Hospital medical waste management in Shandong Province, China

Abstract

Medical waste refers to those hazardous waste materials generated by healthcare activities, including a broad range of materials, and remains as an issue on both public health and environment. In China, there was inadequate information on the implementation of management systems in hospitals based on the national regulatory framework. The objectives of this study were to assess the current situation of medical waste management and to identify factors determining the implementation of a management system based on the national regulatory framework in hospitals. We investigated 23 general hospitals in both urban and rural areas of Shandong Province, China, by both quantitative and qualitative approaches. The medical waste generation rate was 0.744, 0.558 and 1.534 kg bed(-1) day(-1) in tertiary hospitals, urban secondary hospitals and county hospitals, respectively. There is a wide disparity between implementation in tertiary, secondary and county hospitals. With increasing financial, technological, and materials investment, a management system has been established in tertiary and secondary hospitals. Financial support and administrative monitoring by the government is urgently needed to build a sound management system in hospitals located at remote and less-developed areas. In those areas issues in the financial, administrative and technical aspects should be further examined.

Medical waste management in three areas of rural China

“…In fact, financial support was lacking to the point that many hospitals could not afford to transport their medical waste off-site, despite national requirements that they do so. At the same time, the relatively small quantities of medical waste produced by rural or remote hospitals provided little incentive for disposal centers to service these areas to pick up waste [ 14 , 16 ]. Without off-site treatment of medical waste, hospitals had even less of an incentive to enforce proper segregation, packing or disposal of waste.…”

“…Although Act 380 establishes regulations that are nationwide, there is currently limited evidence on compliance, particularly in rural areas where resources enabling compliance with national policy are limited. Researchers have begun to pay attention to medical waste management practices in China in recent years, mostly focusing on urban areas [ 3 , 9 , 14 – 20 ]. Recent papers find low compliance with medical waste management regulations in cities, but little is known about the state of medical waste management in rural China, especially for rural primary health care institutions (i.e.…”

Investigation and Analysis of Rural Medical Waste Management

“…Several studies have proposed in our country. Zhang [12] et al had a quantitative analysis of medical waste management in Nanjing through the questionnaire survey; Xu [13] and Zhang [14] et al respectively investigated waste management research in hospital of Shandong and Gansu Province and proposed to strengthen the management of medical waste from the capital, administrative, technical aspects. In addition Cheng [15] and Li [16] researched medical staff' awareness and evaluation to medical waste management through a questionnaire survey.…”

Medical Waste Management in China: A Case Study of Xinxiang

“…Many studies have focused on medical waste in developing countries such as Malaysia [3], Sudan (2013) [4] and Ghana [5]. China, as the biggest developing country, has carried on the related research recently, and some medical waste management suggestions were given by analyzing the questionnaire such as Nanjing city [6], Shandong province [7] and Gansu province [8]. The hospital was the object in these studies; however, few have paid enough attention on taking the medical waste of segregation, collection, transportation, disposal, management, supervision as a whole system except one study for Shenyang [9].…”