Assessment of medical waste management at a primary health-care center in São Paulo, Brazil

Moreira, Ana Maria Maniero; Günther, Wanda María Risso

doi:10.1016/j.wasman.2012.09.018

Cited by 88 publications

(76 citation statements)

References 13 publications

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“…This was a determining factor for the inadequacy of waste segregation noted across waste groups in this research. Studies corroborate these findings and show that errors in segregation and storage result in a large volume of contaminated waste within health institutions (Moreira and Gunther, 2013;Ramos et al, 2011).…”

Section: Discussionmentioning

confidence: 55%

“…The activities implemented in these units are mainly focused on health promotion and prevention of disease and generate small quantities of waste in comparison with hospitals (Alagoz and Kocasoy, 2008;Gai et al, 2010;Moreira and Gunther, 2013;Pereira et al, 2013;Shinee et al, 2008). The somewhat distant location of these units, together with their relatively low levels of waste generation, hinder daily collection of this waste, which is stored in inappropriate locations for up to seven days until its collection through the public collection service.…”

Section: Introductionmentioning

confidence: 99%

“…The generation of RSS in kg user-day varies between developed and developing countries (Abd El-Salam, 2010;Bendjoudi et al, 2009;Cheng et al, 2009;Debere et al, 2013;Komilis et al, 2012;Patwary et al, 2009;Ruoyan et al, 2010;Sawalem et al, 2009) and across public and private hospitals (Tesfahun et al, 2014). However, few studies have described the characteristics of waste generated in primary care (Gessner et al, 2013;Moreira and Gunther, 2013;Pereira et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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The reality of waste management in primary health care units in Brazil

et al. 2014

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A large number of users are serviced in primary health care units in Brazil, both in health facilities and in households. These services generate waste that must be managed safely, but there is no legislation that regulates this type of waste management in Brazil. The objective of this study was to analyse the production and management of waste in primary health care. A direct observation was performed of the stages in the handling and weighing of waste generated in primary health care units in the municipality of Goiânia (Brazil). The units generated infectious, chemical, and common waste, as well as sharp objects. The generation of waste ranged between 0.027 and 0.075 kg user-day. The generated waste was classified mostly as common and recyclable. Flaws were observed in the management of all types of waste. The critical point is segregation. Only 34.1% of the waste disposed of as infectious actually belonged to this group, the rest was ordinary waste. Flaws at this stage increase the volume of infectious waste, the occupational and environmental risks, and associated costs. Intervention to change this reality is needed and it requires the careful preparation of a waste management plan, corroborating structural changes to the implementation of this plan, and professional training and public policies to guide waste management in primary care, especially those generated in households.

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Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The reality of waste management in primary health care units in Brazil

et al. 2014

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“…While there have been a number of previous studies evaluating factors such as waste generation rates, these have generally tended to focus solely on solid waste and on the environmental sustainability (e.g. Moreira and Gunter, 2013;Maamari et al, 2015;Caniato et al, 2015;Ren et al, 2016;He et al, 2016), with limited research on operational sustainability and the combined evaluation of solid and liquid wastes.…”

Section: Introductionmentioning

confidence: 99%

Environmental audits and process flow mapping to assess management of solid waste and wastewater from a healthcare facility: an Italian case study

Vaccari

Montasser

Tudor

et al. 2017

Environ Monit Assess

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In Europe, there are an increasing number of policy and legislative drivers for a more sustainable approach to the management of natural resources as well as for the mitigation of environmental health risks. However, despite significant progress in recent years, there is still some way to go to achieve circularity of process, as well as risk mitigation within organisations. Using a case study of the Gardone Val Trompia hospital in northern Italy, this manuscript offers a novel holistic examination of strategies to enhance resource efficiency and environmental health within a key sector, i.e. the healthcare sector. Through the use of environmental audits and process flow mapping, trends in waste and waste water arisings, and the associated financial and environmental costs, and risks were identified. Recommendations for developing more resource efficient approaches, as well as mitigating the environmental and public health risks are suggested. These include strategies for 1 Correspondence address: Department of Civil Engineering, Architecture, Land, Environment and Mathematics. University of Brescia. Brescia. Italy. Mentore Vaccari; Email: mentore.vaccari@unib.it 2 improved resource efficiency (including reduction in the hazardous waste), and reduced environmental impacts during the containment, transport and treatment of the waste.

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“…Since the detrimental impacts of inadequate management of health care waste (HCW) were understood by the environmental agencies, adoption of proper HCW service has become a priority for regulatory agencies across the world (Ciplak and Barton, 2012;Moreira et al, 2013). In Turkey, the accession to European Union (EU) requires compliance with the EU legislation.…”

Section: Introductionmentioning

confidence: 99%

Assessing future scenarios for health care waste management using a multi-criteria decision analysis tool: A case study in the Turkish West Black Sea Region

Ciplak

2015

Journal of the Air & Waste Management Association

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The aim of this paper is to identify the best possible health care waste management option in the West Black Sea Region by taking into account economic, social, environmental, and technical aspects in the concept of multi-criteria decision analysis. In the scope of this research, three different health care waste management scenarios that consist of different technology alternatives were developed and compared using a decision-making computer software, called Right Choice, by identifying various criteria, measuring them, and ranking their relative importance from the point of key stakeholders. The results of the study show that the decentralized autoclave technology option coupled with the disposal through landfilling with energy recovery has potential to be an optimum option for health care waste management system, and an efficient health care waste segregation scheme should be given more attention by the authorities in the region. Furthermore, the discussion of the results points out multidisciplinary approach and the equilibrium between social, environmental, economic, and technical criteria. The methodology used in this research was developed in order to enable the decision makers to gain an increased perception of a decision problem. In general, the results and remarks of this study can be used as a basis of future planning and anticipation of needs for investment in the area of health care waste management in the region and also in developing countries that are dealing with the similar waste management problems.Implications: Alternative technologies are not capable to treat some categories of health care wastes, and Turkish practice has to be revised urgently. In doing so, internal health care waste separation is critical for determination of treatment technology. The author verified the methodology in a decision-making framework for a real-world problem. Results indicated that incinerating all health care wastes is not a feasible option due to high cost.

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Assessment of medical waste management at a primary health-care center in São Paulo, Brazil

Cited by 88 publications

References 13 publications

The reality of waste management in primary health care units in Brazil

The reality of waste management in primary health care units in Brazil

Environmental audits and process flow mapping to assess management of solid waste and wastewater from a healthcare facility: an Italian case study

Assessing future scenarios for health care waste management using a multi-criteria decision analysis tool: A case study in the Turkish West Black Sea Region

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