Safe Handling of Health Care Waste A selection from Hesperian Foundation’s forthcoming Community Guide to Environmental Health The Hesperian Foundation is a non-proﬁt organization committed to building a more just world by producing health education materials that enable communities and individuals to take the lead in their own health care. As co-conveners of the U.S. Circle of the People’s Health Movement, we demand “Health for All, NOW!” Contact us at: Hesperian Foundation 1919 Addison St., #304 Berkeley, California, 94704 USA tel: 510-845-4507 fax: 510-845-0539 email: [email protected] website: www.hesperian.org Copyright © 2005 by Hesperian Foundation The Hesperian Foundation encourages others to copy, reproduce, or adapt to meet local needs any or all of this pamphlet provided that what is reproduced is distributed free or at cost — not for proﬁt. Please contact the Hesperian Foundation before beginning any reproduction, adaptation, or translation to avoid duplication of efforts and to make sure you are working with the most recent, updated version of these materials.
Safe handling of health care waste Page Health care waste can cause health problems .3 The most common health problems caused by health care waste .4 The problem of incineration .5 Sangu’s story .6 Preventing harm from health care waste .8 Reducing waste .9 Separating waste .9 Separating with colored containers .10 Storing and transporting waste .11 Protect yourself and others when handling waste .11 Disinfecting waste .12 What wastes need to be disinfected? .12 Disinfecting with chemicals .13 Disinfecting with bleach .14 How to use a bleach bucket .15 Disinfecting with safe chemicals .15 Disinfecting with heat .16 Boiling .16 Steaming .16 Pressure steaming .16 Autoclave .17 Microwave .17 Sharps treatment and disposal .18 Guide to infectious waste treatment and disposal .20 Burying health care waste .21 Safe waste pits .21 Disposing of liquid waste .22 Vaccination programs and their waste .23 Safe disposal of chemical wastes .24 Disposing of chemicals used to clean and disinfect .24 Mercury .25 Antibiotics and other medicines .26 Education for Action: Organizing a health care waste assessment .27 Community-based solutions .30 Health care waste and the law .31 List of difﬁcult words .32 .
Safe handling of health care waste HEALTH CARE WASTE CAN CAUSE HEALTH PROBLEMS H ealth workers in every clinic, hospital, and home do their best to help people heal. But if waste from health care is not handled and treated safely, it can create health problems for the health workers and the surrounding community.
4 A Community Guide to Environmental Health The most common health problems caused by health care waste • Wounds from dirty needles, sharp instruments, and other sharps can cause many illnesses, including: Hepatitis B and C, tetanus, HIV/AIDS, staph infections, and other infections.
Safe Handling of Health Care Waste 5 The problem of incineration In order to destroy health care waste and the germs it carries, many clinics and hospitals burn it in furnaces called incinerators. It is easy to burn health care waste, because different kinds of waste can be collected and simply thrown in the incinerator. But incineration does not completely destroy the waste. Health care waste incinerators release chemicals into the air as smoke, and into the soil and ground water as ashes. When health care waste containing mercury, lead and other metals is burned, poisonous forms of these are released into the environment.
6 A Community Guide to Environmental Health Sangu’s story When Sangu was young she lived in a small village. After years of drought, she and her mother and baby brother moved to the city in search of a better life. They lived with her mother’s family on a steep hill over a dump site. Other children showed Sangu how to beat off stray dogs and pick out things to sell at the dump site. Before school every morning she went to the dump site to collect scraps of tin, glass bottles, plastic bags, and other things. She used the money she made to buy lunch and hot tea after school. But life was hard in the city, and Sangu’s mother was soon working away from the house all day. Sangu had to take care of her baby brother and could no longer go to school. Every day she spent many hours sorting through garbage at the dump with her brother in a sling on her back. Sometimes Sangu found bloody bandages, needles, and other hospital waste all mixed in with the rest of the trash. Sangu’s thin sandals did not protect her from getting hurt by sharps buried in the trash. Broken glass and rusted metal would sometimes cut her ankles. One day a syringe needle pierced her sandal and went right into her foot. Soon after the needle pierced her foot, Sangu got very sick with fever, sore throat, tiredness and swollen lymph glands. Sangu felt better after some weeks, but a few months later she began to feel sick again. She was tired all the time, had fevers, and lost her appetite. She had loose stool and grew very thin. Her mother and family worried about her, but they had no money to take her to a doctor. Her mother borrowed money from a cousin and took Sangu to the health center. The doctor listened to Sangu’s story, examined her and then took a blood test. A few weeks later they returned to the clinic and the doctor told Sangu’s mother that Sangu had HIV/AIDS. Her illness was very grave, but her family had no money to take her to the hospital for treatment.
Safe Handling of Health Care Waste 7 Why did Sangu die? Sangu died from HIV/AIDS after she was infected by stepping on a contaminated syringe needle in a pile of trash. Her illness and death were caused by an environmental problem — poor disposal of health care waste — and a social problem — poverty.
8 A Community Guide to Environmental Health PREVENTING HARM FROM HEALTH CARE WASTE W hether in a small health post, a larger clinic, or when doing health care in the home, medical tools and health care waste must be handled safely to prevent harm. Preventing harm from health care waste includes: • choosing medical supplies carefully to reduce the quantity and harmfulness of the waste • separating wastes where they are created • disinfecting wastes that carry germs • treating chemical wastes to make them less harmful by diluting them with water or adding other chemicals • disposing of health care wastes in the least harmful way possible • safely transporting, storing, and removing waste • training everyone who handles health care waste about safe methods Preventing harm from health care waste depends on people. No matter which method your clinic, center or hospital decides to use, make sure that everyone who handles health care waste, especially new people, understands what needs to be done and why. Often people will bring up new ideas that can make work easier and safer for everyone. Some clinics have a team of people who together are responsible for training and monitoring safe practices.
Safe Handling of Health Care Waste 9 Reducing waste Many materials used in health care become waste. Using fewer materials, and less harmful materials, will reduce the amount of harmful waste. When choosing health care materials, think about what kind of waste will be produced, and how harmful it will be.
10 A Community Guide to Environmental Health Separating with colored containers To make it easier for each kind of waste to get the right treatment, many health centers separate wastes into different colored containers at the places where waste is created. For this to work, everyone in the health center needs to understand how different kinds of waste are treated and disposed of, and what wastes go in what color containers. Different countries use different colors for each type of waste. For example, in some countries the color red is used to indicate danger. So containers for sharps and other harmful or dangerous wastes are marked with red paint, marker or tape.