ENVIRONMENTAL AND HEALTH IMPLICATIONS OF MANAGEMENT OF MEDICAL WASTES IN SELECTED HOSPITALS IN NIGER STATE, NIGERIA

Abstract

Generation of medical wastes is a global issue and if not properly managed, could constitute potential risks to the environment and public health. It concerns everyone. Unfortunately, awareness that it causes environmental pollution is low in many parts of the globe, especially in the developing countries. This study was carried out with the aim of examining the environmental and health implications of management of medical wastes in some parts of Niger State, Nigeria. Accordingly, public and private hospitals were selected using purposive method. Ten hospitals were selected for the study. A cross-sectional study design was used to examine the current practice of medical wastes management systems and morbidity in children (≤ 10 years) using questionnaire, field participant observations, interviews and focus group discussions (FGD). Samples of wastewater were taken from the hospitals during the period for laboratory tests. A longitudinal study design was conducted to determine the hospitals wastes composition and generation rates. Collection and weighing of wastes from all departments of the sampled -hospitals using a calibrated sensitive weight scale for seven consecutive days were done. Data description was made using mean, graph, standard deviation (SD), frequency, and percentage. Majority of the staff of the hospitals were nurses/midwives (49.7%), paramedical (33.8%), medical doctors (9.7%) and waste handlers (6.8%). From the responses, about 72.7% of the respondents said only syringe and needle wastes were segregated, 98.1% said that the hospitals have no waste management manual and plan while 98.6 had no specific training on medical wastes management. Use of wheel barrows was the commonest means of transporting wastes and open surface burning was the common final method of medical wastes treatment and disposal by the hospitals. Hospital wastewater treatment plants were not available in all the selected hospitals thus wastewater was discharged directly into the environment. Wastewater quality parameters (pH, BOD, COD, TSS, DO, TC and FC), all indicated severe pollution of the hospital wastewater. Risk ratios (RR) for respiratory, intestinal and skin infections were 0.25:0.18, 0.44:0.31 and 0.27:0.19 respectively indicating that, the exposed children suffered more from such diseases than the unexposed. Average generation rates of hazardous hospital medical wastes in the selected public hospitals were 0.71kg/bed/day, 0.92kg/patient/day, while those of the private hospitals were 0.10kg/bed/day and 0.13kg/patient/day. Similarly, the average rate of the total hazardous wastes generation for the inpatients and outpatients was 0.25 kg/patient/day. Percentage average hazardous wastes components generated in each of the hospitals based on the number of patient /bed/days were; H1: 58.21%, H2: 65.01%, H3: 61.41%, H4: 52.70%, H5: 64.49%, H6: 60.36%, H7: 61.33%, H8: 53.27%, H9: 67% and H10: 57.26%. From this result therefore, it could be concluded that, improper medical wastes management in the selected hospitals were generally poor due to absence of medical wastes management policies and plans, inadequate financial resources, poor awareness and training of medical personnel. Therefore, there is an urgent need for raising awareness among stakeholders on healthcare waste management issues (segregation, storage, collection, transport, treatment and disposal) and their relevance in addressing public health and environmental issues.