Pengelolaan Limbah Medis

Type of medical waste Medical waste may be classified into different types according to the source, type and risk factors associated with their handling, storage and ultimate disposal Typically : Non-clinical and clinical waste

Further division of clinical waste results in the following categories Infectious waste (e.g. lab cultures, wastes from isolation wards, tissues, used dressings) Pathological waste (e.g. body parts, human fetuses, placentas, blood and other body fluids) Pharmaceutical waste (e.g. unwanted drugs, expired drugs) Chemical waste (e.g. chemical from diagnostic work, cleaning materials) Sharps (e.g. needles, blades and broken glass) Radioactive waste (e.g. radioactive substances from radiotherapy and lab work) Pressurized containers (e.g. gas cylinders, cartridges and aerosol cans) High heavy metal content (e.g. batteries, broken thermometers, blood pressure gauges)

Radioactive waste Radioactive medical waste tends to contain beta particle and gamma ray emitters. It can be divided into two main classes. In diagnostic nuclear medicine a number of short-lived gamma emitters such as technetium-99m are used. Many of these can be disposed of by leaving it to decay for a short time before disposal as normal trash. Other isotopes used in medicine, with half-lives in parentheses: Y-90, used for treating lymphoma (2.7 days) I-131, used for thyroid function tests and for treating thyroid cancer (8.0 days) Sr-89, used for treating bone cancer, intravenous injection (52 days) Ir-192, used for brachytherapy (74 days) Co-60, used for brachytherapy and external radiotherapy (5.3 years) Cs-137, used for brachytherapy, external radiotherapy (30 years)

SEGREGATION AND STORAGE

BIN

Transportasi

TREATMENT PROCESS

Pengolahan Autoclaves; Microwave disinfection systems; Chemical methods; Combustion (low, medium, and high technology); and Disposal on land (e.g. dump site, controlled landfill, pits, and sanitary landfill)

Autoclave

Type of waste for autoclave Sharps; Cultures; Items contaminated with blood; Residues from surgery and from isolation wards; Bandages, gauze, linen, gowns, and other similar materials (also known as “softs”) Non-chemical laboratory wastes.

Microwave disinfection systems Microwaves are very short waves in the electromagnetic spectrum and are within the range of the radio frequency band.

Chemical methods It has also been an option to treat medical wastes. Chemical methods of microbial control include antiseptics and disinfectants, which are non-specific for the cells that they affect. Antiseptics are used on animate objects, while disinfectants are used on inanimate objects.

Cont’d These agents act at the cellular levels, to damage the cell wall or the membrane of the cell, and at the molecular levels, to alter protein and DNA synthesis or cause inhibition through enzymatic reactions

Cont’d Ideally, a disinfectant should have the following characteristics: Capable of destroying all microorganisms as well as viruses; Possess a high degree of stability; Not toxic to humans or to animals; Soluble in water; Tasteless and odorless; and Relatively inexpensive.

Cont’d Chemical disinfectants generally are used to treat the following types of materials: sharps; cultures and stocks; items contaminated with blood, liquid human and animal wastes; residues from surgery and from isolation wards; bandages, gauze, linen, gowns, and other similar materials; and non-chemical laboratory wastes.

Combustion Infectious healthcare waste may be treated by combusting it in a variety of methods. Any method used for the combustion of solid wastes generally produces three types of discharges: gaseous, liquid, and solid

Low combustion In many developing countries, some fractions of healthcare wastes, and in particular used injection equipment, are commonly burned in the open air or in simple and oftentimes improvised units such as pits, burners (made out of brick or cement), and in drums.

Medium- and high-technology combustion

Radioactive waste

Pemajanan Terdapat 3 kategori orang yang dapat terpajan dengan limbah berbahaya dari rumah sakit, yaitu : 1. Pasien 2. Personel rumah sakit 3. Pengunjung

Program Kesehatan Kerja untuk Mengurangi Risiko Kesehatan Penggunaan bahan yang aman Penggunaan wadah tertutup untuk bahan-bahan yang bersifat volatil Penggunaan ventilasi yang baik sesuai dengan prinsip kesehatan kerja Penggunaan Alat Pelindung Diri (APD) seperti sarung tangan dan masker

Program Kesehatan Kerja untuk Mengurangi Risiko Kesehatan Penggunaan wadah dengan warna yang berbeda untuk setiap jenis limbah Pemantauan rutin terutama terhadap aktivitas yang berisiko tinggi Penggunaan analisis epidemiologis untuk menentukan apakah kelompok atau sub kelompok tertentu akan mengalami risiko berlebihan terhadap penyakit tertentu Kemungkinan pengaruh risiko terhadap masyarakat luar seperti risiko pencemaran udara, air, dan tanah