PMLS: Healthcare waste management

acids

Acetic, chromic, hydrochloric, nitric, sulfuric

Non-halogenated solvents

Acetone, acetonitrile, ethanol, ethyl acetate, formaldehyde, isopropanol, methanol, toluene, xylenes

bases

Ammonium hydroxide, potassium hydroxide, sodium hydroxide, sodium bicarbonate

metals

Arsenic, cadmium, chromium, lead, mercury, silver

alcohols

Ethanol, isopropanol, phenols

aldehydes

Formaldehyde, glutaraldehyde, ortho-phthalaldehyde

waste minimization

The most important step in the proper management of health care wastes. using an approach known as the Green Procurement Policy.

corrosive

acid of pH-2.0 and bases of pH>12.0

The Montreal Protocol on Substances that Deplete the Ozone Layer (1987)

adopted in Montreal, Canada on September 16, 1987 and came into force, as agreed upon, on January 1, 1989. It sets the final objective of the Protocol to eliminate ozone depleting substances in the environment. was

Executive Order No. 301 "Establishing a Green Procurement Program for All Departments, Bureaus, Offices, and Agencies of the Executive Branch of Government" (2004)

aims to (a) promote the culture of making environmentally informed decisions in the government, especially in the purchase and use of different products; (b) include environmental criteria in public tenders, whenever possible and practicable; (c) establish the specifications and requirements for products or services to be considered environmentally advantageous; and (d) develop incentive programs for suppliers of environmentally advantageous products or services.

chemical disinfection

chemicals like sodium hypochlorite, hydrogen peroxide, peroxyacetic acid, and heated alkali are added to health care wastes to kill or inactivate present pathogens

reactive

explosive with water

The United Nations Framework Convention on Climate Change (1992)

includes a legally non-binding pledge that by the year 2000, major industrialized nations would voluntarily reduce their greenhouse gas emissions to 1990 levels.

Philhealth Benchbook

includes health care waste management as one of its parameters in the quality assurance of healthcare.

Encapsulation

involves the filling of containers with waste, adding and immobilizing material, and sealing the containers.

The ASEAN Framework Agreement on the Facilitation of Goods in Transit (1998)

is a core instrument that provides nine high level protocols that set out generic standards to be put into place for the implementation of an international transit system.

The Stockholm Convention on Persistent Organic Pollutants (2001)

is a global treaty to protect human health and the environment from persistent organic pollutants (POPs). POPs are chemicals that (1) remain unchanged in the environment for long periods of time; (2) accumulate in the fatty tissues of living organisms; and (3) are toxic to both humans and wildlife.

Microwave

is a technology that typically incorporates some type of size reduction device. Shredding of wastes is done before disinfection.

Republic Act No. 4226 "Hospital Licensure Act" (1965)

is an act that requires the registration and licensure of all hospitals in the country and mandates the DOH to provide guidelines for hospital technical standards as to personnel, equipment, and physical facilities.

The Basel Convention on the Control of the Transboundary Movements of Hazardous Wastes and Their Disposal (1989)

is concerned with the transboundary movements of hazardous waste.

recovery of waste

is defined in two ways: (1) energy recovery, whereby waste is converted to fuel for generating electricity or for direct heating of premises and (2) as a term used to encompass three subsets of waste recovery: recycling, composting, and energy recovery.1

Inertization

is especially suitable for pharmaceutical waste that involves the mixing of waste with cement and other substances before disposal.

Pyrolysis

is the thermal decomposition of health care wastes in the absence of supplied molecular oxygen in the destruction chamber where the said waste is converted into gaseous, liquid, or solid form. This can handle the full range of health care wastes.

Autoclave

is the use of steam sterilization to render waste harmless and is an efficient wet thermal disinfection process.

Republic Act No. 9003 "Ecological Solid Waste Management Act of 2000"

mandates the segregation of solid wastes at the sources including households and institutions like hospitals by using a separate container for each type of waste.

sharps

not applicable

Republic Act No. 8749 "The Philippine Clean Air Act of 1999

prohibits the incineration of bio-medical wastes effective July 17, 2003. It promotes the use of state of-the-art, environmentally-sound, and safe non-burn technologies for the handling, treatment, thermal destruction, utilization, and disposal of sorted, unrecycled, biomedical, and hazardous wastes.

Republic Act 9275 "The Philippine Clean Water Act of 2004

pursues a policy of economic growth in a manner consistent with the protection, preservation, and revival of the quality of the country's fresh, brackish, and marine waters.

Sharps

refer to waste items that can cause cuts, pricks, or puncture wounds

Infectious Waste

refers to all wastes suspected to contain pathogens or toxins in sufficient concentration that may cause disease to a susceptible host.

reusing

refers to either finding a new application for a used material or using the same product for the same application repeatedly

Pharmaceutical Waste

refers to expired, spilt, and contaminated pharmaceutical products, drugs, and vaccines including discarded items used in handling pharmaceuticals.

recycling

refers to the processing of used materials into new products

Pathological and Anatomical Waste

refers to tissue sections and body fluids or organs derived from biopsies, autopsies, or surgical procedures sent to the laboratory for examination

Radioactive Waste

refers to wastes exposed to radionuclides including radioactive diagnostic materials or radiotherapeutic materials.

Non-hazardous or General Waste

refers to wastes that have not been in contact with communicable or infectious agents, hazardous chemicals, or radioactive substances, and do not pose a hazard

DOH Administrative Order No. 2008-0021 dated July 30, 2008 "Gradual Phaseout of Mercury in all Philippine Health Care Facilities and Institutions

requires all health care facilities (HCF) to gradually phaseout the use of mercury-containing devices and equipment.

Presidential Decree No. 1586 "Environmental Impact Statement (EIS) System" (1978)

requires projects, like the construction of new hospital buildings or expansion of existing hospitals, to secure an Environmental Compliance Commitment (formerly Environmental Compliance) Certificate (ECC) prior to the construction and operation of the facility.

Presidential Decree 856 "The Code on Sanitation of the Philippines - Chapter XVII on Sewage Collection and Excreta Disposal" (1998)

requires the approval of DOH in terms of the following: (a) constructions of any approved type of toilet in every house and community which may be allowed for a group of small houses of light material or temporary in nature; (b) plans of individual sewage or sewage system and the sub-surface absorption system or other treatment device; (c) location of any toilet or sewage disposal system in relation to a source of water supply; (d) the discharge of untreated effluent from septic tanks and/or sewage treatment plants to bodies of water; (e) manufacture of septic tanks; and (f) method of disposal of sludge from septic tanks or other treatment plants.

DOH Administrative Order No. 2008-0023 dated July 30, 2008 "National Policy on Patient Safety"

requires the establishment and maintenance of a culture of patient safety in the HCF as the responsibility of its leaders

Republic Act No. 6969 "An Act to Control Substances and Hazardous and Nuclear Wastes" (1990)

requires the registration of waste generators, waste transporters, and operators of toxic and hazardous waste treatment facilities with the EMB.

DOH "Manual on Health Care Waste Management" in 2011 (Revising the 2007 Health Care Waste Management Manual)

serves as a reference for HCF administrators in the implementation of an effective and efficient waste management program.

Infectious waste

strong leak-proof bin with cover labelled "infectious" with biohazard symbol

BFAD Memorandum Circular No. 22, Series of 1994, "Inventory, Proper Disposal, and/or Destruction of Used Vials or Bottles" and BFAD Bureau Circular No. 16, Series of 1999: "Amending BFAD MC No. 22 dated September 8, 1994, Regarding Inventory, Proper Disposal, and/or Destruction of Used Vials or Bottles"

these circulars are released to prevent the proliferation of adulterated, misbranded, and counterfeit drugs brought about by the recycling of used pharmaceutical bottles and vials. It contains the guidelines on the proper inventory and destruction of bottles and vials.

Biological process

uses an enzyme mixture to decontaminate health care wastes

Presidential Decree 813 (1975) and Executive Order 927 (1983) "Strengthening the Functions of Laguna Lake Development Authority (LLDA)"

which further strengthens the powers and functions of the LLDA to include environmental protection and jurisdiction over surface waters of the Laguna Lake basin. Through E.O. 927, the LLDA is empowered to issue permits for the use of surface waters within Laguna de Bay.

flammable

with a flash point below 60 °C

toxic

with health and environment hazards

Halogenated solvents

Calcium hypochlorite, chlorine dioxide, iodine solutions, iodophors, sodium dichloroisocyanurate, sodium hypochlorite (bleach)

Halogenated disinfectants

Chloroform, methylene chloride, perchchloroethylene, refrigerants, trichloroethylene

Presidential Decree No. 984 "Providing for the Revision of Republic Act No. 3931

Commonly known as the Pollution Control Law, and for Other Purposes" (1976) governs the discharge of potentially polluting substances to air and water