Introduction: Given its effects, hospital waste is an environmental concern and a threat to health personnel, users of health services and neighboring populations. Our objective was to assess the perception of health care stakeholders on the environmental effects related to biomedical waste produced in Teaching Hospitals (CHU) in Togo in 2021. Methods: This was a cross-sectional study held from June 24 to August 28, 2021. It targeted three university hospitals, 340 health care providers and services selected by a probabilistic method with a simple random technique in 25 services, 72 directors, deputy directors, supervisors and heads of services, 27 collection and incineration agents selected by a non-probabilistic method with a reasoned choice technique, 44 patients and attendants and 36 householders of neighboring residents selected by a non-probabilistic method with an accidental choice technique. Variables such as the spreading of disease vectors, soil, air and water contamination, the presence of unpleasant odors and unsightly living conditions were assessed. Results: According to the respondents, biomedical waste causes the proliferation of vectors (55.3%), an unsightly environment inside the hospital (47.1%), and unpleasant odors (61.2%). Incineration operations disturb hospital residents (52.8%), according to the householders of the residents. During observation, we note deposits of waste that have not been destroyed and wastewater flowing in some places. Conclusion: Biomedical waste in Togo’s university hospitals generates environmental effects and therefore potentially high risks for human health. Improving their management should be a concern for all hospital actors.
References
[1]
Organisation Mondiale de la Santé (OMS) (2004) Préparation des Plans Nationaux de Gestion des Déchets de soins médicaux en Afrique Subsaharienne: Manuel d’Aide à la Décision. Génève, 81 p.
[2]
Organisation mondiale de la santé (OMS) (2018) Les déchets liés aux soins de santé. https://www.who.int/fr/news-room/fact-sheets/detail/health-care-waste
[3]
Kuchibanda, K. and Mayo, A.W. (2015) Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania. Scientific World Journal, 2015, Article ID: 981756. https://doi.org/10.1155/2015/981756
[4]
Wafula, S.T., Musiime, J. and Oporia, F. (2019) Health Care Waste Management among Health Workers and Associated Factors in Primary Health Care Facilities in Kampala City, Uganda: A Cross-Sectional Study. BMC Public Health, 19, Article No. 203. https://doi.org/10.1186/s12889-019-6528-4
[5]
Arab, M., Baghbani, R.A., Tajvar, M., et al. (2008) The Assessment of Hospital Waste Management: A Case Study in Tehran. Waste Management & Research, 26, 304-308. https://doi.org/10.1177/0734242X08093598
[6]
Al-Khatib, I.A., Khalaf, A.S., Al-Sari, M.I. and Anayah, F. (2019) Management of Medical Waste in Three Hospitals in Jenin District, Palestine. Environmental Monitoring and Assessment, 192, 10. https://doi.org/10.1007/s10661-019-7992-0
[7]
Goswami, M., Goswami, J.P., Nautiyal, S. and Prakash, S. (2021) Challenges and Actions to the Environmental Management of Bio-Medical Waste during COVID-19 Pandemic in India. Héliyon, 7, e06313. https://doi.org/10.1016/j.heliyon.2021.e06313
[8]
Parteek, S.T., Arjun, S., Dapinder, D.S., et al. (2021) Compromising Situation of India’s Bio-Medical Waste Incineration Units during Pandemic Outbreak of COVID-19: Associated Environmental-Health Impacts and Mitigation Measures. Environmental Pollution, 276, Article ID: 116621. https://doi.org/10.1016/j.envpol.2021.116621
[9]
Mahato, S., Mahato, A., Pokharel, E. and Tamrakar, A. (2019) Detection of Extended-Spectrum Beta-Lactamase-Producing E. coli and Klebsiella spp. in Effluents of Different Hospitals Sewage in Biratnagar, Nepal. BMC Research Notes, 12, 64. https://doi.org/10.1186/s13104-019-4689-y
[10]
Sharma, D.R., Pradhan, B., Pathak, R.P. and Shrestha, S.C. (2010) Healthcare Liquid Waste Management. Journal of Nepal Health Research Council, 8, 23-26.
[11]
Mukhaiber, H.M. (2017) The Reality of Liquid Medical Waste Management in Damascus Hospitals. Eastern Mediterranean Health Journal, 23, 110-118. https://doi.org/10.26719/2017.23.2.110
[12]
Hangulu, L. and Akintola, O. (2017) Health Care Waste Management in Community-Based Care: Experiences of Community Health Workers in Low Resource Communities in South Africa. BMC Public Health, 17, 448. https://doi.org/10.1186/s12889-017-4378-5
[13]
Saizonou, J., Ouendo, E.M., Agueh, V., et al. (2014) évaluation de la qualité de la gestion des déchets biomédicaux solides dans la zone sanitaire Klouekanme-Toviklin-Lalo au Bénin. Journal International de Santé au Travail, 1, 1-11.
[14]
Dégbey, C., Gnaro, R., Kpozehouen, A., Ouendo, E.M. and Makoutodé, M. (2019) Hygiène environnementale des centres de santé: Evaluation dans la zone sanitaire de Lokossa-Athiemé (Bénin) en 2018. Hygiènes, 27, 53-57.
[15]
N’Zi, K.C., Traoré, Y., Dindji, M.R., et al. (2018) Management des déchets médicaux et risque biologique à l’hôpital universitaire de Cocody, Côte d’Ivoire. Santé Publique, 30, 747-754. https://doi.org/10.3917/spub.186.0747
[16]
Ndiaye, M., Dieng, M., Ndiaye, N.A., et al. (2020) évaluation du système de traitement des déchets biomédicaux solides dans la commune de Keur Massar, en banlieue dakaroise au Sénégal. Journal of Applied Biosciences, 148, 15252-15260. https://doi.org/10.35759/JABs.148.9
[17]
Olaniyi, F.C., Ogola, J.S. and Tshitangano, T.G. (2019) Efficiency of Health Care Risk Waste Management in Rural Healthcare Facilities of South Africa: An Assessment of Selected Facilities in Vhembe District, Limpopo Province. International Journal of Environmental Research and Public Health, 16, 2199. https://doi.org/10.3390/ijerph16122199
[18]
Ndiaye, M., El Metghari, L., Soumah, M.M. and Sow, M.L. (2012) Gestion des déchets biomédicaux au sein de cinq structures hospitalières de Dakar, Sénégal. Bulletin de la Societe de Pathologie Exotique, 105, 296-304. https://doi.org/10.1007/s13149-012-0244-y
[19]
Ali, M., Wang, W., Chaudhry, N. and Geng, Y. (2017) Hospital Waste Management in Developing Countries: A Mini Review. Waste Management & Research, 35, 581-592. https://doi.org/10.1177/0734242X17691344
[20]
Bilal, A.K., Longsheng, C., Aves, A.K. and Haris, A. (2019) Healthcare Waste Management in Asian Developing Countries: A Mini Review. Waste Management & Research, 37, 863-875. https://doi.org/10.1177/0734242X19857470
[21]
United Nations Children’s Fund (UNICEF), World Health Organisation (WHO) (2005) Water, Sanitation and Hygiene in Health Care Facilities Status in Low- and Middle-Income Countries and Way Forward. Geneva, 59 p.
[22]
Bdour, A., Altrabsheh, B., Hadadin, N. and Al-Shareif, M. (2007) Assessment of Medical Wastes Management Practice: A Case Study of the Northern Part of Jordan. Waste Management, 27, 746-759. https://doi.org/10.1016/j.wasman.2006.03.004
[23]
Kasuku, W., Bouland, C., De Brouwer, C.H., et al. (2016) étude de l’impact sanitaire et environnemental des déchets hospitaliers dans 4 établissements hospitaliers de Kinshasa en RDC. Déchets Sciences et Techniques, 71, 26-33. https://doi.org/10.4267/dechets-sciences-techniques.3357
[24]
Haylamicheal, I.D., Dalvie, M.A. and Yirsaw, B.D. (2011) Assessing the Management of Healthcare Waste in Hawassa City, Ethiopia. Waste Management & Research, 29, 854-862. https://doi.org/10.1177/0734242X10379496
[25]
Hayleeyesus, S.F. and Cherinete, W. (2016) Healthcare Waste Generation and Management in Public Healthcare Facilities in Adama, Ethiopia. Journal of Health and Pollution, 6, 64-73. https://doi.org/10.5696/2156-9614-6-10.64
[26]
Gizalew, E.S., Girma, M.S., Desta Haftu, D.S., et al. (2021) Health-Care Waste Management and Risk Factors among Health Professionals in Public Health Facilities of South Omo Zone, South West Ethiopia, 2018. Journal of Healthcare Leadership, 13, 119-128. https://doi.org/10.2147/JHL.S300729
[27]
Todedji, J.N., Degbey, C.C., Soclo, E., et al. (2020) Caractérisation physicochimique et toxicologique des effluents des Centres Hospitaliers et Universitaires du département du Littoral du Bénin. International Journal of Biological and Chemical Sciences, 14, 1118-1132. https://doi.org/10.4314/ijbcs.v14i3.37
[28]
Wiafe, S., Nooni, I.K., Appiah Boateng, K., et al. (2016) Clinical Liquid Waste Management in Three Ghanaian Healthcare Facilities—A Case Study of Sunyani Municipality. British Journal of Environmental Sciences, 4, 11-34.
[29]
Agbere, S., Melila, M., Dorkenoo, A., et al. (2021) State of the Art of the Management of Medical and Biological Laboratory Solid Wastes in Togo. Héliyon, 7, e06197. https://doi.org/10.1016/j.heliyon.2021.e06197
[30]
Guedehoussou, T., Djadou, E.K., Kombedzra, K.E., et al. (2017) Evaluation de la gestion des déchets issus des activités de vaccination de routine dans le district sanitaire n° 3 de Lomé Commune, Togo. Journal de la Recherche Scientifique de l’Université de Lomé, 19, 631-640.
[31]
Gnaro, T., Ali, A., Adom, A., et al. (2022) Assessing Biomedical Solid and Liquid Waste Management in University Hospital Centers (CHU) in Togo, 2021. Open Journal of Epidemiology, 12, 401-420. https://doi.org/10.4236/ojepi.2022.124033
[32]
Ministère en charge de la Santé du Togo (2016) Plan stratégique de gestion des déchets médicaux, 2016-2020 au Togo. 57 p.
[33]
Roberts, K.P., Phang, S.C., Williams, J.B., et al. (2021) Increased Personal Protective Equipment Litter as a Result of COVID-19 Measures. Nature Sustainability, 5, 272-279. https://doi.org/10.1038/s41893-021-00824-1
[34]
Canning-Clode, J., Sepúlveda, P., et al. (2020) Will COVID-19 Containment and Treatment Measures Drive Shifts in Marine Litter Pollution? Frontiers in Marine Science, 7, 691. https://doi.org/10.3389/fmars.2020.00691
[35]
Peshin, S.S., Halder, N., Jathikarta, C. and Gupta, Y.K. (2015) Use of Mercury-Based Medical Equipment and Mercury Content in Effluents of Tertiary Care Hospitals in India. Environmental Monitoring and Assessment, 187, Article No. 145. https://doi.org/10.1007/s10661-015-4311-2
[36]
Caniato, M., Tudor, T.L. and Vaccaria, M. (2016) Assessment of Health-Care Waste Management in a Humanitarian Crisis: A Case Study of the Gaza Strip. Waste Management, 58, 386-396. https://doi.org/10.1016/j.wasman.2016.09.017
[37]
Word Health Organization (2014) Safe Management of Wastes from Health-Care Activities. 2nd Edition, WHO, Geneva.
[38]
Manga, V.E., Forton, O.T., Mofor, L.A. and Woodard, R. (2011) Health Care Waste Management in Cameroon: A Case Study from the Southwestern Region. Resource Conservation, 57, 108-116. https://doi.org/10.1016/j.resconrec.2011.10.002
[39]
Lan, D.Y., Zhang, H., Wu, T.W., et al. (2021) Repercussions of Clinical Waste Co-Incineration in Municipal Solid Waste Incinerator during COVID-19 Pandemic. Journal of Hazardous Materials, 423, Article ID: 127144. https://doi.org/10.1016/j.jhazmat.2021.127144
[40]
Jade, M.C., Reza, Z., et al. (2021) Sustainable Waste Management of Medical Waste in African Developing Countries: A Narrative Review. Waste Management & Research, 39, 1149-1163. https://doi.org/10.1177/0734242X211029175
[41]
Biswal, S. (2013) Liquid Biomedical Waste Management: An Emerging Concern for Physicians. Journal of Medical Science & Research, 4, 99-106. https://doi.org/10.4103/0975-9727.118238
[42]
Dai, Z., Hao, N., et al. (2020) Portable Photoelectrochromic Visualization Sensor for Detection of Chemical Oxygen Demand. Analytical Chemistry, 92, 13604-13609. https://doi.org/10.1021/acs.analchem.0c03650
[43]
El Mountassir, R., Bennani, B., Merzouki, H., et al. (2017) Characterization of the Chemical and Bacteriological Risks of the Effluents from Some Services of the Hassan II Hospital Center in Fez. Journal of Mechanical Engineering and Sciences, 8, 2288-2295.
[44]
Bouzid, J., Chahlaoui, A., et al. (2013) Etude bactériologique et physicochimique des effluents liquides de l’hôpital Mohamed V de Meknès. Science Library, 5, Article ID: 130803.
