Healthcare Waste: Evaluation of its Generation Rate and Management Practices in Tertiary Care Hospitals of Lahore

Abstract

ABSTRACT

Objective: --To appraise the healthcare waste generation rate in tertiary care hospitals of Lahore and waste management practices in these hospitals.

Study Design:  It was hospital based cross-sectional study.

Place and Duration of Study: The study was conducted from 16^th June to 03^rd July, 2009 in Gulab Devi Hospital, Services Hospital and Jinnah Hospital. For the purpose of determining special waste (pathological and radioactive waste) generation rate and its disposal, INMOL and Central Pathology Laboratory of Punjab Institute of Cardiology, Lahore were included in the study.

Subjects and Methods: The study population comprised Nurses, Sanitary Staff and Sweepers performing duties in the wards of respondent hospitals in connection with the management of healthcare waste. A nurse, charge nurse, nursing assistant, sanitary incharge, sanitary worker and sweeper was the sampling unit. Multistage sampling technique was employed for selecting 05 ( 03 general and 02 specialized) tertiary care hospitals in Lahore, 05 wards from each hospital -and- 05 respondents from each ward. As such, 75 respondents were recruited for this study. Predesigned and pretested questionnaire was got filled, which contained questions about waste generation and management practices and knowledge in accordance with the Hospital Waste Management Rules-2005. Sole reliance was not placed on the information furnished by the respondents. They were interviewed with some leading questions to elicit actual and factual responses. Data was manually sorted out and analyzed with the help of calculator (fx-82TL).

 Results: Average healthcare waste generation rate in the hospitals of Lahore has been estimated at 2.20 kg per bed per day. 65% respondents were found immunized against Hepatitis-B, out of which a number of sanitary workers / sweepers who were most involved in healthcare waste handling was far lesser than nurses. None of the respondents indulged in healthcare waste handling was wearing protective clothing. As regards most of the healthcare waste management practices, there was absolute gap between theory and practice.

Conclusion: Healthcare waste management is a community problem. Hospital Waste Management Rules-2005 are in force, but the hospital waste management practices have not been / are not being given due importance in Pakistan.

Key Words: Disposal of waste, Healthcare (HC) waste, HC waste generation rate, HC waste management, identification of waste, non-risk HC waste, risk HC waste, segregation of waste.

NB: Hospital Waste, Healthcare Waste, Medical Waste, Clinical Waste -and- Biomedical Waste are synonymous and interchangeably used terms.