Safeguarding public health, the core reason for solid waste management

Current practices of waste management in teaching hospitals and presence of incinerators in densely populated areas

BACKGROUND

Hospital waste management (HWM) practices are the core need to run a proper health care facility. This study encompasses the HWM practices in teaching hospitals of Peshawar, Pakistan and examine the enforcement of Pak HWM (2005) rules and risks through transmission of pathogens via blood fluids, air pollution during waste incineration and injuries occurring in conjunction with open burning and dumping.

METHODS

A questionnaire based on World Health Organization (WHO) recommendations was used to survey the selected private and public teaching hospital (n = 16). Site visits and personnel observations were also included in the data. It was spatio-statistically analyzed using descriptive statistics, Krushkal-wallis and Fisher's exact tests.

RESULTS

The findings revealed that the lack of HWM practices in all surveyed hospitals (p > 0.05), besides statistical difference (p < 0.017) in waste generation/day. No proper segregation of waste from generation point to final disposal was practiced. However, the performance of private teaching hospitals (50%) was found better in terms of HWM personnel and practices. In surveyed hospitals, only nine hospitals (56.3%) were found with the incinerator facility while rest of the hospitals (43.7%) practiced open dumping. Moreover, operational parameters of the incinerators were not found satisfactory and located in densely populated areas and emitting hazardous gases.

CONCLUSION

Proper HWM practices are not being followed in the light of WHO guidelines. Hospital waste impose serious menace to healthcare workers and to nearby population. WHO issued documents for improving HWM practices but triggered no change in Pakistan. To improve the situation, insights in this context is need for enforcement of rules.

Occupational Health Hazard Exposure among municipal solid waste workers in Himachal Pradesh, India

The net volume of Municipal Solid Waste (MSW) generated in Himachal Pradesh is 350 tons per day (TPD) with an annual growth rate varying between 1 and 1.33%. This leads to serious considerations regarding potential occupational health hazards of workers associated with MSW. The study generated from non-engineered landfill sites was carried out at three locations- Shimla, Solan, and Mandi in Himachal Pradesh, India. . The main aim of this study was to determine existing occupational hazards in relation to MSW management at these locations, to coordinate with the different municipalities and suggest suitable remedial measures for our study locations. In particular, the exposure assessment to the work force comprising of street sweeping, waste collection, waste processing, and rag picking were assessed using an interview scheduling technique. A questionnaire survey was carried out on these workers with the questions asked related to their work culture, socio-economic conditions, general awareness of occupational health risks and related occupational health hazards associated with the work being performed by them. The results showed that the workforce mainly comprised of males with a low percentage of literacy rates. The age distribution showed that majority of waste collectors and street sweepers were above 30 years of age (67%) and that the rag pickers in Mandi town were below 20 years of age. Income variation between casual and regular workers was highly significant with regular workers (INR 600-1200; USD 9-18) getting almost six times the payment of the casual workers (INR 100-200; USD 3-7.5). From the studies conducted the study deduced that about 64% of waste collectors, 80% of street sweepers and 10% of rag pickers in Solan and about 6.67% street sweepers, 57.47% waste collectors and 100% of rag pickers in Mandi were not provided with any protective equipment. Interestingly, in the capital city of Shimla a small fraction of the street sweepers (28%) and waste collector (6%) confirmed that they were given protective equipment twice in a year. The lack of provisions of protective equipment along with the ignorance of the workers results in occupational health hazards due to different types of external injuries. The major occupational health issues reported by various categories of waste workers were muscle and ligament sprain, cuts and lacerations and different allergies varying between 1.97 and 66.67% [ for e.g. in Solan it varies from 32.47-66.67%; Shimla 1.97-10.16% and in Mandi 9.52-16.67%], 6.36-67.95% and 5.77-42.86%, respectively. From this study, it was observed that such workers are ill-protected against such occupational health hazards new laws and policies are needed to be introduced for their protection.

Occupational exposure to the municipal solid waste workers in Chandigarh, India

Manual handling of municipal solid waste is of serious concern owing to emerging occupational risks. Considering this, health risks of municipal solid waste workers involved in street sweeping, waste collection, waste processing and rag picking were assessed in Chandigarh, India, using an interview schedule as a study tool. Result shows that the waste worker profession is mainly dominated by males, except in rag pickers, and with a lower literacy rate. Age distribution shows that 16% of waste collectors and 11% of rag pickers were below 18 years of age. Daily income of the waste workers ranges from ₹100 to ₹200. It was observed that 22.2% of waste collectors, 43.2% of street sweepers and 25.5% of rag pickers do not use any type of protective gears owing to their casual attitude, which results in various types of injuries. The major occupational health issues reported by various categories of waste workers were respiratory disorders, injuries and allergies having prevalence of 12.3%-17.6%, 4.9%-44.4% and 35.3%-48.9%, respectively. Waste workers are vulnerable to occupational health hazards and hence there is a need to safeguard them through formulation of new laws and policies.