No abstract

Hospital waste management is a current sustainability challenge. Although not always performed, the most applied approach in current protocols is the proper segregation of waste. The incineration of hospital waste is an significant source of emission of specific toxic particles and gases. We highlighted dioxins, whose representatives have been considered carcinogenic agents since 1994. Several experimental and epidemiologic studies have shown greater cancer morbidity and mortality associated with dioxin exposure. In the present study, we presented the impact of a hospital waste management program implemented in an oncology institution based on proper segregation and consequent reduction of incinerated mass. Data were collected for 8 years and the waste was separated into five categories: infectious (A4), chemical (B), recyclable (DR), non-recyclable (DNR), and sharps (E). The classes addressed to incineration were A4, B, and E. A team education starting from the admission process and with a continued education program was essential for a successfully implemented program. We achieved a 66% saving of waste from incineration, equivalent to 76 tons, of which 71.9 tons corresponded to recyclable waste. If the waste separation protocol was not implemented, the biohazardous and chemical material would contaminate the rest of the residues, making incineration as a final destination mandatory for all the waste. This scenario would result in significantly more dioxins release and a 64% higher cost of waste management. This low-cost implementation measure was effective in the cost reduction of waste management and minimization of air release of human carcinogens.

e19128 Background: Hospital waste management is a current sustainability challenge. The proper waste separation is principally recommended in most protocols, despite not always performed. Potentially infectious, sharp and chemical residues must be properly incinerated. Incineration increases the cost of waste management and releases hazardous gases into the atmosphere, such as dioxins. Dioxins are extremely stable compounds with an estimated half-life of 7 to 9 years in humans. As an important compound of air pollution, they have been classified as a class I human carcinogen by the International Agency for Research on Cancer. The dioxin carcinogenicity evolves action on transcriptional activation and inhibition of apoptosis. A higher serum concentration of dioxins is found in individuals who live near incinerators or who consume food produced near them.Furthermore, studies showed a 3 to 4 times higher risk of developing cancer in inhabitants of the neighborhood of waste incinerators and an association of serum concentration of dioxins and mortality from different types of cancer. Some neoplasms related to this exposure are lung cancer, soft tissue sarcomas and Non-Hodgkin Lymphoma. Methods: We present the impact of adequate division of medical waste from an institution in the Federal District - Brazil with data collected for 8 years. The residues were separated into two groups, the first being formed of residues that should be incinerated (potentially infectious, sharps and chemicals); and the second for regular garbage, which could be recyclable or non-recyclable. Results: By training the team and establishing appropriate protocols for proper segregation of materials, we achieved a saving of 66% from what would have been incinerated waste, equivalent to 76 tons, of which 71.9 tons correspond to recyclable waste. Also, the incineration cost was five times higher than the adequate disposal of regular waste. If the waste separation protocol had not been implemented, the biohazardous and chemical material would have contaminated the rest of the residues, making incineration as a final destination mandatory for all the waste, resulting in the release of more gases after incineration and a 64% higher cost. Conclusions: Despite the barriers to the classification of residues such as non-standardization and inadequate training of hospital teams, this low-cost implementation procedures significantly reduces the cost of waste management and the air release of human carcinogens.