Safe Management of Wastes from Health Care Activities

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Safe management of wastes from health care activities A. Pruss, E. Giroult & P. Rushbrook, eds, World Health Organization, 1999. Price in industrialized countries Sw. fr. 72, in developing countries Sw. fr. 50.40. Winner of First Prize in the Public Health category of the Medical Book Competition 2000 of the British Medical Association, ISBN 92-4-154525-9.

It was in the early 1980s that the management of health care waste became a major issue. Problems were brought to a head in the industrialized countries by the surge in use of disposable equipment, which led directly to the production of unprecedented quantities of often hazardous waste. Not only were the traditional methods of incineration proving inadequate, but hospitals were having to shut down their incinerators because of new clean air legislation. There was widespread concern both about the environment and about the dangers posed by infectious, toxic and radioactive waste. The need for safe disposal of blood and used needles was further dramatized by the AIDS pandemic.

Governments in industrialized countries were tackling the problems through legislation and giving guidance on best practices to the health care and waste management industries. Further demand for support came from the newly independent states of the former Soviet Union in the early 1990s. Following the United Nations Conference on the Environment and Development in 1992, an increasing number of low and middle-income countries began to tackle their waste management problems.

In some developing countries inadequate waste management can lead to the reuse of disposable injection equipment. This becomes a significant source of infection, mainly with hepatitis B and C. Also, waste workers or scavengers may manually sort the infectious waste without personal protection. …