A total quality management approach to healthcare waste management in Namazi Hospital,Iran

BackgroundHealthcare waste comprises all wastes generated at healthcare facilities, medical research centers and laboratories. Although 75–90% of these wastes are classified as household waste posing no potential risk, 10–25% are deemed to be hazardous, representing a potential threat to healthcare workers, patients, the environment and even the general population, if not disposed of appropriately. If hazardous and non-hazardous waste is mixed and not segregated prior to disposal, costs will increase substantially. Medical waste management is a worldwide issue. In Iran, the majority of problems are associated with an exponential growth in the healthcare sector together with low- or non-compliance with guidelines and recommendations. The aim of this study was to reduce the amounts of infectious waste by clear definition and segregation of waste at the production site in Namazi Hospital in Shiraz, Iran.Materials and methodsNamazi Hospital was selected as a study site with an aim to achieving a significant decrease in infectious waste and implementing a total quality management (TQM) method. Infectious and non-infectious waste was weighed at 29 admission wards over a 1-month period.ResultsBefore the introduction of the new guidelines and the new waste management concept, weight of total waste was 6.67 kg per occupied bed per day (kg/occupied bed/day), of which 73% was infectious and 27% non-infectious waste. After intervention, total waste was reduced to 5.92 kg/occupied bed/day, of which infectious waste represented 61% and non-infectious waste 30%. The implementation of a new waste management concept achieved a 26% reduction in infectious waste.ConclusionA structured waste management concept together with clear definitions and staff training will result in waste reduction, consequently leading to decreased expenditure in healthcare settings.     

The fate of nitrogen in a moderately alkaline and calcareous soil amended with biosolids and urea

The determination of nitrogen (N) based loading rates for land application of biosolids is challenging and site specific. Over loading may contribute to environmental, agricultural, or human health problems. The objective of this study was to monitor N mineralization and losses in a moderately alkaline and calcareous desert soil amended with either anaerobically digested (AN) or lime-stabilized (LS) biosolids, and irrigated with and without urea enriched water. For Experiment 1, N inputs, leaching and residuals in soil were evaluated in an open soil column system. For Experiment 2, ammonia (NH₃) emissions were evaluated in a closed soil column system. In Experiment 1, AN and LS biosolids increased soil ON (organic N) by three and two fold, respectively. Respective net N mineralization of ON from biosolids alone was 90% and 62% without urea, and 71% and 77%, respectively with added urea. Nitrogen leaching losses and residuals in amended soil did not account for all N inputs into the soil/biosolids system. In Experiment 2, NH₃ emissions were not significantly different among treated soils with or without added urea, except LS amended soil receiving urea. Ammonia losses did not account for unaccounted N in Experiment 1. We concluded that deep placement and rapid mineralization of AN biosolids promoted anaerobic soil conditions and denitrification, in addition to the high denitrification potential of desert soil. LS biosolids showed greater potential than AN biosolids for safe and beneficial land application to desert soils regardless of biosolids placement and the inclusion of N rich irrigation water.