|Fact sheet No 253: Wastes from Healthcare Activities (WHO, 2000, 4 p.)|
Although treatment and disposal of health-care wastes aim at reducing risks, indirect health risks may occur through the release of toxic pollutants into the environment through treatment or disposal.
· Landfilling can potentially result in contamination of drinking water. Occupational risks may be associated with the operation of certain disposal facilities. Inadequate incineration, or incineration of materials unsuitable for incineration can result in the release of pollutants into the air. The incineration of materials containing chlorine can generate dioxins and furans3, which are classified as possible human carcinogens and have been associated with a range of adverse effects. Incineration of heavy metals or materials with high metal contents (in particular lead, mercury and cadmium) can lead to the spread of heavy metals in the environment. Dioxins, furans and metals are persistent and accumulate in the environment. Materials containing chlorine or metal should therefore not be incinerated.
· Only modern incinerators are able to work at 800-1000 °C, with special emission-cleaning equipment, can ensure that no dioxins and furans (or only insignificant amounts) are produced. Smaller devices built with local materials and capable of operating at these high temperatures are currently being field-tested and implemented in a number of countries.
· At present, there are practically no environmentally-friendly, low-cost options for safe disposal of infectious wastes. Incineration of wastes has been widely practised, but alternatives are becoming available, such as autoclaving, chemical treatment and microwaving, and may be preferable under certain circumstances. Landfilling may also be a viable solution for parts of the waste stream if practised safely. However, action is necessary to prevent the important disease burden currently created by these wastes.
In addition, perceived risks related to health-care waste management may be significant. In most cultures, disposal of health-care wastes is a sensitive issue and also has ethical dimensions.