Major Challenges of Clinical Waste Management in
Pakistan
Tabinda Salman*, Aftab Ahmad, Saqib Rafique Shaikh
National Academy of Young Scientists (NAYS®) - Pakistan*Email: [email protected]
INTRODUCTION
Clinical waste management is of great importance due to its
patients, practioners and public health risk and environmental hazards.
clinical waste is not properly managed and disposed in majority of
public and private hospitals of Pakistan and the situation is worst in small
cities, town and villages, where clinical waste is mixed with general
waste and is disposed.
The improper disposal is resulting in many infectious diseases and can
even result in an outbreak.
There are different health risks associated with each type of waste so
their management is necessary.
MAJOR CHALLENGES
According to one of the estimate Pakistan generates 2.0 kg of waste per bed
per day (20% is of risk-waste). This waste includes used syringes, blades, used
gloves, chemicals and drugs etc.
Hospitals produce around 250,000 tons of waste per year.
Only in Karachi City, 610 government and private hospitals generating 30
tones medical waste each day.
Workers dispose of infectious and non-infectious waste in open bins without
proper segregation of waste.
The disposal system in not efficient and workforce involved in its disposal is
ignorant of risk involved.
Landfills and incineration are being used to dispose- off the hospital waste in
Pakistan. In landfill method, hospital waste is buried underground but according
to health experts not a single landfill is constructed on scientific lines. Majority of
incinerators also do not have proper filters and scrubbers. Gases like dioxin and
chemicals are discharged in the air, when waste is burnt, which can be potential
carcinogen.
Sharps waste
34%
Infectious waste
17%
Pathological waste
21%
Pharmaceutical
waste
8%
Chemical waste
11%
Radiactive waste
9%
Types of Healthcare Waste generated
Poster presented at EBSA 20th Annual Conference ‘The Diverse World of Biosafety’ (April 25-28, 2017), Madrid, Spain
Fig: This data has been collected from 178 sources in major cities of Pakistan
SCENARIO IN PICTURES
REFERENCES
Pakistan Environment. Fact Sheet. http://www.wwfpak.org/ factsheets _hwf.php
S. Habibullah, A. Salahuddin, 2007, Waste disposal of government health care
facilities in urban area of Karachi. PJMR; 46: 1-4
MR Khan, F. Fareedi, B. Rashid, 2006, Techno-economic disposal of hospital
wastes in Pakistan. PJMR; 45: 41-45 .
Ather S. Hospital waste management . J Coll Physicians Surg Pak 2004;14:645-
6.
Hashmi SK, Shahab S. Hospital and biomedical waste management. In: Iliyas
M, Editor, Community medicine and public health. 4th ed. Karachi: Time
Publishers,2013, pp. 426-37.
RECOMMENDATIONS & CONCLUSION
Government and associated departments should step in to control the
situation. There is serious need of handling of waste specially sharps and
syringes, pathological waste and infectious waste.
There should be proper system for the segregation, collection, storage
and transportation of waste.
Workers should be given trainings for the awareness of health
hazardous of healthcare waste.
NAYS - Pakistan through its Biosafety Working Group and
collaboration of many national and international organization have
provided training to staff in different hospitals and will extend its
services in future.
Grants won from Health Security Partners (HSP)- US and CRDF-
Global for Biorisk management and biosafety trainings.
BRIGHT SIDE
Few Hospitals and organizations are
Following Hospital Waste Management Rules,
2005.
Shalamar Hospital, Lahore established
in 2000 as non-profit organization. They
have two incinerators, four special vehicles
and 222 collection points in towns nearby Lahore.
Ten incinerator plants are working in Karachi i.e.
Karachi Metropolitan corporation, Aga Khan
Hospital, Abbott & Brookes Pharma, Civil
Hospital, Kidney Center etc..
HEALTH RISKS
According to World Health Organization, in 2000, contaminated syringes
caused:
21 million population suffered from Hepatitis B virus (HBV) infections
2 million suffered from Hepatitis C virus (HCV) infections
Population of 260 000 suffered from HIV infections.
Type of waste Health Impact
Infectious waste (contaminated
needles, sharps etc)
Vomiting, eye and genital
secretions, pus, skin
secretions, cerebrospinal fluid, blood in
faeces.
Chemical & Pharmaceutical waste Skin, mucous membrane diseases
Genotoxic waste Dizziness, nausea, headache & dermatitis
Radio active waste Headache, dizziness, vomiting and genetic
alterations
Sources of Healthcare Waste
Hospitals 78
Clinics 32
Emergency
services16
Research
laboratories18
Animal research
laboratories 06
Blood banks 28