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ASSESSMENT OF HOSPITAL WASTE MANAGEMENT OF SOME
SELECTED FACILITIES IN BAUCHI METROPOLIS
Ph.D. CIVIL ENGINEERING (STRUCTURES)
RESEARCH PROPOSAL
BY
USMAN ABUBAKAR
(PGS/201!201"/2/P/#0$#
DEPARTMENT OF CIVIL ENGINEERING
ABUBAKAR TAFAWA BALEWA UNIVERSITY% BAUCHI
SUPERVISORS&
PROF. A. U. ELINWA
(Ch'*'+ S,- C**33)
E+4. D. DUNA SAMSON
(M*5 S,- C**33)
APRIL% 2016
1
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1.0 INTRODUCTION
1.1& P'*57
The Establishment of a healthcare system is a basic requirement
of every civilized society. Food, medicines, chemicals, equipment
and instruments are used while treating out patients cum patients
admitted into Hospital. Naturally, this leads to production of a
variety of medical and non medical wastes. ppropriate
management and minimization e!orts need to be put in place to
reduce the quantity and volume of these types of waste. The ris"
associated with healthcare waste and its management has gainattention across world in various events, local and international
forums and summits. The genda #$ of the %nited Nations
&onference on Environment and 'evelopment (%N&E') in *io de
+ameiro, +une $#, also identi-ed healthcare waste as being
amongst the environmental issues of great concern to the global
community. &heng et al (#) noted that although medical waste
presented a relatively small portion of the total waste in a
community, its management is considered an important issue
worldwide. The %nited Nations Environment /rogram (%NE/)
argues in their 0nternational 1ource 2oo" on Environmentally
1ound Technologies for 1olid waste management that among
these wastes, healthcare waste is one of the most problematic
types.
The growing a3uence and increasing population concentrated
urban areas have increase the generation of all types of waste
including medical waste. &o"er et al (#) noted that as the
2
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demand for more healthcare facilities increases there is also an
increase in medical waste generation in Nigeria. 2abalola (#)
added that in developing countries li"e Nigeria, high H0450'1
prevalence, high morbidity among the general population has
resulted in high hospital admissions and as a result management
of the medical waste generated become a ma6or challenge in
most healthcare facilities. /oor conduct and inappropriate
disposal methods applied during handling and disposal of medical
waste is increasing signi-cant health hazards and environmental
pollution due to the infectious nature of the waste. ccess to a
clean environment has been recognized as being essential to the
improvement of healthy and social environment. The Federal
7overnment of Nigeria (F7N) has rapidly embar"ed on programs
for delivery of good sanitation to most cities town and villages
8lubu"ola (#).
0n recognition of the signi-cant of clinical waste management the
F7N through the Federal 9inistries of Environment and Health
(F98E and F98H) undertoo" a study on the management of
medical waste in $:, to assessing how critical waste could be
managed within referral and primary healthcare centers (&o"er et
al, #;). &onsequently in $
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vision to raise the environmental sustainability, human health and
natural resources, awareness to meet the needs of current and
future generations(&o"er et al, #>).
'espite all the e!ort to provide good sanitation and soundmedical management, Fadipe et al,(#) noted that numerous
aspect of clinical or healthcare waste management are found to
be haphazard and challenging in most frican Hospitals. &linical
waste is increasingly becoming a problem particularly in Nigerian
healthcare facilities (Ndubisi et al, #$). 0ndiscriminate dumping
of medical waste, clinical waste mi=ed with household waste and
this waste being conveyed using bare hands and transported in
open truc"s from some health facilities have been observed
(&o"er, #$$). 8lubo"ola(#$) noted that environmental quality
in Nigeria has deteriorated due to improper medical waste
segregation, collection, transportation and disposal methods used
in healthcare facilities. 9ongam( #$?) also added that improper
management practice are still evident from point of initial point of
generation, collection to -nal disposal. lthough, signi-cant
progresses have been made in healthcare waste management,
the e=isting healthcare waste management practices in Nigeria
still need a great deal of modi-cation and improvement.
This investigation wor" has been motivated by these
aforementioned challenges noted in medical waste management
practices in Nigerian healthcare facilities. 0t is hope that the
-ndings of this study will be used to bridge the "nowledge gap
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and improve on the medical waste management practice in
2auchi metropolis being the study area.
1.2& S3'3*+3 8 3h -57*
The non sustainable management of Healthcare waste (H&@)
has increasingly continues to generate public interest due to the
health problems associated with e=posure of human being to
potentially hazardous waste arising from healthcare. /resently,
considerable gaps e=ist with regards to the assessment of
healthcare waste management (H&@9) practices particularly in
Nigeria and in several other countries in subAsaharan frica. Thenature and quantity of H&@ generated cum institutional practices
with regards to sustainable methods of H&@9, including waste
identi-cation, segregation, collections, transportation, treatment
and -nal disposal are often poorly observed and documented in
several developing countries li"e Nigeria, despite the ris" posed
by the improper handling of the H&@ ( Farzadi"a et al, #). 0t is
also of serious concern that the level of awareness, particularly of
health wor"ers regarding H&@ has never been adequately
documented. The practical information on this important aspect of
H&@9 is inadequate and research on the public health
implications of inadequate management of H&@ are few and
limited in scope.BCocasay, #> and 8himain, #$) believed that
several hundred of tones of H&@ are deposited openly in waste
dump sites and surrounding environment, often alongside with
non hazardous solid waste. near total absence of institutional
arrangements for H&@in Nigeria has been by others (&o"er et al,
"
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$;). The poor segregation, handling and disposal practices of
many hospitals, clinics and health centers are li"ely
representatives of practices throughout Nigeria and this poses
serious health hazards to people living in the vicinity of such
healthcare facilities ('avid et al, #$#). /revious studies reported
that handling of waste at some healthcare facilities is haphazard,
with used of unacceptable methods of transport such as mortuary
trolleys (&lementina, #$D). 1tephen et al, (#$$) also added that
clinical waste has the potential to cause damage to most aspect
of the environment, especially to land, water, air and wildlife. 0t is
therefore, requires that medical waste be managed in a safe
manner using suitable treatment and disposal methods (8"e,
#>). 0t is against this bac"ground that the researcher wishes to
assess the medical waste management practices in 2auchi
metropolis healthcare facilities.
1.# 9,3:;'3+ 8 3h 3,
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The information and recommendations from the study could be
used to help in ensuring e!ective management of medical waste
in 2auchi metropolis healthcare facilities which could in turn help
to reduce ris"s to healthcare wor"ers, the community at large and
the environment. 0t is hope that the research -ndings may help
2auchi state 7overnment, departments and local authorities in
improving the e=isting policies and planning measures in order to
mitigate ris"s of improper management of medical waste. The
-ndings of the study could also enable the 1tate 7overnment
through the ministries of health and environment to address
identi-ed gaps and strengthen proper management of clinical
waste and could also help to supplement and complement the
e=isting "nowledge on clinical waste management system used in
2auchi metropolis healthcare facilities. @ith the site visits and inA
depth interviews to be conducted in the selected healthcare
facilities, sustainable medical waste management plan will be
proposed.
1.& A* '+< O5=;3
1..1& A*
The aim of this study is to conduct assessment of hospital
waste management practices and environment at some selected
healthcare facilities in 2auchi metropolis
>
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1..2& O5=;3 8 3h 3,
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number in 2auchi metropolis that registered with 2auchi state
ministry of health headquarters, 2auchi would be selected based
on the modi-ed methods of %nited Nations Environmental
/rograms5@orld Health 8rganization (%NE/5@H8, #:) and
Townend and &heeseman (#:) guidelines.
CHAPTER TWO
2. O LITERATURE REVIEW
2.1 P'*57
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8ne of the long standing and most challenging tas" for human
being is to live on a piece of land without spoiling it. Hospitals are
health institutions providing patient care services, and the public
seem to be unaware of the adverse e!ects of the garbage and
-lth they generate. 1harma (#>) added that it is ironic that
health facilities which provide succor to the ailing can also
generate various type of medical wastes. 9oving to # thcentury,
the advert of complicated diseases and ailments led to more
complicated medical waste being generated, which required more
organized methods of waste management. /oor management of
medical waste e=poses healthcare wor"ers, waste handlers and
the community to infections, to=ic e!ects and in6uries in addition
to environmental damages (/russ et al., $).
2.2 H'73h;' ?'3
Healthcare waste can be de-ned as the total waste stream that is
generated from healthcare establishments, health related
research facilities, laboratory and emergency relief donations.
Hospitals, clinics, laboratories, medical research centers,
pharmaceutical manufacturing plants, pharmacies, blood ban"s,
veterinary healthcare centers and nursing home healthcare
activities are some the generators of healthcare waste.
+ang (#$$) de-nes healthcare waste to include a number ofwaste materials such as blood soa"ed bandages, culture dishes
and other glassware, discarded needles and lancets, cultures,
stoc"s and removal body organs.
10
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1harma et al.,(#$) de-nes healthcare waste as waste arising
from medical, nursing, dental, veterinary, pharmaceutical or
similar investigative, treatment care or research practice. &o"er
(#) added that healthcare waste may prove hazardous to
those that come in contact with it. The term healthcare waste has
often been used interchangeably with other terms such as
medical waste, hospital waste, clinical waste, biomedical waste or
biohazardous waste around the world (6ang, #$$). 0n Nigeria, this
waste is generally "nown as healthcare, also @orld Health
8rganization (@H8) and other 0nternational bodies refer this
waste as healthcare waste, recognizing that all waste generated
from healthcare facilities are by product of healthcare activities
(&lementina, #$D). /russ et al., (##) used the term medical
waste as to deal with all types of produced by healthcare
facilities.
@aste generation from healthcare activities can be broadly
categorized general waste and hazardous waste (8gbonna et al.,
#$#).The ma6or portion of waste generated in healthcare
activities is composed of general waste that can be treated in the
same way as domestic waste. However, this remains true only
when proper segregation of waste is practiced according to the
type at source. There are di!erent estimates regarding the share
of hazardous and non hazardous waste constituents of healthcare
waste. 8be"pa et al., (#$#) and 1harma (#$?) estimated that
between >: and of the waste produced by healthcare
facilities is general waste comparable to domestic waste. 0n
addition Fadipe (#$$) reported that ;: of the waste produced
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in hospitals and clinics is non contaminated and pose no ris" of
infection. ccording to the @H8, between $and #:is
hazardous due to its composition. The remaining >:to
poses no ris" of infection transmission as it is comparable to
domestic waste.This mainly comprise waste produced in the
administration and house"eeping sections of the facilities.
Healthcare waste was further classi-ed into two ma6or categories
by @H8(#:)
$ Healthcare general waste is the proportion of healthcare waste
that is not hazardous and comparable to household waste.
# Healthcare ris" waste is the proportion of healthcare waste that
is li"ely to contain pathogenic organism in suGcient quantities to
cause diseases. This waste is commonly referred to as clinical
waste or biomedical waste in certain quarters and falls under
general cluster "nown as hazardous waste.
Healthcare ris" waste is further classi-ed into various other
types according to speci-c composition (8gbonna and %bani,
#$#).
0nfectious waste refers to waste which is suspected to
contain pathogens such as e=creta from patients and wound
dressing.
/athological waste consist of tissue, body parts, human
fetuses, blood and body uid
1harps are category of healthcare waste comprising of items
which can cause cuts and in6uries. These include needles,
scalpels and bro"en glass.
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&hemical waste contains residues of chemical used in
hospitals such as disinfectants and reagents used in
laboratories.
/harmaceutical waste contains remains of pharmaceutical
products such as e=pired drugs.
The below -gure shows how Hossain et al., (#$$) classi-ed
healthcare wastes which agreed with @H8 (#:) healthcare
waste classi-cation system.
F4, 2.1& C7':;'3+ 8 ?'3 8* h'73h;'
8';73 (H'+% 2011)
1#
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P7'3 1& G+'7 ?'3& Th * 8 *,+;-'7 ?'3
3h'3 ;+3 8 8< *+'+3% ,< -'-% 83
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P7'3 2& P'3h74;'7 ?'3& ;+3 8 h,*'+ 3,
,
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P7'3 #& Ph'*';,3;'7 ?'3& ?'3 ;+3'++4
-h'*';,3;'7 .4.
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P7'3& I+8;3, ?'3& ?'3 ,-;3 M
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problems facing the hospitals in developing countries in terms of
medical waste management were identi-ed
Kac" of necessary rules, regulations and instructions on
di!erent aspect of collection and disposal of waste. 9i=ing of hazardous waste with domestic waste of the
hospital.
Failure to quantify the waste generated in a reliable records.
Failure to use appropriate color bags thereby limiting the
bags used to one color for all waste.
bsence of dedicated waste manager and committees
responsible for monitoring medical waste management
practices.
Kac" of education and training on medical waste
management.
ssessment studies on medical waste management in developing
countries have detected several problems and defaults such as
segregation, handling and storage not appropriately conducted.
/ractices for waste minimization are poor, hazardous and
common waste are mingled and disposed in the open dumps or
land-lls, waste incinerators are not equipped with an emission
control apparatus, chemical waste is disposed through the public
sewage system and there are no sta! training programs (2abalola
et al., #$?). He added that some cleaners were found to salvage
used sharps, saline bags, blood bags and test tubes for resale or
reuse.
0n a study by &o"er et al., (#) in 0badan, Nigeria, it was
observed that the secondary and primary healthcare centers do
#6
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not practice any scienti-c disposal of clinical waste. Hospital
waste is often thrown in open garbage dumps or in nearby
dumps. @here waste is segregated by hospital sta!, it is done for
the purpose of retrieving useful items. This gives way to
malpractices as waste recycling by rags pic"ers and possible
reuse of used syringes has become accepted way of life. Hospitals
are currently burning waste or dumping in bins which are
transported to unsecured dumps.
*ag pic"ers in the hospital, sorting out the garbage are at a ris" of
getting tetanus and H04 infections.
#>
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P7'3>& R'4 -;@ + ' h-3'7
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P7'3 & T'+-3+4 *
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2.$ H-3'7 W'3 M'+'4*+3 P7'+
2iomedical waste management strategies include planning
and organization characterization of waste and losses,
development of waste minimization option, technical andregulatory, and economic feasibility, implementation, monitoring
and optimization continued and outgoing evaluation of reaching
zero generation status.
0mplementing e!ective biomedical waste management
programmes require multi sectional cooperation and interaction
at all levels. Establishment of national policy and a legalframewor", training of personnel, and raising public awareness as
essential elements of successful healthcare waste management.
9anagement of healthcare waste should thus be put into a
systematic, multifaceted framewor", and should become an
integral feature of healthcare services.
Each hospital is required to develop a waste management
plan that provides for a thorough segregation and treatment of
waste. The main aims of biomedical waste management are
9inimizing ris" of personnel, general public and
environment.
9inimizing the amount of waste generated.
1egregation and separation of wastes
'esignation of deposit areas in the wards.
Establishment of safety routes for the transportation of
the waste.
0
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Establishment of a safe and proper area for the
temporary storage.
/roper waste treatment and disposal.
#.0 M'3'7 '+< M3h
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to be employed and showing how the research strategy addresses
speci-c aim and ob6ective of the study(2abu et al, #). The
research focuses on an assessment of medical waste
management at -ve selected healthcare facilities in 2auchi
metropolis. The research designs to be adopted by the study are
quantitative and qualitative (mi=ed method approach).
The mi=ed method approach involves both collecting and
analyzing qualitative and quantitative data and is practical in the
sense that the researcher is free to use all method possible to
address a problem('avid and 8gbonna, #$?). The method also
helps the researcher to lay out researcher questions,
methodologies, data collection and analysis needed to conduct a
research.
#.2 S3,
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Five healthcare facilities in 2auchi 9etropolis would be selected
as a representative of the healthcare institutions in the area.
1amples for the study would include three 7overnment and two
private owned healthcare facilities. The samples would be made
up of one referral or tertiary hospital, one secondary or specialist
hospital and primary health center owned by 7overnment, while
the remaining two are to be private clinics. 2y virtue of their
numbers, T2%,Teaching hospital(tertiary) 1pecialist hospital
2auchi (secondary) and %nder-ve primary health center
automatically will be included into the samples. For the purpose of
location and patronage, *eemee and msad clinics would be
selected.
#.#.1 S3,
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/opulat ion
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Health@or"ers
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Fig. ?.# 1trati-ed random sampling plan (Tayobo and 8yeniyi,
#$#)
#. D'3' C77;3+ '+< R';h I+3,*+3
4arious research instruments would be used to ensure reliability
and validity of data that could be collected. &are would be ta"en
to ensure that the research procedures are same at each
healthcare facility included in the study sample. The use of
"
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various research instruments may li"ely improve the quality of the
research -ndings and hence the enhancement of validity of data.
#..1 ,3++'
uestionnaire would be used to collect primary data from
sampled healthcare wor"ers and ancillary sta! of the selected
healthcare facilities. uestionnaires are to be used mostly to
gather information from "ey respondent on their views concerning
the types of medical waste generated, segregation at source,
collection pattern, storage and transporting style, treatment and
disposal methods and ris"s relating to medical waste
management practices. survey questionnaire is to be adopted
because it allows participants to give their views anonymously
and this reduces bias from the researcherJs owned opinion and
also with no verbal or visual clues to inuence the respondents
(1harma, #).
#..2 S3,;3,< I+3? G,
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of segregation, handling, collection and storage are being done
accordingly and if clinical waste receptacles would be provided,
wastes are deposited in appropriate containers, transported
correctly and incinerated according to %NE/5@H8(#:) technical
guidelines on medical waste management.
9easurements would be used to e=press observations numerically
in order to investigate casual relationship. 0tems to be measured
are to be quantity of waste generated and number of patients
who visit the facilities per day. The generated waste would be
measured by ensuring that the waste type generated is put into
preAweight separate container labeled for speci-c type of waste.
digital weighing scale would be used to measured the waste. n
average weight of seven days measurement will be used to
calculate the daily generated waste type per patient and per bed.
camera would also be used in collecting data from the -eld
observations. measurement5observation sheet would be used to
record data to be obtained.
#." P73 S3,
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#.6 D'3' P+3'3+ '+< A+'7 T7
'ata analysis is a practice in which raw data is ordered and
organized so that useful information can be e=tracted from it
(9ahasa and *uhigo, #$D). The types raw data of this researchto be measurements, questionnaire responses and observation to
be made. &harts, graphs and te=tural writeAups of data are to be
used to analyze the data. These method are meant to re-ne and
distill the data so that readers can glean interesting information
without needing to sort through all the data on their own.
1tatistical /ac"age for 1ocial 1cience(1/11) will be used topresent and analyze the data that would be collected. 1ervices of
a statistician may be employed during this phase of the research
process. The raw data will be presented in tables, bar chart graph
and pie chart. 9icrosoft e=cel would be used to produce these
tables and graphs. /lates will also be used to present the
collected data. &omments will be made on each -nding.
&orrelation coeGcients for the amount of waste generated versus
the number of patients who visits the healthcare facilities survey
would calculated. The method of data presentation to be used will
help to clarify data and draw new conclusions.
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INTERVIEW GUIDE& FOR ENVIRONMENTAL OFFICER
$ To what e=tent do healthcare facilities implement and comply
with the $< Nigerian Technical 7uidelines on medical waste
management
# Has the above document being evaluated to assess if it is
addressing all clinical waste issues
? 0s the Nigerian Technical 7uidelines commensurable with
0nternational 1tandard on Environmental issuesR
"0
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D @hat are the ris"s that inappropriate clinical waste
management poses to the environment and human healthR
: How often does 21E/ monitor the management of clinical
waste in healthcare facilitiesR
< 0s clinical waste disposing same as municipal waste at land-llR
INTERVIEW GUIDE& FACILITY WASTE MANAGER/ HEALTHSAFETY OFFICER.
$ How many people visit your healthcare facility (H&F) per day
# @hat is the daily generation quantity of clinical waste in your
H&F
? How many in6uries related to clinical waste have been reportedin the past $# months
D How many health wor"ers in your H&F have received Hepatitis 2
vaccinationR
"1
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: How often is clinical waste collectedR
< 0f the clinical waste is not collected as scheduled, what do you
do with it.
> 0s clinical waste storage accessible to any person or scavengerR
; 'o you record any clinical waste management informationR
How often is inAservice training on clinical waste management
for health wor"ers doneR
$ @ho is responsible for providing a continuous clinical waste
training for for the health wor"ersR
$$ How do you manage ris" associated with clinical wasteR
$# 'o you chec" if clinical waste collected is properly incinerated
before -nal land-ll disposalR
$? @hat are the problems that you encounter in managing clinical
wasteR
$D @hat are the initiatives ta"en for e!ective managing clinical
wasteR
INTERVIEW GUIDE& PERSONNEL RESPONSIBLE FOR
CLINICAL WASTE COLLECTION AND DISPOSAL
$ How often do you collect clinical waste in this H&FR
# How much waste do you collect in Cg5dayR
? 0s the clinical waste you collect, segregated at sourceR
"2
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D @here is clinical waste store, waiting for collection and disposal
: How secure are the clinical waste storage facilities
< @hat do you used in transporting the clinical wasteR
> is the transportation of clinical to designated
; @here is clinical waste treatedR
'id clinical waste handlers received any training in
management of clinical wasteR
$ re waste handlers provided with protective clothing when
handling clinical wasteR
$$ 'o waste handlers receive any vaccination against hepatitis 2
$# @hat are the ris"s associated with clinical waste that have
been encountered by the past $# months.
$? @hat are the problems that you encountered in collection and
disposal of clinical waste.
$D @hat recommendations would you give for the improvement
of medical waste managementR
OBSERVATION/MEASUREMENT SHEET
PLACE OF OBSERVATIONAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
DAY $ # ? D : < >DATEuantity of clinical
waste generated per
"#
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dayNumber of outpatient
per day1ources of clinical
waste1egregation of waste at
source ME1 or N82ags &ontaining waste
Asecured fastened
Anot securely fastened
A/laced at the right
placeAleft for too long1upply of receptacles
dequate5inadequate
Ared plastic
Asharp container
/edal bins
8thers specify%sed of color coded
and labeled receptacles9ode of transport to
storage place
Ause of hand
Apedal bins
Aother specify%sed of protective
clothes when handling
wasteTypes of protective
"
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clothing used&linical storage room
Asecure5insecure
Aventilated5not
ventilated
Apresent of scavengers
Apresent of worms, ies
and animals
A/resent of leachates
Awaste spilling1tate of waste
Arotten
Asmelling
Adry&ollection
Acollected5not collected1torage room,
bins5trolleys cleaned
after collection@aste transportation
o!site
Aused designated
vehicle
Aused any vehicle
/resence of incineratorAincineration procedure
followed5not followed
Aresidues collected to
land-ll5not collected
""
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R8+;
"6
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A5
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B7+@h'+% 9.% I. (2006). JS3'+% N 11% 201#. B'5'37'% 9.% O. (200$). JA S3,
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D7-+4 C,+3. 9,+'7 8 W'3 M'+'4*+3%
2"% 62"!6#>. E3,*% P.% E.% 3 '7. (201#). JA 3,!1"#". H'+ 3 '7.% (2011). C7+;'7 S7< W'3
M'+'4*+3 P';3; '+< 3 I*-';3 + H,*'+
H'73h '+< E++*+3& A R?% 9,+'7 8 W'3
M'+'4*+3% #1% >"!>66. 9'+4% Y. C. (2011). I+8;3, M
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M'h''% P.% S. '+< R,h4' T.% M. (201). JM% N. 1. N4,'@'*% M. (2012). JG+'3+ '+< D-'7 8
S7
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Sh'*'% D. (201#) JG+'3+ 8 H-3'7 W'3& A+
A?'+ *-';3 8 H'73h '+< E++*+3'7
P3;3+. N'3+'7 9,+'7 8 C**,+3 M6!>"1% 2011. Y'+8,7% S. (2010) JCh'';3'3+ '+< M'+'4*+3
S3'34. 9,+'7 8 E*4+4 T+
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nita and Cumal. (#$$). S2ioA9edical @aste incineration sh
*eview with 1pecial Focus on its &haracterization, %tilization and
Keachate nalysis. 0nternational +ournal of 7eology, Earth and
Environmental 1ciences, #$$ 4ol. $, 1eptember U 'ecember, //
D;A:;.
62
7/26/2019 PHD WORK 1.docx
63/75
hmad, N., 8. and 9usa, ., E. (#$D). Sssessment of 9edical
1olid waste 9anagement in Chartoum 1tate Hospital. +ournal of
pplied and 0ndustrial 1ciences, #$D, #(D) #$A#:.
doga, et al. (#$D). SCnowledge and /ractice of 9edical@aste 9anagement among Health @or"ers in Nigeria 7eneral
Hospitals. sian +ournal of 1cience and Technology, 48K. :, issue
$# // ;??A;?;, #$D.
bdel"arim, E. and 9ohammed, 2. (#$?). S9edical @aste
9anagement case study of the 1ouss U 9assa A 'raa *egion,
9orocco. +ournal of Environmental /rotection, #$?, D, $DA$.
ltin, ., ltin (#?). S'etermination of Hospital @aste
&omposition and 'isposal 9ethods case study. /olish +ournal
of Environmental 1tudies, 48K $#, No. #, (#?), #:$A#::.
sante, 8., 2. and Mao"umah, E.,2. (#$D). SHealthcare waste
9anagement, its 0mpact case study of the 7reater ccra,
*egion, 7hana. 0nternational +ournal of 1cienti-c and Technology
*esearch, 48K. ?, issue ?, 9arch, #$D.
2azrafshan, E. and 9ostafapoor, F., C. (#$). S1urvey of
9edical @aste &haracterization and 9anagement in 0ran a case
study of sistan and 2aluchistan /rovince. +ournal of @aste
9anagement and *esearch #(D)DD#AD
7/26/2019 PHD WORK 1.docx
64/75
2len"harn, +., 0. (#
7/26/2019 PHD WORK 1.docx
65/75
Etusim, /., E., et al. (#$?). S study on 1olid waste 7eneration
and &haracterization in some selected Hospitals in 8"igwe, 0mo
1tate, Nigeria. +ournal of Educational and 1ocial *esearch. 4ol.
?(D) #$?.
Fadipe, C., T. and 8gedengbe, T., 8. (#$$). S&haracterization
and nalysis of 9edical 1olid @aste in 8sun 1tate, Nigeria.
frican +ournal of Environmental 1cience and Technology, 4ol. :
($#), //. $#>A$?;, #$$.
Fariba, 9. and Cazim, N. (#$D). Snalysis of the Healthcare
waste 9anagement 1tatus in Tehran Hospitals. +ournal ofEnvironment Health 1cience and Engineering #$D, $#$$ (#), $:#>A$:?:.
Kongs, E., 8. and @illiams, . (#
7/26/2019 PHD WORK 1.docx
66/75
9uduli, C. and 2arve, . (#$#). S&hallenges to @aste
9anagement /ractices in 0ndian Healthcare 1ector. #$#
0nternational &onference on Environmental 1cience and
Engineering 0/&2EE, 4ol. ?#, (#$#), /ress, 1ingapoore.
9artin, et al. (#$#). S/roperties of &oncrete with 9unicipal
1olid waste 0ncinerator 2ottom sh. #$# 0&10T &oimbatore
&onferences 0/&10,T 4ol. #;, (#$#), /ress, 1ingapore.
Narasimhan, +. and Fu, +. ($D). S9edical @aste
&haracterization,. +ournal of Environmental Health, 4ol. :>, No.
$.
Ngoua"am, 9. (#$#). S7eneration and 'isposal of 1olid,
&linical waste in 7eneral Hospital and 0nfectious 'isease Hospital,
0"ot E"pene, "wa 0bom 1tate, Nigeria
8lu"anni, '., 8. and 8"orie, 9. (#$D). S9edical @aste
9anagement /ractices among selected Healthcare Facilities in
Nigeria case study. cademic +ournals 4ol. ($), // D?$AD?.
8mar, '. and 1iti, N.,N., (#$#). S&linical @aste 9anagement
in 'istrict Hospital of Tumpat, 2atu /ahat and Taiping. sia
/aci-c 0nternational &onference on Environment U 2ehavior
1tudies 9ercurele 1phin= &airo Hotel, 7iza Egypt ?$, 8ctober U #
November, #$#.
1harma, '. (#$?) S7eneration of Hospital @aste n
wareness impact of Health and Environmental /rotection.
National +ournal of &ommunity 9edicine 48K. D, issue $, +anuary U
9arch, #$?.
66
7/26/2019 PHD WORK 1.docx
67/75
Toyobo, ., E and 8yeniyi, .,2. (#$#). Sppraisal of %niversity
Teaching Hospital 9edical @aste 9anagement in Nigeria &ase
studies of %niversity, &ollege Hospital (%&H) 0badan and 8bafemi
wolowo %niversity, Teaching Hospital (8%TH) 0leA0fe. %niversal
+ournal of Education and 7eneral 1tudies, 4ol. $ (), //. #A#>.
Tabashi, *. and 9arthandan, 7. (#$?). S&linical @aste
9anagement *eview on 0mportant Factory in &linical @aste
7eneration *ate. 0nternational +ournal of 1cience and
Technology, 4ol. ?, No. ?, #$?.
%mar, ., 2. and Mahaya, 9., N. (#$D). SHospital @aste9anage /ractices case study of /rimary Healthcare centers, in
Fagge Kocal 7overnment rea, Cano 1tate. $:* +ournal of
Nursing and Health 1cience 4ol. ?, issue < 4er. 00, //. #
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MATERIALS
Th *'3'7 '7+4 ?3h -;:;'3+ ?h;h 3 5 ,