Developing an infectious attitude towards proper management of medical waste
Just because he doesn’t wear a white robe or goes around checking people’s vital pulses, Andreas Hoeptner, Founder and Managing Partner of H-2-P Project Management plays as vital a role to your wellbeing as a practiced MD.
In fact, he makes it a habit to spend most of his time around garbage, or more precisely hazardous medical waste in treatment plants, figuring out ways to keep toxic or infected materials safely out of our lives.
A dirty business but someone has to do it.
Hoeptner, a specialist in facility and waste management will be presenting his findings at the Middle East Waste and Recycling Expo at Dubai’s World trade Center next May 23-25 on the topic of ‘Medical Waste Masterplan: Developing a healthcare waste strategy in Ras Al Khaimah.’
“Quantities of medical infectious and hazardous waste are on the rise in the region making it of critical importance that their safe handling, treatment and disposal are of the highest standards,” says Hoeptner.
He should know. For over a year now, he’s been studying, analysing and advising on RAK’s medical waste management where no less than 150 medical waste generators like hospitals, clinics, vet clinics, and pharmacies exist.
And with medical tourism such as in Dubai where tourists seeking medical treatment is slated to reach 500,000 a year by 2020, “the generation of medical waste in the UAE will increase by app. 10% per year over the next 5-10 years reaching 35 tons/day in 5 years from a current 20 tons/day.”
Hoeptner identifies Incineration and sterilization using an autoclave as the two best options to deal with medical waste. For RAK, his company’s advice was sterilization.
“It takes about a year and a half to set up an incinerator with investment costs nearly double those for an autoclave,” he said.
The main cost drivers for burning medical waste are the incinerator itself operating at 1200° C, the stack and the need for continuous emission monitoring.
An autoclave where medical waste is sterilized takes about 6 months to put together.
“You shred the medical waste, then it is forwarded in a vacuum chamber, inject steam at 140° C, sterilize it for ±30 minutes, and it becomes non-hazardous fluff material for disposal in a landfill,” explains Hoeptner.
Problem solved? No. It’s a steep learning curve for the region towards creating proper awareness and practices for storing, collecting, treating and disposing of medical waste.
Medical waste is not of the tin can, paper, plastic or glass variety that you can leisurely dunk in neatly colour coded containers around your neighbourhood streets and alleys.
Simply put, it’s called hazardous if originating from chemicals and labs, and infectious at differing grades when in contact with human or animal body fluids like blood.
“This makes recycling medical waste only partially possible and only if done with extreme care,” says Hoeptner.
For the same reasons, storing it separately is equally crucial.
Medical waste management doesn’t start with collection. It most certainly starts with handling, segregation and storage within the hospitals and clinics.
“We go to hospitals and make assessments about how medical waste is stored and hear strange stories about how it’s stowed next to medical supplies or fresh linen in storage rooms,” remarks Hoeptner.
“Our first action is to devise internal medical waste management processes for proper internal disposal and storage, including separating regular waste from medical ones, which is not always the case in hospitals.”
Then comes collection and here typical garbage trucks just won’t do.
“You need special temperature-controlled vehicles at ideally 5-8° C that transport infected materials to treatment sites.”
All these costly precautions are a necessary evil.
A realistic price for treating medical waste is according to Hoeptner about AED8/kg, collected, treated and disposed. At the current 20 tons per day, this adds up to AED 160,000/day or an astounding AED58.4 million a year.
So let’s reduce the waste from the source, says Hoeptner, though he admits is no easy task.
“We need to create awareness among healthcare professionals that lumping regular and medical waste together is wasteful,” he says no pun intended.
“The cardboard boxes carrying equipment or pills are considered household and not medical waste, so no point mixing them.”
Another good industry practice is to substitute regularly waste-producing products with more durable solutions.
A good example is replacing mercury thermometers with electronic ones.
Hoeptner said pragmatic solutions need to cover the needs of a hygienic and environmentally friendly medical waste management program.
“A program needs to start even before the collection with assessment in hospitals, training of hospital staff, and regular audits,” says Hoeptner.
“The public sector need to also take into consideration new forms of collaboration between it and the private sector with stakeholder engagement such as at municipalities, medical waste generators, Ministry of Health, and medical waste contractors.”
Hoeptner sums up saying that medical waste is a serious issue that deserves the attention of all concerned and that can’t be tackled with cosmetic solutions.
“Governments are coming on board but we still see healthcare institutions who are either not aware, not interested or both in dealing in medical waste management issues.”