ADDIS ABABA UNIVERSITY GRADUATE PROGRAMS CENTER FOR ENVIRONMENTAL SCIENCE Healthcare Waste Generation Rate, Composition and Its Management System: The case of Selected Governmental Hospitals in Addis Ababa, Ethiopia A Thesis Submitted to the School of Graduate Studies of Addis Ababa University, In Partial Fulfillment of the Requirement for the Degree of Masters of Science in Environmental Science By AzebTayework Main Advisors SeyoumLeta (PhD) Co-Advisors Eshetu Lemma (MSc) June, 2016 i ADDIS ABABA UNIVERSITY SCHOOL OF GRADUATE STUDIES Healthcare Waste Generation Rate, Composition, and Its Management System: The Case of Selected Governmental Hospitals in Addis Ababa, Ethiopia By Name Signature Date AzebTayework ________________________ __________________ I the under signed, declare that this is my original work and that all sources of materials used for the thesis have been correctly acknowledged. Department of Environmental Science Addis Ababa University The thesis has been approved for submission by: Name Signature Date SeyoumLeta (PhD) ________________________ __________________ Eshetu Lemma (MSc) ________________________ ___________________ ii Acknowledgements For the success of this work many individuals and institutions has contributed a lot. First, I would like to thank my advisor SeyoumLeta (PhD) and EshetuLemma (MSc) for unreserved comments, advice, and contributions of ideas as well as sharing of time to read the earlier drafts of this paper. For various data and information I received; my foremost thank goes to Black Lion Specialized Teaching Hospital, Yekatit 12 Memorial Hospital, Gandhi Memorial Hospital and People in the study area also deserve acknowledgements for their kindness and hospitability during my actual collection and measurement in field work and also want to acknowledge the data collector and supervisor. Finally, my heartfelt thank go to all my families for assisting me both in ideas and in materials to accomplish this paper. AzebTayework June, 2016 iii Acronyms AAS Atomic Absorption Spectrometer AZT Azidothymidine CSA Central Statistics Authority EIA Environmental Impact Assessment EPA Environmental Protection Agency HCW Health Care Waste HCWM Health Care Waste Management HWM Hospital Waste Management MOE Ministry of Environment MOH Ministry of Health MSW Municipal Solid Waste OPD Outpatient Door IPD Inpatient Door TEPA Taiwan Environmental Protection Administration WHO World Health Organization SPSS StatisticalPackage For Social Science iv Table of content Contents Acknowledgements.....................................................................................................................iii Acronyms....................................................................................................................................iv Table of content............................................................................................................................... v List of table...............................................................................................................................viii List of Figure...............................................................................................................................ix Abstract....................................................................................................................................... xi 1. Introduction............................................................................................................................ 11 1.1. Background of the Study.................................................................................................11 1.2. Statement of research problem..........................................................................................3 1.3. Objectives of the Study..................................................................................................... 4 1.3.1. General objective of the study;......................................................................................4 1.3.2. Specific objectives of the study;................................................................................ 5 1.4. Delineation of the study.................................................................................................... 5 1.5. Research question............................................................................................................. 5 1.5.1. Main research question.............................................................................................. 5 1.5.2. Specific research questions........................................................................................5 1.6. Scope of the Study............................................................................................................ 5 1.7. Organization of the Study................................................................................................. 6 1.8. Clarification of basic terms and concepts......................................................................... 6 2. Review of related literature...................................................................................................... 7 2.1. Healthcare waste definitions............................................................................................. 7 2.1.1. Healthcare waste generation rate............................................................................... 8 v 2.1.2. Classification of healthcare waste............................................................................. 9 2.2. Healthcare waste management........................................................................................12 2.3. Public health of healthcare waste management.............................................................. 14 2.3.1. Effect of infectious waste and sharps...................................................................... 16 2.4. Conceptual structure of the study....................................................................................17 2.5. Bottom ashes heavy metals............................................................................................. 18 3. Materials and Methodology....................................................................................................20 3.1. Materials..........................................................................................................................20 3.2. Description of the study area.......................................................................................... 21 3.2.1. Geographic location.................................................................................................21 3.2.2. Climate.....................................................................................................................22 3.2.3. Temperature.............................................................................................................23 3.2.4. Demography of the Study Area:-.............................................................................24 3.3. Sampling techniques....................................................................................................... 25 3.4. Data collection................................................................................................................ 25 3.4.1. Data procedure and analysis technique:.................................................................. 26 3.5. Heavy metal determination............................................................................................ 27 3.6. Data management and statistical analysis.......................................................................28 3.7. Data quality assurance mechanisms................................................................................29 3.8. A tabular summary of the methods applied in this study................................................29 4. Results and Discussion...........................................................................................................30 4.1. Healthcare wastes composition and generation rate....................................................... 30 4.1.1. Healthcare waste composition:................................................................................ 30 4.1.2. Healthcare waste generation rate............................................................................. 33 4.2. Heavy metal concentration..............................................................................................37 vi 4.3. The practice of healthcare waste management................................................................38 4.3.1. Healthcare waste segregation practice.....................................................................42 4.3.2. Temporary storage of hospital healthcare waste practice on point of source..........43 4.3.3. Collection and transportation of healthcare waste...................................................44 4.4. Hospital healthcare waste treatment and disposal practice.............................................44 4.5. Hospital healthcare waste reuse and recycling practice..................................................45 5. Conclusion and Recommendations........................................................................................ 46 5.1. Conclusions.....................................................................................................................46 5.2. Recommendations...........................................................................................................47