MANAGEMENT of HEALTH-CARE WASTE in İZMİR

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1 MANAGEMENT of HEALTH-CARE WASTE in İZMİR Ahmet Soysal MD, PhD Hatice Şimsek MD PhD Student Dokuz Eylül University Scholl of Medicine Department of Public Health Izmir TURKEY Dilek Soysal MD, Specialist of IM Funda Alyu MD Atatürk Traning and Education Hospital Department of Internal Medicine Izmır TURKEY

2 IZMIR Turkey is a candidate member of EU. Izmir is located in the Aegean coastal region of Turkey. Izmir is the third biggest city in Turkey. The total population of İzmir is approximately 3.8 million (based on the census 2007).

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4 IZMIR There are 28 districts in Izmir. 18 districts are in the municipal borders.

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6 Health Care Waste Health-care waste includes all the waste generated by health-care establishments, research facilities and laboratories. Infectious waste (waste suspected to contain pathogens ), Pathological waste (human tissues, organ, body fluids..), Waste sharps (needles, syringes, glass..) Pharmalogical waste Genotoxic and cytotoxic waste Chemical waste, heavy metals Radioactive waste ect

7 Health Care Waste Between 75% and 90% of the waste produced by health-care providers is non-risk or general health-care waste, comparable to domestic waste.

8 SOLİD WASTE MANAGEMENT İN TURKEY. First Medical Waste Control Guide 1993 Second Medical Waste Control Guide (Appropriate with EU) First Solid Waste Control Guide 2004 open the negotiations for EU accession

9 Health Care Waste Management in Izmir In health institutions in Izmir, Municipal wastes are collected according to city solid waste management plan, Medical wastes are collected apart according to Turkey Health Care Wastes Control Guide. According to the guide, medical wastes are seperated at the health institutions and stored temporarily for maximum 48 hours in these institutions.

10 Health-Care Waste Management in Izmir Metropolitan Municipality of İzmir collects health-care waste from each hospital by 6 special registered medical waste collecting vehicles and stores it in special areas apart from the municipal waste storage areas.

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12 AIM The aim of this study was to examine the health-care waste management in 18 towns in the area of Metropolitan Municipality of İzmir, the third biggest city in Turkey, and determine the solution suggestions.

13 Methods This cross-sectional study was carried out with 825 health institutions* in 18 districts in the area of Izmir Metropolitan Municipality at The whole universe was included into the study. Data were collected from the Izmir Metropolitan Municipality and Provincial Directorate of Health records. *Institutions:Hospital, clinics, policlinics.. etc.

14 Methods Health-care waste at 18 districts in the area of Izmir Metropolitan Municipality is collected from each hospital s temporary waste stores in 48 hours time by the Metropolitan Municipality with 6 special registered medical waste collecting vehicles and stored in municipal waste storage areas.

15 Results The total amount of medical waste collected was 4841 tons/y from the 825 health institutions. 621 kgs/y for each patient s bed in 2007.

16 Results Most of the medical wastes were collected from Konak, Karşıyaka and Bornova districts and were 2308, 272 and 1020 tons/year, respectively. Population and the number of institutions in these three districts are more than in those other districs.

17 Results There were statistically significantly positive and strong correlations between the amount of health care waste collected from districts and the district population (r=0.79, p=0.00) and the number of beds for patients (r=0.83, p=0.00), respectively. These results are similar with the results of Turkey.

18 District Population Number of patient bed Amount of Health-Care Waste,tons/y Amount of Health-Care Waste,per person kgs/y Amount of Health-Care Waste,per bed kgs/y Balçova* Bornova* Buca Çiğli Gaziemir Güzelbahçe Karşıyaka Konak Narlıdere Aliağa Bayındır Foça Kemalpaşa Menderes Menemen Seferihisar Torbalı Urla İZMİR (18) TÜRKİYE

19 Results We don t have sufficient information on how the genotoxic waste e.g. waste containing cytostatic drugs, genotoxic chemicals, heavy metals, radioactive waste and chemical waste are removed. Also the Metropolitan Municipality of İzmir has got no project for the re-cycling of medical waste.

20 Conclusions In Izmir, to provide a safe health care waste management, Metropolitan Municipality must provide hazardous waste separation of health institutions, establish the sterilization units for infected wastes, concentrate on recycle projects, and provide the last storage of medical wastes in completely different, safe and special areas from the municipal waste storage areas.

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23 Thank you