Human Health and Environmental Concerns
Inefficient handling and management of medical waste may lead to problems such as spread of disease and infections, environmental pollution, etc., and the groups of people at the highest risk of such encounters are health-care staff, rag pickers and scavengers, municipal workers, and the public.
Several ways in which medical waste pose dangers to the public shall be discussed below.
Definition of Term
Ensuring safe public health and a clean environment in the face of improper medical waste disposal is of great significance. While there are studies indicating unavailability of data to show the direct evidence of the harm done by the mishandling of medical waste, the dangers associated with these occurrences are obvious.
Read Also: Recommended Methods of Waste Disposal
Inefficient handling and management of medical waste may lead to problems such as spread of disease and infections, environmental pollution, etc., and the groups of people at the highest risk of such encounters are health-care staff, rag pickers and scavengers, municipal workers, and the public.
Several ways in which medical waste pose dangers to the public shall be discussed below.
Spread of Infection and Disease
As discussed earlier in the previous section, medical waste often contains certain materials that are termed “infectious”.
Some of these materials have been discussed in the previous sections. There is a strong evidence of transmission of certain infectious agents such as blood-borne pathogens via medical waste.
It has been estimated that the chances of infection after a needle-stick injury from a contaminated syringe is 0.3% for HIV, 1.8% for hepatitis C but 30% for hepatitis B.
The hepatitis B virus is very persistent in dry air and can survive for several weeks on a surface, brief exposure to boiling water and to some antiseptics, including 70% ethanol.
An infective dose of hepatitis B or C virus can survive for up to a week in a blood droplet trapped inside a hypodermic needle. Due to unsafe medical waste management, there is risk of the spread of such an infection, which may affect those in-house as well as the surrounding population.
There are other notorious bacteria living as opportunistic pathogens such as; Pseudomonasaeruginosaand Acinetobacterbaumannii that are commonly found adhering to medical devices, for example, hypodermic needles, blades, etc., and capable of causing serious infections in immune-compromised individuals.
The presence of these and many more pathogens can pose a serious threat to the public especially during cases of injury from sharps such as needles, blades, etc., that are easily found littering places where medical waste is dumped.
Waste recycling is an important activity with many benefits. It helps in the protection of the environment against pollution, production of biogas through anaerobic digestion processes, composting, and so on.
Normally, medical waste is often excluded from municipal waste that is meant for recycling. Cases whereby recycling facilities becomes hazardous usually occur whenever medical waste enters the mix.
Unauthorized sweepers and rag pickers who scavenge waste sites for disposable items such as bottles, hypodermic needles, blades, etc., often cause such unfortunate occurrences.
They process these untreated items either by granulation or making them into other products, or by washing and repackaging them for resale. Rag pickers and sweepers with such practices are common in many parts of the world with particular reports in Asian countries with large populations, for example, India, Pakistan, Bangladesh, as well as some African countries, for example, South Africa.
Read Also: Different Types of Hospital Wastes
These activities are dangerous and can constitute a major threat to the public and cause the spread of infection among susceptible individuals who may by chance get into contact with these recycled items.
The possibility of transference of disease and infection from animals to humans (zoonosis) is well established. The spread of infection and disease through vectors such flies, mosquitoes, insects, as well as mammals, such as monkeys and bats, has been well documented.
According to the UK Health and Safety Executive (2000), there are approximately 40 zoonotic diseases in the United Kingdom of which salmonella and influenza (avian flu and H1N1) are among the notable ones.
Animals, such as dogs, cats, rats, cattle, goats, birds, and even elephants, are usually found roaming waste sites looking for something to eat. These animals face a grave danger of contracting diseases such as tuberculosis, anthrax, and other infections which may possibly be transferred to humans who consume their meat.
However, the extent to which they can spread infection has not been extensively reported.
Spread of Resistant Pathogen
Antibiotic-resistant bacteria pose an enormous risk to global health because they are responsible for the failure of treatment in many hospitals. Inadequate waste management from the hospital, especially in waste that contains pathogenic organisms, can affect the environment in a number of ways.
Firstly, they affect the flora and fauna by increasing the pathogenic strains of hospital origin and decreasing the commensals that contribute beneficially to the ecosystem.
Secondly, they pose great risk to the public because hospital waste harboring resistant nosocomial bacteria that are found at waste dumping sites can contaminate the groundwater, streams, and rivers via flooding thereby making such water unfit for drinking.
There have been reports of groundwater contaminated with drug resistant Gram-negative bacteria such as Escherichiacoli, Klebsiellapneumoniae,Enterobacter spp., etc.
Most of these isolated bacteria are commonly encountered in hospitals. Another significant way by which the environment and public health is affected is through the spread of resistance genes.
Certain bacteria are known to easily acquire resistance genes via plasmids and integrons through their interaction with other resistant bacteria of the same or different genera in the environment, this is called horizontal gene transfer. Many bacterial resistant genes that are widely disseminated across the globe are mostly of hospital origin.
Antibiotic-resistant bacteria are a pressing global health concern. Over the last three decades several types of bacteria have emerged with different resistance genes causing therapeutic failure among individuals that are infected.
Recently, other bacteria with a new gene called New Delhi Metallo β-lactamase have emerged from India and have been detected in more than 13 countries in Europe, Asia, North America, the Middle East, and Africa. The gene was initially isolated from a hospital patient from India and has since been predominantly found among people who had previously been to India or Pakistan.
Dangers to the Public
The public is also at risk of activities associated with inefficient medical waste management in society. Developing countries where people do not have effective water supply are in great danger of consuming water that is already contaminated with bacteria washed from waste sites.
These can result to development of sickness and ailments such as tuberculosis, typhoid, and other water borne diseases. The role of rag pickers and scavengers, who assist unscrupulous recyclers in the repackaging of medical equipment such as syringes, hypodermic needles, expired drug, and other waste medical items for resale, also contribute immensely to the dangers to the public.
They end up selling such material to small pharmacies patronized by members of the public who may be asked to provide their own syringes, needles, and even drugs. Anyone involved in these unfortunate scenarios are at high risk of contracting disease and infection.
Many of such cases of outbreak of diseases have been reported in countries such as India where doctors are blamed for reusing syringes and also transacting in second-hand syringes.
In conclusion, ensuring safe public health and a clean environment in the face of improper medical waste disposal is of great significance. While there are studies indicating unavailability of data to show the direct evidence of the harm done by the mishandling of medical waste, the dangers associated with these occurrences are obvious.
Read Also: Assessment of Pollutants and Risk Assessment in Public Health
Inefficient handling and management of medical waste may lead to problems such as spread of disease and infections, environmental pollution, etc., and the groups of people at the highest risk of such encounters are health-care staff, rag pickers and scavengers, municipal workers, and the public.
Developing countries where people do not have effective water supply are in great danger of consuming water that is already contaminated with bacteria washed from waste sites. These can result to development of sickness and ailments such as tuberculosis, typhoid, and other water borne diseases.
The role of rag pickers and scavengers, who assist unscrupulous recyclers in the repackaging of medical equipment such as syringes, hypodermic needles, expired drug, and other waste medical items for resale, also contribute immensely to the dangers to the public.
They end up selling such material to small pharmacies patronized by members of the public who may be asked to provide their own syringes, needles, and even drugs.
