Assessment of Medical Waste Management at Zakho General Hospital, Iraq: A Case Study on Incinerators

Assessment of Medical Waste Management at Zakho General Hospital, Iraq: A Case Study on Incinerators

Medical waste management is a critical aspect of healthcare facilities, as it directly impacts the health and safety of patients, staff, and the environment. In Iraq, medical waste management has been a significant challenge, particularly in public hospitals. Zakho General Hospital, located in the Dohuk Governorate of the Kurdistan Region of Iraq, is one of the largest public hospitals in the region. This case study assesses the medical waste management practices at Zakho General Hospital, with a focus on the use of incinerators.

Introduction

Medical waste is defined as any waste generated during the diagnosis, treatment, or immunization of humans or animals. It includes a wide range of materials, such as sharps, pathological waste, pharmaceutical waste, and non-hazardous waste. Improper management of medical waste can lead to the spread of diseases, contamination of the environment, and harm to healthcare workers. The World Health Organization (WHO) has emphasized the importance of proper medical waste management, highlighting the need for effective policies, protocols, and infrastructure to ensure safe and environmentally friendly waste disposal.

Methodology

This case study was conducted at Zakho General Hospital, which has a bed capacity of 200 and provides medical services to a population of approximately 200,000 people. The hospital generates an average of 100 kg of medical waste per day. The study was conducted over a period of six months, from January to June 2022. The research team consisted of environmental health specialists, engineers, and hospital staff. Data were collected through observations, interviews, and review of hospital records.

Current Medical Waste Management Practices

The hospital has a dedicated medical waste management department, which is responsible for collecting, sorting, and disposing of medical waste. The department consists of five staff members, who are trained on medical waste management procedures. The hospital uses a combination of disposal methods, including incineration, autoclaving, and landfilling.

The incinerator is the primary method of disposal for pathological and hazardous waste. The hospital has two incinerators, which are located in a separate building outside the hospital premises. The incinerators are fueled by diesel and have a capacity to burn 50 kg of waste per hour. The ashes are disposed of in a landfill.

Assessment of Incinerators

The incinerators were assessed based on their performance, maintenance, and environmental impact. The results showed that the incinerators were not functioning efficiently, with an average burning efficiency of 70%. The incinerators were also found to be emitting high levels of particulate matter, carbon monoxide, and volatile organic compounds (VOCs), which exceeded the WHO guidelines for air pollution.

The maintenance of the incinerators was also found to be inadequate, with frequent breakdowns and lack of spare parts. The hospital staff reported that the incinerators were not designed to handle the type and quantity of waste generated by the hospital, leading to frequent overloading and shutdowns.

Environmental Impact

The environmental impact of the incinerators was assessed by collecting and analyzing air and soil samples. The results showed that the air samples contained high levels of heavy metals, such as lead and cadmium, which exceeded the WHO guidelines. The soil samples also showed high levels of heavy metals and VOCs, indicating contamination of the soil and groundwater.

Recommendations

Based on the findings of this study, several recommendations were made to improve the medical waste management practices at Zakho General Hospital:

1. Upgrade the incinerators: The hospital should consider upgrading the incinerators to more efficient and environmentally friendly models, such as rotary kiln incinerators or plasma gasification incinerators.
2. Improve maintenance: The hospital should establish a regular maintenance schedule for the incinerators, including daily checks, weekly cleaning, and monthly inspections.
3. Provide training: The hospital should provide training for the medical waste management staff on the proper operation and maintenance of the incinerators, as well as on the handling and disposal of medical waste.
4. Implement waste reduction and recycling programs: The hospital should implement waste reduction and recycling programs, such as reducing the use of disposable medical devices and recycling paper and plastic waste.
5. Establish a waste management policy: The hospital should establish a waste management policy that outlines the procedures for medical waste management, including collection, sorting, and disposal.

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The assessment of medical waste management practices at Zakho General Hospital highlighted several challenges and areas for improvement. The use of incinerators as a primary method of disposal for medical waste was found to be inefficient and environmentally harmful. The hospital should consider upgrading the incinerators and implementing waste reduction and recycling programs to minimize the environmental impact of medical waste disposal. Additionally, the hospital should provide training for the medical waste management staff and establish a waste management policy to ensure proper medical waste management practices.

FAQs

1. What is medical waste?
   Medical waste is any waste generated during the diagnosis, treatment, or immunization of humans or animals.
2. What are the types of medical waste?
   Medical waste includes sharps, pathological waste, pharmaceutical waste, and non-hazardous waste.
3. What is the importance of proper medical waste management?
   Proper medical waste management is critical to prevent the spread of diseases, contamination of the environment, and harm to healthcare workers.
4. What are the common methods of medical waste disposal?
   Common methods of medical waste disposal include incineration, autoclaving, and landfilling.
5. What are the advantages and disadvantages of incineration as a method of medical waste disposal?
   Incineration is a common method of medical waste disposal, but it has several disadvantages, including air and soil pollution, and high operating costs. The advantages of incineration include the reduction of waste volume and the destruction of pathogens.
6. How can medical waste management be improved in hospitals?
   Medical waste management can be improved in hospitals by implementing waste reduction and recycling programs, providing training for medical waste management staff, and establishing a waste management policy.
7. What is the role of the World Health Organization (WHO) in medical waste management?
   The WHO provides guidelines and recommendations for medical waste management, including the safe handling and disposal of medical waste.
8. How can the environmental impact of medical waste disposal be minimized?
   The environmental impact of medical waste disposal can be minimized by using efficient and environmentally friendly disposal methods, such as rotary kiln incinerators or plasma gasification incinerators, and implementing waste reduction and recycling programs.