Report on healthcare waste management in Dinalupihan, Bataan

REPORT ON HEALTHCARE
WASTE MANAGEMENT OF
MUNICIPALITY OF
DINALUPIHAN, BATAAN
REPORT ON HEALTHCARE WASTE MANAGEMENT OF MUNICIPALITY OF DINALUPIHAN,
BATAAN

BATAAN
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CONTENTS
I. Administrative Aspects of Health Care Waste Management Program ............................................. 4

a. laws and regulatio ......................................................................................................................................... 4
i. Republic Act No. 8749 “ Clean Air Act of 1999” ........................................................................................... 4
ii. Republic Act No. 9003“Ecological Solid Waste Management Act, 2001” ...................................................... 4
iii. Republic Act No. 4226 “Hospital Licensure Act” ......................................................................................... 4
iv. Republic Act No. 6969 “An Act to Control Toxic Substances And hazardous and Nuclear Wastes” ............. 4
v. Presidential Decree No. 856“Code on Sanitation of the Philippines” ........................................................... 4
II. organization and function ......................................................................................................................... 4
a. COMPOSITION OF THE HCWM COMMITTEE (general format) ..................................................................... 4
III. Health Care Waste Definition, Sources, Composition and Categories ......................................................... 5
a. Definition of Health Care Waste .................................................................................................................. 5
IV. sources of healthcare waste ...................................................................................................................... 6
a. MINOR SOURCES OF HEALTH CARE WASTE .................................................................................. 6
A. Small Health Care Facilities ........................................................................................................................ 6
B. home ........................................................................................................................................................... 6
C. Institutions ................................................................................................................................................... 6
D. Ambulances and Emergency Care ................................................................................................................. 6
E. Cosmetic Body Piercing & Tattoo Parlors ........................................................................................................ 7
b. MAJOR SOURCES OF HEALTH CARE WASTE .................................................................................. 7
A. Hospitals ..................................................................................................................................................... 7
B. Clinics ......................................................................................................................................................... 7
C. Laboratories and Research Centers ............................................................................................................... 7
D. Drug Manufacturing Companies ..................................................................................................................... 7
E. Mortuary and Autopsy Center ........................................................................................................................ 8
V. Categorization of HCW ............................................................................................................................. 8
a. hazardous hcw ........................................................................................................................................... 8
i. sharp waste ................................................................................................................................................ 8
ii. sharp waste ................................................................................................................................................ 9
iii. Pathological and anatomical waste ............................................................................................................. 9
iv. Pharmaceutical waste ................................................................................................................................. 9
v. genotoxic including Cytotoxic Waste ........................................................................................................ 10
vi. Chemical Waste ........................................................................................................................................ 10
vii. radioactive Waste ................................................................................................................................. 10
viii. Pressurized containers ......................................................................................................................... 10
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ix. general waste ........................................................................................................................................... 11

VI. risk assesment ........................................................................................................................................... 11
a. person at risk ............................................................................................................................................. 11
b. mode of transmission .................................................................................................................................. 12
c. hazards from Infectious, Sharps, Pathological and Anatomical Wastes ............................................................ 13
d. hazards from chemical and pharmaceutical Wastes ....................................................................................... 13
e. hazards from genotoxic Wastes ................................................................................................................... 13
f. hazards from radioactive Wastes ................................................................................................................. 13
g. hazards from wastewater............................................................................................................................. 13
VII. Engineering methods, management,and mitigation programs ..................................................... 14
a. pLANNING ........................................................................................................................................... 14
b. HCW MINIMIZATION ....................................................................................................................... 14
c. RECYCLING ......................................................................................................................................... 15
d. SEGREGATION .................................................................................................................................... 16
e. COLOR CODING ................................................................................................................................. 16
f. LABELING AND MARKING ............................................................................................................. 16
VIII. BEST PRACTICES IN HEALTHCARE WASTE MANAGEMENT ............................................... 18
a. sanitation planning team ..................................................................................................................... 18
b. labeling ................................................................................................................................................... 20
c. central waste storage facility ............................................................................................................... 20
d. scheduled hcw collection (non hazardous and pre treated) ............................................................................. 20
e. wastewater siphoning service ...................................................................................................................... 21
f. WATER SAMPLING ................................................................................................................................... 21
g. disinfection................................................................................................................................................. 21
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I. ADMINISTRATIVE ASPECTS OF HEALTH CARE WASTE MANAGEMENT

PROGRAM
A. LAWS AND REGULATIO
I. REPUBLIC ACT NO. 874 9 “ CLEAN AIR ACT OF 1 999”
Banning of Incineration, Use of non-burn technologies that complies with at least

one of the following conditions;
 Destruction chamber is free of oxygen.

 Fire is not used within the destruction chamber.
 Source of heat is not fire
 Heat conducting material or medium is used to destroy the waste.
II. REPUBLIC ACT NO. 9003“ECOLOGICAL SOLID WA STE MANAGEMENT ACT,

2001”
Ensure the proper segregation, collection transport, storage, treatment and disposal
of solid waste.
III. REPUBLIC ACT NO. 4226 “HOSPITAL LICENSURE ACT”
AO- 70- Revised Rules and Regulations Governing the Regulation, Licensing and
Operation of Hospitals and other Health Facilities
IV. REPUBLIC ACT NO. 6969 “AN ACT TO CONTROL TOXIC SUBSTANCES AND
HAZARDOUS AND NUCLEAR WASTES”
Control toxic substances and hazardous and nuclear wastes.
V. PRESIDENTIAL DECREE NO. 856“CODE ON SANITATION OF THE

PHILIPPINES”
Chapter XVIII ― Refuse Disposal‖- Requires all cities and municipalities to provide an
adequate and efficient system of collecting, transporting and disposing refuse in their areas of
responsibilities in a manner approved by the local health authority.
II. ORGANIZATION AND FUNCTION
A. COMPOSITION OF THE HCWM COMMITTEE (GENE RAL FORMAT)
1. Chief/Director of the Health Facility-Chairperson
2. Department Heads
3. Infection Control Officer
4. Chief Pharmacist
5. Radiation Officer
6. Senior Nursing Staff
7. Hospital Engineer
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8. Financial Controller
9. Waste Management Officer
10. Health Educator/Information Officer
III. HEALTH CARE WASTE DEFINITION, SOURCES, COMPOSITION AND

CATEGORIES
A. DEFINITION OF HEALTH CARE WASTE
Means waste generated as a result of Diagnosis, treatment or immunization of

human beings or animals; Research pertaining to the said activities; Production or testing
of biological products; and Other activities from minor sources. In addition, HCW includes the
same types of waste originating from minor and scattered sources, such as waste produced in the
course of health care undertaken in the home (e.g., home dialysis, self-administration of insulin,
recuperative care).
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IV. SOURCES OF HEALTHCARE WASTE
A. MINOR SOURCES OF HEALTH CARE WASTE
A. SMALL HEALTH CARE FA CILITIES
 Physician’s Offices
 Dental Clinics
 Alternative Medicine Clinics
B. HOME
Home (Treatment at home such as dialysis, insulin injection, etc
C. INSTITUTIONS
Medical Schools, Nursing Homes, Dental Schools, Paramedics Services, Drug Rehabilitation
Centers, etc.)
D. AMBULANCES AND EMERGENCY CARE
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E. COSMETIC BODY PIERCI NG & TATTOO PARLORS
B. MAJOR SOURCES OF HEALTH CARE WASTE
A. HOSPITALS
B. CLINICS
C. LABORATORIES AND RESEARCH CENTERS
D. DRUG MANUFACTURING C OMPANIES
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E. MORTUARY AND AUTOPSY CENTER
V. CATEGORIZATION OF HCW
HCW can be broadly categorized into ―hazardous‖ and ―non-hazardous‖ waste types. Each category is described
in detail in the succeeding sub-sections.
A. HAZARDOUS HCW
Hazardous HCW refers to waste that may pose a variety of environmental and health risks. It can
be further classified into sharps waste, infectious waste, pathological and anatomical waste, pharmaceutical
waste, genotoxic waste, chemical waste, radioactive waste, and pressurized containers.
I. SHARP WASTE
Sharps are considered as the most hazardous HCW and must be managed with
utmost care. This is because of the double danger it poses—it can cause accidental pricks, cuts,
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or punctures; it can also potentially spread infection through these injuries. Examples of sharps
include needles, syringes, scalpels, saws, blades, broken glass, infusion sets, knives, nails, and
other items that can cause a cut or puncture wound. Whether or not they are infected, such items
are usually considered highly hazardous and should be treated as if potentially infected.
II. SHARP WASTE
This type of waste is most likely to contain pathogens (bacteria, viruses, parasites, or
fungi) in sufficient concentration or quantity to cause diseases in susceptible hosts. Examples of
infectious waste include:
 Cultures and stocks of infectious agents from laboratory work;

 Wastes from surgeries and autopsies on patients with infectious diseases
(e.g., tissues, materials or equipment that have been in contact with blood or
other body fluids
 Wastes from infected patients in isolation wards (e.g., excreta, dressings
from infected or surgical wounds, clothes heavily soiled with human blood or
other body fluids
 Wastes that have been in contact with infected patients undergoing
hemodialysis (e.g., dialysis implements such as tubing and filters, disposable
towels, gowns, aprons, gloves, and laboratory coats
 Infected animals from research laboratories; and
 Other instruments or materials that have been in contact with infected
persons or animals.
Among these are highly infectious wastes that require disinfection at source, such as
microbial cultures and stocks of highly infectious agents from medical analysis laboratories
and body fluids from patients with highly infectious diseases. Special requirements regarding
management of infectious waste must be imposed whenever waste is known or – based on
medical experience – expected to be contaminated with causative agents of diseases and
when this contamination gives cause for concern that the disease might spread.
III. PATHOLOGICAL AND ANA TOMICAL WASTE
Pathological waste could be considered a subcategory of infectious waste but is

often classified separately – especially when special methods of handling, treatment, and
disposal are used. It consists of tissues, organs, body parts, blood, body fluids, and other
waste from surgery and autopsies, including human fetuses and animal carcasses. Within this
category, recognizable human or animal body parts are also called anatomical waste.
IV. PHARMACEUTICAL WASTE
Pharmaceutical waste includes expired, spilt, and contaminated pharmaceutical

products, drugs, vaccines, and sera that are no longer required and need to be disposed of
appropriately. This category also includes discarded items used in handling of
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pharmaceuticals, such as bottles, vials, or boxes with residues, gloves, masks, and connective
tubing.
V. GENOTOXIC INCLUDING CYTOTOXIC WASTE
Pharmaceutical waste includes expired, spilt, and contaminated pharmaceutical

products, drugs, vaccines, and sera that are no longer required and need to be disposed of
appropriately. This category also includes discarded items used in handling of
pharmaceuticals, such as bottles, vials, or boxes with residues, gloves, masks, and connective
tubing
VI. CHEMICAL WASTE
Chemical waste consists of discarded solid, liquid, and gaseous chemicals used in
diagnostic and experimental work and in cleaning, housekeeping, and disinfecting procedures.
VII. RADIOACTIVE WASTE
Radioactive wastes are materials contaminated with radionuclides. They are

produced as a result of procedures such as in vitro analysis of body tissue and fluid, in vivo
organ imaging and tumor localization, and various investigative and therapeutic practices.
VIII. PRESSURIZED CONTAINERS
Many types of gas are used in health care and are often stored in portable
pressurized cylinders, cartridges, and aerosol cans. Many of these are reusable, once empty
or of no further use (although they may still contain residues). However, certain types –
notably aerosol cans – are single-use containers that require disposal. Whether inert or
potentially harmful, gases in pressurized containers should always be handled with care;
containers may explode if incinerated or accidentally punctured.
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IX. GENERAL WASTE
More commonly known as ―general waste,‖ non-hazardous HCW refers to waste that
has not been in contact with infectious agents, hazardous chemicals, or radioactive
substances and does not pose any special handling problem or hazard to human health or to
the environment. General waste is usually similar in characteristics to municipal solid waste
and comes mostly from the administrative and housekeeping functions of HCFs. Non-
hazardous HCW can be further classified into recyclable waste, biodegradable waste, and (c)
residual waste that is neither recyclable nor biodegradable.
VI. RISK ASSESMENT
A. PERSON AT RISK
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B. MODE OF TRANSMISSION
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C. HAZARDS FROM INFECTIO US, SHARPS, PATHOLOGICAL AND ANATOMICAL

WASTES
D. HAZARDS FROM CHEMICAL AND PHARMACEUTICAL WASTE S
Although chemical and pharmaceutical wastes may be found in small quantities in

HCFs, these substances are hazardous. They may cause intoxication, either by acute or by
chronic exposure and injuries, including burns. Intoxication can result from absorption of a
chemical or pharmaceutical substance through the skin or the mucous membranes, or from
inhalation or ingestion. Injuries to the skin, the eyes or the mucous membranes of the airways
can be caused by contact with flammable, corrosive or reactive chemicals (e.g., formaldehyde
and other volatile substances). The most common injuries are burns.
E. HAZARDS FROM GENOTOXI C WASTES
The pathways of exposure are inhalation of dust or aerosols, absorption through the
skin, ingestion of food accidentally contaminated with cytotoxic drugs, ingestion as a result of
bad practice, such as mouth pipetting. Exposure may also occur through contact with body
fluids and secretions of patients undergoing chemotherapy.
F. HAZARDS FROM RADIOACTIVE WASTES
Health effects caused by exposure to radioactive substance or contaminated

materials can range from reddening of the skin and nausea to more serious problems such as
cancer induction and genetic consequences to succeeding generations of the exposed
individual. The handling of high activity sources, e.g., certain sealed and unsealed radiation
sources used in cancer therapy, poses higher health risks such that adequate protective
measures must be established to minimize these risks.
G. HAZARDS FROM WASTEWAT ER
Wastewater from HCF is composed of a myriad of materials that pose a hazard to

public health and to the environment. Wastewater may contain pathogens such as bacteria,
helminths, protozoa, and viruses that are hazardous if the wastewater is inadequately treated
or the untreated wastewater is used for irrigation of crops. The salt content in wastewater may
also increase soil salinity in the area, rendering the soil useless for agricultural purposes.
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VII. ENGINEERING METHODS, MANAGEMENT,AND MITIGATION PROGRAMS
A. PLANNING
Wastes generated at the HCFs may pose harm and risks to the health
care workers and communities if not properly managed. Health care waste
management (HCWM) is a process that helps in ensuring the proper
management of HCW from the point of generation to until disposal.
B. HCW MINIMIZATION
The HCW generated within the HCF follows an appropriate and well
tream from point of generation until their final disposal, that is composed of
several steps that includes waste generation, segregation, collection,
transportation (on-site and off-site), storage, treatment, and disposal.
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C. RECYCLING
Recycling involves processing of used materials (waste) into new

products to prevent loss of potentially useful materials, reduce the
consumption of fresh raw materials, reduce energy usage, reduce air
pollution and water pollution (from land filling) by reducing the need for
“conventional” waste disposal and lower greenhouse gas emissions as
compared to virgin production. However, from an environmental
perspective, recycling is less desirable than reusing a waste item, because it
frequently requires substantial energy input and transport to off-site
recycling centers.
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D. SEGREGATION
Segregation is the process of separating different types of waste at

the point of generation until its final disposal. The correct segregation of
HCW is the responsibility of the person who produces each waste item,
whatever their position in the organization
E. COLOR CODING
The purpose of color-coding is to make it easier for HCF workers to

put the waste into correct bins and maintain segregation during collection,
storage, transport, treatment, and disposal.
F. LABELING AND MARKING
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VIII. BEST PRACTICES IN

HEALTHCARE WASTE
MANAGEMENT
A. SANITATION PLANNING
TEAM
In-charge of planning of
disinfection, and waste disposal of
healthcare and other relevant
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waste on health facilities within dinalupihan.
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B. LABELING
Warning signs and labels

were installed on critical
areas in health facilities.
C. CENTRAL WASTE
STORAGE FACILITY
Waste from all health

facilities is being transferred
to this facility. This waste is
then collected by 3rd party
hazardous waste collector.
D. SCHEDULED HCW
COLLECTION (NON
HAZARDOUS AND PRE
TREATED)
Collection from barangay

health station to rural health
unit then to central storage
area.
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E. WASTEWATER
SIPHONING
SERVICE
Collection of infectious
wastewater from Covid
treatment center by
DENR accredited
Siphoning services
F. WATER SAMPLING
Water sampling of water supply to ensure

safe use of water
G. DISINFECTION
To ensure that facility is safe from the

threats of communicable diseases
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H. COLLECTION OF HEALTHCARE WASTE
To ensure that facility is safe from the threats of communicable diseases particularly
COVID 19
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23

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REPORT ON HEALTHCARE

REPORT ON HEALTHCARE WASTE MANAGEMENT OF MUNICIPALITY OF DINALUPIHAN,

I. Administrative Aspects of Health Care Waste Management Program ............................................. 4

ix. general waste ........................................................................................................................................... 11

I. ADMINISTRATIVE ASPECTS OF HEALTH CARE WASTE MANAGEMENT

A. LAWS AND REGULATIO

I. REPUBLIC ACT NO. 874 9 “ CLEAN AIR ACT OF 1 999”

Banning of Incineration, Use of non-burn technologies that complies with at least

 Destruction chamber is free of oxygen.

II. REPUBLIC ACT NO. 9003“ECOLOGICAL SOLID WA STE MANAGEMENT ACT,

III. REPUBLIC ACT NO. 4226 “HOSPITAL LICENSURE ACT”

Control toxic substances and hazardous and nuclear wastes.

V. PRESIDENTIAL DECREE NO. 856“CODE ON SANITATION OF THE

II. ORGANIZATION AND FUNCTION

A. COMPOSITION OF THE HCWM COMMITTEE (GENE RAL FORMAT)

1. Chief/Director of the Health Facility-Chairperson

3. Infection Control Officer

6. Senior Nursing Staff

9. Waste Management Officer

10. Health Educator/Information Officer

III. HEALTH CARE WASTE DEFINITION, SOURCES, COMPOSITION AND

A. DEFINITION OF HEALTH CARE WASTE

Means waste generated as a result of Diagnosis, treatment or immunization of

IV. SOURCES OF HEALTHCARE WASTE

A. MINOR SOURCES OF HEALTH CARE WASTE

A. SMALL HEALTH CARE FA CILITIES

Home (Treatment at home such as dialysis, insulin injection, etc

D. AMBULANCES AND EMERGENCY CARE

E. COSMETIC BODY PIERCI NG & TATTOO PARLORS

B. MAJOR SOURCES OF HEALTH CARE WASTE

C. LABORATORIES AND RESEARCH CENTERS

D. DRUG MANUFACTURING C OMPANIES

E. MORTUARY AND AUTOPSY CENTER

II. SHARP WASTE

 Cultures and stocks of infectious agents from laboratory work;

III. PATHOLOGICAL AND ANA TOMICAL WASTE

Pathological waste could be considered a subcategory of infectious waste but is

IV. PHARMACEUTICAL WASTE

Pharmaceutical waste includes expired, spilt, and contaminated pharmaceutical

V. GENOTOXIC INCLUDING CYTOTOXIC WASTE

Pharmaceutical waste includes expired, spilt, and contaminated pharmaceutical

VI. CHEMICAL WASTE

VII. RADIOACTIVE WASTE

Radioactive wastes are materials contaminated with radionuclides. They are

VIII. PRESSURIZED CONTAINERS

IX. GENERAL WASTE

VI. RISK ASSESMENT

C. HAZARDS FROM INFECTIO US, SHARPS, PATHOLOGICAL AND ANATOMICAL

D. HAZARDS FROM CHEMICAL AND PHARMACEUTICAL WASTE S

Although chemical and pharmaceutical wastes may be found in small quantities in

E. HAZARDS FROM GENOTOXI C WASTES

F. HAZARDS FROM RADIOACTIVE WASTES

Health effects caused by exposure to radioactive substance or contaminated

G. HAZARDS FROM WASTEWAT ER

Wastewater from HCF is composed of a myriad of materials that pose a hazard to

VII. ENGINEERING METHODS, MANAGEMENT,AND MITIGATION PROGRAMS

Recycling involves processing of used materials (waste) into new

Segregation is the process of separating different types of waste at

The purpose of color-coding is to make it easier for HCF workers to

F. LABELING AND MARKING

VIII. BEST PRACTICES IN

waste on health facilities within dinalupihan.

Warning signs and labels