MANAGEMENT OF MEDICAL WASTE Prepared By: Nihan Isbil Gke Alpay
Bengi Berker Burcu Yalnkaya 1
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Objectives In our presentation, wed like to inform you about:
What is medical waste? Sources of medical wastes Whos collecting
medical wastes? Methods for treatment The treatment methods and
application in Turkey Ways to improve the current applications.
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What is Medical Waste? This symbol is the International
Biohazard Symbol. It is also known as Trifoil. Biohazard materials
include Medical Waste. 3
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What is Medical Waste? Any solid or liquid waste which is
generated in the Diagnosis, Research, Treatment Immunization of
human being or animals are called as Medical Waste. 4
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What is Medical Waste? Medical Waste cant be considered as
general waste. Since the medical wastes are infectious,
bio-hazardous and they could lead to the spread of diseases; they
should be collected separately from commercial and residential
wastes. 5
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What is Medical Waste? Medical wastes have a risk of
transmitting: Human Immunodeficiency Virus (HIV), Hepatitis B Virus
(HBV) Other agents that are associated with blood-borne diseases.
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What is Medical Waste? Chemical composition of the medical
wastes consists of: 50 % of Carbon, 20 % of Oxygen, 6 % of
Hydrogen, Many other trace elements. 7
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Sources of Medical Waste Hospitals and Clinics, Bio-technology
Institutes, Laboratories, Medical Research Facilities, Nursing
Homes, Diagnostic Laboratories 8
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Examples for Medical Waste Blood or body fluid, Cultures and
stocks of agents, Discarded vaccines, culture dishes and devices
used at those actions; Blood products such as serum, plasma, 9
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Examples for Medical Waste Pathological wastes, such as
tissues, organs, body parts, and body fluids that are removed
during surgery and autopsy, Discarded needles, scalpel blades,
those have come contact with infectious agents, Radioactive
materials, Used operation room clothes, Dialysis wastes. 10
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Examples for Medical Waste Wastes from normal veterinarian
activities and from farms or ranches, Paper towels, which didnt
contact with the infectious agents and does not contain fluid
blood, Are not considered as Medical Waste. 11
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Generation Rate of Medical Waste in Turkey For example; medical
waste generation rate depends on: o The type of the facility, o The
treatment methods and the materials used during those actions
According to the survey that is run throughout Turkey, the most
medical waste production is in Istanbul (about 34 tons per day);
which contributes 17% of the total waste production. In contrast,
Tunceli has the least waste production rate which is approximately
32 kilograms per day. 12
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Regulations & Applications Of Medical Waste Management The
aim of Management of Medical Wastes Regulation: To protect
human-beings and environment from the hazardous wastes from their
generation to final disposal. x NO YES 13
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Regulations & Applications Of Medical Waste Management The
Ministry of Environment and Forests has published Regulation on
Control of Medical Wastes on 1993. 14
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Regulations & Applications Of Medical Waste Management
According to the regulation; management consists of 6 steps: a.
Separate collection at the source, b. Remove from the source in
different containers, c. Storing temporarily until collection, d.
Collection of wastes with proper licensed medical waste vehicles
and transferring to the disposal site, e. Treatment or destruction
of wastes by incineration, f. Tracking period. 15
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Steps Seperation @ Source Storing temporarily until collection
Collection of wastes with proper licensed medical waste vehicles
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Packages The potential infectious medical wastes must be coded
with color red. The packing should be strong enough to withstand
during handling, storage and transportation. The packages must have
150 microns thickness. Also the packaging should be moisture
resistant, insect proof. 17
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Applications For Medical Waste Treatment In World-wide & In
Turkey The most used method for treatment of medical waste is
Autoclaving and Incineration. Besides those methods, also new
technologies are used to improve existing ones; like Microwave
& Chemical Disinfections, Plasma Technology. 18
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Applications For Medical Waste Treatment In World- wide &
In Turkey Medical Waste Incinerators burn trash and infectious
medical waste. Autoclaving is the usage of superheated, pressurized
steam; so that medical waste can be harmlessly buried in landfills.
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Advantages & Disadvantages of Methods Incineration
AdvantagesDisadvantages Volume & Weight ReductionHigh
Investment & Operation Costs Heat Recovery for Large
SystemsHigh Maintenance Cost Fits for Every Type of WasteAir
Pollution Expensive Equipment Hazardous Fly Ash Autoclaving
AdvantagesDisadvantages Low Investment CostAppearance & Volume
Remain Still Low Operating CostNot Suitable for All Waste Types Low
Hazard ResiduePossible Air Pollution Ergonomic Concerns 20
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Applications For Medical Waste Treatment In Turkey The
treatment method used in Turkey is Incineration. In Istanbul, ISTAC
is responsible for collection of medical wastes. Therere 16
licensed medical waste collection vehicles in Istanbul. Medical
wastes collected from the hospitals and different health care
facilities, are brought the Kemerburgaz Odayeri Landfill Facility.
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Applications For Medical Waste Treatment In Turkey At the
gates, the trucks are controlled by 4 radio- activity detectors, in
order to locate the radioactivity in the truck if exists. The
incinerator system in Odayeri has a daily capacity of 24 tones. All
of the system is controlled by PLC System. The wastes are
incinerated at temperatures of 1000C to 1200C. By incineration, 95%
reduction in volume and 75% reduction in mass is obtained. Also
electricity is obtained from the incineration activity and is used
in the complex. 23
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Researches Government Hospital Our group visited the Silivri
Devlet Hastanesi. Theres only one employee for medical waste
collection. He said he is obligated to wear special clothes which
are in color orange. Also he has to wear gloves, caps, plastic
yellow boots and masks. Theres a main container that is used for
collection of medical wastes from very unit. Wastes are collected
in every morning and every evening. The collected wastes are stored
in a storage room which is constructed according to the regulation
rules. 25
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Researches Government Hospital STA collects the wastes two
times in a week. The wastes wait in the storage room about 3 days.
The vehicles are sent to the hospital at evenings. Theyre not
interested in what is done to wastes at STA, they said that theyre
just collecting and sending the wastes. Theyre using the red
medical waste packages. Theyre very careful about separate
collection of medical wastes from residential wastes. 27
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Researches Clinic Laboratory Also, we visited Kzltoprak
Referans Clinic Laboratory. They gave us the following information:
Since we are a small facility, theres not much medical waste
generation. Because of that reason, STA visits us once in two
weeks. They collect their wastes in an red container without any
usage of red packages. When we asked the reason, the manager said
that Theres no harmful waste generation in our facility. So, we
dont need to use packages. But the bad thing is that, the container
is put into the street. Theres no special place for the container.
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Comments & Recommendations for STA According to our
impression at the hospitals and at the technical trip, we saw that
STA is well-working about medical waste management. STA collects
all of the medical waste and brings them to Odayeri for
incineration. But in clinics or local health care centers,
generated waste is not that hazardous or pathologic. Instead of
incinerate all of the wastes, those kinds of low or non- hazardous
wastes can be collected separately and they can be sterilized by
autoclaving and could send to the landfills. 30
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Autoclaves 31
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An incinerator example. Incineration 32
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Comments & Recommendations for STA The major disadvantage
of incineration is emissions of toxic materials like mercury and
dioxin. So, by reducing the amount of waste to be incinerated, we
can also reduce the air pollution from those materials. By
autoclaving, we can eliminate the generation of dioxin. 33
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Comments & Recommendations for STA Besides autoclaving and
incineration therere also new technologies. Historical systems can
be replaced with those technologies. STA can investigate those
technologies and use for medical waste treatment. 34
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Comments & Recommendations for Waste Generators Since the
collection from source and temporarily storage part belong to
hospitals; there should be controllers who are working for
government or for STA. They should be controls on a regular basis.
According to the hospitals weve talked and the investigations weve
made theres no such a regular- basis control. Heres some examples
for the bad collection: 35
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With Our Recommendations we Achieve Less environmental impact
Waste minimization Strict conformation to the regulations Recycle
& reuse of wastes Reducing the air pollutant release. 38
