[INFORMATIVE] Impacts of Medical Wastes
Impacts of Medical Wastes
By: Khang Nguyen
Understanding medical wastes: Classifications and hazards:
Medical or clinical wastes are the by-products of daily healthcare operations. Many major producers of global medical waste range from hospitals and medical facilities to mortuaries and animal care. Medical wastes can either directly or indirectly be generated by the activities of those operations, i.e. single-use equipment like gloves and syringes to expired or contaminated drugs and vaccines. Medical wastes are composed of a wide range of materials and substances, which are classified as illustrated:
- Non-hazardous or general wastes: These generally do not pose any biological, chemical or radioactive hazards but are still required to be processed accordingly. Including but not limited to packagings, plastic capsules, lab coats and IV bags. Although there are no health concerns, general medical wastes still take up 85% of the 87 000 tonnes of global medical wastes annually (Doung, 2023). General medical wastes also represent the majority of landfill, which greatly contributes to the global excess greenhouse gas emissions.
- Infectious wastes: These are wastes that are contaminated with bodily fluids such as bloods, saliva, or lymphatics. Infectious wastes can come from a variety of medical processes, such as discard autopsies and diagnostic samples or from patient’s treatments in the form of bandages, masks, swabs, etc. The infectious agents and harmful microorganisms within these not only directly endangers humans, but also releases drug-resistant organisms from the facilities into the environment (WHO, 2018)
- Pathological wastes: Pathological wastes concern with the disposal of direct human tissues and organs or even animal carcasses. Similar to infectious wastes, pathological wastes can gravely endanger the wild lifes through spread of diseases such as Hepatitis B&C, Cholera, lung related infections the likes of asthma and obstructive pulmonary diseases, etc (Daniels Health, 2021). The health risks resulting from the improper disposal of pathological waste can potentially transfer diseases to rodents, parasites and birds which can rapidly spread through the wildlife populations.
- Chemical wastes: Chemical wastes are excess, unwanted or expired chemicals from pharmaceuticals or laboratories processes. Chemicals are the most variegated medical wastes, ranging from excess solvents or reagents in disinfectants and sterilants, or metals in medical devices such as thermometer and batteries. With incineration being amongst the most common and cheapest waste management methods, many chemical wastes can generate detrimental air pollutants and contaminants airborne particles. It is estimated that there are around 15 000 premature deaths in Canada alone each year due to air pollutants, which causes a variety of cardiovascular issues, heart attacks, hypertension and angina (Daniels Health, 2021). Chemical wastes also contaminate water sources, rendering it unusable for consumption or agricultural irrigation, which causes both short and long term health issues.
- Radioactive wastes: Hospital and healthcare facilities are actually amongst the largest producers of radioactive wastes alongside nuclear reactors and fuel processing plants. These are products contaminated by radionuclides, including radioactive diagnostic or radiotherapeutic materials used in treatments (WHO, 2018). They have the potential to release radioactive airborne particles, disseminating air pollutants across vast areas. Radioactive wastes in the wild can devastate habitats, agricultural lands, water sources, and even aquatic lives.
With the rise in global demand for medical services, the healthcare industry also rose in corporate responsibilities and accountabilities. However, just like every other industry on the planet, there is no way to completely erase human industrial impacts on the planet, only mitigations and delaying the effects. The healthcare industry in particular faces undeniable challenges when it comes to implementing proper waste management practices, especially those in developing countries. A global progress report conducted by the World Health Organization in 2021 found that over a quarter of healthcare facilities do not have access to potable water services, and 10% with no sanitization services. The social and economic pressures on healthcare facilities in developing countries to operate without proper infrastructures, operations, and maintenance have greatly contributed to the improper and sanitary management practices of medical waste. This would be the reason why most facilities would resort to cheap and accessible disposal methods such as landfills and incinerators instead of responsibly sorting and processing individual classes of medical waste. Single-use non-recyclable medical devices such as plastic gloves, swabs, and needles are no doubt crucial for any healthcare operations, but they also undoubtedly have devastating impacts on the environment. Furthermore, the strict and legislative nature of medical waste processing is incredibly taxing and time-consuming. Even for developed countries, there are many layers of compliance complexities to managing waste, the bureaucratic policies and licensing make it difficult for many facilities across the EU to find an acceptable waste processor (Healthcare Plastics Recycling Council, 2023).
Progress on medical waste management: A global effort
The global concerns for medical waste started in the 1980s after tonnes of medical waste were washing up on several U.S. East Coast beaches (US EPA, 2016). The Medical Waste Tracking Act was enacted in 1980 which promulgated the regulations of medical wastes. The act expired in 1991 and other federal agencies such as FDA and OSHA would continue to develop environmental regulations for the healthcare industry to this day. The global response to medical waste has also surged in 2019, where more than 70% of countries have conducted research, implementing waste management methods and improving operations and maintenance, (WHO, 2021). There is still much room for improvement in the clean future, and many regulators bodies should work closer together with healthcare facilities. As of right now, many hospital waste items are automatically classified as non-recyclables, such as plaster casts, even though they can in fact be recycled with proper sanitary and management practices. As demands for healthcare raises, so will the national concerns for clinical wastes, our clean future is truly a global effort.
Citations:
1910.1450 App A - National Research Council Recommendations Concerning Chemical Hygiene in Laboratories (Non-Mandatory) | Occupational Safety and Health Administration. (2024). Osha.gov. https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1450AppA
Barriers to Recycling Healthcare Plastics | HPRC. (2023, June 8). Healthcare Plastics Recycling Council. https://www.hprc.org/barriers-to-recycling-healthcare-plastics/#:~:text=Hospital%20Barriers,-Multi%2DMaterials&text=For%20example%2C%20a%20product%20may,for%20waste%20processors%20to%20recycle.
Duong, D. (2023). Improper disposal of medical waste costs health systems and the environment. Canadian Medical Association Journal, 195(14), E518–E519. https://doi.org/10.1503/cmaj.1096046
Global progress report on water, sanitation and hygiene in health care facilities. (2020). World Health Organization. https://www.who.int/publications/i/item/9789240017542
Government Digital Service. (2012, October 9). Hazardous waste. GOV.UK. https://www.gov.uk/dispose-hazardous-waste
Medical Waste | US EPA. (2016, February 17). US EPA. https://www.epa.gov/rcra/medical-waste
Negative Effects of Biomedical Waste on the Environment. (2021, October 21). Daniels Health. https://www.danielshealth.ca/knowledge-center/negative-effects-biomedical-waste-environment#:~:text=Trace%20cytotoxic%20waste-,Sharps,Pathological%20waste
World. (2018, February 8). Health-care waste. Who.int; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/health-care-waste
https://publications.gc.ca/collections/collection_2015/ec/En108-3-1-42-eng.pdf
World Health Organization. (2022). Global analysis of healthcare waste in the context of COVID-19. World Health Organization. https://www.who.int/publications/i/item/9789240039612
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