value was less than 0.05.

RESULTS

41.7% of the workers in south zone and 25% in east zone had no knowledge about BMW generation (χ2=24.26, p=0.001). 57 (95%) workers in south zone and 55 (98.2%) in east zone agreed strongly that BMW management is helpful in reducing spread diseases in the community (χ2=1.22, p=0.5). On observation, it was found that 13 (21.7%) nursing homes in south zone and 15 (26.8%) in east zone did not have black bags. Practice of biomedical waste management in nursing homes in both the zones of Delhi was poor.

CONCLUSION

The study concluded that the awareness regarding biomedical waste management was not satisfactory among health care workers in private sector. There is a need of strict implementation of guidelines of BMW management.