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Table Of Contents

1 Introduction
2Definition and characterization of health-care waste
2.1Health-care waste: definition and classification
2.1.2Infectious waste
2.1.3Pathological waste
2.1.5Pharmaceutical waste
2.1.6Genotoxic waste
2.1.7Chemical waste
2.1.8Wastes with high content of heavy metals
2.1.9Pressurized containers
2.1.10Radioactive waste
2.2Sources of health-care waste
2.3Health-care waste generation
2.4Physicochemical characteristics of hazardous health-care waste
References and suggested further reading
3Health impacts of health-care waste
3.1Hazards of health-care waste
3.1.1Types of hazards
3.1.2Persons at risk
3.1.3Hazards from infectious waste and sharps
3.1.4Hazards from chemical and pharmaceutical waste
3.1.5Hazards from genotoxic waste
3.1.6Hazards from radioactive waste
3.1.7Public sensitivity
3.2Public health impact of health-care waste
3.2.1Impacts of infectious waste and sharps
3.2.2Impacts of chemical and pharmaceutical waste
3.2.3Impacts of genotoxic waste
3.2.4Impacts of radioactive waste
3.3Survival of pathogenic microorganisms in the environment
3.4Needs for further research and epidemiological surveys
4Legislative, regulatory, and policy aspects
4.2Legal provisions
4.3Policy document and technical guidelines
5Health-care waste management planning
5.1The need for planning
5.2International recommendations for waste management
5.3National plans for health-care waste management
5.3.1Purpose of a national management plan
5.3.2Action plan for the development of a national programme
5.4Waste management plan for a health-care establishment
5.4.1Assignment of responsibilities
5.4.2Management structure, liaison paths, and duties
5.4.3Assessment of waste generation
5.4.4Development of a waste management plan
5.4.5Implementation of the waste management plan
5.5Management of health-care waste from scattered small sources
5.5.1Basic principles
5.5.2Private medical or dental practitioners
5.5.3Research activities
5.5.4Nursing homes
5.5.5Home treatment
5.5.6Ambulance services
6.2Safe reuse and recycling
Handling, storage, and transportation of health-care waste
7.1Waste segregation and packaging
7.2On-site collection, transport, and storage of waste
7.2.3On-site transport
7.3Off-site transportation of waste
7.3.1Regulation and control system
7.3.2Special packaging requirements for off-site transport
7.3.4Labelling for radioactive waste
7.3.5Preparation for transportation
7.3.6Transportation vehicles or containers
8.1.1Principles of incineration
8.1.2Pyrolytic incinerators
8.1.3Rotary kilns
8.1.4Incineration in municipal incinerators
8.1.5Incineration options that meet minimum requirements
8.1.6Environmental control technology for incinerators
8.2Chemical disinfection
8.2.1Simple chemical disinfection processes
8.3Wet and dry thermal treatment
8.3.1Wet thermal treatment
8.3.2Screw-feed technology
8.4Microwave irradiation
8.5Land disposal
8.5.1Municipal disposal sites
8.5.3Safe burial on hospital premises
8.5.4Land disposal of residues
9.1Infectious waste and sharps
9.2Pharmaceutical waste
9.2.1Disposal of small quantities of pharmaceutical waste
9.2.2Disposal of large quantities of pharmaceutical waste
9.3Cytotoxic waste
9.4Chemical waste
9.4.1Disposal of general chemical waste
9.4.2Disposal of small quantities of hazardous chemical waste
9.4.3Disposal of large quantities of hazardous chemical waste
9.5Wastes with high heavy-metal content
9.6Pressurized containers
9.7Radioactive waste
9.7.1Radioactive waste classification
9.7.2Radioactive waste segregation and characterization
9.7.3Management options for radioactive health-care waste
10Collection and disposal of wastewater
10.1.1Microbiological pathogens
10.1.2Hazardous chemicals
10.1.4Radioactive isotopes
10.1.5Related hazards
10.2Wastewater management
10.2.1Connection to a municipal sewage treatment plant
10.2.2On-site treatment or pretreatment of wastewater
11.3Cost estimation
11.4Recommendations for cost reductions
12.2Workers’ protection
12.2.1Protective clothing
12.3Cytotoxic safety
13Emergency response
13.2Dealing with spillages
13.3Reporting accidents and incidents
14Hospital hygiene and infection control
14.2Epidemiology of nosocomial infections
14.2.1The transition from contamination to infection
14.2.2The sources of infection
14.2.3The routes of transmission
14.3The prevention of nosocomial infection
14.3.2Isolation of infected patients and standard precautions
14.3.6Hand hygiene
15.1Public education on hazards linked to health-care waste
15.2Education and training of health-care personnel
15.2.2Implementing a training course
15.3Training of health-care waste management operators
15.3.1Training for staff who transport waste
15.3.2Training of treatment plant operators
15.3.3Training of landfill operators
16Minimal programmes for health-care waste management
16.1Basic principles
16.2Health-care waste segregation
16.2.1The waste categories
16.2.2Segregation and packaging
16.2.3Safe handling and storage
16.3Minimization and safe recycling of health-care waste
16.3.1Chemicals and pharmaceuticals
16.3.2Pressurized containers
16.3.4Recyclable sharps
16.4Treatment and disposal of hazardous health-care waste
16.4.1Thermal processes
16.4.2Wet thermal disinfection
16.4.3Chemical disinfection
16.4.4Containment processes
16.5Management of hazardous health-care waste by waste categories
16.5.1Infectious waste and sharps
16.5.2Pharmaceutical waste
16.5.3Chemical waste
16.5.4Cytotoxic waste
16.5.5Radioactive waste
16.5.6Pressurized containers
16.5.7Used batteries and thermometers
16.6Workers’ training and safety at work
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Published by Beatriz Figueiredo

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Published by: Beatriz Figueiredo on Nov 29, 2011
Copyright:Attribution Non-commercial


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