LAHORE, Aug 10: Punishment of a one-month imprisonment or a fine of Rs10,000 or both has been proposed for the people found guilty of failure to ensure safe disposal of hospital waste in the first-ever Draft Hospital Waste Management Rules ready for submission to the Punjab government for enforcement.
The rules fixing the responsibility for hospital waste management from general to final disposal have been drafted by a committee, headed by prominent environmentalist Dr Pervez Hassan constituted by the Lahore High Court bench hearing a writ petition filed for the return of the Mahmood Boot Landfill Site by its former owners.
The constitution of a provincial hospital waste management advisory committee, headed by the health secretary and consisting of the local government secretary, directors general of health services and environment, vice-chancellor of a medical university, medical superintendents of two public sector and two private sector hospitals, representatives of two Egos and Pakistan Medical Association president or his representative has been proposed for periodical review of implementation of the rules.
Formation of the waste management teams, comprising heads of various departments, infection control officers, senior radiologists, nursing superintendents, engineers, sanitation officers and Solid Waste Management representatives headed by medical superintendents has been proposed in all the hospitals.
The teams will be responsible for planning, monitoring, periodic review, revision or updating the waste management plan formulated under the rules. One of the committee members will be nominated as the waste management officer and will be responsible for preparing a plan for ensuring internal collection of waste bags and containers and transport to a central storage facility daily for disposal within 24 hours.
The officer will ensure that the sanitary workers are not involved in waste segregation and only handle waste bags and containers in accordance with the provisions of the Standard Operational Procedures Guidelines. The medical superintendents will also arrange regular waste audit of the hospital by an internal or external agency designated by the government.
The responsibility for proper management of waste generated in different departments of the hospitals is proposed to be fixed on the heads and making it mandatory for them to arrange proper training of the nurses, doctors, clinical and non-clinical staff for the purpose. They will also be required to ensure installation of syringe cutters in all the hospital wards.
Appointment of infection control officers, senior pharmacists and radiology control officers has also been proposed in every hospital to advise on methods of controlling infection and standards of infectious, pharmaceutical and radioactive waste disposal systems and ensuring training of the nursing staff, medical assistants and sanitary staff for the purpose.
The hospital engineers will be responsible for installation, maintenance, and safe operation of waste storage facilities and waste handling equipment.
It has been proposed to segregate the risk waste from the non-risk at source i.e the ward, operation theatre, laboratory or any other place in the hospital where it is generated and ensure cutting or breaking of all disposable medical equipment like syringes, needles, plastic bottles, drips and infusion bags immediately after use.
All risky waste other than sharps, pharmaceutical or chemical waste with quantity of mercury or cadmium such as broken thermometers or used batteries or radioactive waste shall be placed in properly marked metallic containers with lids and lined with strong yellow plastic.
Large quantities of pharmaceutical waste shall be returned to the suppliers for destruction and smaller quantities placed in yellow bags after crushing. Large quantities of chemical waste and waste with a high mercury content shall not be incinerated and placed in chemical resistant containers for dispatch to specialized treatment facilities.
Radioactive waste containers shall be properly labelled and waste would be stored under the supervision of the nuclear medicine physicians pending its return to the suppliers for disposal.
Every hospital shall establish central waste storage facilities close to the incinerators and away from the food storage and preparation areas. Waste shall not be stored for more than 24 hours.
All risk waste will be inactivated or made safe before disposal by suitable thermal, chemical, irradiation, incineration, filtration or other treatment. The yellow-bagged waste shall be disposed of by burning in an incinerator or burial in a landfill site. Ash and residues from incineration shall be sent for burial at the landfill sites located at places with minimum risk of pollution of groundwater or rivers.
Risk and non-risk waste shall be buried in separate areas. All liquid infectious waste shall be discharged into the sewerage system after proper treatment and disinfection. Only the district governments will arrange transportation of waste outside the hospitals.