doctors’ efforts toward appropriate medical waste management · waste management out of the...
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Asia 3R Conference
DoctorsDoctors’’ Efforts TowardEfforts TowardAppropriate Medical Appropriate Medical Waste ManagementWaste Management
Satoshi IMAMURA, MDSatoshi IMAMURA, MDExecutive Board MemberExecutive Board Member
Japan Medical Association Japan Medical Association http://http://www.med.or.jpwww.med.or.jp//
Mita Conference HallOctober 30, 2006
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About JMA
• Japan Medical Association (JMA)• Founded in 1916 • National voice of Japanese physicians• 165,000 members (about 60% of all
licensed physicians in Japan)• Mission
– to play leadership for citizens– to promote the highest standards of medical
ethics and education
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Why should doctors
take care of Medical Wastes?
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Medical wastescause diseases,
andDoctors should prevent them
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Threats of Medical Waste
• Threats to Health– 4 needlestick accidents per 100 beds in a year – Infectious rate by needlestick accidents
• HBV 10 ~ 35%• HCV 2 ~ 5%• HIV 0.2 ~ 0.5%
• Threats to EnvironmentCause environmental pollution
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Responsibility of Waste Generators
Responsibility from the beginning (generation) to the end (final disposal)
If waste are illegally disposed by otherssuch as contracted waste disposal companies・・・・
We may still have responsibility to recoverthem.
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Doctors’ Activities• I. Waste management in the hospital
1. Identification2. Segregation3. Container4. Bio-hazard Mark5. Medical Waste Supervisors
• II. Waste management out of the hospital6. Slips used for Waste Management7. Visiting Waste Treatment Facility
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1. IdentificationInfectious w
astes
Non-infectious wastes
[Step 1] Appearance1) Blood, blood serum, blood plasma and body fluid (including semen)2) Pathologic waste (organs, tissues, skins, etc.)3) Waste used in tests and examinations related to pathogenic microbes4) Sharps with blood, etc.
[Step 1] Appearance1) Blood, blood serum, blood plasma and body fluid (including semen)2) Pathologic waste (organs, tissues, skins, etc.)3) Waste used in tests and examinations related to pathogenic microbes4) Sharps with blood, etc.
[Step 3] Infectious DiseaseWaste generated after the medical treatment and examination for the infectious disease
[Step 3] Infectious DiseaseWaste generated after the medical treatment and examination for the infectious disease
NO
YES
YES
YESNO
NO
[Step 2] PlaceWaste generated after the use of; 1) Medical treatment, examination, etc. 2) In beds for infectious diseases3) Operation 4) Emergency Room5) ICU (Intensive Care Units) 6) Laboratories
[Step 2] PlaceWaste generated after the use of; 1) Medical treatment, examination, etc. 2) In beds for infectious diseases3) Operation 4) Emergency Room5) ICU (Intensive Care Units) 6) Laboratories
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2. Segregation
Plastics(compatible)
Glass bottlesSharps
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Segregation (Laboratory Wastes)
Only Needles
Only InjectionsOthers
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• For Sharps (Needles, surgical knife)– Made of metal or plastics– Made of anti-penetrate
containers• For Solid
– Double-Use of plastics bag
• For Liquid and Sledge– Made by anti-leak
container (Keep out liquid)
3. Containers
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Used for containers with special color to distinguish types of wastes easily– Red : for Liquid or Sludge waste– Orange : for Solid waste– Yellow : for Sharps waste
4. Bio-hazard Mark
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• Each Facility should appoint the supervisor
• Responsibilities include;– Managing medical wastes in the facility– Improving awareness among staffs– Developing “Waste Management Plans”
• QualificationDegrees in medicine, pharmacy, public health, hygieiology or veterinary science(Medical Doctors, Dental Doctors, Pharmacists, Veterinarians, Health Nurses, Midwives, Nurses, Clinical/Health Laboratory Technologists and Dental Hygienists)
5. Medical Waste Supervisor
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Removal
TransportationTreatment
II. Waste management out of the hospital
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Final DisposalSite
Waste TreatmentFacility
As Disposer
AsGenerator
Waste Generator Transporter Transporter
Send the Copy containing the final disposal specification
Send the Copy containing the final disposal specification
Specify the final disposal in the copySpecify the final disposal in the copy
6. Slips for Waste Management
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7. Visiting Facilities
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JMA’s Activities
8. Promotion for appropriate treatment (ex. seminars)
9. Selection of most appropriate disposal company
10. Social Contribution against Illegal Dumping
11. Technology Development such as IC Chips
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8. Seminars
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9. Coordination between hospitals & waste disposal
companies• Local Medical Associations should play a key role• Build Networks for small clinics
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10. Technology Development such as IC Chips.
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WasteInjection Cylinder
Covered
by soil
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11. Social Contribution against illegal dumping
IndustriesNational
Government
IllegalDumping
Fund
LocalGovernment
Treatment
JMA
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Take Home Messages
• Medical waste causes serious adverse effects to human health and environment
• History shows that medical waste increasesin accordance with industrialization
• Appropriate treatment system is essential
• Doctors can and should play a key role
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Thank you!Thank you!