Healthcare waste management in developing countries
Practical Action
NO
MAYBE
Category
General Waste
Chemical Waste
YES Pathological Waste
YES Radioactive Waste
YES Infectious Waste
YES Sharps
YES Pharmaceutical Waste
YES Pressurized containers
Table 1: Categories of healthcare waste
Examples
Domestic waste, packing material, non-infectious
animal waste, bedding, wastewater from laundries, etc.
Discarded solid, liquid and gaseous chemicals, for
example generated from diagnostic and experimental
work, cleaning, housekeeping and disinfecting
procedures.
Tissues, organs, body parts, human foetuses, animal
carcasses, blood and body fluids.
Solid, liquid, and gaseous materials contaminated with
radionuclides: for example, from radiotherapy or
laboratory research, contaminated glassware, packages,
etc.
Waste suspected to contain pathogens: laboratory
cultures, tissues, excreta, etc.
Needles, syringes, scalpels, blades, saws, glass, nails
and any other item that could cause a cut or puncture.
Pharmaceutical products, drugs and chemicals that
have been returned from wards, have been spilled or
outdated or contaminated, or are to be discarded
because they are no longer required.
Gas cylinders, gas cartridges, aerosols cans; they may
explode if incinerated or accidentally punctured.
Health-care waste treatment options
Incineration
Incineration is one of the most used options for healthcare waste treatment. Incineration is a
high-temperature dry oxidation process that reduces organic and combustible waste to inorganic,
incombustible matter and results in a very significant reduction of waste volume and weight. But
it can generate significant emissions containing atmospheric pollutants and may produce odours,
as described later.
Different types of incinerators can be used, ranging from single-chamber furnaces to highly
complex rotary kilns. Advantages and drawbacks of the three types of incinerator most commonly
used in low-income countries, namely drum / brick incinerator, single-chamber incinerator and
pyrolitic incinerator, are presented in Table 2, as well as the categories of healthcare waste they
are adequate for.
Type of incinerator
Pyrolitic
incineration
Advantages
- Very high disinfection
efficiency.
- Low cost models
available.
Drawbacks
- Incomplete destruction
of cytotoxics.
- Relatively high
investment and operating
costs.
Adequate for
- All infectious waste
- Most pharmaceutical
waste.
- Most chemical waste.
Single-chamber
incineration
2
- Good disinfection
efficiency.
- Drastic reduction of
weight and volume of
waste.
- The residues may be
disposed of in landfills.
- No need for highly
trained operators.
- Relatively low
investment and operating
- Significant emissions of
atmospheric pollutants.
- Need for periodic
removal of slag and soot.
- Inefficiency in
destroying thermally
resistant chemicals and
drugs such as cytotoxics.
- General healthcare
waste
- Infectious waste
BUT significant emissions