Performance evaluation of infectious waste treatment facilities-a case study in Tabriz hospitals

Abstract

Introduction; Medical waste plays a major role in the spread of contagious diseases among the population as well as creating environmental infections caused by sanitary collection and disposal of them. According to Act 64 in Iran's Medical Waste Management Regulations, all waste producers in middle-sized and large cities are responsible for treating their infectious waste. So, most of the hospitals in the country have selected on-site treating method as the preferred one. Numerous studies have been carried out about the characterization, regulation, management, treatment, and disposal of medical waste. Nevertheless, the data available to date about the performance evaluation of on-site medical waste treatment facilities are rare, especially in Iran. Therefore, the performance assessment of on-site medical waste treatment equipment in hospitals in Tabriz metropolitan, Iran, is the key objective of the present study. Materials and methods: Out of the 22 hospitals in Tabriz city, 10 cases with different on-site medical waste treatment equipment (autoclave, chemical disinfection, hydro-clave, and dry thermal treatment) were selected to participate in the survey. The primary data were collected from the hospitals using a checklist and site visiting. Then chemical and biological monitoring was carried out per month (for a six month period) without any change in the regular operation of the facilities in all of the selected hospitals, except in one of them due to technical problems. The result of medical waste treating equipment that was not working during the study due to operation and maintenance problem was considered positive, without placing biological indicators inside them.69 Results: The results of chemical monitoring indicated that 39% of the inspected autoclaves had operational problems in pre-vacuum, air leaks, inadequate steam penetration in to the waste, and/or vacuum pump failures. Furthermore, the rustles of biological indicators revealed that about 55% of the samples were positive. Most of the applied devices were not suitable for treating anatomical, pharmaceutical, cytotoxic, and chemical waste. Conclusion: Currently in Tabriz city most of the generated infectious medical wastes of major generators (55%) were sent and deposited in a municipal solid waste landfill without enough disinfection, which was not designed for medical waste. Most of on-site medical waste treating systems (30%) had operational and maintenance problems. Otherwise, the current condition of on-site waste treating facilities showed that they were only wasting the capital and human resources. For improving the condition, Ministry of Health and Environment Protection Agency should strictly supervise the operation of on-site medical waste densification and treatment equipment.