The quantification of medical waste from the point of generation to the point of disposal: case studies at three private hospitals in Pretoria

Abstract

The South African Waste Information System (SAWIS) was developed by the Department of Environmental Affairs and Tourism (DEAT) in 2005. This is a system used by government and industry to capture routine data on the tonnages of waste generated, recycled and disposed of in South Africa on a monthly and annual basis. All waste producers and waste management organisations should contribute to this national waste database and should accurately monitor the types and quantities of waste produced and handled. According to DEAT (2006) the need for Data verification is important. DEAT (2006:59) defined the term Data Verification as: "assessing data accuracy, completeness, consistency, availability and internal control practices that serve to determine the overall reliability of the data collected." The aim of the study is to determine a procedure, as well as the nature and extent of internal and external source documents, which could be used in the reconciliation of medical waste quantities from generation to disposal. The key objectives are to determine whether the selected hospitals keep internal records of the quantities of medical waste generated; to reconcile the waste quantities on the internal records with the external records, such as the collection certificates, invoices and waste incineration certificates; to ascertain whether the quantity of medical waste generated is equal to the quantity of waste incinerated and disposed of to determine the ratio factor between the quantity of medical waste before incineration and the quantity of the residue (ashes) after incineration, and to make recommendations on the reconciliation of waste quantities from the point of generation to the point of disposal. The results of the study indicate that the destruction certificate is the proof that the waste that was on-site collected by the service provider has been disposed /treated. Especially as an internal control measure. The health care risk waste (HCRW) management record keeping of quantities of weight as per Hospital A, Hospital B and Hospital C allows the opportunity to analyse the weight per month and per Hospital and per category and to make comparisons. The weakness or the gap however still exist that the waste is not weighed at the point of origin, but at the point where the waste service provider collects the waste onsite. It is from this point onwards that the service level agreement between the hospital and the waste service provider and the document management system and the tracking receipt and the waste collection documents (WCD) becomes relevant and where the quantities of waste per category are for the first time recorded. The hypothesis as stated in Chapter 1 was proven valid. The study concludes that reconciliation and comparison between the collection certificate and the destruction certificate and the monthly invoice is therefore possible, but the risk of mixing of waste and the understating or overstating of waste quantities is still not overcome.