PESHAWAR: Lack of proper incineration of hospital waste has been posing serious threats of infectious diseases to the people, says a study.

“There is an urgent need for a central incineration system to safeguard people from diseases, like hepatitis, HIV, etc,” says the study conducted by Prime Institute of Public Health in collaboration with Khyber Pakhtunkhwa Environmental Protection Agency (EPA).

Healthcare waste is a serious threat to anyone getting in contact with it at any level. A total of 15 to 20 per cent healthcare waste is infectious while about 80 to 85 per cent is non-infectious and non-segregation of the former from the latter makes the waste 100 per cent infectious.

The study says that there is a plethora of research about multiple health hazards including polluting general municipal waste, effect on sex ratio in child birth, congenital anomalies, and cancer among residential communities located within four kilometres radius of an incineration plant.

Recommends centralised incineration system away from residential areas

It points out that waste disposal through dumping is posing major risk for adjoining communities and lack of segregation of waste turns even its harmless portion into hazardous one. Besides, inadequate incineration results in release of cancer causing pollutants, such as dioxin and furans into the air.

Citing EPA’s survey, the study says that 70 per cent private and 60 per cent public hospitals dispose waste through dumping while the rate of using incinerator is four and 17 per cent respectively.

It says that mismanagement of healthcare waste is a national. Studies in Lahore, Karachi, Islamabad and Rawalpindi have shown that lack of proper management of healthcare waste occurs at all levels from segregation to its final disposal. This is alarming as about 0.8 million tons of waste is produced on a daily basis by the hospitals in the country.

In Peshawar, there are 10 teaching hospitals, several small scale specialised hospitals and laboratories. Despite presence of incinerators in public hospitals, two third of these are not functional due to several reasons.

Of private hospital, only 57 per cent have incinerators that are all functional but the incinerators are located within the health facilities in residential areas due to which people face health risks.

The study shows that there has been no segregation and colour coding of waste, no written healthcare waste management (HWM) procedures, no record of waste disposal, no safe transfer and no restricted access to internal dumping sites, no documentation of HWM tasks in job descriptions, no formal training for handling hospital waste, and no provision of protective materials for staff dealing with healthcare waste among all facilities.

It says that waste management officers in the hospitals are not qualified properly in the relevant field of environmental science and nominated by the administration concerned.

The study says that types of waste are infectious, pathological, sharps, chemical, pharmaceutical, genotoxic, radioactive, non-hazardous and general waste. It adds that 30 per cent people risk Hepatitis B, 1.8 per cent Hepatitis C and 0.3 per cent HIV.

Improper incineration causes short term health risks including skin lesions and altered liver functions while long term dangers are impairment of immune, nervous, endocrine and reproductive system.

The waste management rules were notified in 2005 by federal government in line with the Pakistan Environmental Protection Act, 1997 but those hadn’t been fully implemented yet. Following the 18th Amendment, the ministry of environment’s control was devolved to provinces and Khyber Pakhtunkhwa Assembly passed KP Environmental Protection Act, 2014.

However, rules regarding HWM have not yet been framed. There is also ambiguity about oversight responsibility, whether it should come under the department of health or environment or a collaboration of institutions.

The study has recommended effective waste management system, appointment and training of technical and dedicated personnel and installation of a centralised system away from the residential areas to save the people from ill-effects.

Published in Dawn, December 29th, 2017