Medical waste – a health risk for many

“Hepatitis C is rapidly spreading among young garbage pickers/scavengers, as they pick up used syringes and other clinical waste from different public/private hospitals of the city for recycling…” This story carried in “The News International”, a Karachi newspaper in December, 2007 quoted an official as saying that most hospitals in the city were not disposing of their infectious waste properly. The official said a random study estimated that 50,000 garbage collectors, mainly young children whose families fled from Afghanistan, were hepatitis positive as well, because of the contaminated material to which they were exposed.
This is one example cited in the latest study of the UN expert who monitors the impact on human rights of the movement and dumping of toxic and dangerous products and wastes. In his report to the Human Rights Council, Special Rapporteur Calin Georgescu focuses on the dangers posed by the unsound management and disposal of medical waste.
A significant amount of medical waste is generated through material used for patient diagnosis, treatment or immunization, and may pose significant risks to human health and the environment if not managed and disposed of appropriately.

1. The report identifies this waste as consisting of sharps, which include needles, syringes, scalpels and other sharp objects; pathological waste, including blood, mucus and anatomical parts or tissues removed during surgery or autopsy; chemical waste, including the products used during cleaning and disinfecting processes; pharmaceutical waste, which consists of expired, unused, spilt and contaminated pharmaceutical products, drugs and vaccines; and radioactive waste from medical therapy and research.

In his report the Special Rapporteur says the disposal of hazardous medical waste poses significant threats to the enjoyment of human rights, including the right to health, and is particularly problematic in developing countries. It is worsening because of the expansion of health-care systems and services. “Medical waste is often mixed with general household waste,” he says, “and is either disposed of in municipal waste facilities or dumped illegally.”
While industrialized countries are phasing out incinerators as the preferred means for disposing of medical waste because of health and environmental concerns, in developing countries combustion is the favoured option, he says.

Incineration of medical waste at low temperatures releases toxic emissions which may contain heavy metals and dioxins. The residual ash also may contaminate food, and sources of drinking water. The report quotes a study which analysed free-range chicken eggs collected near a small-scale medical waste incinerator and found they had levels of dioxins - known carcinogens – sometimes five and a half times higher than the upper limit set by the European Union.

Of particular concern too is the practice of recycling syringes and needles which have not been properly sterilized. The child scavengers in Karachi referred to in the newspaper article were looking for “sharps” to sell. The Special Rapporteur quotes figures from the World Health Organization which estimate that worldwide up to 40 per cent of injections are given with syringes and needles reused without sterilization. In some countries the figure is as high as 70 percent.
In his report Georgescu calls for the development of a comprehensive international legal framework to protect human health and the environment from the adverse effects of improper management and disposal of hazardous waste. The Special Rapporteur also urges the replacement of incineration as a method of getting rid of dangerous medical refuse using more effective and environmentally friendly methods such as autoclaving.