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Health Hazards of Medical Waste and its Disposal 117

Step 7: Review the national health-care waste management program
after implementation
When selecting an appropriate medical waste sterilization or disposal
technology, it is important to consider the following issues:
1. Types and quantities of medical waste produced.
2. Capital investment and operational costs associated with each
technology.
3. Infrastructure requirements for installation and operation of each
technology.
4. Medical waste volume and mass reduction issues that impact final dis-
posal in landfill.
5. Occupational health and safety, including needle-stick prevention.
6. Training and operation requirements.
7. Monitoring requirements for noncombustion technologies to ensure
treatment efficacy.
8. Country-specific regulatory requirements.
9. Environmental (air, water, soil) impacts.
10. Locally available treatment and disposal technologies.
11. Community acceptability.

8.9.3 International Recommendations for Waste Management

The United Nations Conference on the Environment and Development
(UNCED) in 1992 led to the adoption of Agenda 21, which recommends
a set of measures for waste management. The recommendations may be
summarized as follows:
(a) Prevent and minimize waste production.
(b) Reuse or recycle the waste to the extent possible.
(c) Treat waste by safe and environmentally sound methods.
(d) Dispose of the final residues by landfall in confined and carefully de-
signed sites.

FURTHER READING
[1] Safe Health Care Waste Management. Policy Paper. Geneva: World Health Organiza-
tion; 2004.
[2] Alvim-Ferraz MC, Afonso SA. Incineration of different types of medical wastes: emis-
sion factors for particulate matter and heavy metals. Environ Sci Technol 2003;37(14):
3152–7.
[3] Healthcare Without Harm website. Available at: http://www.noharm.org/; (Accessed
September 24, 2005).
[4] Sani-Pak. n.d. World Health Systems [catalog]. Tracey, CA: Sani-Pak.