Effect of Medical Waste upon the Environment - Report Example

Effect of Medical Waste upon the Environment [Name of the Student] [Name of the University] Effect of Medical Waste upon the Environment Introduction This research work claims that improper clinical waste disposal in Australia contributes to global warming. Global warming has been an issue from the 1980s, when scientists drew the attention of the world towards increasing surface temperatures and enhanced variations in the climate. At that time, it was observed that the atmospheric carbon dioxide concentrations were gradually increasing. The increase in carbon dioxide concentrations was shown by the historical data to be the cause of rising surface temperatures[Bro121]. With respect to controlling pollution, as of the year 2008, the Australian Government had been contemplating the imposition of a carbon tax or a cap – and – trade scheme. The Australian Prime Minister, Kevin Rudd, had ratified the Kyoto Protocol in December 2007. This indicated the intention of Australia to make strong efforts to address the issue of climate change. In addition, the government had declared its firms resolve to reduce emissions by 60% by the year 2050. The cap - and - trade scheme constitutes a major feature of the strategy to reduce emissions[And08]. As such, the individual states in Australia and the US have commenced to introduce carbon trading on the Kyoto model[Oli07] In this regard, a substantial amount of attention and diligence has to be bestowed upon the management of health care waste. This is indispensable for circumventing the significant disease burden associated with poor practice, such as exposure to toxic substances and infectious agents. A provisional solution is furnished by incinerators, and this is especially true of the developing nations, wherein waste disposal choices tend to be restricted[Wor11]. As such, in order to bring about the optimum functioning of the system, it is necessary to promote best practices. It is in this context that the best practices pertaining to incineration have to be adopted. This will reduce exposure to toxic pollutants resulting from combustion, such as co-planar PCBs, dioxins, furans, nitrogen oxide and sulphur oxide[Wor11]. The Guidelines of the Australian and New Zealand Waste Industry Group have defined clinical waste as human tissue. This includes materials or solutions consisting or contaminated with blood. There is a dearth of national data regarding the production of medical waste. Around 15% to 25% of this material has been evaluated as being infectious. In addition, this material depicts considerable variation between and within hospitals[McG10]. In addition, hospitals, in Australia, generate a large amount of waste material. For instance, the public hospital sector of Victoria produces a quantity of waste that is the equivalent of the waste produced by 200,000 households. This sector incurs an expenditure of $10 million, every year, in disposing of this material. Household and medical waste differ principally, due to the presence of clinical or infectious waste[McG10]. Moreover, in Australia, the notion of clinical audit as a normal feature of quality assurance has now come to be widely recognised in the various medical specialities. Nevertheless, auditing has not been widely adopted as a procedure for controlling reducing environmental pollution, resulting from medical care. As of the year 2010, there is an absence of obligatory auditing of the actual content of hospital waste and opportunities for recycling[McG10]. Furthermore, in most of the countries, the separation of infectious waste from the other waste material has been a part of the realm of infection control. It is essential to exercise unflagging vigilance, in order to maintain separate waste streams. Several studies in the UK have emphasised that there is a substantial amount of cross contamination of infectious waste with non – infectious material. In Australia, the disposal of hospital waste involves expenditure that is ten times that of non – infectious or general waste. This makes a strong case for the separation of waste streams, from the financial perspective[McG10]. In addition, Fiona Armstrong, the national professional officer of the Australian Nursing Federation (ANF) has made a very important declaration. She has opined that communities and governments will be compelled to transfer the emphasis of healthcare towards the prevention of illness and the promotion of health. This will be of great assistance in creating resilience against the consequences of climate change. Her contention is based on the disclosure of IPCC reports that providing adequate funds for health programmes is indispensable for reducing vulnerability. This has been reiterated by the World Health Organization, which has declared that preventive public health measures have to be intensified and should be rendered the very core of sustainable development[Bar081]. However, several of the principal health sector entities have scrutinised methods to reduce global warming. Fiona Armstrong of the ANF has stated that waste production in hospitals and health facilities has to be reduced. She has made a strident call upon the Federal Government’s National Health and Hospitals Reform Commission. As such, she has demanded that the waste and energy efficiency audits should be undertaken by public health facilities, as a component of their funding agreements. Armstrong emphasised that an enormous obligation is weighing upon the health sector to ensure that it does not harm the environment and human health[Bar081]. Furthermore, in November 2006, the ANF commenced to strike a warning note regarding the effect of climate change upon health. This was actuated by the UK Stern Review, and the ANF asked the Australian Government to undertake measures to reduce climate change, which had the potential to cause significant harm to the health of the populace[Bar081]. Consequently, the ANF and other unions in Australia have begun to negotiate with employers. The objective behind these negotiations is to mitigate the impact of the health sector on greenhouse gases. In fact, Kearney, the national secretary of ANF has declared that workplace design, products employed in nursing and the disposal of garbage constitute important areas that the ANF should include in its future negotiations[Bar081]. In addition, the employment of methods other than incineration are suitable only with regard to some types of waste. This makes it indispensable to segregate waste at the very source. This will serve to ensure that a particular type of waste is not processed in an unsuitable manner. As such, it is the responsibility of the waste generator to ensure that waste is forwarded to the appropriate treatment facility[Env09]. However, several reasons behind the inappropriate disposal of waste have been described in the literature. One of the primary reasons is fear of law enforcement. Thus, a sizeable number of drug abusers rapidly dispose of their hypodermic syringe after injecting the intoxicant drug. Their fear is that detection of such syringes on their person or among their belongings, could provide the police with tangible evidence that would be subsequently used to support a drug charge[Dev08]. Moreover, the possession of new or used hypodermic syringes is not illegal in Victoria. Nevertheless, used syringes or traces of drug can be utilised as evidence of use of a drug of dependence. Consequently, drug abusers, in general, abstain from retaining a syringe till such time as it can be placed in a disposal unit. A study involving 71 consumers of drugs in Victoria has provided some interesting insights. For instance, public disposal units have been regarded as convenient and safe. The participants in this study suggested that disposal units had to be in the vicinity of street markets and recognised drug centres, as this would ensure swift and silent disposal. Kelsall et al., have declared that inappropriate disposal transpires, usually, on account of absence of control and the availability of insufficient alternatives[Dev08]. Furthermore, the disposal of used hypodermic syringes and needles has emerged as an issue of alarming proportions for several of the local government authorities, such as the Melbourne City Council. Despite the comparatively small number of inappropriately discarded syringes and needles, considerable community concern has been generated[Dev08]. In addition, the Melbourne City Council has extended support to the Needle and Syringe Program as a public health measure. At the same time, it has acknowledged the presence of discarded syringes, the danger to public health, and the negative effect on the perception of the public regarding community safety. To its credit, the Melbourne City Council has adopted a proactive and strategic attitude towards syringe management. In the year 2001, it adopted the Syringe Management Plan, which aims to maximise appropriate syringe disposal, ensure rapid removal of syringes from the community, and monitor and respond to altering trends in injecting drug use[Dev08]. Moreover, the improper management of waste has the possibility of endangering care staff, employees who hand medical waste, patients and their families, and the people in the vicinity. Moreover, environmental contamination may result from the unsuitable disposal or treatment of waste. Mercury constitutes an extremely hazardous substance. It is present, in the main, in some types of batteries, dental alloys, manometers, and thermometers. It is a liquid metal at room temperature and has a very high density. Upon evaporation, it can persist in the atmosphere for 12 months. Mercury accumulates in sediments and is transformed into Methyl-Mercury, which constitutes a highly toxic organic derivative. Some of the important sources of atmospheric Mercury are the health care facilities, on account of incineration of medical waste[Sha131]. Moreover, these facilities can cause the pollution of surface water with Mercury. Furthermore, the inappropriate disposal of clinical waste has a significant financial and environmental effect. Several studies have indicated the presence of numerous opportunities for improving healthcare waste disposal. Karen Hames, conducted a study to demonstrate the presence and nature of opportunities to improve the disposal of clinical waste, via a clinical waste audit. This study had also been aimed at obtaining a better understanding into the approaches needed for engendering behavioural change pertaining to successful waste disposal. The Karen Hames study had been conducted in an intensive care unit located in Melbourne. The baseline audit was complemented by a questionnaire and education. Subsequently, a follow up audit was conducted to analyse the influence of education. The results of the preliminary clinical waste audit depicted 41% clinical waste, 44% general waste and 14% sharps waste[Ham131]. Subsequent to the education, clinical waste was seen to be slightly more than general waste; whereas, the sharps waste showed a drastic decrease to 3.5%. This decrease in sharps waste was construed to be on account of a clarification regarding a misnomer relating to the disposal of glass. The questionnaires exhibited the absence of knowledge[Ham131]. However, they indicated a desire to obtain information, and a partiality towards learning via signage and in-services. Finally, this study disclosed that behaviour change necessitated several in-services and enhanced signage. This was in conformity with other studies that had disclosed the necessity of staff involvement for achieving sustainable waste management. As such, it was discerned that improvement in healthcare waste disposal could significantly limit the adverse environmental and financial impacts[Ham131]. In addition, a preliminary evaluation of the position of medical waste management practices discloses the following. In order to properly address the growing apprehension of the public, with respect to the management of clinical waste, the policy makers will have to address these issues in an extremely expeditiously manner[USC88]. Moreover, the publicly operated hospitals, in general, envisage a major problem with regard to funding. This tends to be all the more prominent, in the case of low and middle income nations. It is the usual practice for the state to provide more than half of the services and there is frequent stretching of budgets. This has motivated managers to seek the options that provide the best performance for the money on hand[Obi13]. Several landfilling options have been developed over the years. Some of these are; embedding the infectious waste in a landfill containing municipal solid waste (MSW); or constructing a separate and specialised landfill cell for infectious waste on the location of a municipal waste landfill. The advantage of this process is that the majority of the infectious agents have a short lifetime under landfill conditions[Obi13]. It has been the practice among the nations of Western Europe, and the US to have in place, incinerators. These incinerators possess the capacity to totally disinfect clinical waste. Moreover, the quantity of waste reduces significantly upon being incinerated. Despite these benefits, incinerating has resulted in Mercury and dioxin emissions. Thermometers, sphygmomanometers, amalgam, or batteries upon being incorrectly discarded as medical waste, and subjected to incineration produce Mercury emissions. The presence of chlorine in clinical waste produces dioxins upon incineration. This is usually due to the presence of polyvinyl chloride (PVC) in clinical waste, and the chlorine employed in chemical disinfection[Obi13]. However, the operating costs of waste incinerators have increased substantially, on account of the implementation of higher emission norms, with respect to labour and flue gas scrubbing. This has led to the closure of several of the small hospital incinerators. As such, some of the important methods of treating clinical waste, prior to disposal are; incineration or thermal treatment; autoclaving or thermal disinfection with steam; the use of microwave devices to achieve disinfection; employing chemicals for the purpose of disinfection; and the controlled medical landfill on sanitary landfill. These procedures provide the means for safely disposing of infectious and pathological clinical waste. All the same, there are significant discrepancies between the environmental, technical and economic features of these alternatives[Obi13]. Considerable intricacy is involved in selecting a specific clinical waste treatment or disposal procedure. For instance, it would be inapt to select an option solely on the basis of environmental, social or technical grounds, if it were to incur an expenditure that would be greater than what the generators of medical waste could afford. Furthermore, it would be inappropriate to recommend an option that failed to consider the conditions and specifications of a specific place[Obi13]. Thus, it is essential to adopt an integrated approach. Conclusion It is essential to treat clinical and related waste before their final disposal. The ultimate goal of a waste treatment procedure is to ensure that the waste is made inoffensive and non-hazardous. This is essential for the safe disposal of the waste. Moreover, it has to be ensured that the treatment process is properly controlled, as this will eliminate the creation of other environmental issues. Hence, considerable ground has to be covered by medical waste management. This is chiefly in the areas of classifying waste types, collection, labelling, storage, transportation, treatment, disposal and the relevant regulations. Medical waste management, per se, has emerged as an issue that defies solution, in several of the developing nations. Moreover, it is crucially important to acquire greater information regarding the dangers posed by clinical wastes and their management. Furthermore, it is critically important to conduct more research in the area of alternate treatment technologies and management techniques. However, it is vital to immediately implement a comprehensive regulatory programme, in the area of medical waste management. The best integrated and rational policy regarding clinical waste management can be generated, only upon addressing the critical issues in a comprehensive manner. Some of these issues are; definition, classification, nature of risks, types of disposal choices, and the implications of regulatory action. As such, medical waste management is of great significance, in the wake of global warming. Since managing and disposing clinical waste is costlier than disposing normal waste, it is a matter of great concern, in many countries. In Australia, there is an absence of obligatory auditing with respect to content of clinical waste and the available options for recycling. This evidences the dearth of an effective care policy for organisations. Moreover, illegal drug users do not undertake the safe disposal of the vials, hypodermic syringes and needles used by them. This has been attributed to their fear of being apprehended by the police and being prosecuted. Under these circumstances viable alternatives for disposing such material, have to be provided. These are some of the reasons behind the ineffective management of medical waste disposal in Australia. New methods have to be implemented, which prove to be cost beneficial, in the management of clinical waste disposal. As such an integrated approach that takes into consideration all the above issues is essential for rendering the management of medical waste, a success in Australia. References Bro121: , (Brown, Buettner, & Canyon, 2012, p. 76), And08: , (Andrews, 2008, p. 409), Oli07: , (Oliver, 2007, p. 21), Wor11: , (World Health Organization, 2011), McG10: , (McGain, 2010, p. 37), Bar081: , (Barlow, 2008, p. 26), Env09: , (Environment Protection Agency Victoria, 2009), Dev08: , (Devaney & Berends, 2008, p. 141), Dev08: , (Devaney & Berends, 2008, p. 142), Sha131: , (Sharma, 2013, p. 185), Ham131: , (Hames, 2013, p. 110), USC88: , (US Congress, Office of Technology Assessment, 1988, p. 32), Obi13: , (Obid, 2013), Read More

Furthermore, in most of the countries, the separation of infectious waste from the other waste material has been a part of the realm of infection control. It is essential to exercise unflagging vigilance, in order to maintain separate waste streams. Several studies in the UK have emphasised that there is a substantial amount of cross contamination of infectious waste with non – infectious material. In Australia, the disposal of hospital waste involves expenditure that is ten times that of non – infectious or general waste.

This makes a strong case for the separation of waste streams, from the financial perspective[McG10]. In addition, Fiona Armstrong, the national professional officer of the Australian Nursing Federation (ANF) has made a very important declaration. She has opined that communities and governments will be compelled to transfer the emphasis of healthcare towards the prevention of illness and the promotion of health. This will be of great assistance in creating resilience against the consequences of climate change.

Her contention is based on the disclosure of IPCC reports that providing adequate funds for health programmes is indispensable for reducing vulnerability. This has been reiterated by the World Health Organization, which has declared that preventive public health measures have to be intensified and should be rendered the very core of sustainable development[Bar081]. However, several of the principal health sector entities have scrutinised methods to reduce global warming. Fiona Armstrong of the ANF has stated that waste production in hospitals and health facilities has to be reduced.

She has made a strident call upon the Federal Government’s National Health and Hospitals Reform Commission. As such, she has demanded that the waste and energy efficiency audits should be undertaken by public health facilities, as a component of their funding agreements. Armstrong emphasised that an enormous obligation is weighing upon the health sector to ensure that it does not harm the environment and human health[Bar081]. Furthermore, in November 2006, the ANF commenced to strike a warning note regarding the effect of climate change upon health.

This was actuated by the UK Stern Review, and the ANF asked the Australian Government to undertake measures to reduce climate change, which had the potential to cause significant harm to the health of the populace[Bar081]. Consequently, the ANF and other unions in Australia have begun to negotiate with employers. The objective behind these negotiations is to mitigate the impact of the health sector on greenhouse gases. In fact, Kearney, the national secretary of ANF has declared that workplace design, products employed in nursing and the disposal of garbage constitute important areas that the ANF should include in its future negotiations[Bar081].

In addition, the employment of methods other than incineration are suitable only with regard to some types of waste. This makes it indispensable to segregate waste at the very source. This will serve to ensure that a particular type of waste is not processed in an unsuitable manner. As such, it is the responsibility of the waste generator to ensure that waste is forwarded to the appropriate treatment facility[Env09]. However, several reasons behind the inappropriate disposal of waste have been described in the literature.

One of the primary reasons is fear of law enforcement. Thus, a sizeable number of drug abusers rapidly dispose of their hypodermic syringe after injecting the intoxicant drug. Their fear is that detection of such syringes on their person or among their belongings, could provide the police with tangible evidence that would be subsequently used to support a drug charge[Dev08]. Moreover, the possession of new or used hypodermic syringes is not illegal in Victoria. Nevertheless, used syringes or traces of drug can be utilised as evidence of use of a drug of dependence.

Consequently, drug abusers, in general, abstain from retaining a syringe till such time as it can be placed in a disposal unit.

Read More