A Gap Analysis in Selected Asian Countries, 3R Knowledge Hub ...

44
3R Gap Analysis and Findings
HEALTHCARE WASTE
In China, healthcare waste has not been
categorized into a special group yet, but it is
listed as part of the hazardous waste although it
is not mentioned in national statistics on
industrial solid waste/hazardous waste (ISW/
HW). According to National Catalogue of
Hazardous Waste (1998), healthcare waste in
hospitals and other medical treatment
institutions are defined as either clinical waste,
unused pharmaceuticals, used develop and fix.
Even though this definition of healthcare waste
exists in China, definition of categories
corresponding to the hazardous nature of the
different types of wastes, adequate disposal,
and proper handling methods to facilitate a
systematic healthcare waste treatment system is
missing.
In total, about 10 million tons of hazardous
waste was generated in 2002. Of this, 44% of
hazardous waste was recycled, 27% was stored,
13.5% was disposed and 15.4% was discharged.
Of the total hazardous waste generated, 40%
was produced by the chemical materials and
chemical products industry. High priority was
given to medical waste after the outbreak of
SARS, in 2002. The total amount of medical
waste generated is about 650,000 tons (1,780
tons per day) and is projected to reach around
680,000 tons by 2010.
This is because hazardous waste regulations
were nonexistent until the general provision
under the Law on Solid Waste Pollution came
into effect in 1996. The law mandates
responsible treatment of hazardous waste and
establishment of one site per locality for its
management. Halfway through the year 1999
the State Council issued implementation
guidelines for the Law in Solid Waste Pollution
that also includes regulation on hazardous
waste management.
At present, hospitals are required to dispose of
and treat their healthcare waste by themselves
and not centrally. According to the stipulations
introduced in the early 90s, hospitals at and
above county level should have their own
incinerators installed within the hospital
complex. About, 120 out of the 473 healthcare
waste producers in Shanghai own an
incinerator.
Findings
In China, hazardous waste treatment is still in its
nascent stage. The incinerators used by the
hospitals are small-scale ones designed for a
burning temperature of 800°C. In practice,
however, these incinerators cannot reach this
temperature due to low quality, inadequate
maintenance and short life expectancy.
Furthermore, secondary pollution treatment
facilities are also missing.
A field study in Shanghai reports that in most
Shanghai hospitals the following methods for the
disposal and treatment of healthcare waste are
carried out:
• Disposable medical articles such as
disposable syringes must be sent to Shanghai
Sanitation and Anti-Epidemic station as
required by the Shanghai Health Bureau.
• Organic waste/body parts (e.g. caecum)
remaining from surgery are mainly burnt in
crematories.
• Unused pharmaceuticals are sent back to the
pharmaceutical companies.
• Used developer and fixer are either recycled
by the “Yongsheng Metal Melting Factory” or
collected by individual entrepreneurs. The
branches of Shanghai Public security
Bureau dispose other inflammable, explosive
material and radioactive waste.
• Waste-recycling stations are responsible for
disposing medical packaging materials.
According to State Environmental Protection
Administration (SEPA), China, Shanghai
Hazardous Waste Management Centre and
Shanghai Environmental Protection Bureau, the
major problems and challenges faced in
managing healthcare waste are due to:
• Illegal Recycling of hazardous healthcare
waste
• Poor regulatory framework and
implementation guidelines
• Lack of enforcement of existing regulations
leading to disposal of healthcare waste with
municipal (household) waste or poor
segregation of waste into clinical and general
hospital waste
• Lack of technical guidance and missing
definition of responsibilities of authorities in
charge