Lagos State Hospital Waste Management Practices: A Descriptive Overview with Stakeholders’ Role and Key Recommendations

Background: Waste generation and its disposal is an essential issue in the sustainability of the environment and the planet’s future. Waste management is essential across sectors, likewise the health sector. Therefore, there is a need to employ extra care and attention to handling waste generated from healthcare facilities to avoid the dangers of poor biomedical waste management. We carried out this study to examine the waste management practice in healthcare facilities in Lagos State. Methods: The study was a descriptive survey carried out in one-thousand two hundred and fifty-six (1256) healthcare facilities in Lagos State. Nine hundred sixty-nine (969) of these facilities are located in urban areas, while two hundred and eighty-seven (287) are rural. The facilities studied are government/public health facilities (15.45%), private-for-profit facilities (82.88%), NGOs, Mission/Faith-Based medical facilities (1.67%). The data collected were analyzed using descriptive statistics. Specifically, we utilized bar charts, frequency, and percentage. Result: The result shows that 98.4% (1236) of the studied facilities are registered with the Lagos State Waste Management Authority (LAWMA), while 1.6% (20) are not registered. 98.5% (191) of the 194 government-owned facilities, 98.5% (1025) of the 1041 private-for-profit facilities, and 98.2% (20) of the 21 NGOs/faith-based health facilities are registered with Lagos State Waste Management Authority. The result also shows that 94% of the healthcare facilities studied in Lagos State use color-coded waste bags to segregate waste at the point of origin. 58.7% of the facilities use red-colored bags, 33.3% use yellow-colored bags, 10.7% use black-colored bags, and 1.3% use brown biohazard bags for segregating Infectious waste. Also, 34.2% of the health facilities in Lagos state use red-colored bags, 36.9% use yellow-colored bags, 11% use black-colored bags, and 4.1% use brown-colored bags to segregate their hazardous waste. Conclusion: Some healthcare facilities in Lagos State do not follow the recommended guidelines for medical waste segregation. Waste generated is not appropriately segregated at the point of origin into the recommended colored bags/bins in some facilities. Thus, a policy and procedure regulating healthcare waste are mandatory. It is important to regularly train healthcare workers on proper waste management practices and encourage staff to read and apply WHO rules in managing healthcare waste. Healthcare personnel should realize that hazardous material is a potential cause of a public disaster.

Assessment of leaching behavior and human bioaccessibility of rare earth elements in typical hospital waste incineration ash in China

Leaching behavior and gastrointestinal bioaccessibility of rare earth elements （REEs） from hospital waste incineration （HWI） fly and bottom ash samples collected from Beijing and Nanjing Cities were assessed. In the same ash sample, the leaching concentrations of individual REEs determined by the Toxicity Characteristic Leaching Procedure （TCLP） were higher than those detected by the European standard protocol （EN-type test）, thereby suggesting that the low pH value of leaching solution was an important factor influencing the leacha（bility-of REE. The REE bioaccessibility results, which were evaluated using the physiologically based extraction test （PBET）, indicated that REEs were highly absorbed during fgastric phase by dissolution; and subsequently precipitated and/or re-adsorbed in small intestinal phase. The relative amounts of the total REEs extracted by the TCLP method, EN-type test and PBET test were compared. In addition to the pH value of extraction solutions, the chelating role of REEs witllt organic ligands used in the PBET method was also an important parameter affecting REE adsorption in human body. Additionally, this study showed that REEs were extracted by these methods as concomitants of heavy metals and anions （NO3^-, F^-, SO4^2- , and Cl^-） from HWI ash, which probably caused the remarkably complex toxicity on human body by the exposure pathway.

Re-Use of Hospital Plastic Waste in Asphalt Mixes as Partial Replacement of Coarse Aggregate

About 1.3 billion tons of waste is being generated in the world annually. This waste is a cause of various diseases. Open dumping of waste also destroys valuable agricultural land. Various researchers have beneficially used plastic waste in cement concrete and asphalt concrete in the past. This study aims at the use of aggregates, made from different types of plastic waste, as partial replacement of coarse aggregates in asphalt mixes. For this purpose waste is collected from different hospitals of the city. Sorted plastic from the waste consists of 64% low density polyethene, 32% high density polyethene and 4% of polypropylene. Plastic waste is shredded, heated and after cooling, pulverizes manually and mechanically. Specific gravity of plastic aggregates is 0.96. Water absorption and soundness values are 4.68% and 7.68% respectively. Impact, crushing and Loss Angeles values of plastic aggregates are 0.7%, 0.5%, and 1.1% respectively. Replacement of natural aggregates by plastic aggregates in asphalt mixes is done up to 25% with 5% incremental increase. Density of asphalt mixes decreases to 2060 kg/m3. Consequently flow increases to 5.73 mm. Maximum stability is at 20% replacement i.e. 34.57 KN. Cost analysis of the study indicates that 205% increase in stability are observed with 219% increase in cost.

Estimation of Different Categories of Healthcare Waste Generated at Two Different Hospital Categories in Four Hospitals in Dar es Salaam City

This study aims to estimate the quantity of healthcare waste categorically generated in four different healthcare in Dar es Salaam city namely, Muhimbili National Hospital, Mwananyamala Regional Referral Hospital, Temeke Regional Referral Hospital and Ilala Regional Referral Hospital to evaluate the quantities of medical waste generated based on their level and capacity. Waste was collected in different categories of non-infectious, sharps, infectious, infectious plastics, and pathological waste which were measured daily for fourteen (14) consecutive days in all hospitals by using a weighting scale and observational checklist to document related waste management information and the assessment of the healthcare waste generation in each hospital. The average general healthcare waste generation rate per healthcare ranges from 298.9 kg/day to 1554.4 kg/day. The high fluctuation in general medical waste was established to be attributed to specialization difference between one hospital to the other, and the large number of in-patients and out patients between hospitals. The overall average sharps waste generation rate was established to range from 8.5 ± 2.7 - 13.9 ± 1.8 kg/day. Higher values of sharps waste generated observed at Muhimbili hospital are due to emergency cases referred to from other hospitals located within the city and from the surrounding districts and other regions of the country. The results from this study, raise alarm to hospital administrators, and other health stakeholders working in related fields to give special attention and priority in setting a related share in their budgets for proper management of medical waste in their health facilities.

Hospital Hygiene Maternity Hospital Public Lubumbashi Democratic Republic of Congo

Introduction: Public hospitals in the DRC are of significant disrepair, while there is a strong link between the failure of hospital hygiene and the incidence of nosocomial infections. We have conducted a study with the objective of evaluating the structural-functional conditions of hospital hygiene maternity wards of public hospitals in Lubumbashi. Methodology: It was a descriptive cross-sectional study and structural-functionalist whose population consisted of nurses responsible for 7 of 12 maternity hospitals which were selected based on the inclusion criteria. The observation with an observation guide and maintenance using a questionnaire we used to collect data. Results: The results showed that hospital hygiene conditions in maternity wards of public hospitals in Lubumbashi are not good because almost all maternity services and surgery are not always water in the taps (14.3%). The bins were a means for care units, no coding system exists to distinguish the type of waste. The medical waste are mixed and the other waste are burned in the open or in makeshift incinerator with other types of waste. Conclusion: These maternity wards have poor hygiene, staff responsible for this sector did not follow any training in this area. There is need to regulate the sector and train them.