ASSESSMENT OF STATUS MEDICAL WASTE MANAGEMENT AND TREATMENTIN TUYEN QUANG GENERAL HOSPITAL

THAI NGUYEN UNIVERSITY UNIVERSITY OF AGRICULTURE AND FORESTRY VU LAN TRANG TOPIC TITLE: ASSESSMENT OF STATUS MEDICAL WASTE MANAGEMENT AND TREATMENTIN TUYEN QUANG GENERAL HOSPITAL BACHELOR THESIS Study Mode : Full- time Major : Bachelor in Environmental Science and Management Faculty : International Training and Development Center Batch : K42- Advance Education Program Thai Nguyen, 23/ 01/2015 i Thai Nguyen University of Agriculture and Forestry Degree Program Bachelor of Environmental Sciences and Management Student Name Vu Lan Trang Student ID DTN1053100118 Thesis Title Assessment of status medical waste management and treatment in Tuyen Quang General Hospital Supervisor Dr Nguyen Hung Quang Abstract: Assessment and analyze the status of medical waste management in Tuyen Quang General Hospital: Assess the classification, transportation, storage and treatment of medical waste and wastewater generated in operation process of Tuyen Quang General Hospital Analyze and propose solutions: Causing of existence in the management and treatment of medical waste in hospital Solutions to improve the management efficiency and treatment medical waste: Treating waste to improve the efficiency for medical waste management in Tuyen Quang General Hospital Keywords Medical waste; Hazardous medical waste; waste management; wastewater treatment system; Tuyen Quang; Number of pages 59 Date of submission 23/01/2015 ii ACKNOWLEDGMENT With the consent of the Managing Board - Thai Nguyen University of Agriculture and Forestry, International Training and Development Center, the assistance and guidance of Dr Nguyen Hung Quang I conduct research with topic: "Assessment of status medical waste management and treatment in Tuyen Quang General Hospital" In order to complete this thesis, firstly I would like to sincerely thank the managing board of Thai Nguyen University of Agriculture and Forestry, International Training and Development Center, thank teachers, who imparted to me the knowledge and skills during the time I study and practice at Thai Nguyen University of Agriculture and Forestry Especially, I would like to sincerely thank the enthusiastic help of Dr Nguyen Hung Quang who guided me during the time of graduation exercises to implementation and complete this thesis I would like to thank the assistance of staffs who are working at Department of Natural Resources and Environment of Tuyen Quang province, Environmental Protection Agency has helped me during internships time, impart practical experience for me I would like to thank staff and officers at Tuyen Quang General Hospital who created the best conditions for me to completed this thesis This is the first time I've implementation a thesis, due to knowledge of myself and the time are limited, certainly in my thesis was shortcomings and restrictions I hope to receive feedback, comments and additions to my thesis complete and found the exist shortcomings of myself I would like to sincerely thank! Tuyen Quang, 23 rd January, 2015 Student Vũ Lan Trang iii TABLE OF CONTENTS LIST OF FIGURES LIST OF TABLES LIST OF ABBREVIATIONS PART I INTRODUCTION 1.1 Research rationale 1.2 Research’s objectives 1.3 Research questions and hypotheses 1.4 Limitations 1.5 Definitions PART II.LITERATURE REVIEW 2.1 Scientific base of the study 2.2 Theoretical base of the study 2.2.1 Classification of the medical waste 2.2.2 Harmful effects of medical waste 11 2.3 Current status of medical waste management in Vietnam 14 2.3.1 General situation 14 2.3.2 The process of collecting, sorting and transporting waste in the health care facilities 18 2.3.3 Measures and technologies to treat hazardous medical waste 19 PART III METHODS 22 3.1 Material 22 3.2 Methods 23 3.3.1 Interview methodology in the field 23 3.3.2 Methods of analysis, synthesis document 23 3.2.3 The sampling method of wastewater 24 3.2.4 Experimental and analysis methods in the laboratory 24 PART IV RESULTS 26 4.1 The overview of Tuyen Quang General Hospital 26 4.1.1 Functions and tasks 27 iv 4.2 Sources of waste and the methods to collect, classify and treat medical waste in Tuyen Quang General Hospital 30 4.2.1 Common Solid Waste 30 4.2.3 Hazardous waste 32 4.2.3 Wastewater 35 4.2.3 Gas emission 40 4.3 Assessment the preliminary way of medical waste 47 4.3.1 Domestic waste 47 4.3.2 Hazardous medical waste 48 4.3.3 Wastewater 49 4.4 Assessment the quality of wastewater in Tuyen Quang General Hospital 50 4.4.1 Sources of wastewater 50 4.4.2 Result of observational, analysis 51 4.5 Recommendation some solutions for collection and treatment activities of medical waste in Tuyen Quang General Hospital 53 4.5.1 Solution in the collection, storage and treatment of medical waste 53 4.5.2 Solutions for wastewater treatment system 54 4.5.3 Management mission 54 PART V DISCUSSION AND CONCLUSION 56 5.1 Discussion 56 5.1.1 Area and position of Tuyen Quang General Hospital 56 5.1.2 Status of waste management and treatment in hospital 56 5.1.3 Results of the environmental research 57 5.2 Conclusion 58 REFERENCES 60 v LIST OF FIGURES Figure 4.1.Organization chart of Tuyen Quang General Hospital 29 Figure 4.2 Hazardous medical waste generating trendy in 2013-2014 .34 Figure 4.3 Treatment technology of wastewater 37 Figure 4.4 Preliminary way of domestic waste 48 Figure 4.5 Preliminary way of Hazardous medical waste 49 Figure 4.6 Preliminary way of wastewater 50 LIST OF TABLES Table2.1 Some examples of infection due to contact with medical waste Microorganism category of pathogenic and procedure infection 12 Table 2.2.Waste arising under the beds in Vietnam in 2012 .15 Table 2.3 Distribution of medical waste by type of urban 16 Table 2.4 Comparison of medical waste generated in Vietnam with some neighboring countries in 2012 .17 Table 3.1 Notation of sampling locations 22 Table 4.1 List of hazardous waste generated an average of 01 month .32 at Tuyen Quang General Hospital 32 Table 4.2 Reality amount of hazardous medical waste in Tuyen Quang General Hospitals 33 Table 4.3 Time existence of some microorganisms 42 Table 4.4 Results of the wastewater target analysis of Tuyen Quang General Hospital .51 LIST OF ABBREVIATIONS BOD5 The biochemical oxygen demand in days COD Chemical oxygen demand MONRE Ministry of Natural Resources and Environment MOH Ministry of Health MOC Ministry of Construction One member co., Ltd One Member Limited Liability Company PART I INTRODUCTION 1.1 Research rationale Caring, protecting and improving human's health is an important task of the health sector In order to adequately meet for medical examination and treatment and health care demand of people, received the attention of the Party and State, medical facility system have been continuously enhanced, expanded and improved However, during operation process, the health system, especially the hospital has discharged a large amount of medical waste substances, including hazardous medical waste According to the World Health Organization (WHO, 1994), the components of medical waste about 10% of the infection waste and 5% is noxious waste such as radioactive, cytotoxic substances, toxic substances generated in the diagnosis and treatment procedure It is risk factors of environmental pollution, pathogens spread from hospital to surroundings area, lead to increased risk of monomial infection and increased disease incidence of local communities living in contiguous areas In order to assess the status of medical waste as well as the impact of medical waste on the environment, they need to have research of the scientists and agencies Research has been showing that existed in the medical waste management in our country However currently, for many reasons, including the pressure on the need of medical examination and treatment of people, the overload of many hospitals, lack of uniformity in infrastructure of the hospital means environmental sanitation of many hospitals is not guaranteed Tuyen Quang General Hospital is the provincial hospital It is the medical examination and treatment center of Tuyen Quang province The scale of hospital is 500 beds, with all the Department of Internal Medicine, Department of Surgery and Clinical Departments The number of patients examined on average is between 400500 cases/ day The rate of bed occupancy often exceeds 100% The hospital is located in the city center where it is the largest concentration of population so that the shortcomings in the management and treatment of medical waste will greatly affect to surrounding communities Stemming from the above problems I conducted research topics “Assessment of status medical waste management and treatment in Tuyen Quang General Hospital” 1.2 Research’s objectives - Cursory review of Tuyen Quang General Hospital - Assessment of status medical waste management and treatment in Tuyen Quang General Hospital - Propose solutions to increase the effect of medical waste management and reduce pollution 1.3 Research questions and hypotheses - What is the current situation of medical waste management in Tuyen Quang General Hospital? - What is the way to treatment medical waste of Tuyen Quang General Hospital? - How we can closely management the medical waste of Tuyen Quang General Hospital? Departments, chambers Patient’s room Canteen, kitchen of hospital Green containers, volume 240l Campus’s hospital Workers of Tuyen Quang Environmental Services and Urban Management One member Co., Ltd Collect and transport to gather place Classification Recycle waste was stored at the Infectious Control Department and sold for units have recycling function Solid waste taken to treatment at Nhu Khe landfill twice a day, at a.m and p.m Figure 4.4 Preliminary way of domestic waste 4.3.2 Hazardous medical waste Hazardous medical waste is frequently collected by sanitation team of hospital from Clinical, Subclinical, Infection Control and Pharmacy Departments In departments, chambers have yellow bins with plastic bags available to contain hazardous medical waste, bins have lids and sanitation team of the hospital collected and transported immediately next to the incinerator system and at 13 p.m daily, caseworker conducted incinerated waste Ashes of incinerator system have been buried and rendered inert in the hospital campus 48 Yellow bins with plastic bags Clinical Departments Subclinical Departments Infection Control Departments Pharmacy Departments Sanitation team Collect and transport to gather place located near the incinerator system 13 pm daily Incinerating waste Ashes of incinerator system have been inverted in buried the and hospital campus Figure 4.5 Preliminary way of Hazardous medical waste 4.3.3 Wastewater Wastewater from functional departments, patient's room, canteen, kitchen of hospital directly flow to the preliminary treatment through the underground septic tanks system of hospital with capacity around 210 m3/ day After that it leads directly into the wastewater treatment system of hospital located inside Tuyen Quang Tuberculosis and Lung Diseases Hospital next to Tuyen Quang General Hospital with capacity approximate 330m3 /day to thoroughly treat before discharged into the sewer system of the city Particularly sludge from septic tanks will be sucked periodically and taken for treatment 49 Function Departments Patient’s room Canteen Rainwater runoff in hospital’s campus Preliminary treatment through the underground septic tanks system with capacity 210 m3/day Sludge will be suck periodically and take to treat from to months/times Wastewater treatment system located inside Tuyen Quang Tuberculosis and Lung Diseases Hospital next to Tuyen Quang General Hospital with capacity approximate 330m3/day Sewer system of the city Figure 4.6 Preliminary way of wastewater 4.4 Assessment the quality of wastewater in Tuyen Quang General Hospital 4.4.1 Sources of wastewater Wastewater of Tuyen Quang General Hospital generated primarily from the following sources: - Domestic wastewater of officers and workers, patients, family members of patients and visitors: the wastewater effluents from the floor, sink and septic tank of treatment facilities, offices, administrative areas - Wastewater generated from the course of medical treatment: Wastewater effluents from the floor and sink of the tests and X-rays area, emergency rooms, operating rooms 50 Wastewater from two sources contained organic substances, suspended solids, detergents, pharmaceuticals and especially pathogenic bacteria - Surface wastewater: Mostly rainwater runoff will be entrainment waste, soil and other suspended substances 4.4.2 Result of observational, analysis Table 4.4 Results of the wastewater target analysis of Tuyen Quang General Hospital pH BOD5 mg/l 7.5 54 7.6 26 Vietnam Standards 28:2010/MONRE (Column B) 6.5-8.5 50 COD mg/l 130 35 100 PO43- mg/l 4.9 4.6 10 NO3Coliform mg/l MNP/100ml 2.3 1500 1.8 900 50 5000 No Indicators Unit Before treatment (NT1) After treatment (NT2) Wastewater before treatment Medical wastewater contains chemicals and has important cumulative property to evaluate the quality of wastewater Through the analysis results of wastewater before treatment, some indicators not achieved and exceed the standards quality allowed under Vietnam Standard 28: 2010 Specifically as follows: - Indicator BOD5 is 54 mg/l exceed 1.08 times compared with the standard quality allowed BOD5 is one indicator to assess the level of pollution of waste and self-cleaning ability of water, due to the characteristics of medical waste is collected from the surgery room, examination and treatment area so the content of BOD5 in medical wastewater exceed Vietnam Standard 28: 2010 /MONRE 51 - Indicator COD is 130 mg/l exceed 1.3 times compared with the standard quality allowed COD is used to define the amount of organic contamination found in wastewater surface, is a useful measure of water quality When oxygen demand exceeds indicator allowed so the self-cleaning ability of water is not responding, due to characteristic of medical wastewater is collected from the surgery room, examination and treatment area so the content of COD in wastewater exceed Vietnam Standard 28: 2010/MONRE Wastewater after through treatment system Medical wastewater after through treatment system, the physical, biological indicators had dropped to standard quality allowed by Vietnam Standard 28:2010 /MONRE Specifically as follows: - Indicator BOD5 decreased to 26 mg/l - Indicator COD decreased to 35 mg/l Comparison results of the analysis of wastewater samples before and after treatment Through the table 10 compare results of the analysis of wastewater samples before and after treatment of hospital showed that: the process of system did reduce the contamination rate than the incoming wastewater The basic indicators are within the limits allowed under Vietnam Standard 28: 2010/MONRE And medical wastewater samples before treatment have content of BOD5, COD exceed the limit allowed - Content of BOD5 in wastewater samples before treatment exceed 1.08 times than Vietnam Standard 28: 2010/MONRE After treatment in wastewater treatment system of hospital, it reduced in the range of allowed under Vietnam Standard 28: 2010/ MONRE 52 - Content of COD in wastewater samples before treatment exceed 1.3 times than Vietnam Standard 28: 2010/MONRE After treatment in wastewater treatment system of hospital, it reduced in the range of allowed under Vietnam Standard 28: 2010/MONRE 4.5 Recommendation some solutions for collection and treatment activities of medical waste in Tuyen Quang General Hospital 4.5.1 Solution in the collection, storage and treatment of medical waste - Reducing at source: Choosing to purchase and sale medical materials arise a small amount of hazardous medical waste, prevent medical materials prodigal -Management chemicals and pharmaceuticals warehouse: Order with moderate amounts, have a long shelf life Hospital should use the recyclable materials inside or outside hospital - Waste classify: Classification carefully into different categories can significantly reduce amount of medical waste, so this activity will be the highest priority implementation - Recycling and using domestic waste: recycling materials such as paper, glass, plastics can be save for hospital the costs for transportation, treatment or get more money from the sale of scrap recycling so should be encouraged to implement this task - Planting more trees for air equable in hospital, often spray disinfectants in hospital campus to ensure the best environment for examination and treatment activities 53 4.5.2 Solutions for wastewater treatment system - Hospitals should regularly check and take measures to deal with the septic tanks construction and toilets to avoid the blocked pipe and increase efficiency for wastewater treatment system - Regular inspection of the underground sewer system from the functional areas to wastewater treatment system to avoid the risk of clogging by waste and inorganic waste 4.5.3 Management mission - Function organizations needs to supervise and inspect surrounding environment periodically in order to timely detect serious violation to the environment: + Conducting periodic observation to detect the signs of pollution + Environmental Protection Agency of Tuyen Quang province and Environmental Police should cooperate to carry out unannounced inspections about wastewater treatment system as well as sanitary and environmental activities of the hospital - Board of leaders as well as staff of Tuyen Quang General Hospital should increase the awareness in environmental protection, strengthen and upgrade the wastewater treatment system, adding more human resource to be suitable with the hospitals current scale - Adding more expense, equipment, human resource on urban management and more staff being in charge of environment matters 54 + Holding short-term training courses, seminars about new technologies for staff in charge of environmental matters Receiving and integrating the global scientific knowledge for the hospitals 55 PART V DISCUSSION AND CONCLUSION 5.1 Discussion 5.1.1 Area and position of Tuyen Quang General Hospital Tuyen Quang General Hospital is provincial hospital grade II with the total area approximate 48.284 m2, the scale 500 beds Ensuring the hygiene standards about surface area/bed (96.5m2) Hospital located at 44 Le Duan Street, Tan Ha ward, Tuyen Quang city where is far from city center 2,000 m to the North Position of Tuyen Quang General Hospital shows that it has specific effect to economic – society of Tan Ha ward, as well as Tuyen Quang city In social terms,Tuyen Quang General Hospital has wide effect in province because annual examination and treatment for the thousands turn of people Quality of service, whole-hearted of staffs, doctors in hospital to patients and relatives people will have a positive impact on society, citizens are believed which is contribute to social stability in the province However, the hospital is located in detrimental position to residential areas Around is concentrated population So if medical waste is not well management, the ability affect to residential areas is unavoidable 5.1.2 Status of waste management and treatment in hospital a Status of waste management Domestic waste is collected by sanitary team of Tuyen Quang Environmental Services and Urban Management One member Co., Ltd which has responsible for collect and taken to treat Particularly, medical waste is collected by sanitation teams of hospital from departments/chambers and transport to gathering place to sort, then it is treated at incinerators in campus of hospital 56 Hospital has implemented the collection and classification of waste at source However, we can unavoidable mistakes in classify activity from that can be increase costs for hazardous waste treatment, increase the risk of environmental pollution due to cross-contamination between the types of waste, on the other hand, increases the risk of injury to people who are collect and transport So there should be a specific assignment, reasonable in the waste management to attach people to their responsibilities and also facilitates for control and supervision are conveniently Gathering place is meets the sanitation standards: closed, roofed, there is no water from gathering place seeping outside b The situation of waste treatment - Liquid Waste: Wastewater is preliminary treated through the underground septic system of the hospital before being led to treat at the wastewater treatment system of Tuyen Quang General Hospital and Tuyen Quang Tuberculosis and Lung Disease Hospital The biochemical indicators standards before discharged into the sewer system of city - Solid medical waste: Hospital treated whole volume of all clinical waste by incinerators Ashes of incinerators system is chemical inverted and buried in campus of hospital 5.1.3 Results of the environmental research Before through wastewater treatment system Wastewater pre-treatment of hospital have BOD, COD exceeds the B allowed limit The indicators pH, PO43-, NO3- are in the range of permissible limits 57 After through wastewater treatment Generally, after wastewater through wastewater treatment system, indicators in the range of B permissible limits Comparing the quality of wastewater before and after through treatment system we see the quality of wastewater after treatment is satisfied the standards when it discharged into the sewage system of the city Even when untreated, quality of wastewater has satisfied biochemical indicators I think probably in hospital, wastewater is pretreatment in the departments/ chambers and through the underground septic system before flowing into the wastewater treatment system So clearly the hospital strictly implemented wastewater treatment from the departments/chambers will limit the risk of pollution to the environment 5.2 Conclusion During internships time, based on analysis of hospital operation process, collecting data, investigating of pollution sources I have the following conclusion: Tuyen Quang General Hospital is located in a convenient area to medical examination and treatment for people in province and contiguous provinces Tuyen Quang General Hospital is in a safe area for not being effected by flood in the wet season 100% solid waste of the hospital is collected and sorted at sources before being taken to storage area by sanitary staffs, the path to transport are specified separately, avoid passing through areas of patient health care and other clean areas, go the way after hospital and put into storage place Hazardous medical waste is treated by incineration methods whereby incinerator has the capacity to process 35kg/hour (built in 2003) and incinerator has capacity to process 40kg/hour (built in 2011) 58 Domestic waste of the Hospital is contracted with Tuyen Quang Environmental Services and Urban Management -One member Co., Ltd cleaned up and collected and taken to treat at Nhu Khe landfill with frequency times/ day, at am and pm Wastewater of hospital is treated by wastewater treatment system located inside Tuyen Quang Tuberculosis and Lung Diseases Hospital next to Tuyen Quang General Hospital with capacity approximate 330m3/day After treated, wastewater will reach following standard before joining the sewer system of the city: - Indicator BOD5 decreased to 26mg/l - Indicator COD decreased to 35mg/l Environmental protection measures being applied by hospital ensure that operation and business of Tuyen Quang General Hospital will take no effect to surrounding environment 59 REFERENCES Environmental Technical Institute (2006) Technical of wastewater treatment Hanoi Frank, L.C (1973) Handbook on hospital solid waste management Techno Publishing co Jenny, A., & Mansoor, A (2000) Risk from healthcare waste to the poor Well, USA Ha Noi Environmental Science and Technology Department (1996) Report on the situation of hospital waste quality Hanoi LaGrega, M D., Buckingham, P L., & Evans, J C (2010) Hazardous waste management Waveland Press Lee, C C., & Huffman, G L (1996) Medical waste management/incineration Journal of Hazardous Materials, 48(1), 1-30 Lien, H.T (2009) Research about the status a number of factors related to the management of medical waste in Thai Nguyen Central hospitals Master Thesis, University of Medicine and Pharmacy Thai Nguyen MONRE (2005) The situation and treatment solutions pollution in hospitals Journal of Environmental Protection, No.3/2005 Hanoi MOH (2007) Regulation about Medical waste management of the Ministry of Health issued Decide No 43/2007/Decide - MOH dated November 30th, 2007 Hanoi MOH (2007) Decide No.43/2007/Decide – MOH dated November 30th, 2007 Ministry of Health promulgate Regulations about Medical waste management Hanoi MONRE (2010) Annual report of the local Hanoi MONRE (2011) Circular No.12/2011/Circulars – MONRE dated April 14th, 2011 Ministry of Natural Resources and Environment about Hazardous waste management Hanoi 60 MOH (2014) Circular No.2340/2014/Circular – MOH dated April 29th , 2014 Ministry of Health about Strengthening about medical waste management Hanoi Prüss, A., Giroult, E., & Rushbrook, P (Eds.) (1999) Safe management of wastes from health-care activities World Health Organization Tao, T.D (2002) Assessment of status the management and influence of medical waste of Phu Tho General Hospital to the surrounding environment" Master Thesis, Military Medical Institute Hanoi Thuy, T.T., Khue, L.N., & Khoa, N.T (2002) Strengthening management and treatment of medical waste in Vietnam, some urgent issues of medical care task Medical Publishing House Hanoi Tuyen Quang General Hospital (2006) Explanation for the operational principle of wastewater treatment system of Tuyen Quang General Hospital Tuyen Quang Tuyen Quang General Hospital (2013) Survey about management work the medical waste in hospital Tuyen Quang Tuyen Quang General Hospital (2013) Report on the Infection control activity of hospital Tuyen Quang Tuyen Quang General Hospital (2014) Report on the management of hazardous waste the Quater I - II/2014 Tuyen Quang Tuyen Quang General Hospital ( 2014) Report on the present and technology demand for medical waste treatment Tuyen Quang Tuyen Quang General Hospital (2014) Report on the Infection control activity of hospital Tuyen Quang.Vietnamese Government (2007) Decree No.59/2007/Decree – Vietnamese Government dated April 09th, 2007 The 61 Government of Socialist Republic of Vietnam about Solid waste management Hanoi WHO (1994) Managing medical waste in developing country Geneva WHO (1997) Treatment waste from hospitals and other health care establishment Malaysia 62 [...]... overview of Tuyen Quang General Hospital Tuyen Quang General Hospital was established in 1945 predecessor from the revolutionary policlinic of Tuyen Quang province Tuyen Quang General Hospital is located in the center of Tuyen Quang city It belongs to Tan Ha ward, surrounded by a densely populated area and located in the main transport hub of the city, convenient traffic and transportation of patients to medical. .. Tuyen Quang General Hospital 4.2.1 Common Solid Waste The sources of common solid waste generated in hospitals including domestic solid waste, non- hazardous medical waste and waste from the hospital hygiene process - Domestic solid waste which is generated from the daily activities of patients to examination and treatment, family members of patients and staff of departments and function chambers of hospital. .. Department of Biochemistry - Microbiology 5 Chamber of Public Administration - Management 5 Department of Surgery - Cells 6 Chamber of Materials - medical equipment 6 Department of Infection Control 7 Chamber of Training - Steering gland CLINICAL DEPARTMENTS: Figure 4.1.Organization chart of Tuyen Quang General Hospital 29 4.2 Sources of waste and the methods to collect, classify and treat medical waste in Tuyen. .. this matter in Tuyen Quang General Hospital to assess the status of management and treatment mission Due to Tuyen Quang General Hospital located in convenient area with the high population density and big scale of hospital so the assessment activities has limit 1.5 Definitions According to MONRE (2007), there are some definitions which are use in the research: - Medical waste is all waste materials... from the staffs and faculties of Infection Control Department and Plan -Synthesis Department - Collecting the rules and standards of medical solid waste, hazardous medical waste and domestic solid waste - Gathering comments from teachers, professionals - Collecting documents related to the concept of solid waste, hazardous medical waste 23 3.2.3 The sampling method of wastewater Selection criteria... medical care Facilities of the hospital are improving The construction of the hospital is constantly renovating, building or upgrading Tuyen Quang General Hospital is a provincial hospital, have fully the Department of Internal Medicine, Department of Surgery, Clinical Departments Hospital is the clinics and treatment center of Tuyen Quang province with scale of 500 beds The number of patients examined... group, the amount of medical waste generated of Vietnam at lower levels in the region 17 The amount of medical waste tends to increase over time It is increase in both general medical waste and hazardous medical waste Meanwhile, environmental of health issues are not adequate attention According to statistics from the Ministry of Health (2012), currently only about 44% hospitals have solid waste treatment... system, storage waste of hospital waste + Waste treatment station of hospital 26 4.1.1 Functions and tasks It is a provincial hospital grade II, Tuyen Quang General Hospital has the following functions and task: a Emergency - Examination - Treatment Receive all cases of patient from the outside or from other hospitals transfer to emergency, medical examination, treatment for inpatient and outpatient Organize... 2.2 .Waste arising under the beds in Vietnam in 2012 Hospitals Unit Total of Hazardous medical waste medical waste Central Hospital (kg/bed) 0.97 0.16 Provincial Hospital (kg/bed) 0.88 0.14 District Hospital (kg/bed) 0.72 0.11 Average (kg/bed) 0.86 0.14 (Department of Environmental Management, 2012) 15 Table 2.3 Distribution of medical waste by type of urban Type of city Special Provinces having 1st class city... institutions, the medical institutions and drug manufacturing The estimated amount for 2015 of medical wastewater will increase over 300,000 m3/day Emission trends of medical waste: Although the general total of medical waste discharged has not changed or just slightly increased, but the amount of hazardous medical waste must be treated specially to increases over time by two trends: - Increasing use of disposable ... topics Assessment of status medical waste management and treatment in Tuyen Quang General Hospital 1.2 Research’s objectives - Cursory review of Tuyen Quang General Hospital - Assessment of status. .. situation of medical waste management in Tuyen Quang General Hospital? - What is the way to treatment medical waste of Tuyen Quang General Hospital? - How we can closely management the medical waste of. .. waste management and treatment in Tuyen Quang General Hospital Supervisor Dr Nguyen Hung Quang Abstract: Assessment and analyze the status of medical waste management in Tuyen Quang General Hospital: