10 Qualitative Characterization of Healthcare Wastes
169
in the microbiological laboratories based on pathogenicity into four risk classes,
where E. coli and Salmonella spp. are classified within Risk Group 2 (moderate
individual risk, low community risk) and Risk Group 3 (high individual risk, low
community risk), while P. aeruginosa, E. faecalis, K. pneumonia, and S. aureus are
within Risk Group 2. Subsequently, it can be noted that these wastes lay between
the non-hazardous wastes which have microbial loads that belong to the Risk Group
1 (no or low individual and community risk) and high hazardous wastes which contain
infectious agents within Risk Group 4 (high individual and community risk).
Human body fluids (HBFs) are among the various types of the clinical wastes
which have high potential source for surviving infectious agents due to the presence
of the survival factors such as nutrients and growth factors available in the blood
(Pruss et al. 1999). Moreover, blood has high nutritive value and can be considered
as enriched medium for bacterial and fungal growth (Carrwtero and Pares 2000). In
this paper, the quantities and qualities of the clinical wastes as well as the health risk
associated with these wastes in the developing countries are reviewed.
10.2 Clinical Waste Generation
The amount of clinical waste generated from different healthcare facilities, which has
been increased at a rapid pace in recent years, has drawn serious attention from the
society. In Malaysia, it was estimated that the total quantities of the clinical wastes
have increased from 3,303 to 18,055 tons per year during the period between 1997
and 2012. In 2010, 8000 tons was generated, while it is expected to reach 33,000 in
2020 (DS 2013; Ambali et al. 2013). Clinical wastes represent more than 50% of the
total solid and liquid wastes generated from the healthcare facilities, with 10–25%
of them classified as high-risk wastes (Shinee et al. 2008).
The quantities of the clinical wastes vary among countries depending on the
total population and healthcare facilities as well as the size and type of the medical
institution and number of patient care. In the United States of America, the quantities
of the clinical wastes were estimated to be 6,600 tons of waste per day. In 2012,
Malaysia had more than 398 hospitals (147 public and 251 private hospitals) with
42707 versus 14165 beds for public and private hospitals, respectively (DS 2013).
Based on the daily amount of clinical wastes generated in Malaysia (1.9 kg/bed/day),
the estimated quantities of clinical wastes generated from public hospitals in 2012
were 29,617.546 tons/year. However, DS (2013) reported that only 18,055 tons have
been handled for destruction by incinerator. It was due to that the maximum loading
capacity for incinerators in Malaysia is 18,000 tons/year (Frost and Sullivan 2010).
In comparison, Yemen has only 56 hospitals which generate different clinical wastes
(MPHP 2012). The quantities of the clinical wastes are between 7000 and 10,000
tons/year.
The studies indicated that the quantities of the clinical wastes generated from
the developed countries are more than that for developing countries (Fig. 10.2).
For instance, in North America, 5.5 kg/bed/day are generated compared to
169
in the microbiological laboratories based on pathogenicity into four risk classes,
where E. coli and Salmonella spp. are classified within Risk Group 2 (moderate
individual risk, low community risk) and Risk Group 3 (high individual risk, low
community risk), while P. aeruginosa, E. faecalis, K. pneumonia, and S. aureus are
within Risk Group 2. Subsequently, it can be noted that these wastes lay between
the non-hazardous wastes which have microbial loads that belong to the Risk Group
1 (no or low individual and community risk) and high hazardous wastes which contain
infectious agents within Risk Group 4 (high individual and community risk).
Human body fluids (HBFs) are among the various types of the clinical wastes
which have high potential source for surviving infectious agents due to the presence
of the survival factors such as nutrients and growth factors available in the blood
(Pruss et al. 1999). Moreover, blood has high nutritive value and can be considered
as enriched medium for bacterial and fungal growth (Carrwtero and Pares 2000). In
this paper, the quantities and qualities of the clinical wastes as well as the health risk
associated with these wastes in the developing countries are reviewed.
10.2 Clinical Waste Generation
The amount of clinical waste generated from different healthcare facilities, which has
been increased at a rapid pace in recent years, has drawn serious attention from the
society. In Malaysia, it was estimated that the total quantities of the clinical wastes
have increased from 3,303 to 18,055 tons per year during the period between 1997
and 2012. In 2010, 8000 tons was generated, while it is expected to reach 33,000 in
2020 (DS 2013; Ambali et al. 2013). Clinical wastes represent more than 50% of the
total solid and liquid wastes generated from the healthcare facilities, with 10–25%
of them classified as high-risk wastes (Shinee et al. 2008).
The quantities of the clinical wastes vary among countries depending on the
total population and healthcare facilities as well as the size and type of the medical
institution and number of patient care. In the United States of America, the quantities
of the clinical wastes were estimated to be 6,600 tons of waste per day. In 2012,
Malaysia had more than 398 hospitals (147 public and 251 private hospitals) with
42707 versus 14165 beds for public and private hospitals, respectively (DS 2013).
Based on the daily amount of clinical wastes generated in Malaysia (1.9 kg/bed/day),
the estimated quantities of clinical wastes generated from public hospitals in 2012
were 29,617.546 tons/year. However, DS (2013) reported that only 18,055 tons have
been handled for destruction by incinerator. It was due to that the maximum loading
capacity for incinerators in Malaysia is 18,000 tons/year (Frost and Sullivan 2010).
In comparison, Yemen has only 56 hospitals which generate different clinical wastes
(MPHP 2012). The quantities of the clinical wastes are between 7000 and 10,000
tons/year.
The studies indicated that the quantities of the clinical wastes generated from
the developed countries are more than that for developing countries (Fig. 10.2).
For instance, in North America, 5.5 kg/bed/day are generated compared to