Documents

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.

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

This WHO fact sheet presents the different types of healthcare waste (HCW) and the health impact risks associated with their disposal.

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.

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.

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.

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.

Cette affiche illustre comment éliminer correctement les seringues.

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

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.

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.

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.

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.

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.

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...

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.

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.

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.

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

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

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.

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.

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.

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.