The design and development of a system for disinfecting medical waste at the site of origin is presented. Investigation of the current commercial systems that accomplish this task shows that they all expose the waste to physical conditions that are harmful to all forms of life. Further, most are very expensive to install and to operate. A recently developed biochemical process promises to effectively inactivate harmful pathogenic organisms economically and without the danger of extreme heat or poisonous chemicals. The biochemical process is not yet fully developed. Nonetheless, the development of a marketable system to take advantage of this technology has been initiated. The motivation for developing this technology and the particular system that will employ it is presented. A general overview of the system and components is presented. Previous and suggested future testing strategies are explained. Component interactions and process control are described. / Master of Science

published_or_final_version / Environmental Management / Master / Master of Science in Environmental Management

A problemática que envolve os resíduos de serviços de saúde vem ganhando espaço na mídia internacional a partir dos inúmeros acidentes ocorridos envolvendo resíduos desta natureza, como é o caso do incidente ocorrido nas praias de New Jersey e New York, no verão de 1988, ou mesmo o acidente radiativo ocorrido em Goiânia. Tais eventos provocaram grande reação na opinião pública preocupada com sua disposição inadequada, fato agravado com o advento da AIDS e sua rápida proliferação. A estratégia de gerenciamento utilizada para os resíduos perigosos, que segue os resíduos desde sua geração até seu destino final, mostra-se adequada também a resíduos de serviços de saúde. Da mesma forma a segregação na origem e a minimização são possíveis, baseando-se numa caracterização prévia que leve em consideração o risco potencial de infecção e possibilite, mediante uma graduação do risco inerente, uma classificação em distintas categorias. Este trabalho propõe, mediante revisão bibliográfica, levantar as polêmicas e as visões divergentes sobre o tema. Sugere uma proposta de metodologia para caracterização biológica e mostra suas dificuldades de implementação. Apresenta a caracterização destes resíduos como instrumento básico para se efetuar seu gerenciamento, o qual permitirá a minimização dos riscos ocupacionais, sanitários e ambientais devidos a este tipo de resíduos. Finalmente analisa criticamente os distintos trabalhos executados nos países latino-americanos, nos últimos vinte anos, sobre caracterização de resíduos hospitalares, ressaltando a metodologia empregada e os resultados a que chegaram / Medical wastes have been given much space in the international midia, along with several disasters involving these wastes which occurred lately, namely the disaster at New Jersey and New York beaches, in the summer of 1988, or even the one occurred in Goiania, involving radioactive materials. These events brought about the concern of the public opinion with the inadequate disposal of theses wastes, specially when AIDS and its spreading is a reality. The management strategy used for hazardous wastes, which is, to track the waste from its generation to its final disposal, shows also adequate for medical wastes. Segregation at source and minimization also possible based on a previous characterization which includes both the potencial infection hazard and the classification of these wastes into categories of scaled inherent risks. The study presents a survey carried out on international literature to point out the different viewpoints and the controversial aspects of the matter. It suggests a methodology for the biological characterization of the wastes and points out the difficulties in implementing it. It states the characterization of the waste as a mean of providing the management of these wastes, with minimization of occupational, sanitary and environmental hazards. Finally, it critically analyses similar surveys performed in Latin America countries during the last twenty years, about characterization of hospital wastes, emphasizing the adapted methodology and the results obtained

A problemática que envolve os resíduos de serviços de saúde vem ganhando espaço na mídia internacional a partir dos inúmeros acidentes ocorridos envolvendo resíduos desta natureza, como é o caso do incidente ocorrido nas praias de New Jersey e New York, no verão de 1988, ou mesmo o acidente radiativo ocorrido em Goiânia. Tais eventos provocaram grande reação na opinião pública preocupada com sua disposição inadequada, fato agravado com o advento da AIDS e sua rápida proliferação. A estratégia de gerenciamento utilizada para os resíduos perigosos, que segue os resíduos desde sua geração até seu destino final, mostra-se adequada também a resíduos de serviços de saúde. Da mesma forma a segregação na origem e a minimização são possíveis, baseando-se numa caracterização prévia que leve em consideração o risco potencial de infecção e possibilite, mediante uma graduação do risco inerente, uma classificação em distintas categorias. Este trabalho propõe, mediante revisão bibliográfica, levantar as polêmicas e as visões divergentes sobre o tema. Sugere uma proposta de metodologia para caracterização biológica e mostra suas dificuldades de implementação. Apresenta a caracterização destes resíduos como instrumento básico para se efetuar seu gerenciamento, o qual permitirá a minimização dos riscos ocupacionais, sanitários e ambientais devidos a este tipo de resíduos. Finalmente analisa criticamente os distintos trabalhos executados nos países latino-americanos, nos últimos vinte anos, sobre caracterização de resíduos hospitalares, ressaltando a metodologia empregada e os resultados a que chegaram / Medical wastes have been given much space in the international midia, along with several disasters involving these wastes which occurred lately, namely the disaster at New Jersey and New York beaches, in the summer of 1988, or even the one occurred in Goiania, involving radioactive materials. These events brought about the concern of the public opinion with the inadequate disposal of theses wastes, specially when AIDS and its spreading is a reality. The management strategy used for hazardous wastes, which is, to track the waste from its generation to its final disposal, shows also adequate for medical wastes. Segregation at source and minimization also possible based on a previous characterization which includes both the potencial infection hazard and the classification of these wastes into categories of scaled inherent risks. The study presents a survey carried out on international literature to point out the different viewpoints and the controversial aspects of the matter. It suggests a methodology for the biological characterization of the wastes and points out the difficulties in implementing it. It states the characterization of the waste as a mean of providing the management of these wastes, with minimization of occupational, sanitary and environmental hazards. Finally, it critically analyses similar surveys performed in Latin America countries during the last twenty years, about characterization of hospital wastes, emphasizing the adapted methodology and the results obtained

INTRODUCTION All waste generated at health care facilities in the past was regarded as hazardous and needed to be incinerated first before it was disposed. The purpose of this study was to investigate health care waste (HCW) management practices employed in public health clinics in the iLembe District, with a view of developing a HCW management intervention strategy. METHODOLOGY The study design was observational, descriptive, and cross-sectional. Data was collected using a structured individual questionnaire, which was administered to key informants from 31 rural and urban government fixed public clinics in the iLembe District Municipality. RESULT Thirty public clinics in iLembe district participated in the study. A total of 210 kg/day (0.06 kg/patient/day) of HCW was estimated to be generated in public clinics, 69% was health care general waste (HCGW) and 31 % was health care risk waste (HCRW). The district's generation rate was 0.04 kg/patient/day and 0.018 kg/patient/day, for HCGW and HCRW, respectively. The study found that HCW was improperly managed in the district. DISCUSSION The findings are different when compared to World Health Organisation norms and this was attributed to improper segregation of waste categories other than sharp waste, which was given special treatment. Factors such as the number of patients, size of the clinic, types of health care services rendered, and socio-economics status of the patient played a pivotal role in the waste volume generated. It is evident that no proper HCW management plan was being implemented in the district public clinics. CONCLUSION The management of health care risk waste is of great concern. There is a need for development of a health care waste management intervention strategy that must be implemented consistently and universally in the district. RECOMMENDATIONS It is recommended that a proper health care waste management intervention strategy be developed and implemented in the whole district. This strategy must incorporate training programmes and a waste management plan. / Thesis (MPH)-University of KwaZulu-Natal, 2007.

Submitted in accordance with the requirements for the Doctors Degree of Technology: Business Administration, Durban University of Technology, 2009. / Although there is an abundance of health care waste information in South Africa, not enough studies have been done in public district hospitals particularly in rural areas. Hospitals find it difficult to comply with the minimum requirements of health care waste management guidelines, such as segregation of waste. If hazardous waste gets mixed with non-hazardous waste, waste disposal and treatment become costly. Furthermore, there has been a sharp increase in the amount of waste generated from health facilities. However, there seem to be uncoordinated efforts in each province in dealing with waste problems. The purpose of this study was to evaluate the process of operational and administrative procedures of health care waste management in hospitals. The study was conducted to facilitate the optimisation of waste management. A quantitative approach was chosen for this study because cause and effect relationships can more easily be identified, and the research is more structured and controlled. The project involved an enquiry into the perception of respondents on the procedures used in managing health care waste. Data was collected from 270 respondents out of 27 hospitals in nine provinces of South Africa. The informants were health care waste workers who were either directly or indirectly involved in waste management. A questionnaire was used as a research instrument. Results were analysed statistically using a special package for scientific studies. It has been found that in the midst of financial challenges, hospitals are unable to prioritise and rank absolutely important activities that are necessary to be undertaken to meet minimum requirements of health care waste management as laid out in the health care waste guidelines and directives. Shortages of waste equipment such as trolleys, waste containers, and temporary storage areas were the main challenges facing hospitals. The recommendations set the tone and provide a blueprint that health care managers may consider in facilitating improvement in the management of health care waste.

Thesis (MTech (Environmental Health))--Cape Peninsula University of Technology, 2007 / This study examined the medical waste management practices of Tygerberg Hospital. The researcher made use of both primary and secondaiy data. Since this was a is study, the analysis is essentially descriptive.The results of this study revealed that both general and medical wastes are generated in the hospital. Tygerberg Hospital does not quantify medical waste. Segregation of medical wastes into infectious medical waste and non-infectious medical waste is not conducted according to definite rules and standards. The hospital does not label infectious waste with Biohazard symbol. Separation of medical waste and municipal waste is however practiced to a satisfactory extent. Wheeled trolleys are used for on-site transportation of waste from the points of production (different wards) to the temporary storage area. Staff responsible for collecting medical waste use almost complete personal protective equipment. The results of this study indicated that off-site transportation of the hospital waste is undertaken by a private waste management company. Waste is transported daily and small pickups are mainly used by the waste management company for transporting the waste to an off-site area for treatment and disposal. The final disposal of the medical waste is done by the private waste management company. The main treatment method used in the final disposal of infectious waste is incineration. Non-infectious waste is disposed of using land disposal method. The hospital does not recycle medical waste materials except white office paper and mixed office paper and the use of empty containers of antiseptics for the collection and temporary storage of sharps.The hospital does not provide training for staff members on the health and environmental effects of infectious waste. The waste management company's workers have also not received any formal training with regards to medical waste management. The study showed that Tygerberg Hospital does not have a policy and plan in place for managing medical waste. There is no definite policy or plan for purchasing the necessary equipment and for providing the facilities for the correct management of medical waste in the hospital. There are also no policies and guidelines regarding the recycling of medical waste products. There are a number of problems the hospital faces in terms of medical waste management, including; lack of necessary rules, regulations and instructions on the different aspects of collection and disposal of waste, intermingling of hazardous wastes with domestic waste in the hospital sometimes, failure to quantify the waste generated in reliable records, lack of use of coloured bags by limiting the bags to only one colour for all waste, the absence of a dedicated waste manager, the supervisor in charge of general services has waste management as part of his job schedule, and there is no committee responsible for monitoring the management of medical waste. From the results of this study, it is obvious that medical waste management is not practiced according to the World Health Organisation's (WHO's) recommended standards. There are some areas where medical wastes are not properly managed. It is imperative for significant investment in the proper management of medical waste in order to reduce the health risk it poses.

Since 1994, there have been sweeping changes made to South African policy and legislation, including environmental rights for all people, environmental protection and the consideration of sustainability in all activities. A national policy for medical waste management is being developed and guidelines for the South African Veterinary Council are currently being revised. By auditing contemporary veterinary waste management in one of South Africa's largest cities, this study sought to provide appropriate input into these initiatives. As a study area, the Durban Unicity provided the opportunity to audit a large population of veterinary clinics within a relatively short distance of each other arid also the opportunity to ascertain whether waste management practices were dependent on the socio-economic status of the clinics catchment area. A pilot study was used to inform the design of a questionnaire, which was then administered to thirty-two clinics sampled to represent a range in size of clinic, predominant type of patient treated and catchment socio-economic status. Another questionnaire was administered to four waste disposal companies and one veterinary diagnostics laboratory that removed waste for disposal from veterinary practices. The main findings suggest that there is a health risk to staff and the public, due to the incorrect separation, storage, handling and disposal of sharps, anatomical, contaminated domestic and infectious material. Staff at 6.3% of clinics sampled are not provided with any safety equipment. Most veterinarians (63%) as well as two of the five waste disposal companies audited were not aware of their responsibilities in terms of waste management policy and legislation. Sixty nine percent of the practices sampled reported that employees have either never been trained or have not received training in waste management in the past five years. Domestic waste contaminated with other potentially hazardous waste forms 12% of the total waste stream reported by practices. Even though the results indicate that a, few veterinary practices are mismanaging their waste this has the potential negative impact on staff, the public and the environment. The findings of the study would suggest a need for well communicated, enforceable guidelines outlining sustainable veterinary waste management for practices and waste disposal companies. The study highlights the similarities between veterinary and medical waste and the need to consider this in planning an effective waste management strategy. It also provides guidelines for a sustainable approach to veterinary waste management. / Thesis (M.Sc.)-University of Natal, Durban, 2003.

Thesis (Ph. D.)--University of Illinois at Chicago, 1999. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--University of Illinois at Chicago, 1999. / Includes bibliographical references.