THAI NGUYEN UNIVERSITY THAI NGUYEN UNIVERSITY OF AGRICULTURE AND FORESTRY NGUYEN THI NGOC THUY TOPIC TITLE: “ASSESSMENT OF MEDICAL WASTE MANAGEMENT AND TREATMENT STATUS IN THAI NGUYEN HOSPITAL OF TRADITIONAL MEDICINE” BACHELOR THESIS Study Mode : Full- time Major : Bachelor in Environmental Science and Management Faculty : International Training and Development Centre Batch : K43- Advance Education Program Thai Nguyen, October 2015 n DOCUMENTATION PAGE WITH ABSTRACT Thai Nguyen University of Agriculture and Forestry Degree Program Bachelor of Environmental Science and Management Student name Nguyen Thi Ngoc Thuy Student ID DTN1153040143 Thesis Title Assessment of medical waste management and treatment status in Thai Nguyen Hospital of Traditional Medicine. Ho Ngoc Son Abstract: The purpose of this study is the assessment of medical waste management and treatment status in Thai Nguyen Hospital of Traditional Medicine. The main focus is in 3 aspects: the current status of medical waste in Thai Nguyen Hospital of Traditional Medicine, interviewing staff and patients and evaluate how they can understand all in medical waste management and the solutions to manage domestic waste in study area. Conclusion, this hospital is becoming more and more complete day by day thanks to the management and the assistance of hospital authorities as well as the relevant agencies.
Keys Words Medical waste, hazardous waste, treatment, solution. Number of Pages 45 Date of 30/9/2015 Submission: Supervisor’s signature ii n ACKNOWLEDGMENT I would like to express my gratitude to my supervisor, Dr. Ho Ngoc Son for his invaluable useful comments, remarks, encouragement and engagement through the learning process of this graduated thesis. I sincerely thank Mr.
Duong Van Hung who helps me a lot when I work as trainee in Centre for Observation and Environmental Technology Thai Nguyen. I also thank the support of Thai Nguyen University of Agriculture and Forestry, the coordinators and program managers for their support and assistance. I am using this opportunity to express my gratitude to my classmates, who supported me throughout this course, by their aspiring guidance, invaluably constructive criticism and friendly advice. I am sincerely grateful to them for sharing their truthful and illuminating views on a number of issues related to my thesis.
Also, I like to thank the participants in my survey, who have willingly shared their precious time during the process of interviewing. I would like to thank my loved ones, who have supported me throughout entire process, both by keeping me harmonious and helping me putting pieces together. Thank you all very much! Sincerely yours, iii n TABLE OF CONTENT LIST OF TABLES .3 Research questions and hypotheses. Generation sources and medical waste classification.
The origin arising, composition and properties of medical waste .2 Composition of hospital wastewater. Influence of medical waste on the environment and public health .1 Harmful effects, the risk of medical waste on the environment and public health .2 Influence of medical waste in Viet Nam. Situation collection and processing of medical waste in the world and Vietnam .1 Status of collection of medical waste in the World. Current situation and management of medical waste treatment in Vietnam 15 2.
Current situation and management of medical waste treatment in Thai Nguyen .1 Forms solid waste collected at the health facility. The status of the equipment collected, transported medical waste. Medical waste treatment methods. Dealing with microwave technology.
Handling of biotechnology. Treated with radioactive substances .1 Secondary data collection methods .2 Questionnaire and Interview methods .3 Analyzing, synthesizing and assessing data methods .27 v n PART IV: RESULT .1 The current status of medical waste in Thai Nguyen Hospital of traditional medicine.1 Origins incurred hospital waste. Status of collection, classification, storage, transportation and disposal of solid waste in hospital. Understanding of staff, patients on the medical waste management of hospital 29 4.
For hospital staff. For patients and patients' family. Proposed solutions for the collection, handling medical waste in Traditional Medicine Hospital Thai Nguyen. Solutions for Environmental Management.
Solutions to improve the sorting, collection, transport. DISCUSSION AND CONCLUSION .37 APPENDICES vi n LIST OF TABLES Table 2.1 Classification of medical waste. Composition of hospital wastewater. The bacteria isolated in hospital wastewater.
Sanitary norms in hospital wastewater before and after treatment with biological methods. The volume of medical waste in hospitals hazards of some provinces. The amount of waste generated at the hospital department. Composition of solid waste from hospitals.
Understanding the regulation medical waste management. Understanding the color code utensils. Understanding the management of hospital waste .1 Research rationale The most vital mission of Health Ministry is supervision, protection and health development for people. Today, to meet a demand of the increase of medical examination and health care, the system of medical facilities more and more strengthen, extend and become be perfect.
However, during operation, health systems, especially hospitals, discharged a huge amount of endanger waste. According to WHO, components of hospital waste have about 10% septic waste, 5% toxic waste such as radioactive substances, cytotoxic substances, harmful chemicals generated during the diagnosis and treatment disease, these factors are caused environmental pollution, spread germs from hospitals to surroundings. It leads to increases the risk of nosocomial infection and the illness rate of communities living in adjacent areas. Vietnam's population is increasing, and economic development, that led to the need and treatment increases, the number of patients increased too.
According to statistics of Health Ministry, there are about 1050 hospitals, more than 10 thousand commune health stations apart from Research Institute, Preventive Medicine Centre, and the pharmaceutical manufacturing facilities. Since 1997, the text of hospital waste management are issued, but most of the hospital waste is not managed in accordance with a closely regulation. Environmental pollutions are caused by the activities that the actual health status is less effective treatment of hospital waste. These facilities emitted huge amount of garbage, solid waste is more than 400 tons per year (Health 2 n Ministry, 2007).
However, only 1/3 amount of waste is burned with modern electric oven, 2/3 of them is burned outdoor, by craft ovens, buried in the grounds of the hospital or exhausted in general landfill. It is a culprit of the pollution of environment. In addition, the interaction with medical waste can cause sickness or injury. The medical waste may contain infectious elements, which are toxic substances contained in medical waste, chemicals and pharmaceuticals dangerous, radioactive waste and sharps.
All employees who exposed to hazardous medical waste can put their health at risk, include those who work in the health facilities, work in medical waste collection and those in communities exposed to waste due to errors in the waste management process. Starting from the actual situation and requirements of the collection and processing of medical waste in hospitals, the research topic: “Assessment of Medical Waste Management and Treatment status in Thai Nguyen Hospital of Traditional Medicine - Thai Nguyen city” was conducted in Thai Nguyen city.2 Research’s objective - Study the status of the collection and disposal of medical waste in Thai Nguyen Hospital of Traditional Medicine. - Propose solutions to manage and treat medical waste in Thai Nguyen Hospital of Traditional Medicine.3 Research questions and hypotheses - What is the status of medical waste in Thai Nguyen Hospital of Traditional Medicine? - Evaluation of understanding of staff’s hospital, patients on the medical waste management of the hospital. 3 n - What are solutions to manage domestic waste in study area? 1.4 Limitations The study cannot include all the management issues and treatment of medical waste in Thai Nguyen Hospital of Traditional Medicine.
Because of the short time studies, the thesis was restricted by many factors in the survey and investigated process about the garbage in the study area.5 Definitions Medical waste is material in solid, liquid and gas, which discharged from the medical facility including hazardous medical waste and common waste. Hazardous medical waste is medical waste containing hazardous for human health and the environment as infectious, poisonous, radioactive, flammable, explosive, corrosive or properties other hazardous waste if it is not safe destruction. Management of hazardous waste is activities related to the prevention, mitigation, delineation, classification, direct reuse, temporary storage, transportation and disposal of hazardous waste. Management of medical waste management activities is sorting, initial processing, collection, transportation, storage, reduction, reuse, recycling, treatment and disposal of medical waste and inspects and supervises the implementation.
4 n PART II LITERATURE REVIEW 2. Generation sources and medical waste classification 2.1 Clinical waste - Group A: the contaminated waste, including blood absorbent materials, absorbent service, the excreta of an infected person like gauze, cotton, gloves, bags, blood transfusion, the catheters, wires and fluid bags saved. - Group B: the sharps, including needles, scalpel blades and personnel, syringes, broken glass and all materials that can cause cuts and puncture whether they can infected or not infected. - Group C: waste is highly infectious risk, arising from the laboratory, including: gloves, glass slides, test tubes, and swabs after testing, blood bags.
- Group D: pharmaceutical wastes, including overdue Pharmaceuticals, pharmaceutical contamination, spillage, pharmaceuticals no longer needs to use cytotoxic drugs. - Group E: Were the tissues, organs of people and animals, including all body tissues, organs, limbs, placentas, foetuses, dead animals/[5].2 Radioactive waste Radioactive waste is that individual activities like radioactive substances. At the health facility, radioactive wastes are arising from the operation diagnosis, chemotherapy, and research. Radioactive waste is including solid waste, liquid and gas.
5 n - Solid radioactive waste, including materials used in the tests, diagnosis, treatment, such as antiseptic swabs, test tubes, bottles radioactive substances. - Liquid radioactive wastes, including: solutions containing radionuclides generated during the diagnosis and treatment of diseases such as urine, excrement, and rinse water containing the radioactive instruments. - Radioactive waste gas, including clinical gases. The gas released from the radioactive material storage/[5].3 Chemical waste Chemical waste includes solid waste, liquid and gas.
Wastes in medical establishments are classified into two categories: waste non-hazardous chemicals such as sugars, fatty acids, some inorganic salt, organic and hazardous chemical wastes include: - Formaldehyde is used in surgery, dialysis, embalming and preserving the samples in a number of other departments. - Photochemical substances are included in the fixed solution and hydroquinone- coated film, silver. - Solvents: + The evaporation aesthetics: halothane (Flu thane), Enflurane (Ethane), iso- flurane (Forage), + No halogen compounds: Xylene, Acetone, Isopropanol, Toluene, Ethyl acetate, Acetonitrile, and Benzene. + Ethylene oxide: used to sterilize medical equipment, operating rooms should be fitted with cylinders and equipment sterilization.
This hard type can cause more toxic and may cause cancer in humans. 6 n + The chemical mixture: include cleaning solutions and disinfectants such as phenols, lubricants, cleaning solvents, ethanol, methanol, and acid/[5].4 Tank pressure The medical facilities often have the pressure gas cylinders as pitchers O2, CO2, gas tanks and gas cylinders content disposable. These cylinders are flammable and explosive when burned, so be collected separately/[5].5 Domestic waste Domestic waste is waste not contain infectious elements, hazardous chemical, radioactive, flammable, and explosive, including: Domestic waste from the wards (except isolation wards); waste arising from the activities of medical professionals such as glass bottles, bottles of serum, the plastic material, the type cast in closed fractures. These wastes are not stained with blood, biological fluids and hazardous chemicals; waste arising from the administrative work: paper, newspapers, documents, packing materials, cartons, plastic bags, film bags; external waste: leaves and debris from the external sector/[5].
The origin arising, composition and properties of medical waste 2. According to the Regulation on Medical Waste Management (Health Ministry), the medical waste as material in solid, liquid and gas, was discharged from the medical facility including medical waste and hazardous substances ordinary waste. Hazardous medical waste is medical waste containing hazardous for human health and the environment as infectious, poisonous, radioactive, flammable, explosive, corrosive or risk characteristics other harmful if these wastes are not completely destroyed.