| BackgroundMedical waste is the infectious, poisonous and harmful garbage produced in medical treatment, disease prevention, health care and other related activity. If medical waste was not treated properly, infection in hospital and environment pollution will occur which will be harmful to health directly. With the outbreak of the SARS, Government and hospitals paid high attention on the infection in hospital and medical waste treatment. And a lot of law of medical waste management and technical standard about centralized disposition were promulgated. Management Regulations on Medical Waste was issued on June 16, 2003 which provides legislative authority for collecting, transporting, depositing, and supervising. Medical waste should be set on fire concentrated and incinerator should be set up in one year by this regulation.Since the implementation of Management Regulations on Medical Waste, there has been great progress in medical waste management, but there are still lots of questions. Now there are technical and management defect in course and method, and there are discarding and mixing with general garbage. In order to realize the centralized processing which does least harm to environment and disease diffusion, there are lots of challenge not only from technology but also from uniform collecting, proper depositing, safe transporting, centralized disposition system and system building, so the related research about medical waste management is the a great topic in recent public health field.Our country has special character in current management and development, and there isn't all-around research up to the present. Because there is advantage in social demography of social economic population in Shandong Province, medical waste actuality was investigated in Shandong in this study cooperated under the cooperation between Shandong University and Tokyo University. Advanced conception of medical waste management such as "zero diacharge", "3R"principle: reducing, recycling, reusing and so on was introduced from Japan at the same time of knowing the waste management actuality of Shandong. Combining these advanced ideas and the technology with the current status of medical waste management in China our country medical waste management will be beneficial to solve the problems in scientific medical waste management and centralized processing and provide precious experience to the similar field.ObjectiveIn order to know the present situation of medical waste management, the quantity of medical waste and the influencing factors, the cognition level of medical personnel, and the protecting conscious of cleaning personnel in hospital. Suggestion will be given to existing questions which will provide scientific foundation to the management of medical waste, training on the related personnel and technical guidance.MethodsThis study involved three cities in Shandong Province. First, all the cities in Shandong Province were classified into three levels by its economic level. Then one city was selected random in every level. The Three samples were Dongying, Weifang and Binzhou. The hospitals in every city were classified by its level and sort .Then 2 third-tier hospitals, 2 second-tier hospitals, 4 township health centers,4 community health service stations,8 villageship health centers and 8 CDC clinic were selected random. Finally, in every third-tier hospital 20 leaders of department, 81 medical personnel ,20 cleaning personnel, in every second-tier hospital 10 leaders of department, 46 medical personnel ,10 cleaning personnel, in every township health center 5 leaders of department, 24 medical personnel ,5 cleaning personnel, in every village ship health centers/community health service stations 1 leader of department and 1 medical personnel, in CDC 3-5 related people were selected random.The study included: l)The management and the quantity of medical waste in hospital;2)The knowledge of medical personnel;3)The consciousness of protection of cleaning personnel.Correlation analysis and statistics test were done by methods of Spearman ranking correlation, chi-square test and variance analysis on the basis of general descriptive analysis about present situation and knowledge. ResultsThis study shows: (1) The quantity of medical waste was large. The average per sickbed every day was 0.8kg in hospitals in different level, which of township health center is largest, 1.5kg, and which of rural clinics should not be ignored, 0.06kg per outpatient service.and which of the CDC is 1.8kg. (2) The second-tier hospital and third-tier hospital did well, the township health center and villageship health center/ community health service station did very bad in the centralized treatment, collecting, depositing, transporting, disposing of medical waste.Only 11 hospitals handed the medical waste to processing center in 23 hospitals in which 100% third-tier hospitals and 83.3% second-tier hospitals medical waste were handed to processing center and no township health center handed them to processing center, and there are mixing with general garbage and callback as waste. the percent of immediate classifying after engendering, using especial symbol on container, using appropriative transferring tool, and using airproof ash-bin is 54.6%, 36.4%, 45.5%, 36.4% respectively. 87.5% of t villageship health center/ community health service station dealt the medical waste by themselves, only 75.0% personnel of dealing with medical waste have protecting clothing, only 46.9% of them were given physical examination .(4)The cognition of medical personnel was high. There was statistical significance of the cognition of medical personnel by occupation, education level and medical organization.The congnition rate of medical waste classification, related regulation was 53.6%, 74.2%. 98.9% personnel thought it was essential to learn related knowledge. (5)The training, physical check-up, defending measure on cleaning personnel should be strengthened. 49.7% cleaning personnel had been damaged by edge tool, and 22.1% of them couldn't deal with the wound correctly. 24.0% cleaning personnel didn't do physical check-up before working; only 56.3% of them did physical check-up regularly; 58.7% of them had taken immunity vaccination. 98.8% of them thought it was essential to get train about protecting knowledge. SuggestionsThis study suggests that: (1) The drumbeating, education and training of related knowledge about management of medical waste should be strengthened; (2)The policy of medical waste which fit the region better should be framed and perfected; (3) Correlative government department should cooperate efficiently at the same time of strengthening hospitals management and government supervision; (4)Government and hospitals should enlarge the investment on medical waste, regulate medical waste depositing measure, and building temporary depositing location; (6)In order to reduce pollution the new disposable product should be made relying on advanced technology, and new measure should be taken to deal with pollution.
|
PDF Full Text Request