Title |
Author |
Year |
Safe Management of Wastes from Health-Care Activities (second version)
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WHO and al |
2013 |
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This handbook - the result of extensive international consultation and collaboration - provides comprehensive guidance on safe, efficient, and environmentally sound methods for the handling and disposal of health-care wastes.
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Blood transfusion safety
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WHO |
2011 |
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Blood transfusion services generate infectious and non-infectious waste through its activities such as blood samples, blood bags, sharps, glass/plastic ware, chemicals and medical devices.
It also have to dispose a huge amount of blood and blood products: red cells, plasma and platelets due to infectious units, expired units and other processing defects. These waste are generated in various health-care settings. Blood and blood products should be treated and disposed adequately and not mixed with the municipal wastes stream.
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Gestion des déchets biomédicaux: outil d'évaluation rapide. Seconde édition.
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WHO |
2011 |
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Cet outil est conçu comme une aide lors de l'évaluation de la gestion des déchets biomédicaux au niveau d'un pays. Il permet de synthétiser les pratiques actuelles, de se faire une idée du degré de conscience des risques associés avec une gestion inapropriée des DAS, d'aborder les questions légales, etc.
Le document d'origine (en anglais) a été élaboré par Mark Haltmeier et Frank Bouvet à la demande de l'OMS et de l'UNEP/SBC.
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HCWM - Rapid Assessment Tool (RAT). Second edition.
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WHO and UNEP/SBC |
2011 |
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This assessment tool has been created to help get an overall picture of the HCWM situation prevailing within a country at all levels (ministerial down to small HCFs).
It enables to assess management, training, regulatory, technical and financial issues and it’s analysis should help pinpoint critical issues that need to be addressed within the framework of a National Action Plan (NAP).
Prepared by Mark Haltmeier and Frank Bouvet on behalf of the Protection of the Human Environment departments / Water, Sanitation and Health unit at WHO and UNEP/SBC
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Health-care waste management - Fact sheet n° 281
|
WHO |
2011 |
|
WHO has issued a fact sheet that discusses the controversy over the incineration of certain types of HCW, especially plastics that contain PVC (polyvinyl chloride) and may lead to the emissions of dioxins, furans and other toxic air pollutants.
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Waste from health-care activities - Fact sheet n° 253
|
WHO |
2011 |
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This WHO fact sheet presents the different types of healthcare waste (HCW) and the health impact risks associated with their disposal.
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HCWM - Expanded Costing Analysis Tools (ECAT) - High-income countries
|
WHO |
2007 |
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Allocating insufficient financial resources to manage HCW properly has an even greater financial cost in the medium and long term in terms of morbidity and mortality as well as environmental damage, that will, in the end, impact negatively on peoples’ health.
The expanded costing analysis tool (ECAT) is a modified version of the cost analysis tool (CAT) and provides more options and approaches than the CAT. It was created to help the user estimate costs related to health care waste management (HCWM) at the health care facility (HCF), central treatment facility or cluster, and national levels.
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HCWM - Expanded Costing Analysis Tools (ECAT) - Low-income countries
|
WHO |
2007 |
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Allocating insufficient financial resources to manage HCW properly has an even greater financial cost in the medium and long term in terms of morbidity and mortality as well as environmental damage, that will, in the end, impact negatively on peoples’ health.
The expanded costing analysis tool (ECAT) is a modified version of the cost analysis tool (CAT) and provides more options and approaches than the CAT. It was created to help the user estimate costs related to health care waste management (HCWM) at the health care facility (HCF), central treatment facility or cluster, and national levels.
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HCWM - Expanded Costing Analysis Tools (ECAT) - Medium-income countries
|
WHO |
2007 |
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Allocating insufficient financial resources to manage HCW properly has an even greater financial cost in the medium and long term in terms of morbidity and mortality as well as environmental damage, that will, in the end, impact negatively on peoples’ health.
The expanded costing analysis tool (ECAT) is a modified version of the cost analysis tool (CAT) and provides more options and approaches than the CAT. It was created to help the user estimate costs related to health care waste management (HCWM) at the health care facility (HCF), central treatment facility or cluster, and national levels.
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International Meeting on Health-Care Waste, Geneva, Switzerland, June 20-22, 2007
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WHO / Dr Jorge Emmanuel |
2007 |
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An international meeting on health-care waste was held in Geneva on June 20-22, 2007. The meeting was attended by 53 participants from about two dozen countries representing 33 organizations concerned with health-care waste management (HCWM). The specific objectives of the meeting were: to explore areas of collaboration between the International Solid Waste Association (ISWA) and key international partners on HCWM; to agree on a plan to update the WHO reference document on health-care wastes; to review the latest developments in projects related to HCWM; and to obtain agreement on core principles regarding funding of HCWM.
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The Hazardous Chemicals and Wastes Conventions
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UNEP |
2007 |
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Presentation of the three Conventions: Basel, Rotterdam and Stockholm
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WHO core principles for achieving safe and sustainable management of health-care waste
|
WHO |
2007 |
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The safe and sustainable management of health-care waste is a public health imperative and a responsibility of all. Improper management of health-care waste poses a significant risk to patients, health-care workers, the community and the environment. This problem can be solved. The right investment of resources and commitment will result in a substantive reduction of disease burden and corresponding savings in health expenditures.
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Albania: Injection Practices - Rapid Assessment and Proposed Action Plan
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WHO |
2006 |
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As Albania was planning a mass measles/rubella vaccination campaign for November 2000, the World Health Organization carried out a rapid assessment of both injection practices as well as healthcare waste management.
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Georgia: Immunization Programme Management Review
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WHO |
2006 |
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Various immunization programme components (such as management, coordination, strategies, policies, monitoring, etc.) at the national and sub-national levels were examined and are summarized in the present report.
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Georgia: Waste Management Assessment and Planning for the National Immunization Programme
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WHO |
2006 |
|
Initial assessment and elaboration of a waste management plan for NIP outlining program management, capacity building, IEC and M&E components, and description of proposed waste management technologies for the national program.
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Gestion des déchets produits par les injections - Poster
|
WHO |
2006 |
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Cette affiche illustre comment éliminer correctement les seringues.
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Gestion des déchets produits par les injections au niveau des districts. Guide à l'intention des administrateurs sanitaires de district
|
WHO |
2006 |
|
Due to financial and institutional constraints, limited efforts have been made to provide District Management Teams with simple and adequate guidelines to set-up health-care waste management plans for primary and secondary health-care facilities. In particular, management of waste from mass and routine injection activities remains problematic as significant quantities of disposable or auto-disable syringes and needles are generated, for which there must be safe disposal options.
This guide is designed as a simple and practical tool to help District Health Managers elaborate a realistic
District level plan to reduce improper disposal of waste from injection activities.
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HCWM - Costing Analysis Tool (CAT)
|
WHO |
2006 |
|
This costing tool has been created to help estimate and calculate costs relating to HCWM at National and health-care facility (HCF) levels.
Prepared by Mark Haltmeier on behalf of the Protection of the Human Environment departments / Water, Sanitation and Health unit at WHO
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Management of waste from injection activities - Poster
|
WHO |
2006 |
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This poster provides a good overview of what needs to be done to dispose of syringes in a safe way.
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Management of waste from injection activities at district level: guidelines for district health managers
|
WHO |
2006 |
|
Due to financial and institutional constraints, limited efforts have been made to provide District Management Teams with simple and adequate guidelines to set-up health-care waste management plans for primary and secondary health-care facilities. In particular, management of waste from mass and routine injection activities remains problematic as significant quantities of disposable or auto-disable syringes and needles are generated, for which there must be safe disposal options.
This guide is designed as a simple and practical tool to help District Health Managers elaborate a realistic
District level plan to reduce improper disposal of waste from injection activities.
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National Steering Committees and National Working Groups for Health-Care Waste Management Policy Development and Planning
|
WHO |
2006 |
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The WHO policy paper “Safe health-care waste management” (August 2004) calls on countries to develop and implement national plans, policies, and legislation on health-care waste. This paper describes an organizational model and strategy for developing health-care waste management policies and plans through National Steering Committees and National Working Groups.
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Republic of Moldova: HCWM situation analysis and NAP
|
WHO |
2006 |
|
The Moldovan Health Authorities have recently made a real effort to standardize the Health Care Waste Management (HCWM) procedures and reinforce legislation with the edition in 2002 of a new regulation for medical waste management.
An assessment carried out in 2004 shows that HCWM practices are still unsafe and should be more in accordance with the international procedures recommended by the World Health Organization.
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Ukraine: Injection safety pilot project on needle removing and plastic recycling
|
WHO |
2006 |
|
As a follow up of the 2002 injection safety assessment and the 2003 introduction of AD syringes in Ukraine, a pilot project was initiated with the objective to design a safe and viable process for disposing AD syringes through a non-burn option.
The project was to test a system using:
a) needle removing with needle cutter,
b) neutralisation by autoclaving,
c) containment with safety container and autoclaving bag,
d) different methods of transport,
e) disposal through shredding and recycling.
The costs analysis was also an objective of the pilot project.
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|
Better health care waste management: An integral component of health investment
|
Raki Zghondi - WHO / CEHA and Philip Rushbrook - World Bank |
2005 |
|
The overall objective of this publication is to demystify the topic of health care waste management and demonstrate that positive improvements are possible in almost every situation with relatively modest levels of effort and investment.
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Gestion des déchets de soins
|
WHO Africa / IT Power India
|
2005 |
|
Ces guides se focalisent sur les spécifications, l'installation, l'opération et la maintenance de l'Unité de Gestion des Déchets. Ces guides peuvent être supplémentés par un manuel pour opérateur. Ces guides sont divisés en quatre sections:
Section 1 offre une large vision de l'unité de gestion des déchets.
Section 2 couvre l'installation incluant des spécifications techniques, procédure de construction, les appels d'offres et des aspects de contrôle de qualité dirigés vers des techniciens...
Section 4 adresse les aspects de maintenance, planification et d'autres procédures et est à l'intention d'un ministère de la santé, contracteur en charge de la maintenance...
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Gestion des déchets solides d'activités de soins dans les centres de santé primaire: Guide d'aide à la décision
|
WHO |
2005 |
|
Ce document a pour objectif de fournir une aide au choix des méthodes les plus appropriées à la gestion des déchets solides générés dans les centres de soins de santé primaires des pays en développement.
Les six arbres de décision proposés pour aider l’utilisateur à identifier les méthodes appropriées de gestion des déchets sont un outil essentiel de ce guide. Celui-ci tient compte des conditions locales à ne pas négliger, de la sécurité des personnels de santé et de la population générale, ainsi que des critères environnementaux.
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Health-care waste management rapid assessment tool [Russian]
|
WHO |
2005 |
|
This assessment tool has been created to help get an overall picture of the HCWM situation prevailing within a country at all levels (ministerial down to small HCFs). It enables to assess management, training, regulatory, technical and financial issues and it’s analysis should help pinpoint critical issues that need to be addressed within the framework of a National Action Plan (NAP). Prepared by Mark Haltmeier and Frank Bouvet on behalf of the Protection of the Human Environment departments / Water, Sanitation and Health unit at WHO and UNEP/SBC
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|
Health-care waste management: Guidance for the development and implementation of a National Action Plan
|
WHO |
2005 |
|
This document provides guidance to assess and analyse the HCWM situation at the national level so as to be able to draft up a National Action Plan (NAP), with the aim of improving the overall HCWM system in the country.
The draft NAP would then be reviewed by persons involved in the national or regional policy setting, interested donor agencies, NGOs and other concerned organizations or stakeholders and roles and resources for its implementation identified.
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|
Management of solid health-care waste at primary health-care centres: A decision-making guide
|
WHO |
2005 |
|
The objective of this document is to provide guidance for selecting the most appropriate waste management methods for safely managing solid waste generated at Primary Health-Care centres (PHCs) in developing countries. The main tool of this guide consists of six decision-trees aimed at assisting the user in identifying appropriate waste management methods. The guide takes into consideration the most relevant local conditions, the safety of workers and of the general public as well as of environmental criteria.
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|
Managing Health Care Waste Disposal
|
WHO Africa / IT Power India
|
2005 |
|
The guidelines focus on the product specification, installation, operation and maintenance of a Waste Disposal Unit. These can be supplemented by an operator's manual. The guidelines are divided into four sections.
Section 1 provides an overview of the waste disposal unit.
Section 2 covers installation, including technical specification, construction process, tendering and quality control issues for engineers...
Section 3 is a training manual intended for trainers.
Section 4 addresses maintenance and planning and other procedures and is intended fr ministry of health, maintenance contractors...
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Mercure et soins de santé: document d'orientation stratégique
|
WHO |
2005 |
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Mercury in health care
|
WHO |
2005 |
|
Mercury is highly toxic, especially when metabolized into methyl mercury. Health-care facilities are one of the main sources of mercury release into the atmosphere because of emissions from the incineration of medical waste. To understand better the problem of mercury in health-care sector, it is recommended that countries conduct assessments of current mercury usage and health-care waste management programmes. WHO proposes to work in collaboration with countries through short-, medium- and long-term strategic steps presented in this document.
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Préparation des Plans Nationaux de Gestion des Déchets de Soins Médicaux en Afrique Subsaharienne: Manuel d’aide à la décision
|
OMS / SCB-PNUE |
2005 |
|
The manual is the result of experience gathered over several years (2000-2004) in conducting technical assistance projects in a number of countries in the Sub-Saharan region. It aims at identifying appropriate practices for health care waste management by providing assessment and planning tools applicable in most sub-Saharan countries of Africa. The document is divided into four sections.
Prepared by Frank Bouvet & Mark Haltmeier on behalf of the Protection of the Human Environment department / Water, Sanitation and Health unit at the World Health Organization and the Secretariat of the Basel Convention
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Safe Management of Bio-medical Sharps Waste in India - A report on alternative treatment and Non-burn disposal practices
|
WHO South-East Asia |
2005 |
|
Sharps are one of the most hazardous categories of waste generated in health care
facilities. Injections are responsible for the generation of the largest quantity of
infectious sharps generated during both immunization and curative practices. Due
to the risks associated with sharps it is very important to manage them properly and
to ensure they remain safe to the health care workers and the community at large.
The present study documents successful sharps management systems in urban
areas and evaluates non-burn treatment and disposal technologies. The study
evaluated the coherence of these technologies with the current regulatory health
care waste management (HCWM) framework in India. Due to the nation-wide
introduction of Auto Disable (AD) syringes for immunization programmes, the study
also analyses the implications linked to their use and the possibilities of material
recovery of these syringes.
The findings of the study indicate that it is of paramount importance to contain
the infectious sharps in puncture resistant containers, disinfect and mutilate them at
point of generation to ensure the safety of the health care workers and the community
at large. The use of alternative treatment and disposal technologies covered in the
13 success stories include needle cutters, chemical disinfection, autoclaving,
microwaving, advanced autoclave like Hydroclave™, cement encapsulation and
sharps pit. The health care institutions were satisfied with the technologies and felt
that mutilation after disinfection was the most effective technique to ensure that
infectious sharps are not re-used.
Currently, the methods used for final disposal of sharps were not found to be
sustainable. The health care workers felt that it was important to look into the option
of material recovery from the injection units.
The concept of AD syringes was new to many health care workers they felt that
AD syringes would be very useful during immunization programmes, as it would
make sure that the sharps are not re-used. However, the health care workers felt
that more research needs to be carried out in identifying the treatment and sustainable
final disposal options of AD syringes before these are introduced throughout the
country.
Recommendations for the future in the field of sharps management are also
presented.
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Ukraine: Injection safety HCWM pilot project - needle removing and plastic recycling
|
WHO EURO |
2005 |
|
As a follow up of the 2002 injection safety assessment and the 2003 introduction of AD syringes in Ukraine, a pilot project was initiated with the objective to design a safe and viable process for disposing AD syringes through a non-burn option. The project was to test a system using a) needle removing with needle cutter, b) neutralisation by autoclaving, c) containment with safety container and autoclaving bag, d) different methods of transport, e) disposal through shredding and recycling. The costs analysis was also an objective of the pilot project.
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Une meilleure gestion des déchets d'activités de soins: une composante intégrale de l'investissement dans la santé
|
P. Rushbrook et R. Zghondi |
2005 |
|
Cette publication a pour objectif de démystifier le sujet de la gestion des déchets d’activités de soins et de démontrer que des améliorations sont possibles dans pratiquement toutes les situations avec des efforts et des investissements relativement modestes.
Elle s’adresse aux directeurs et conseillers des établissements de santé auxquels elle offre une introduction du sujet facile à lire, et au personnel technique de ces établissements en leur servant de guide de référence.
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Management of wastes from immunisation campaign activities. Practical guidelines for planners and managers
|
WHO |
2004 |
|
This document – developed by WHO and UNICEF – provides practical guidelines for planners, managers of healthcare facilities or mobile vaccine team leaders to improve planning and coordination at the central level as well as waste management practices at the local level where immunisation activities are conducted.
We encourage immunisation campaign coordinators to field test this and send there comments / feedback to hcwaste@who.int.
Prepared by the Immunization, Vaccines and Biologicals department and Protection of the Human Environment department / Water, Sanitation and Health unit at WHO
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Preparation of national health-care waste management plans in sub-saharan countries: a guidance manual
|
WHO and UNEP/SBC |
2004 |
|
The manual is the result of experience gathered over several years (2000-2004) in conducting technical assistance projects in a number of countries in the Sub-Saharan region. It aims at identifying appropriate practices for health care waste management by providing assessment and planning tools applicable in most sub-Saharan countries of Africa. The document is divided into four sections.
Prepared by Frank Bouvet & Mark Haltmeier on behalf of the Protection of the Human Environment department / Water, Sanitation and Health unit at the World Health Organization and the Secretariat of the Basel Convention
|
|
Republic of Moldova: Healthcare waste management situation analysis and national action plan
|
WHO EURO |
2004 |
|
The Moldovan Health Authorities have recently made a real effort to standardize the Health Care Waste Management (HCWM) procedures and reinforce legislation with the edition in 2002 of a new regulation for medical waste management. An assessment carried out in 2004 shows that HCWM practices are still unsafe and should be more in accordance with the international procedures recommended by the World Health Organization.
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Review of health impacts from microbiological hazards in health-care wastes
|
WHO |
2004 |
|
This document aims at reviewing the scientific literature for findings on health impacts from microbiological hazards of health-care wastes. It also reviews health impacts of similar exposures in similar circumstances, to evaluate health risks by analogy.
Although the available literature is relatively scarce, this document may constitute an initial review, to be updated as additional evidence becomes available.
It is targeted at scientists and public health professionals, and those involved in policy setting around health-care waste management.
Prepared by the Department of Blood Safety and Clinical Technology and the Department of the Protection of the Human Environment / Water, Sanitation and Health unit at WHO
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Safe health-care waste management: Policy paper
|
WHO |
2004 |
|
This document reviews the risks before providing guiding policy principles and a strategy to implement it.
This policy paper also exists in French, Spanish and Russian.
Prepared by Immunization, Vaccines and Biologicals depratment and the Protection of the Human Environment department / Water, Sanitation and Health unit at WHO
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Technical guidelines on the environmentally sound management of biomedical and healthcare wastes (Y1, Y2)
|
SBC / UNEP |
2003 |
|
The guidelines provide information for the proper treatment of wastes from health-care establishments (public and private). The information provided takes due consideration of the waste management requirements of disposal and recovery measures as well as hygiene requirements. In addition to ecological aspects, the information and recommendations should be economically feasible and easy to undertake. It and also makes allowances for technical progress.
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"First, do no harm" Introducing auto-disable syringes and ensuring injection safety in immunization systems of developing countries
|
WHO |
2002 |
|
note: update for the document.
Health-care waste should be treated according to national regulations. WHO promotes the principle of environmentally sound management of health-care waste.
Low temperature incineration (.<800°C) and any other form of burning (drum, pit, open space etc) remains the last option for infectious waste in emergemcy situations when no alternative treatment is available, e.g.: during acute outbreaks of communicable diseases. (adapted from safe managemenmt of wastes from health care activities, 1999, page 86).
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Albania: Injection Practices - Rapid Assessment and Proposed Action Plan
|
WHO |
2000 |
|
As Albania was planning a mass measles/rubella vaccination campaign for November 2000, the World Health Organization carried out a rapid assessment of both injection practices as well as healthcare waste management.
|
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Starting health care waste management in medical institutions: a practical approach
|
Philip Rushbrook et al. |
2000 |
|
This document has been prepared in response to numerous requests for advice and assistance by staff in ministries of health and health care institutions, particularly from those who are responsible for introducing better waste management practices in medical institutions so as to reduce infection risks and improve hygiene.
The information provided is of a practical nature. It is based on the outcome of several field projects in the WHO European Region involving schemes to improve health care waste management in hospitals and similar institutions.
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Guidelines for Safe Disposal of Unwanted Pharmaceuticals in and after Emergencies
|
A group of internationals institutions coordinated by WHO |
1999 |
|
In this document guidance is provided on the disposal of drugs in difficult situations in or after emergencies, in relation to armed conflicts, natural disasters or others. In such situations, it may happen that large quantities of unwanted drugs accumulate due to difficulties, mismanagement of stocks and inappropriate donations.
The guidance provided consists in relatively simple and low-cost measures and is addressed to local authorities, health care personnel or other professionals confronted to this type of problem.
Main content:
- existing disposal methods;
- recommended disposal methods by waste category.
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Safe Management of Wastes from Health-Care Activities (first version)
|
WHO / Annette Pruess, E. Giroult, P. Rushbrook |
1999 |
|
This handbook - the result of extensive international consultation and collaboration - provides comprehensive guidance on safe, efficient, and environmentally sound methods for the handling and disposal of health-care wastes.
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Teacher's Guide: Management of waste from health-care activities
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WHO / A. Prüss, W.K. Townend |
1998 |
|
The teacher's guide accompanies the WHO publication on management of wastes from health care activities.
It provides teaching materials (ready-to-copy texts for overhead transparencies, lecture notes, handouts, exercises and course evaluation forms) and recommendations for a three-day training course.
It is designed mainly for managers of health care establishments, public health professionals and policy makers. A selection of pictures to support training in health care waste management is available on line.
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