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Lebanese Sterilization Network

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... decree 8006/13389 Hospital accreditation Health Care Waste issue Infectious wastes containing micro-organisms capable of causing illness to a susceptible host. – PowerPoint PPT presentation

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Title: Lebanese Sterilization Network


1
Lebanese Sterilization Network of Potentially
Infectious Health Care Waste creation and
management system
2
Health Care Waste issue
  • "Health Care Waste" refers to materials
    accumulated as a result of patient diagnosis,
    treatment or immunization of human beings or
    veterinary activity.

3
Health Care Waste issue
potentially infectious health care waste
(PIHCW) 25
hazardous healthcare waste (HHCW) 30
Health care waste (HCW)
waste comparable to household waste (HCHW) 70
Non infectious hazardous health care waste
(NIHHCW) 5
4
Health Care Waste issue
  • Potential health hazards and pollution effects of
    wastes may be categorized as follows
  • Infectious wastes containing micro-organisms
    capable of causing illness to a susceptible host.
    Through this path, AIDS, Hepatitis B, C and D,
    allergies, gastro-enteric infections, respiratory
    infections, skin infections can be transferred.
  • Toxic chemicals that can cause poisoning when
    inhaled ingested or brought into contact with the
    skin.
  • Carcinogens (cancer-causing agents) in wastes
    from bio-medical research laboratories.
  • Flammable liquids and explosive gases that can
    cause injury to personnel or damage to the
    hospital structure by fire and explosion.
  • Packaged caustic materials (acids or bases) that
    can cause injury.
  • Physically injurious wastes that can produce
    punctures, cuts, or abrasions.
  • Radioactive contaminated wastes.

5
Health Care Waste issue
  • In Lebanon, until 2003, hospital wastes...
  • ...have been disposed with the municipal wastes
    in landfills.
  • ...eliminated through incineration.
  • ...not segregated at source within hospital.

6
Health Care Waste issue
  • In Lebanon, until 2003, hospital wastes...
  • ...have been disposed with the municipal wastes
    in landfills.
  • ...eliminated through incineration.
  • ...not segregated at source within hospital.

7
Health Care Waste issue
  • Ministry of environment and Ministry of Public
    Health obliged hospitals to treat waste through

decree 8006/13389
Hospital accreditation
8
Health Care Waste issue
  • Infectious wastes containing micro-organisms
    capable of causing illness to a susceptible host.
    Through this path, AIDS, Hepatitis B, C and D,
    allergies, gastro-enteric infections, respiratory
    infections, skin infections can be transferred.
  • Independently of any treatment strategy,
    segregation must be considered one of the most
    important steps
  • "PIHCW are susceptible to contain pathogens or
    their toxins in sufficient concentration to cause
    diseases to a potential host (HIV, HBV,
    gastro-enteric infections, respiratory
    infections)"
  • PIHCW production in Lebanon was estimated to be
    10 T/day, which corresponds to de 0.4 of total
    solid waste.
  • The PIHCW forms 85 of the hazardous HCW.

9
Health Care Waste issue
  • Infectious wastes containing micro-organisms
    capable of causing illness to a susceptible host.
    Through this path, AIDS, Hepatitis B, C and D,
    allergies, gastro-enteric infections, respiratory
    infections, skin infections can be transferred.
  • Independently of any treatment strategy,
    segregation must be considered one of the most
    important steps
  • "PIHCW are susceptible to contain pathogens or
    their toxins in sufficient concentration to cause
    diseases to a potential host (HIV, HBV,
    gastro-enteric infections, respiratory
    infections)"
  • PIHCW production in Lebanon was estimated to be
    10 T/day, which corresponds to de 0.4 of total
    solid waste.
  • The PIHCW forms 85 of the hazardous HCW.

10
Methodology for Handling the problem of PIHCW in
Lebanon
  • Who should be in charge of the treatment for
    PIHCW ?
  • Which kind of service provider is needed ?
  • How should the PIHCW be managed in Lebanon ?
  • What technique should be used ?

11
Methodology for Handling the problem of PIHCW in
Lebanon
  • A. The treatment provider
  • The mission of health care institutions is to
    treat the patient.
  • Difficulty to achieve profitability when working
    on an individual basis.
  • Difficulty of maintaining control.
  • Chronic economical crisis.
  • Low production only 165 hospitals, less than
    0.4 of the solid waste.
  • Difficulty of managing a successful coordination
    between competing institutions in case of
    failure.
  • Profit-making service shows no interest
    establishing training programs for PIHCW
    reduction.

12
Methodology for Handling the problem of PIHCW in
Lebanon
  • A. The treatment provider
  • The mission of health care institutions is to
    treat the patient.
  • Difficulty to achieve profitability when working
    on an individual basis.
  • Difficulty of maintaining control.
  • Chronic economical crisis.
  • Low production only 165 hospitals, less than
    0.4 of the solid waste.
  • Difficulty of managing a successful coordination
    between competing institutions in case of
    failure.
  • Profit-making service shows no interest
    establishing training programs for PIHCW
    reduction.

Performance Zone

management for PIHCW by an NGO
13
Methodology for Handling the problem of PIHCW in
Lebanon
  • B. The treatment methodology
  • Incineration cant be considered as an optimal
    solution because of its major drawbacks
    possibility of toxic emissions, expensive
    controls techniques, generation of hazardous
    ashes containing heavy metals, dioxins and furans
    that may pollute the soil and water, high
    investment and operating costs...
  • Autoclaving associated to shredding optimal from
    environmental, economical and social point of
    view safe, low-emissions technique, low
    investment and operating costs...

14
Methodology for Handling the problem of PIHCW in
Lebanon
  • B. The treatment methodology
  • Incineration cant be considered as an optimal
    solution because of its major drawbacks
    possibility of toxic emissions, expensive
    controls techniques, generation of hazardous
    ashes containing heavy metals, dioxins and furans
    that may pollute the soil and water, high
    investment and operating costs...
  • Autoclaving associated to shredding optimal from
    environmental, economical and social point of
    view safe, low-emissions technique, low
    investment and operating costs...

Autoclaving associated to Shredding Optimal
solution
15
Methodology for Handling the problem of PIHCW in
Lebanon
  • Who should be in charge of the treatment for
    PIHCW ?
  • Which kind of service provider is needed ?
  • How should the PIHCW be managed in Lebanon ?
  • What technique should be used ?

16
Methodology for Handling the problem of PIHCW in
Lebanon
  • Who should be in charge of the treatment for
    PIHCW ?
  • Which kind of service provider is needed ?
  • How should the PIHCW be managed in Lebanon ?
  • What technique should be used ?

17
Methodology for Handling the problem of PIHCW in
Lebanon
  • Who should be in charge of the treatment for
    PIHCW ?
  • Which kind of service provider is needed ?
  • How should the PIHCW be managed in Lebanon ?
  • What technique should be used ?

18
Methodology for Handling the problem of PIHCW in
Lebanon
  • Who should be in charge of the treatment for
    PIHCW ?
  • Which kind of service provider is needed ?
  • How should the PIHCW be managed in Lebanon ?
  • What technique should be used ?

19
Methodology for Handling the problem of PIHCW in
Lebanon
7 programs agriculture employment environment
health rehabilitation social youth
  • A Lebanese non profit organization
  • Since 1985, with and for every person in
    difficulty
  • Recognized of public utility in 1995
  • Mission participate to societys lasting
    development by supporting fragilized groups and
    integrating marginalized people.

20
Methodology for Handling the problem of PIHCW in
Lebanon
21
Methodology for Handling the problem of PIHCW in
Lebanon a national network strategy, for an
integrated and sustainable solution
  • 5 treatment centers for the country
    semi-centralized
  • secures a back up system, easy to activate...
    since the network managed by one operator.
  • ensures training for PIHCW reduction... since
    the network is managed by a non-profit
    organization
  • cares for public awareness.
  • takes in charge the whole process training,
    collection, treatment
  • guaranties a quality and reliable traceability
    system.
  • puts all findings and experience at the disposal
    of relevant authorities, in order to upgrade
    regulations... through a research and a
    development unit

22
Results
5 treatment centers.
  • Today, arcenciel provides through a unique
    specialized comprehensive service in Lebanon
  • The proper and efficient training of health care
    institutions staff.
  • the PIHCW collection of the PIHCW from the health
    care institutions in specialized vehicles.
  • The sterilization by autoclaving associated to
    grinding, in five treatment centers covering the
    whole Lebanese territory.
  • The monitoring of the process
  • The public awareness.

23
Results
  • training of Health Care Staff more than 7000
    persons trained.
  • Special training sessions for health care staff,
    cleaning staff, administrative staff
  • Risks prevention
  • Emergency procedures
  • Sorting at the source and PIHCW minimization
  • Monitoring of the process

24
Results
  • PIHCW collection
  • Specially equipped collection vehicle in
    compliance to the WHO recommendations.
  • Trained staff.
  • Occupational health and safety system.
  • Bins traceability.

1111
25
Results
  • 5 treatment centers.

26
Results
Treatment by autoclaving coupled with shredding
of 6.5 tons of PIHCW per day
27
Results
  • treatment by autoclaving coupled with shredding
  • Environmentally friendly
  • Low investment and operating costs
  • Proper sterilization in 40 minutes
  • Volume reduction of 80
  • Unrecognizable ground waste assimilated to
    domestic waste

28
Results
  • Traceability and monitoring
  • Traceability
  • Follow-up notebooks slips the name of the
    center, the date, the quantity received,
    signatures...
  • Treatment monitoring
  • Cycles reports printed by the
  • autoclave.
  • A chemical test, performed daily.
  • A biological test, performed
  • everyday by an independent
  • laboratory.

29
Results
  • Traceability and monitoring
  • production monitoring

30
Results
  • Public awareness

31
prospects
  • arcenciel is still pursuing its objective of
    research and development of eco-friendly
    treatment technologies, alternatives to
    incineration for hazardous waste (mainly
    solvents, chemicals and pharmaceuticals) in
    cooperation with ministries and universities.

32
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