Дисертації з теми "Hospitals Australia Waste disposal"

This thesis critically evaluates the policies, processes and practices of medical waste management in selected rural hospitals in the Eastern Cape. Medical Waste Management is a growing public health and environmental issue worldwide. Research shows large scale incapacity in dealing with medical waste in an efficient and sustainable fashion globally, which demonstrates that it is not merely a developing world problem alone. This study is conducted against the backdrop of an increasing medical waste crisis in South Africa. Although there are an abundance of studies on solid waste management, there is a lack of data and research particularly on medical waste management in rural hospitals. The crisis of medical waste management in South Africa is closely intertwined with the collapsing health care system and an overburdened natural environment. It is an undisputable fact that South Africa’s generation of medical waste far exceeds its capacity to handle it effectively. This thesis argues that the neglect of medical waste as an environmental-health issue and the absence of an integrated national medical waste management plan aggravate the medical waste problem in the country. In explaining the medical waste crisis, this thesis adopts a Marxist perspective which is based on the premise that industrial capitalist societies place economic growth and production at high priority at the expense of the natural environment; creating a society that is engulfed by high health risk due to the generation of hazardous and toxic waste. Industrial societies view themselves as superior and separate from the natural environment, whereas one cannot separate nature from society as they are interlinked. As society attempts to adopt a sustainable environmental approach towards environmental management, science and technology are enforced as a solution to environmental problems in order to continue developing countries’ economies whilst sustainably managing and protecting the environment, which is contradictory. This thesis emphasises that medical waste management is a socio-political problem as much as it is an environmental problem, hence the need to focus on power relations and issues of environmental and social justice. The results of the study identified gaps in policy framework nationally and institutionally on medical waste management. In addition, there were poor waste management practices due to poor training, inadequate infrastructure and resources as well as poor budget support.

Bibliography: p. 367-392. This thesis takes an overview of urban waste disposal practices in Sydney, Melbourne and Adelaide since the time of their respective settlement by Europeans through to the year 2000. The narrative identifies how such factors as the growth of representative government, the emergence of a bureaucracy, the visitation of bubonic plague, changed perceptions of risk, and the rise of the environmental movement, have directly influenced urban waste disposal outcomes.

This thesis is a study of public policy issues relating to multinational geological repositories for high-level radioactive waste disposal (HLW). Nuclear states have attempted for decades to implement effective radioactive waste policies, though with limited success. The safe disposal of HLW has proven particularly troublesome and, thus far, a solution has eluded all states. A review of radioactive waste policy in the UK, the US and Switzerland reveals some of the underlying themes behind community opposition to repository siting and the reasons for a broader global search. The failure to achieve HLW repositories at a national level has led to much research into the technical, social and political obstacles to site selection, and into international collaboration. In 1999 Pangea Resources International (PRI) concentrated its efforts in securing a multinational HLW repository in the Australian outback, with its two main arguments being economic incentives for Australia and safety and security benefits for a broader range of nation states. The 'proposal' failed to gain public or political acceptance. An examination of the Pangea multinational project is undertaken to determine why the proponents were unable to adequately make their case for the shared repository's benefits. The study finds that the arguments presented to Australia were rejected because the public perceived the risks from hosting the repository to be much greater than the associated benefits.

This thesis presents details of investigations into the potential for co-disposal of the two rejects from Clarence Colliery and Kable's Transport Sand Mine. Column experiments were undertaken to simulate field conditions. The experiment consisted of: 1/. creating the required co-disposal arrangement and structure in containers 2/. infiltrating water through each container and measuring the rates of infiltration and overflow 3/. measuring the chemical properties of the leachate water. Geotechnical tests of co-disposal pile stability were undertaken using a specially constructed shear box. Results of this study suggest the co-disposal of course coal washery reject from Clarence Colliery with clay tailings from Kable's Transport Sand Mine is a feasible option for managing the generation of acetic drainage. It is recommended that field trials comprise layers of coal reject and clay tailings in a 9:1 ratio. Layering the coal reject with clay tailings creates a semi-permeable barrier which acts to restrict water percolation through the reject as well as reacting with the leachate to increase the leachate pH and adsorb metals
Master of Engineering (Hons)

Thesis (MTech(Environmental Health))--Cape Peninsula University of Technology, 2011.
Pharmaceuticals have been formulated to influence physiological systems in humans, animals, and microbes but have never been considered as potential environmental pollutants by healthcare professionals. The human body is not a barrier to chemicals, but is permeable to it. Thus after performing their in-vivo functions, pharmaceutical compound introduced into the body, exit mainly via urine and faeces. Sewage therefore contains highly complex mixtures of chemicals in various degrees of biological potency. Sewage treatment works including those in South Africa, on the other hand, are known to be inefficient in removing drugs from sewage and consequently either the unmetabolised pharmaceutical compounds or their metabolites emerge in the environment as pollutants via several trajectories. In the environment, the excreted metabolites may even undergo regeneration to the original parent molecule under bacterial influence, resulting in “trans-vivo-pharmaceutical-pol ution-cycles”. Although all incinerators are known to generate toxins such dioxins and furans from the drugs they incinerate, all the medicines disposed by the hospitals under research, were incinerated, as the preferred option of disposal. The incineration process employed was found to be environmentally unsafe. Expired and unused medicines which the general public discard as municipal solid waste become landfilled. Because many landfill sites are not appropriately engineered, the unwanted drugs landfilled therein, leach into the surrounding ground water, which is the influent source of water treatment plants. Water treatment plants, including those in South Africa, are also inefficient in eliminating pharmaceutical compounds, releasing them in sub-therapeutic concentrations into potable tap water as pollutants, the full effects of which are yet to be determined.

Thesis (MTech (Environmental Health))--Cape Peninsula University of Technology, 2011.
Pharmaceuticals have been formulated to influence physiological systems in humans, animals, and microbes but have never been considered as potential environmental pollutants by healthcare professionals. The human body is not a barrier to chemicals, but is permeable to it. Thus after performing their in-vivo functions, pharmaceutical compound introduced into the body, exit mainly via urine and faeces. Sewage therefore contains highly complex mixtures of chemicals in various degrees of biological potency. Sewage treatment works including those in South Africa, on the other hand, are known to be inefficient in removing drugs from sewage and consequently either the unmetabolised pharmaceutical compounds or their metabolites emerge in the environment as pollutants via several trajectories. In the environment, the excreted metabolites may even undergo regeneration to the original parent molecule under bacterial influence, resulting in "trans-vivo-pharmaceutical-pollution-cycles". Although all incinerators are known to generate toxins such dioxins and furans from the drugs they incinerate, all the medicines disposed by the hospitals under research, were incinerated, as the preferred option of disposal. The incineration process employed was found to be environmentally unsafe. Expired and unused medicines which the general public discard as municipal solid waste become landfilled. Because many landfill sites are not appropriately engineered, the unwanted drugs landfilled therein, leach into the surrounding ground water, which is the influent source of water treatment plants. Water treatment plants, including those in South Africa, are also inefficient in eliminating pharmaceutical compounds, releasing them in sub-therapeutic concentrations into potable tap water as pollutants, the full effects of which are yet to be determined.

The Koongarra uranium deposit is hosted by quartz-chlorite schists. A conceptual model for the hydrogeology of the deposit is proposed on the basis of lithologic criteria and limited hydraulic testing. Water-level and aquifer-test data are presented that indicate the deposit lies within a partially confined, heterogeneous, anisotropic fractured-rock aquifer. The aquifer is dynamic with annual, diurnal, and semidiurnal water-level fluctuations. The results of aquifer tests indicate a high degree of connectivity in the aquifer. Fracture-dominated flow is observed in some tests, but the overall aquifer response appears to be that of an equivalent porous medium. A homogeneous, anisotropic model is used to estimate the transmissivity tensor for subregions of the aquifer. Anisotropy is well-developed with north- to east-northeast-oriented principal transmissivities. Northeast directions represent large-scale drawdown patterns and are subparallel to bedrock structure and the Koongarra fault. Northerly directions are localized and may reflect a less extensive fracture fabric or a flexure in the bedrock foliation.

Orientador: Li Li Min
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Embora o avanço tecnológico tenha viabilizado o uso dos sistemas digitais para a aquisição de imagens radiográficas, ainda hoje, no Brasil, os filmes radiográficos convencionais continuam sendo os tipos de receptores mais utilizados nos consultórios odontológicos. Deste modo, após a exposição aos raios X, os filmes radiográficos devem ser processados em soluções químicas a fim de que a imagem latente seja convertida em imagem real, passível de análise para diagnóstico. Sabe-se que, tanto o revelador quanto o fixador radiográfico contém em sua composição substâncias químicas altamente tóxicas, podendo apresentar risco à saúde de profissionais, que podem desenvolver lesões cutâneas e dermatites em decorrência do manuseio e manipulação destas soluções de processamento, além de apresentarem risco à saúde pública, caso ocorra a ingestão de produtos oriundos do meio ambiente previamente contaminado e ainda, sérios prejuízos ao meio ambiente, contaminação da fauna e flora, em virtude do descarte indevido destas soluções após seu uso. Tendo isto em vista, os objetivos deste trabalho foram: 1) Avaliar a eficácia de um novo modelo de recipiente para processamento radiográfico manual em câmara-escura portátil, para uso em consultórios odontológicos; 2) Avaliar qualitativamente e quantitativamente as imagens radiográficas obtidas por meio do processamento radiográfico nos diferentes recipientes; 3) Comparar os resultados obtidos em ambas as análises; sob a hipótese de que, devido às suas configurações geométricas, este novo modelo de recipiente propiciaria a economia de soluções químicas para que a execução do processamento radiográfico manual, reduziria os custos aos profissionais da área odontológica e, além disto, promoveria a redução do impacto ambiental devido à minimização da quantidade de químicos usados nestes recipientes. Para atender aos objetivos e conhecer sobre a aplicabilidade deste trabalho, realizou-se um outro estudo no qual se fez uma investigação sobre o descarte dos Resíduos de Serviço de Saúde produzidos em consultórios odontológicos localizados no Estado do Tocantins, Brasil. O estudo abordou aspectos relacionados ao conhecimento e atitudes dos cirurgiões dentistas frente aos resíduos gerados em seu ambiente de trabalho, e sua percepção sobre os resíduos gerados nos demais consultórios odontológicos. Um questionário foi aplicado a 239 cirurgiões-dentistas. Destes, 78,2% trabalhavam em clínica particular e 68,6% já haviam cursado alguma pós-graduação. Do total dos entrevistados, 87,9% afirmaram realizar exames radiográficos em seu consultório e estes foram unânimes em afirmar que o processamento das imagens era realizado manualmente em câmara-escura portátil e a maioria dos entrevistados (88,1%) afirmou que, em média, a cada 5 dias, descartava no esgoto as soluções químicas de processamento utilizadas. Ademais, 30,1% dos participantes acreditavam que os resíduos de amálgama eram descartados, por outros profissionais, em lixo comum e outros 8,8% supunham que o descarte era feito na pia dos consultórios; 61,9% acreditavam que o lixo contaminado (infectante) era disposto juntamente com o lixo comum e, em relação os resíduos perfurocortantes, 14,2% acreditavam que eram descartados em recipientes plásticos e 9,2% em lixo comum. Por meio deste trabalho, concluiu-se, que, em geral, os cirurgiões-dentistas entrevistados desconheciam sobre o correto descarte dos resíduos de serviço de saúde, uma vez que foi observada negligência desta prática por muitos deles, além da percepção de que outros profissionais também realizavam o descarte incorreto dos resíduos gerados em seu ambiente de trabalho. De posse destas informações, testou-se um novo modelo de recipiente para processamento radiográfico manual. Foram obtidas imagens radiográficas dos dentes posteriores de um phantom de mandíbula humana macerada e em seguida, estas imagens foram processadas em quatro câmaras-escuras portáteis. Em uma delas foram colocados dois recipientes convencionais (R1) abastecidos com 200ml das soluções de processamento e, em cada uma das demais câmaras-escuras, para este mesmo propósito, foi disposto um par de cada um dos três tipos de recipientes desenvolvidos pelos autores, R2, R3 e R4, abastecidos com 12, 19,2 e 24ml das soluções reveladora e fixadora respectivamente. Foram processadas 184 películas em R1, 40 em R2, 48 em R3 e 56 em R4. As películas radiográficas foram digitalizadas e posteriormente submetidas à análise objetiva no programa MaZda; em seguida, foram dispostas de maneira ordenadas, obedecendo a sequência do processamento, em papel cartão preto, para que pudessem ser submetidas à análise subjetiva. Os resultados da análise subjetiva mostraram que houve concordância dentre os cinco examinadores em relação às imagens consideradas aceitáveis para diagnóstico para os quatro recipientes estudados, e os resultados da análise objetiva mostraram que as imagens foram consideradas satisfatórias para diagnóstico até o 15º dia de pesquisa para R1, até o 4º dia para R2 e R3, e 5º dia para R4. A análise subjetiva mostrou-se menos sensível que a objetiva na avaliação da qualidade das imagens radiográficas processadas nos recipientes convencionais (R1), porém, mostrou grande correlação com a objetiva na avaliação da qualidade das imagens processadas nos demais recipientes (R2, R3 e R4). Deste modo, concluiu-se que o novo modelo de recipiente viabilizou o processamento de películas radiográficas em câmara-escura portátil, utilizando menor quantidade de soluções químicas para o processamento radiográfico manual, sendo que estas se apresentaram com qualidade satisfatória para diagnóstico.
Abstract: Even though the technological advances have allowed the utilization of digital systems for acquisition of radiographic images, conventional radiographic films are still the most used in dental offices in Brazil. Thus, after X-ray exposure, the radiographic films must be processed in chemical solutions to change the latent stored images into visible images for diagnostic purposes. Both the developer and fixer contain highly toxic chemical substances that may endanger the health of professionals, who may present skin lesions and dermatitis due to handling of these solutions. These chemicals may also constitute a public health problem if contaminated products of the environment are ingested, besides posing serious risks to the environment by contamination of the fauna and flora if these chemical solutions are improperly discarded after utilization. Therefore, this study aimed to: 1) evaluate the efficacy of a new container for manual radiographic processing in portable darkrooms for utilization in dental offices; 2) qualitatively and quantitatively evaluate the radiographic images obtained by radiographic processing in the different containers; 3) compare the results obtained in both analyses, considering that the design of the new container would allow dental professionals to save the chemical solutions used for manual radiographic processing, reducing the costs and also the environmental impact, considering the minimization of the quantity of chemical solutions used in these containers. To meet these objectives and know the applicability of this study, a previous study was conducted in which we investigated the discard of Health Service Wastes produced in dental offices of the state of Tocantins, Brazil. The study discussed the aspects related to the knowledge, perception and attitudes of dentists towards the waste generated in their work environment. We interviewed 239 dentists using a structured questionnaire, of whom 78.2% worked at private offices and 68.6% had post-graduate degree. From the total of respondents, 87.9% stated that they did perform intraoral radiographic exams in their offices, and these professionals unanimously used portable dark rooms from commercial brands for radiographic processing. Most dentists (88.1%) that perform radiographic exams in their offices declared that the mean period for changing the radiographic processing chemicals was 5 days. Conversely, 30.1% of participants believed that amalgam wastes were discarded in common garbage, and 8.8% believed that amalgam wastes were discarded in the offices' sink; 61.9% of them believed that the infectious waste were discarded together with the common garbage. Regarding the sharp objects, 14.2% believed that these were discard in plastic recipients, and 9.2% believed that the majority of dentists discarded sharp objects in the common garbage. The data obtained in this study revealed that, in general, the dentists interviewed were unaware of the correct procedures for the discard of health service waste, since there was both negligence in these practices by many of them and the perception that other professionals also performed incorrect discard of waste generated in their work environment. After achievement of these data, a new model of container for manual radiographic processing was tested. Radiographic images were obtained from the posterior teeth of a phantom dry human mandible and processed in four portable darkrooms. One darkroom had two conventional containers (R1) filled with 200ml of processing solutions. For the same purpose, each of the other darkrooms had one pair of the three types of containers designed by the authors, namely R2, R3 and R4, filled with 12, 19.2 and 24ml of developing and fixer solutions. A total of 184 films were processed in R1, 40 in R2, 48 in R3 and 56 in R4. The films were digitized and objectively analyzed using the software MaZda; following, they were arranged according to the sequence of processing in black cardboards for subjective analysis. The results of the subjective analysis revealed good agreement between the five examiners concerning the images considered acceptable for diagnosis for all four containers investigated. The results of the objective analysis demonstrated that the images were considered satisfactory for diagnosis until the 15th day of investigation for R1, fourth day for R2 and R3, and fifth day for R4. The subjective analysis was less sensitive than the objective analysis to evaluate the quality of radiographic images processed in the conventional containers (R1), yet presented high correlation with the objective analysis for evaluation of the quality of images processed in the other containers (R2, R3 and R4). Thus, it was concluded that the new model of container allowed processing of radiographic films in portable darkrooms using a smaller quantity of chemical solutions for manual radiographic processing and presenting satisfactory quality for diagnosis.
Doutorado
Neurocirugia
Doutor em Fisiopatologia Medica

碩士
國立屏東科技大學
環境工程與科學系所
98
The major purpose of the study is search for the management and disposal of pharmaceutical wastes generated by hospitals in Taiwan. The samples of the study are those hospitals accredited above excellent hospital by the new hospital accreditation system from 2006 to 2009. The study is conducted using survey as the method, and a questionnaire “The Questionnaire for Hospital Pharmaceutical Waste Management and Disposal” is designed for the study purpose. For data collection, there are 92 hospitals selected to the survey. The result showed that: 1.In respect of the collection, there are 71% of the hospitals that consider the disposed or expired pharmaceutical products as hazardous industrial wastes, and 62 % of the hospitals combine the disposed or expired pharmaceutical products with biomedical wastes for collection. Statistical results from the chi-square test reveal no significant difference in the categorizing method ( p = 0.38 ) or in the collecting method ( p = 0.39 ). 2.In respect of the clearance, there are 67% of the hospitals cleaning up of the disposed or expired pharmaceutical wastes on daily. There are 42% of the hospitals that combine the disposed or expired pharmaceutical wastes with biomedical wastes for cleaning up. There are 49% of the hospitals that have the companies supplying the products to recycle and to dispose the product wastes. 3.In respect of reporting via online transmission, the chi-square test results suggest that a significant difference exists ( p = 0.04 < 0.05 ) in the area of using classification codes for reporting wastes via online transmission, where the wastes include both the disposed or expired pharmaceutical products and the genotoxic pharmaceutical products. 4.In respect of general comments, results from the t-test show that the factor “Differences in Perception for Categorization” is insignificant, because t =-1.098 with a p = 0.143 > 0.05. Where as the factor “Reporting Difficulties Due to A Small Quantity”, it is also insignificant because t = -0.051 with p = 0.48 > 0.05. By generalizing results, the study agree with majority of the hospitals by considering pharmaceutical wastes of the hospital as hazardous industrial wastes that need to be managed and regulated. The study provides “Plans for the Regulation of Pharmaceutical Waste in Hospitals” as a reference for policy making by the authorities. Key word: pharmaceutical waste, waste pharmaceuticals, genotoxic waste, medical waste

Bibliography: leaves 183-191. This thesis establishes a model for the treatment of organic materials in wastewaters produced by the wine industry, by irrigation of soils. Winery and distillery wastewaters were analysed to determine the origins and concentrations of the major organic and inorganic components.

Waste generated by the health care industry has been cited as a major source of toxic pollution, including mercury and dioxins, which poses a serious threat to public health. The purpose of this study was to investigate pollution prevention activities of health care facilities in Oregon related to environmentally preferable purchasing practices, recycling, mercury reduction efforts, and written policy. Surveys were sent to 57 hospitals in Oregon, 24 facilities responded (42.1 %). Results indicate that the following environmentally-preferable purchasing practices are being implemented: purchasing reduced hazardous material (92%); using recycled packaging (75%); and, using products made from recycled content material (83%). Other practices, such as the purchasing of cadmium-free red bags (25%), supplies shipped in reusable shipping containers (34%), and using minimal packaging (46%) are being implemented in a few hospitals. None of the hospitals are purchasing chlorine-free office paper. The majority of participating Oregon hospitals are recycling paper (96%), cardboard (96%), clear glass (67%), linens (87.5%), batteries (67%) and X-ray film (83%). Fewer hospitals are recycling plastics: #1 PET and #6 polystyrene (37.5%), #2 HDPE (42%), #5 polypropylene (33%). Fewer hospitals are also composting food (46%), computers and equipment (42%), fluorescent lamps (21%) and solvents/fixers (29%). Major barriers to recycling in hospitals include lack of established markets for some materials, limited space to collect the materials, and low employee participation. The majority of participating hospitals are reducing the purchasing of mercury containing products, replacing mercury blood pressure units and gauges, replacing lab and housekeeping chemicals, and pharmaceuticals. Fewer than 50% of then participating hospitals are replacing switches, recycling batteries and conducting an inventory of mercury sources. Few hospitals are checking drains and pipes for mercury contamination (13%), recycling fluorescent lamps (21%) and requiring vendors to disclose mercury content below 1% (17%). While most hospitals no longer purchase new mercury-containing devices, the cost associated with disposal of mercury as a hazardous waste is a major barrier to elimination. Hospitals located in urban areas in Oregon are more likely to implement pollution prevention strategies than rural hospitals. Nearly all Oregon hospitals lack a corporate policy on pollution prevention/source reduction, or written goals on waste volume reduction or waste toxicity reduction efforts. The few hospitals (8%) that have put policies in place have done so voluntarily, and with the full support from upper-level management. Based on theses findings recommendations include the following: 1) Establish a "Green Team" of hospital staff from diverse departments. This group can then strategize about courses of action for the facility with input from all responsible sectors. 2) Conduct a waste audit. This establishes a baseline of existing hospital waste and will help determine how to shape a waste minimization program and pollution prevention plan. 3) Pollution prevention education should be a top priority for all departments within each hospital including purchasing, nursing, housekeeping and top management. Many health care professionals are not aware of the link between the products and practices they choose and the environmental consequences of these choices. 4) Rural hospitals can join pollution prevention email list serves such as the Oregon Health Care Without Harm list (HCWHoregon-health.org) or the H2E list serve (www.h2e-online.org) to share, learn and identify practical strategies for pollution prevention and waste minimization. 5) Approach and involve upper level management to work with hospital "green teams" to develop and implement a hospital policy on pollution prevention.
Graduation date: 2003

Bibliography: leaves 183-191.
xxi, 191 leaves : ill. ; 30 cm.
This thesis establishes a model for the treatment of organic materials in wastewaters produced by the wine industry, by irrigation of soils. Winery and distillery wastewaters were analysed to determine the origins and concentrations of the major organic and inorganic components.
Thesis (Ph.D.)--University of Adelaide, Dept. of Soil Science, 1996?

Economic, environmental, social and political influences made the management of solid waste or garbage an important issue for all foodservice directors, including those in health care facilities. The study objectives were to: (1) identify what components of integrated waste management programs were being used in hospital foodservice facilities in Oregon, Washington and Idaho, (2) identify decision making factors for implementing or not implementing components of a solid waste management (SWM) program, (3) determine which of the decision factors were perceived to be the greatest barriers to implementing a SWM program, and (4) determine if demographic characteristics influenced the foodservice director's decision regarding SWM. A survey was sent to all (N=199) hospital foodservice directors in the three state region. Of the 164 returned surveys, 75% of the directors reported they had recycling programs, 51% participated in source reduction and 6% used incineration. Foodservice labor, space to store recyclables, corporate support, monetary return and the director's personal feelings were identified as decision factors (p= < .05) Space to store recyclables and foodservice labor were considered the greatest barriers to recycling. Larger hospitals recycled more often and contracted foodservice operations participated more in source reduction. Information on the decision factors that were identified, can provide guidance to other directors as to the critical factors that should be considered when attempting to implement a successful SWM program and solutions could be developed to overcome or lessen the effects of the barriers.
Graduation date: 1996

Thesis (MPH.) -- University of Limpopo, 2016.
Background: Health care workers produce various types of waste in the course of rendering health care services. Each classification of waste must be disposed according to the prescribed guidelines. Improper disposal of waste may pose a danger to employees, patients and the environment. Health care workers must have adequate knowledge on disposal of medical waste. This study was therefore done to determine the knowledge and practices of health care workers on medical waste disposal. Objectives: This study aims to determine the knowledge and practices of health care workers on medical waste disposal at a hospital in the Mpumalanga Province in South Africa. Methods: A quantitative cross-sectional research approach was used at a regional hospital for the Mpumalanga Province in the Bushbuckridge Municipality under the Ehlanzeni District. The study respondents included professional nurses, enrolled nurses, enrolled nursing assistants, medical doctors, dental health and allied health staff. Data were collected through self-administered questionnaires analysed using International Business Management Statistical Package for Social Sciences 22 (IBM SPSS 22). Results: The results show that a high percentage of health care workers did not have adequate knowledge regarding disposal of medical waste but disposed medical waste appropriately. The results further show that knowledge and practice of health care workers had no association with age, gender and years of experience. There is an association between professional category and knowledge and practice of healthcare workers. Conclusion: Disposal of medical waste is the responsibility of all health care workers. There should be regular training of all categories of health care workers to improve their knowledge on disposal of medical waste and minimise the risks associated with improper waste management. This will further increase compliance with the guidelines of disposal of medical waste. Key words: Health care workers, medical waste, knowledge, practice, disposal

Over the past 10 years, with Australia's urban population ,growth there has been an increasing pressure on land, resource and waste management throughout the States and Territories. Local government, one of the public sectors traditionally responsible for waste services, is being required to take more environmental issues into account in order to develop a sustainable community. The purpose of this study is to investigate current practices of environmental accounting for local government waste management and to explore possible explanations for these environmental accounting practices. This study applies a mixed method design to achieve the research objectives, starting with the case studies of 12 local councils in New South Wales (NSW) Australia, and extending them to a mail survey of all councils in NSW. The case studies allow the researcher to explore the practices of environmental accounting for waste management in a real-life context. The case study findings indicate that contingency theory and institutional theory are most likely to provide insightful explanations for current environmental accounting practices in local government waste management. Contingency theory views organisations as technically devised instruments aiming for effective and efficient control of their work processes. Based on this theory, environmental uncertainty, environmental strategy and task complexity are proposed as explanatory variables. Institutional theory views organisations as social actors and the "carriers" of social structures aiming for legitimacy from a wide range of social institutions. Based on this theory, regulatory pressures, cognitive pressures, community expectations, and inter-professional communication, are proposed as explanatory variables. The mail survey assesses the effectiveness of the two theoretical explanations. The results reveal that the use of environmental accounting in local government waste management is generally moderate rather than little or none as previously suggested. However, the variance in environmental accounting practices in local government waste management is significant. When the scope of environmental accounting information becomes broader, from direct to indirect, from internal to external, lower levels of accounting are found. Among the local councils investigated, accounting for external environmental costs and impacts in waste management has always drawn the least attention. The assessment of theoretical explanations reveals that current environmental accounting practices in local government waste management arc significantly driven by proactive environmental strategics, complex waste operation tasks, a high level of interprofessional communication, and uncertain waste management environments. Task complexity, inter-professional communication, environmental uncertainty, community expectations and environmental strategy are all significantly associated with the level of direct waste flow and activity accounting. However, only environmental strategy, task complexity and inter-professional communication, play a significant role in explaining the levels of accounting for indirect/hidden and external costs and impacts in waste management. It appears that community's environmental expectations and uncertain waste management environments cannot provide a significant incentive for local government to account for indirect/hidden and external environmental costs and impacts. Two institutional factors, regulatory pressures and environmental cognitive pressures do not significantly contribute to any aspect of environmental accounting practices in local government waste management. When testing the effects of type and size of local councils, it is found that urban councils have a significantly higher level of direct waste flow and activity accounting than rural councils, but the differences in the levels of indirect/hidden and external cost and impact accounting are not statistically significant. Size of local councils does not explain any aspect of environmental accounting practices in local government waste management. The results of this thesis indicate that contingency theory provides better explanations for environmental accounting practices in local government waste management than institutional theory. The weaker role of institutional theory explanations implies that the development and institutionalisation of environmental accounting for local government waste management may take a longer time than expected. The explanations for current development of environmental accounting are mainly related to pursuing efficiency and effectiveness of working processes.

Submitted in accordance with the requirements for the Doctors Degree of Technology: Business Administration, Durban University of Technology, 2009.
Although there is an abundance of health care waste information in South Africa, not enough studies have been done in public district hospitals particularly in rural areas. Hospitals find it difficult to comply with the minimum requirements of health care waste management guidelines, such as segregation of waste. If hazardous waste gets mixed with non-hazardous waste, waste disposal and treatment become costly. Furthermore, there has been a sharp increase in the amount of waste generated from health facilities. However, there seem to be uncoordinated efforts in each province in dealing with waste problems. The purpose of this study was to evaluate the process of operational and administrative procedures of health care waste management in hospitals. The study was conducted to facilitate the optimisation of waste management. A quantitative approach was chosen for this study because cause and effect relationships can more easily be identified, and the research is more structured and controlled. The project involved an enquiry into the perception of respondents on the procedures used in managing health care waste. Data was collected from 270 respondents out of 27 hospitals in nine provinces of South Africa. The informants were health care waste workers who were either directly or indirectly involved in waste management. A questionnaire was used as a research instrument. Results were analysed statistically using a special package for scientific studies. It has been found that in the midst of financial challenges, hospitals are unable to prioritise and rank absolutely important activities that are necessary to be undertaken to meet minimum requirements of health care waste management as laid out in the health care waste guidelines and directives. Shortages of waste equipment such as trolleys, waste containers, and temporary storage areas were the main challenges facing hospitals. The recommendations set the tone and provide a blueprint that health care managers may consider in facilitating improvement in the management of health care waste.

The South African Waste Information System (SAWIS) was developed by the Department of Environmental Affairs and Tourism (DEAT) in 2005. This is a system used by government and industry to capture routine data on the tonnages of waste generated, recycled and disposed of in South Africa on a monthly and annual basis. All waste producers and waste management organisations should contribute to this national waste database and should accurately monitor the types and quantities of waste produced and handled. According to DEAT (2006) the need for Data verification is important. DEAT (2006:59) defined the term Data Verification as: "assessing data accuracy, completeness, consistency, availability and internal control practices that serve to determine the overall reliability of the data collected." The aim of the study is to determine a procedure, as well as the nature and extent of internal and external source documents, which could be used in the reconciliation of medical waste quantities from generation to disposal. The key objectives are to determine whether the selected hospitals keep internal records of the quantities of medical waste generated; to reconcile the waste quantities on the internal records with the external records, such as the collection certificates, invoices and waste incineration certificates; to ascertain whether the quantity of medical waste generated is equal to the quantity of waste incinerated and disposed of to determine the ratio factor between the quantity of medical waste before incineration and the quantity of the residue (ashes) after incineration, and to make recommendations on the reconciliation of waste quantities from the point of generation to the point of disposal. The results of the study indicate that the destruction certificate is the proof that the waste that was on-site collected by the service provider has been disposed /treated. Especially as an internal control measure. The health care risk waste (HCRW) management record keeping of quantities of weight as per Hospital A, Hospital B and Hospital C allows the opportunity to analyse the weight per month and per Hospital and per category and to make comparisons. The weakness or the gap however still exist that the waste is not weighed at the point of origin, but at the point where the waste service provider collects the waste onsite. It is from this point onwards that the service level agreement between the hospital and the waste service provider and the document management system and the tracking receipt and the waste collection documents (WCD) becomes relevant and where the quantities of waste per category are for the first time recorded. The hypothesis as stated in Chapter 1 was proven valid. The study concludes that reconciliation and comparison between the collection certificate and the destruction certificate and the monthly invoice is therefore possible, but the risk of mixing of waste and the understating or overstating of waste quantities is still not overcome.
Environmental Sciences
M. Sc. (Environmental management)

Thesis (MPH.) -- University of Limpopo, 2016
Introduction The aim of the study was to determine the knowledge and practices of health care workers on medical waste disposal at George Masebe Hospital, Waterberg District, Limpopo Province, South Africa. Method A cross sectional study was conducted and simple random sampling was used to select participants. Data was collected using self-administered questionnaire which where total of 141 participants were sampled using the Slovin formula. Data were analyzed using the IBM SPSS Version 22 and both descriptive and inferential statistics were used to answer the study objectives. Results The study shows that 43% of the respondents had good knowledge on medical waste disposal, 13% were not sure and 44% had insufficient knowledge. Forty nine percent (49%) of the respondents practiced safe medical waste disposal, 4, 3% were moderate in practice and 46, 1% had insufficient practice in place. There was no statistical significant relationship between knowledge and practice of medical waste disposal control measures of health care workers. Conclusion The study concluded that knowledge of the respondents on medical waste disposal was insufficient, there were satisfactory medical waste practices and there was no relationship between knowledge and practice.