Medical Waste, Essay Example

Medical Waste Protocols in UAE and Comparison to EU Standards

Abstract

In recent decades the issue of waste disposal has become an international and transnational concern.  Spurred by findings that developed countries were dumping hazardous waste in underdeveloped nations, the Basel Convention established guidelines for the handling and disposal of potentially dangerous materials. Among the types of waste covered by Basel standards is medical waste, which is becoming a significant issue in the developed and developing worlds. The standards and protocols established by Basel have been adopted by international and transnational organizations, as well as national governments, for the purpose of developing and implementing legislation and regulation related to medical waste. The UAE has adopted such legislation and regulation in accordance with the Basel Convention, though some evidence indicates that compliance levels in the UAE are not in accordance with the nations of the EU and other leading Basel signatories. Using Dubai and Abu Dhabi as case studies, this paper provides a brief introduction to the issue of medical waste in the UAE and the methods the government has used to deal with handling and disposing of this waste.

Introduction

The issue of waste disposal has been a significant consideration for civilizations throughout history. In the last century, however, with the advent of the Industrial Age and subsequent developments in technology, the issue of waste disposal has become more important than ever. As the global population grows exponentially, increasing amounts of hazardous waste are produced, posing a threat to human health and the environment. The massive amounts of hazardous waste produced in developed nations have posed a particular danger to less-developed countries (LDCs) as first-world nations have used them as a dumping ground for everything from radioactive materials to garbage to medical waste. Concerns over this situation led to the creation of the Basel Convention, a transnational organization dedicated to regulating the handling and disposal of hazardous waste. Advances in health care coupled with economic development in many parts of the world have led to a need for protocols related to medical waste, and the Basel Convention signatory nations have developed legislation and regulatory schemes based largely on the Basel guidelines. Despite the development and implementation of such legislative and regulatory structures, the issue of how to handle and dispose of medical waste remains a pressing concern.  The following paper focuses on the UAE as a case study for how medical waste regulations and guidelines are implemented, and compares and contrasts conditions in the UAE with those in the EU.

Literature Review

Since the development of the Basel Conference, an enormous body of literature has been produced related to the handling of hazardous waste in general and medical waste in particular. The issue of medical waste alone has been the focus of countless thousands of studies and research projects as well as the basis of innumerable conferences, publications, and other works of literature and media. In order to provide as broad and comprehensive an overview as possible in the constraints of a brief discussion of the subject, the following review of literature will contain several different examples of the type of information that has been written and published on the subject of medical waste handling and disposal in the UAE and the EU.

Helal, Edger and Hawkins (2011) conducted a study of medical waste handlers (MWHs) in five leading hospitals in Abu Dhabi, and poublished the results in the article “Factors affecting health and safety, particularly sharps injuries, in medical waste handlers in hospitals in the rapidly developing desert emirate of Abu-Dhabi; a questionnaire study.” The primary focus of this study was to determine the health risks and effects for MWHs in Abu Dhabi. According to the researchers, MHWs in developing countries such as the UAE are at particular risk for injury from sharps (needles) and from medical waste that is improperly handled, stored, or disposed of. Despite their concerns, the results of their study indicated a fairly high compliance rate with the use of safety equipment such as gloves (92%) and facemasks (85%), though the researchers also noted that anything less than 100% compliance puts MHWs and patients at risk for contamination and infection from medical waste.

In the article “Sustainable Medical Waste Management in the Emirate of Dubai,” Karkain (2010) provides a comprehensive overview of the procedures, regulations, and systems in place in Dubai for the handling and disposal of medical waste. Karkain describes the protocaols for hospitals and clinics that must handle medical waste, and explains the different standards for different types of facilities, from the applicable legislation to the segregation of medical waste at various sources. These sources include treatment rooms, operating rooms and intensive-care units (ICUs), general wards, infectious disease wards, medical trolleys, oncology wards, laboratories, and x-ray and radiography units. Karkain goes on to address the efforts that Dubai has made to comply with the standards established by the Basel convention, noting that Dubai has built and activated a medical waste incinerator that is fully operational as of 2009. This incineration facility has made it possible for Dubai to cease exporting any of its medical waste for recovery or disposal in LDCs, making Dubai fully compliant with Basel Convention guidelines and protocols.

Among the ways that the UAE and other nations in the region have sought to deal with medical waste and other hazardous materials is through adherence to standards established by the Gulf Cooperation Council (GCC). An organization known as EcoMENA, which promotes positive environmental and sustainable activities in the Middle East and North Africa (MENA) region has produced a number of reports and research studies about the issue of medical waste in the UAE and other nations. The report “Medical Wastes in the GCC” (Zafar, August 2013) notes that there are widely-varying levels of compliance with GCC guidelines and protocols among the participating nations. Zafar addresses some of the specific issue and concerns related to medical waste, noting the following:

 “Medical wastes which pose the greatest risk to human health are infectious waste (or hazardous medical waste) which constitutes 15 – 25 percent of total healthcare waste.

Infectious wastes may include all waste items that are contaminated with or suspected of being contaminated with body fluids such as blood and blood products, used catheters and gloves, cultures and stocks of infectious agents, wound dressings, nappies, discarded diagnostic samples, contaminated materials (swabs, bandages, and gauze), disposal medical devices, contaminated laboratory animals etc.” –“Medical Waste in the GCC,” Zafar, Salman. August 2013.

Zafar goes on to list Saudi Arabia as the leading producer of medical waste in the GCC, with the UAE coming in second. According to Zafar, the UAE produces 21.5 tons per day of medical waste, and more than half of that is produced just in Abu Dhabi. The author raises the issue that medical waste handling and disposal protocols and legislation are developed and implemented at various levels of government, and that oversight for assuring that such wastes are disposed of properly are often left to municipal authorities who are overwhelmed with the responsibility of carrying out such duties (Zafar, August 2013).

In a similar article, Zafar  (July 2013) addresses the issue of hazardous waste in the UAE, with an emphasis on radioactive waste, chemical and industrial waste, and medical waste. Zafar notes that the UAE signed on to the Basel Convention in 1992, agreeing to the stated guidelines that ‘Transportation and disposal of locally produced hazardous waste through land borders, marine environment limit and air space shall be controlled in accordance with the rules, procedure and controls mentioned and specified in Basel Agreement and in coordination with Federal Environmental Agency” (Zafar, July 2013). The author goes on to note that the UAE has not signed on to the so-called Basel Ban, an amendment to the Basel Convention that would prohibit any developed nations from transporting hazardous waste to any LDCs for processing or disposal (Zafar, July 2013). Few nations have signed on to the Basel Ban, which means that the Basel Convention gudilines apply when moving hazardous wastes across borders, but there is no legal force in the Basel Convention to stop member nations for transporting waste to other member nations or to LDCs. Like Dubai, Abu Dhabi has developed facilities for the incineration of medical waste (as well as for other hazardous materials); according to Zafar, Abu Dhabi and Dubai are able to incinerate virtually all of their medical waste, making it unnecessary for either of these emirates to transport such materials to other emirates or other nations.

Despite the positive reports published by some agencies and organizations, the group Health Care Without Harm (HCWH) submitted a reported to the United Nations Human Rights Council that claims, among other things, that medical waste disposal remains s significant issue in many parts of the world, including the UAE (Stringer, 2011). According to the report, the emirates of Dubai and Abu Dhabi are implementing and adhering to appropriate guidelines, but the rate of development and growth, coupled with lacking oversight, means that some medical waste is not being disposed of properly, and instead is ending up in municipal dumps and other inappropriate locations (Stringer, 2011).

Methodology

Because it is extraordinarily difficult to access appropriate and accurate data related to the production, handling, and disposal of medical waste in the UAE, any research into the matter is inherently handicapped and subject to the limitations of the available evidence. With such limitations in mind, the literature discussed in the previous section was reviewed for content related to several key areas. The first of these areas concerns the laws, protocols and procedures related to the handling and disposal of medical waste; the second related to compliance with these laws, and the third concerns the degree to which UAE standards and practices adhere to standards in the EU and other international standards. A broad qualitative analysis of this information is then developed to express the comprehensive findings.

Results

The results of the qualitative analysis reveal a number of different issues and concerns related to the handling and disposal of medical waste in the UAE. There is no question that UAE as a whole has established laws, regulations, and guidelines for the handling and disposal of medical waste that adhere to the standards of the Basel Convention and the member bodies and nations such as the EU and the United States. Moreover, both Dubai and Abu Dhabi have built central medical-waste incinerators that reportedly make it possible for each of these emirates to dispose of their medical waste without the need to transport it to LDCs. Despite these advances, however, there are indications that enforcement and oversight of medical waste protocols is lacking, allowing some amount of medical waste to be disposed of in municipal incinerators, landfills, and other inappropriate and potentially dangerous sites.

Discussion

The exponential population growth and rate of development in the UAE is placing enormous pressure on the governments to keep up with the mountains of medical waste produced on a daily basis. As the UAE continues to make the transition from developing nation to developed nation, the challenges of keeping up with medical waste and other hazardous waste will continue to grow. While the current Basel Convention protocols allow member nations to strike deals for moving waste across international and transnational borders, the LDCs that currently profit financially from such arrangements will have less incentive to take in and dispose of such waste as they continue to develop. The UAE currently has standards in place that adhere to international standards, but its compliance with those standards is questionable. The long-term prospects for the UAE are that it will become increasingly difficult to mismanage hazardous waste as it continues to advance in the developed world. With this in mind, it is vital that the UAE develop comprehensive and effective systems for handling and disposing of medical waste that live up to the legal and regulatory standards it has adopted.

References

Basel.int,. (2011). Basel Convention > The Convention > Overview. Retrieved 14 June 2014, from http://www.basel.int/TheConvention/Overview/tabid/1271/Default.aspx

Karkain, R. (2010). Sustainable Medical Waste Management in Dubai. 2Nd Annual E-Health Conference, Dubai, UAE.

Stringer, R. (2011). HCWH: UN Report on Medical Waste and Human Rights.

Zafar, S. (2013). Hazardous Wastes in UAE. EcoMENA. Retrieved 14 June 2014, from http://www.ecomena.org/hazardous-waste-management-in-uae/

Zafar, S. (2013). Medical Wastes in GCC. EcoMENA. Retrieved 14 June 2014, from http://www.ecomena.org/medical-waste-management/