曾獲“腹腔鏡子宮肌瘤剜除術(shù)”科技課件

WHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)RichardM.CarrWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)ContentofPresentationNeedsAssessmentNationalActionPlansRelativeRisksTechnologyOptionsWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NeedsAssessmentWHYNeeded?IdentifieshealthrisksDescribescurrentmanagementpracticesRaisesawarenessProvidesinformationonamounts andtypesofwastegeneratedSupportsdevelopmentofaNationalActionPlanWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NeedsAssessmentHow?AssessHCWMatrepresentativefacilitiesofallsizesand intypicalsettingsInterviewfacilitystaffatalllevelsInterviewstafffromkeygovernmentagencies,NGOs, andmunicipalitiesEvaluatecurriculumsatSchoolofPublicHealth,Medicine Nursing,etc.AssesscurrentlawsgoverningHCWMWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NeedsAssessmentTools/Resources

WHORapidAssessmentTool(RAT)Aide-MemoireSafehealth-carewastemanagementWebsites:

TechnicaloptiondatabaseonwebsiteWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NationalActionPlanSuccessfulHCWMStrategiesInclude:

NationalpolicyforsafeHCWMComprehensivesystemofHCWMAwarenessandtrainingSelectionofoptionsforHCWMWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NationalActionPlanNationalpolicyforsafeHCWMDesignateresponsibleauthorityRegulatoryframework&guidelinesAssessmentofstatus&problemsOverallwastemanagementplanMonitoring&evaluationWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NationalActionPlanComprehensivesystemforHCWMAssignwastemanagementresponsibilitiestostaffAllocateResourcesMinimizationofwaste(procurement)SegregationofwasteSafecollection,handlingandstorageSafetreatmentanddisposalWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NationalActionPlanAwarenessandTrainingAddwastemanagementtothecurriculaforhealth-carepersonnelDevelopnationaltrainingpackageDeveloptrainthetrainersprogrammesEducationonhealthrisksEducationonsafepracticesIncreasecommunityawarenessWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NationalActionPlanManagementOptionsforHCWReviewavailableoptionsfordifferentsizefacilitiesand differentsettingsEvaluatesafetyandenvironmentalaspectsEnsureworker’ssafetyEvaluatesustainabilityAssessacceptabilityMonitoringofsafetyandefficiencyWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)RelativeHealthRisksReuseofneedlesandsyringesposethegreatesthealthrisks topatients,staffandthecommunityRiskstohealth-careworkersandthecommunitycanstillbe significantevenwithoutreuseBurningHCWatlowtemperaturesproducesdioxins: persistenttoxinswhicheffecthumanhealthandtheenvironmentBurningHCWcanreleasemercuryandotherheavymetals whicheffecthumanhealthandtheenvironmentRisksfromdioxinandmercuryduetoburningHCWareunknownWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)Risk:ReuseStaff&CommunityDioxinMercuryRelativeHealthRisksStrategiesforreducingrisk:ADsyringes,Over-supplyneedlesandsyringes,Goodmanagementanddisposal,HepatitisBvaccinationofstaffandchildrenSharpsboxes,protectiveclothing,training,Communityawarenessprogrammes,goodmanagementanddisposalHepatitisBvaccinationofstaffandchildrenNon-incinerationdisposaloptions,hightemperatureIncineration,procurementWastesegregation,non-incinerationdisposaloptions,procurementWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)ManagingWasteNoone-size-fits-allsolutionSolutionsdoexistformanysituations“non-availability”of technologiesisoftena“wrongproblem”-ornotatechnicalone

Allocatedresources? Regulatorycompliance? Socialacceptance?Environmentalconcerns,pressuregroups,Kyoto, bansonburninginsomecountries

“polluterpays”principle---WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteSafetyboxes-firstlineofdefense

BundledwithvaccinesWorkwellinvaccinationcampaignsandfor someroutineprogrammeneedsReusableplasticsharpsboxescanbeusedforroutineneedsDisposableboxesrequirefrequentre-supplyDisposalrequiresburningorincineration–limitsoptions

WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteNeedleCuttersandDestroyers

ReducerisksbyremovingthesharpbeforedisposalPreventreuseandcommunityexposureReducemostdangerouswastesignificantlyManualneedlecuttersmaystillposehealthrisksfromsplashingExpensiveNeedledestroyersveryexpensiveandrequireelectricity

WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteBurning–Lowtemperature

OpenpitBrickenclosuresandopenbrickincinerators“Drum”incineratorsLowcostsCreatemaximumpollutionIncompletecombustiondoesnotdestroyallsharpsLeastdesirableoption

WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteBurning–Hightemperature

Locallybuiltbrickincineratorse.g.“DeMontford”Smallfactorybuiltpre-fabricatedsteelincineratorOtherindustrialincinerators

WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteBurning–Hightemperature

Appropriateformediumtolargefacilities –betterforlessdenselypopulatedareasReduceharmfulemissionsbyhightemperatureincinerationCompletecombustionofallsharpsModeratelyexpensivetobuildUS$1500–5000MayrequirefueltooperateRequirestrainingtooperateandmaintainRequireswastesegregation–heavymetals

WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteBurning–Hightemperature

DeMontfordLocallybuiltbrickIncineratorUS$1500InstalledWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteBurning–Hightemperature

FactorybuiltPrefabricatedIncineratorUS$5000InstalledWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteSteamSterilizerse.g.“Hydroclave”AppropriateformediumtolargefacilitiesEssentiallynoemissionsGoodfordenselypopulatedareasCompletedestructionofallsharpsExpensiveRequirestrainingtooperateandmaintainRequireswastesegregation–heavymetals

WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteWasteBurialPitSuitableforsmallclinicsEasytobuild,operateandmaintainRequiresspaceon-sitePropersegregationofsharpscanincreaselifeMaynotbesuitableforareaswithhighwatertables

WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteWasteBurialPitWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteOtherOptionsEncapsulationMeltingovensProfessionalrecoveryandrecyclingWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteWasteMinimizationReduceinjectionoveruseNewdeliverysystemsBiodegradablesyringesandneedlesReducepackagingEliminateuseoftoxiccomponentsWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)ConclusionSafeHCWMrequiresacomprehensivesystemLackofresourcescanbeovercomewithcreativityandthewillto manageHCWsafelyTechnologyisonlypartofthesolutionRaisingstaffandcommunityawarenessarekeystosuccessWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)RichardM.CarrWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)ContentofPresentationNeedsAssessmentNationalActionPlansRelativeRisksTechnologyOptionsWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NeedsAssessmentWHYNeeded?IdentifieshealthrisksDescribescurrentmanagementpracticesRaisesawarenessProvidesinformationonamounts andtypesofwastegeneratedSupportsdevelopmentofaNationalActionPlanWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NeedsAssessmentHow?AssessHCWMatrepresentativefacilitiesofallsizesand intypicalsettingsInterviewfacilitystaffatalllevelsInterviewstafffromkeygovernmentagencies,NGOs, andmunicipalitiesEvaluatecurriculumsatSchoolofPublicHealth,Medicine Nursing,etc.AssesscurrentlawsgoverningHCWMWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NeedsAssessmentTools/Resources

WHORapidAssessmentTool(RAT)Aide-MemoireSafehealth-carewastemanagementWebsites:

TechnicaloptiondatabaseonwebsiteWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NationalActionPlanSuccessfulHCWMStrategiesInclude:

NationalpolicyforsafeHCWMComprehensivesystemofHCWMAwarenessandtrainingSelectionofoptionsforHCWMWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NationalActionPlanNationalpolicyforsafeHCWMDesignateresponsibleauthorityRegulatoryframework&guidelinesAssessmentofstatus&problemsOverallwastemanagementplanMonitoring&evaluationWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NationalActionPlanComprehensivesystemforHCWMAssignwastemanagementresponsibilitiestostaffAllocateResourcesMinimizationofwaste(procurement)SegregationofwasteSafecollection,handlingandstorageSafetreatmentanddisposalWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NationalActionPlanAwarenessandTrainingAddwastemanagementtothecurriculaforhealth-carepersonnelDevelopnationaltrainingpackageDeveloptrainthetrainersprogrammesEducationonhealthrisksEducationonsafepracticesIncreasecommunityawarenessWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)NationalActionPlanManagementOptionsforHCWReviewavailableoptionsfordifferentsizefacilitiesand differentsettingsEvaluatesafetyandenvironmentalaspectsEnsureworker’ssafetyEvaluatesustainabilityAssessacceptabilityMonitoringofsafetyandefficiencyWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)RelativeHealthRisksReuseofneedlesandsyringesposethegreatesthealthrisks topatients,staffandthecommunityRiskstohealth-careworkersandthecommunitycanstillbe significantevenwithoutreuseBurningHCWatlowtemperaturesproducesdioxins: persistenttoxinswhicheffecthumanhealthandtheenvironmentBurningHCWcanreleasemercuryandotherheavymetals whicheffecthumanhealthandtheenvironmentRisksfromdioxinandmercuryduetoburningHCWareunknownWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)Risk:ReuseStaff&CommunityDioxinMercuryRelativeHealthRisksStrategiesforreducingrisk:ADsyringes,Over-supplyneedlesandsyringes,Goodmanagementanddisposal,HepatitisBvaccinationofstaffandchildrenSharpsboxes,protectiveclothing,training,Communityawarenessprogrammes,goodmanagementanddisposalHepatitisBvaccinationofstaffandchildrenNon-incinerationdisposaloptions,hightemperatureIncineration,procurementWastesegregation,non-incinerationdisposaloptions,procurementWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)ManagingWasteNoone-size-fits-allsolutionSolutionsdoexistformanysituations“non-availability”of technologiesisoftena“wrongproblem”-ornotatechnicalone

Allocatedresources? Regulatorycompliance? Socialacceptance?Environmentalconcerns,pressuregroups,Kyoto, bansonburninginsomecountries

“polluterpays”principle---WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteSafetyboxes-firstlineofdefense

BundledwithvaccinesWorkwellinvaccinationcampaignsandfor someroutineprogrammeneedsReusableplasticsharpsboxescanbeusedforroutineneedsDisposableboxesrequirefrequentre-supplyDisposalrequiresburningorincineration–limitsoptions

WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteNeedleCuttersandDestroyers

ReducerisksbyremovingthesharpbeforedisposalPreventreuseandcommunityexposureReducemostdangerouswastesignificantlyManualneedlecuttersmaystillposehealthrisksfromsplashingExpensiveNeedledestroyersveryexpensiveandrequireelectricity

WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteBurning–Lowtemperature

OpenpitBrickenclosuresandopenbrickincinerators“Drum”incineratorsLowcostsCreatemaximumpollutionIncompletecombustiondoesnotdestroyallsharpsLeastdesirableoption

WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteBurning–Hightemperature

Locallybuiltbrickincineratorse.g.“DeMontford”Smallfactorybuiltpre-fabricatedsteelincineratorOtherindustrialincinerators

WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteBurning–Hightemperature

Appropriateformediumtolargefacilities –betterforlessdenselypopulatedareasReduceharmfulemissionsbyhightemperatureincinerationCompletecombustionofallsharpsModeratelyexpensivetobuildUS$1500–5000MayrequirefueltooperateRequirestrainingtooperateandmaintainRequireswastesegregation–heavymetals

WHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteBurning–Hightemperature

DeMontfordLocallybuiltbrickIncineratorUS$1500InstalledWHOHealthCareWasteManagemeWHOHealthCareWasteManagementProtectionoftheHumanEnvironment(PHE)TechnicalOptionsforManagingWasteBurning–Hightemperature

FactorybuiltPrefabricatedIncineratorUS$5000InstalledW