ABSTRACT
Sharps waste is part of infectious medical waste; its management seems as a significant problem in Mental Hospital Lagos. This study aimed to describe the current clinical waste management at Mental hospital Lagos. The study was carried out at Yaba National Mental Hospital on clinical waste management. Twenty five (25) staffs of Yaba National Mental hospital and 25 people living nearby the hospital participated in the study. Non probability purposive sampling method was used to recruit study participants. A questionnaire, observation and focus group discussion was done in order to know the real practice of sharp waste at the hospital. It was found out that there is a great diseases transmission risk posed by poorly disposed sharp waste at the hospital. Also there is environmental pollution caused by sharp waste following poor planning and monitoring of health care waste; inadequate financial resources and equipment, lack of motivation and negligence of health care workers. Hospital management should plan and implement on the best ways. Sharps waste can be managed to avoid unnecessarily disease transmission and environmental pollution.
CHAPTER ONE
INTRODUCTION
1.1 Background of study
Common medical materials treated as sharps waste are injection devices, syringes, blades, lacent and slides (Memish et al., 2002). Numbers of studies have indicated that; inappropriate and poor handling disposal of healthcare waste poses health risks such as hepatitis to health workers who may be directly exposed to waste and to people who live nearby health facilities particularly children and scavengers (Abah and Ohimain, 2011).
Sharp waste is a common problem in developing countries including Lagos, in study done in Nigeria mainland at the municipal health facilities level found that sharps waste was transported by hands leading to high risks of exposure to needle stick injuries (Manyele et al., 2003). Moreover it was found that boots, aprons and masks were among the personal protective equipment missing in health facility, while latex gloves that cannot protect workers from injuries caused by sharps waste were readily available at the hospital (Manyele et al., 2003). According to Manyele and Lyasenga (2010) African countries practicing poor medical waste management which also including sharp waste as they quoted to (Leonard, 2003; Manyele et al., 2003, Manyele, 2004a; Manyele 2004b; Manyele and Anicetus, 2006).
Management of sharps wastes needs greater attention because of the risks to both human health and the environment caused by inadequate waste management practices. Urgent actions are needed to save the current situation on clinical waste management at Mental hospital, if the situation is neglected it can cause health risk to the surrounding people. A study done in Nigeria mainland in municipal health facilities found that patients are at higher risk of infection with needle sticks or sharps during medical care. Frequency of these injuries is related to the daily tasks of each health care group such as doctors, nurses, and waste handlers as well as the patients in the hospital and nearby community (Manyele et al, 2003).
Sharps waste is a product of provision of health care. Its poor management exposes health care workers, waste handlers and the community to infections, toxic effects and injuries including contamination of the environment, resulting in an increased burden of disease worldwide. The World Health Organization estimates that each year there are 8 to 16 million new cases of Hepatitis B virus (HBV), 2.3 to 4.7 million cases of Hepatitis C virus (HCV) and 80,000 to 160,000 cases of human immune deficiency virus due to unsafe injections and mostly arising from very poor waste management systems in various health care facilities (WHO, 1999).
Mismanagement of healthcare waste poses health risks to people and the environment by contaminating the air, soil and water resources. Hospitals and healthcare units are supposed to safeguard the health of the community. However health care wastes, if not properly managed can pose greater threat than the original diseases themselves found in health care waste (Abah and Ohimain, 2011).
The current disposal method adopted by the various health care facilities, which is dumping and burning medical wastes in open premises poses health risks to patients and people living closer to health care facilities (Kuroiwa et al., 2008). For instance, when medical waste burnt, dioxin is a major air pollutant of concern from chlorinated polymer as reported by the World Health Organization (WHO, 2004).
Hazardous health care wastes poses potential risk of injury or infection to all exposed person such as medical staffs, doctors, nurses, sanitary staff and hospital maintenance personnel, patients receiving treatment in health care facilities as well as their visitors and relatives. In addition workers who support services linked to health care facilities such as laundries, waste handling, transportation services and workers in waste disposal facilities have great risk of infection compared to other health professions. Furthermore scavengers and general public especially children who play with items scavenged from open waste dumps, are all at risk (HPCSA, 2008).
The WHO (2002) estimates that over 20 million infections of Hepatitis B, C and HIV occur yearly occurred in the world due to unsafe injection practices, reuse of syringes and needles in the absence of sterilization. Improperly disposed hazardous health care waste also poses indirect risks to humans through direct environmental effects by contaminating soils and ground water of respectively place (Abah and Ohimain, 2011).
During open burning or incineration of hospital waste, air pollutants are released into the atmosphere causing respiratory illnesses to nearby populations. Immediate improvements in the waste disposal system can be achieved through a combination of waste segregation and a simple high temperature system as means of disposing medical waste (Abah and Ohimain, 2011).
The study aimed to assess the current clinical waste management and its impacts to the environment of Yaba Mental hospital. This hospital care insane people who has poor insight and bizarre behaviour and they do not care about their health. Insane people are in great risk of acquiring communicable disease due to playing with rubbish and disposal matters.
1.2 Problem Statement
Medical sharp waste is a growing problem in Lagos where the disposal sites are few. There is a poor method of handling it which is unsafe to the handler and the environment. Sharp wastes are dumped in open pits so it is very easy for children to play with it as well as patient. Client cared in Mental hospital are insane and sometimes experiencing hallucination and illusion which influence their insight and behavior (Patel, 2008).
There are no studies on clinical waste management and its environment impact conducted in Lagos especially mental hospitals. The magnitude and impact of poor management of sharp waste in Mental hospital still is inadequately known so it is necessary to conduct study in order to explore the real situation for better reservation of environment and prevention of communicable diseases in surrounding society.
1.3 Research Objectives
1.3.1 General Objective
The main objective of the study was to assess the management of sharp wastes and their impact on health and the environment at Yaba Mental Hospital, Lagos.
1.4 Specific Objectives
(i) To evaluate the risks posed by clinical waste management at Yaba Left
(ii) To determine the extent of environment contamination due to clinical waste management at Yaba Left
(iii) To establish the barriers that hinder safe handling and disposal of sharps waste.
(iv) To assess the awareness of the community, medical personnel and waster handlers on health and environmental effect of clinical waste management
1.5 Hypotheses
(i) Risk factors associated with sharp waste around Yaba Mental Hospital is high.
(ii) The extent of environment contaminated with sharp waste is high in Yaba Mental Hospital.
(iii) Inadequate resources hinder safe handling of sharp waste at Yaba Mental Hospital.
(iv) Lack of knowledge of community members, medical personnel and waste handler on health and environmental effect of clinical waste management affects proper management of sharp waste at Yaba Mental Hospital.
1.6 Significance of the Study
Clinical waste management is of increasing importance in the issue of public health and environmental conservation. This study provides detail information about clinical waste management and how it affects the environment and community surrounding the hospital. The information gained will be a guide for proper handling and disposal of sharp waste in the hospital.
Findings of this study is useful to health workers, hospital management, Municipal Council and community surrounding the environment of hospital that are at great risk to the impact of poor management of sharp waste in the hospital. Also the study is a
starting point for further studies on clinical waste management and generates new knowledge to the community.
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