All of us are now familiar with the term “COVID-19”. Mankind has suffered a lot during this pandemic whether it is on economic front, social front or emotional stability. But not only mankind has suffered even the environment has got sick with all those medical waste we have created.
Medical waste is a portion of the waste generated by human activities. It is capable of carrying out infectious outbreaks. Thus such waste is infectious or potentially infectious material generated at the health care services like hospital, clinics and microbiology laboratories.
As the waste can be the host of several infections and outbreaks, accurate disposal and management of the waste becomes the need of the hour. Several procedures need to be followed for different types of medical waste. However, segregation is the foremost and most time consuming stage. This is the point where most organisations fail due to lack of awareness.
Data regarding medical waste by WHO
According to the reports of the World Health Organisation, of the total medical waste generated in the world, 85% belongs to the non hazardous type. Rest 15% waste is hazardous, toxic, infectious and contains radioactive materials.
However, the data needs to be updated regularly. Also the data depends on several other factors. The great portion shared by the non hazardous materials requires accurate quantification at each and every healthcare organisation.
Categories of medical waste
According to the categorisation given by WHO, there are eight types of medical waste:
- Infectious- any medical material that has a potential to cause contamination or infection.
- Sharps- medical materials such as needles, razors, broken glass.
- Pathological- the human body or animal body part, fluids are all included in the pathological waste.
- Pharmaceutical- the waste of creams, drugs, pills and tablets used within the healthcare faculties.
- Genotoxic- cytotoxic drugs that are carcinogenic in nature.
- Radioactive- any waste that has the potential to emit radioactive radiations.
- Chemical- liquid waste from the machineries and batteries.
- Non hazardous- the waste material which is not capable of causing any hazard such as paper.
Medical waste management and disposal
As the medical waste is quite risky, it needs proper management and disposal techniques. The health workers and the medical waste management communities or services are more vulnerable to the infections through the waste.
Managing medical waste requires certain stages to be followed:
The first step of accumulation always starts with the segregation of waste. The stage requires efforts and is time consuming. Thus most organisations and services fail to segregate the medical waste.
After segregation, the waste has to be accumulated within leak proof and strong containers to avoid any potential of leakage. For the accumulation purpose certain colour coded bins are in use:
The other step is storing the accumulated waste material. Storing refers to the action of keeping the waste safely until the time of treatment. This step requires knowledge about the different materials that can be used for storing the waste.
Handling the waste is another step in management of medical waste. Handling the waste has to be done at each and every step i.e. it has to be done while accumulating the waste, storing the waste and taking away the waste for treatment procedures. Certain special precautions have to be followed by the health workers.
The most important stage is the treatment and disposal of the medical waste. There are two broad methodologies for treating:
1. On site treatment
2. Off site treatment
On site treatment is the treating of the waste at the place of generation only. It requires expensive equipment, space and labour.
The accumulated waste first needs to be autoclaved or shredded, incinerated (if required) and has to be disposed of within landfills/ secure landfills.
An autoclave is a device that eliminates the microbiological load such as bacteria, fungi and other microorganisms. It uses steam and pressure to sterilize the medical equipment. The autoclaved material is sometimes also grinded or shredded.
Incineration is the process of burning the waste at extreme temperatures. However, this process is the parent of other environmental issues i.e. air pollution.
There are three types of incinerators:
- Controlled air incinerator
- Excess air incinerator
- Rotary kiln
Basically the design is the same for all the three types of incinerators. All the types have a primary combustion chamber.
Controlled air incinerators are also known as starved incinerators, two stage incinerators or modular combustion. The waste is first entered into the primary combustion chamber. Thus the waste gets dried out and volatilized. Gases causing air pollution such as CO2 are released in the process.
Excess air incinerators also have a primary combustion chamber where the waste is dried and volatilized. The chamber has a presence of moisture.
Rotary kiln is a device with the capacity to handle both dry and wet waste simultaneously. It has a rotating drum which continuously keeps on rotating and allows the waste to vapourize. The device is considered as the most environmentally friendly.
For off site treatment of the medical waste, you need to choose an external biomedical waste handling agency. They carry the waste in cardboards or plastic bags.
Most of the times the collected waste is incinerated and the remains after incineration are settled within the landfill sites.
Sometimes the collected waste material is also autoclaved and shredded before dumping into the landfills.
Also there are some other techniques useful for the treatment of biomedical waste. Micro auto gasification systems are the most compacted devices and are a green and clean alternative of incineration.
The system converts the mixed waste containing several types of materials such as plastic, paper etc. into thermal energy and biochar.
The waste is first inserted into the gasification chamber where the waste is converted into syngas and solid biochar. The syngas is then entered into the combustion chamber where it is combusted to produce fuel for the gasification chamber.
The remaining syngas is cooled with water and after overcoming a certain clean up process, it is released into the atmosphere.
Still, we can’t really say that we are advanced in handling the medical waste. We require more advancement in this field. We need procedures that are more environmentally friendly and also cost effective. There is a need to create awareness among people especially in the developing countries.
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