Adnane Mbarki^*, Belkacem Kabbachi, Abdelkarim Ezaidi, Mohamed Benssaou

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Environmental Sciences and Geoscience Department, Faculty of Sciences, University Ibn Zohr, Agadir, Morocco.
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Abstract:

Medical waste management is of major concern due to the potentially high risks to both human health and the environment caused by inadequate waste management practices. In Morocco, as in many developing countries, little information is available regarding generation handling, and disposal of medical waste. The specific objective of this study was to analyse the medical waste management practices in the Souss-Massa-Draa region, Morocco. The study was carried out in seven of the twelve hospitals in the region, covering 66.2% of the bed capacity. A total of 219 healthcare personnel and their assistants were included: 35 doctors, 98 nurses, and 86 housekeepers. Site visits, interviews, and survey questionnaires were implemented to collect information regarding different medical waste management aspects, including medical waste generation, separation, collection, storage, transportation, and disposal. The results indicated that the medical waste generation rate ranged from 0.4 to 0.7 Kg/bed-day with a weighted average of 0.53 Kg/bed-day. The percentage of infectious and hazardous wastes in the total medical waste stream was about 30.5%. The remaining 69.5% was general wastes similar in properties to municipal wastes. Concerning waste separation, housekeepers demonstrate a slightly higher knowledge about waste separation, with 49.4% of correct answers, with nurses at 45.7%, and doctors the lowest value at 38.6%. The results about other management aspects indicated that practices in most surveyed hospitals did not comply with the principles stated in Moroccan legislation. Based on the findings, some measures are suggested to improve the present conditions and ensure that potential health and environmental risks of medical waste are minimized.

Keywords: Environment; Health; Healthcare Personnel; Medical Waste; Morocco

Cite this paper: A. Mbarki, B. Kabbachi, A. Ezaidi and M. Benssaou, "Medical Waste Management: A Case Study of the Souss-Massa-Drâa Region, Morocco," Journal of Environmental Protection, Vol. 4 No. 9, 2013, pp. 914-919. doi: 10.4236/jep.2013.49105.

References

[1]   M. Tsakona, E. Anagnostopoulou and E. Gidarakos, “Hospital Waste Management and Toxicity Evaluation: A Case Study,” Waste Management, Vol. 27, No. 7, 2007, pp. 912-920. doi:10.1016/j.wasman.2006.04.019

[2]   WHO, “Safe Healthcare Waste Management: Policy Paper,” World Health Organization, Geneva, 2004.

[3]   M. A. Patwary, W. T. O’Hare, G. Street, K. M. Elahi, S. S. Hossain and M. H. Sarke, “Country Report: Quantitative Assessment of Medical Waste Generation in the Capital City of Bangladesh,” Waste Management, Vol. 29, No. 8, 2009, pp. 2392-2397. doi:10.1016/j.wasman.2009.03.021

[4]   S. A. Tamplin, D. Davidson, B. Powis and Z. O’Leary, “Issues and Option for the Safe Destruction and Disposal of Used Injection Materials,” Waste Management, Vol. 25, No. 6, 2005, pp. 655-665. doi:10.1016/j.wasman.2004.07.007

[5]   WHO, “Healthcare Waste Management,” World Health Organization, Geneva, 2005.

[6]   B. K. Lee, M. J. Ellenbecker and R. Moure-Eraso, “Alternatives for Treatment and Disposal Cost Reduction of Regulated Medical Waste,” Waste Management, Vol. 24, No. 2, 2004, pp. 143-151. doi:10.1016/j.wasman.2003.10.008

[7]   L. F. Diaz, G. M. Savage and L. L. Eggerth, “Alternatives for the Treatment and Disposal of Healthcare Wastes in Developing Countries,” Waste Management, Vol. 25, No. 6, 2005, pp. 626-637. doi:10.1016/j.wasman.2005.01.005

[8]   C. E. Silva, A. E. Hoppe, M. M. Ravanello and N. Mello, “Medical Wastes Management in the South of Brazil,” Waste Management, Vol. 25, No. 6, 2005, pp. 600-605. doi:10.1016/j.wasman.2004.03.002

[9]   F. Abdulla, H. A. Qdais and A. Rabi, “Site Investigation on Medical Waste Management Practices in Northern Jordan,” Waste Management, Vol. 28, No. 2, 2008, pp. 450-458. doi:10.1016/j.wasman.2007.02.035

[10]   M. Askarian, M. Vakili and G. Kabir, “Results of Hospital Waste Survey in Private Hospitals in Fars Province, Iran,” Waste Management, Vol. 24, No. 4, 2004, pp. 347-352. doi:10.1016/j.wasman.2003.09.008

[11]   E. Shinee, E. Gombojav, A. Nishimura, N. Hamajima and K. Ito, “Healthcare Waste Management in the Capital City of Mongolia,” Waste Management, Vol. 28, No. 2, 2008, pp. 435-441. doi:10.1016/j.wasman.2006.12.022

[12]   Ministry of Health, “Handbook of Medical Waste,” MOH, Kingdom of Morocco, 2010, pp. 35-44.

[13]   W. H. Bassett, “Clays Handbook of Environmental Health, 16th Edition, Chapman & Hall Medical, London, 1992, pp. 615-656.

[14]   MOHP, “Handbook of Hazardous Health Care Waste Management,” Ministry of Health and Population, Bangkok, 1995, pp. 54-86.

[15]   Centers for Disease Control and Prevention, “Guidelines for Protecting the Health and Safety of Health Care Workers,” CDC, Atlanta, 1998. pp. 88-119.

[16]   E. Cole, “Health Care Waste Management within Hospitals,” 3rd Edition, C.V. Mosby, St Louis, Baltimore, 1998. pp. 168-247.

[17]   A. Pruss, E. Giroult and P. Rushbrook, “Safe Management of Wastes from Healthcare Activities,” World Health Organization, Geneva, 1999.

[18]   World Health Organization, “Safe Management of Waste from Health Care Activities,” Western Pacific Regional Office Preparedness, WHO, Geneva, 2003, pp. 58-64.

[19]   M. S. Kaiser Alam Sarkar, M. A. Haque and T. A. Khan, “Hospital Waste Management in Sylhet City,” ARPN Journal of Engineering and Applied Sciences, Vol. 1, No. 2, 2006.

[20]   M. M. Abd El-Salam, “Hospital Waste Management in El-Baheira Government, Egypt,” Journal of Environmental Management, Vol. 91, No. 3, 2010, pp. 618-629. doi:10.1016/j.jenvman.2009.08.012

[21]   M. E. Birpinar, S. B .Mehmet, et al., “Medical Waste Management in Turkey: A Case Study of Istanbul,” Waste Management, Vol. 29, No. 1, 2009, pp. 445-448. doi:10.1016/j.wasman.2008.03.015

[22]   R. Y. Gai, L. Z. Xu, H. J. Li, C. C. Zhou, J. J. He, S. Yoshihisa, W. Tang and K. Chushi, “Investigation of Healthcare Waste Management in Binzhou District, China,” Waste Management, Vol. 30, No. 2, 2010, pp. 246-250. doi:10.1016/j.wasman.2008.08.023

[23]   N. Marincovic, T. Pavic, K. Vitale, N. J. Holcer and A. Dzakula, “Management of Hazardous Medical Waste in Coatia,” Waste Management, Vol. 28, No. 6, 2008, pp. 1049-1056. doi:10.1016/j.wasman.2007.01.021

[24]   L. Galtier and C. Bekaert, “Healthcare Waste Management on an International Scale,” Appropriate Environmental and Solid Waste Management and Technologies for Developing Countries, Vol. 1, ISWA 2002, Istanbul, 2002, pp. 289-294.

[25]   C. C. Lee and G. L. Huffman, “Medical Waste Management/Incineration,” Journal of Hazardous Materials, Vol. 48, No. 1-3, 1996, pp. 1-30. doi:10.1016/0304-3894(95)00153-0

[26]   L. F. Diaz, L. L. Eggerth, Sh. Enkhtsetseg and G. M. Savage, “Characteristics of Healthcare Wastes,” Waste Management, Vol. 28, No. 7, 2008, pp. 1219-1226. doi:10.1016/j.wasman.2007.04.010

[27]   N. Gardan, “Professional Development, Infection Control, the Role of the Nurse,” Nursing Journal, Vol. 4512, 1991. pp. 23-32.

[28]   K. Kisliore and O. K. Ingle, “Biomedical Waste Management in India,” Century Publications, New Delhi, 2004, p. 144.

[29]   WHO, “Management of Solid Health-Care Waste at Primary Health-Care Centres: A Decision-Making Guide,” World Health Organization, Geneva, 2005.

[30]   M. Alvim-ferraz and S. Afonso, “Incineration of Healthcare Wastes: Management of Atmospheric Emissions through Waste Segregation,” Waste Management, Vol. 25, No. 6, 2005, pp. 638-648. doi:10.1016/j.wasman.2004.07.017

[31]   A. Coad, Christen and J. March, “How Are We Managing Our Healthcare Waste,” Skat Publisher, Switzerland, 1999.