Medical waste, due to its content of hazardous substances, poses serious threats to environmental health [1
]. The hazardous substances include pathological and infectious material, sharps, and chemical wastes [3
]. In hospitals, different kinds of therapeutic procedures (i.e. cobalt therapy, chemotherapy, dialysis, surgery, delivery, resection of gangrenous organs, autopsy, biopsy, para clinical test, injections etc.) are carried out and result in the production of infectious wastes, sharp objects, radioactive wastes and chemical materials [7
]. Medical waste may carry germs of diseases such as hepatitis B and AIDS. In developing countries, medical waste has not received much attention and it is disposed of together with domestic waste [8
]. Improper medical waste management is alarming in Bangladesh and it poses a serious threat to public health.
Medical waste contains highly toxic metals, toxic chemicals, pathogenic viruses and bacteria [10
], which can lead to pathological dysfunction of the human body [13
]. Medical waste presents a high risk to doctors, nurses, technicians, sweepers, hospital visitors and patients due to arbitrary management [15
]. It is a common observation in Dhaka City that poor scavengers, women and children collect some of the medical wastes (e.g. syringe-needles, saline bags, blood bags etc.) for reselling despite the deadly health risks. It has long been known that the re-use of syringes can cause the spread of infections such as AIDS and hepatitis [17
]. The collection of disposable medical items (particularly syringes), its re-sale and potential re-use without sterilization could cause a serious disease burden [18
The safe disposal and subsequent destruction of medical waste is a key step in the reduction of illness or injury through contact with this potentially hazardous material, and in the prevention of environmental contamination [19
]. The transmission of blood-borne viruses and respiratory, enteric and soft tissue infections through improper medical waste disposal is not well described [7
]. The management of medical waste therefore, has been of major concern due to potentially high risks to human health and the environment [20
The growing number of hospitals, clinics, and diagnostic laboratories in Dhaka City exerts a tremendous impact on public health and environment. All of the hospitals, clinics, and diagnostic laboratories are considered here as the HCE. Some 600 HCE in Dhaka city generate about 200 tons of waste a day [22
]. Like ordinary household waste, medical wastes are generally dumped into DCC bins. It is reported that even body parts are dumped on the streets by the HCE. The liquid and solid wastes containing hazardous materials are simply dumped into the nearest drain or garbage heap respectively.
Proper management of medical waste is crucial to minimise health risks. The improvement of present waste management practices for HCE in Bangladesh will have a significant long-term impact on minimising the spread of infectious diseases. Medical waste requires specialized treatment and management from its source to final disposal. Simply disposing of it into dustbins, drains, and canals or finally dumping it to the outskirts of the City poses a serious public health hazard. Thus, there is a need to initiate a concentrated effort to improve the medical waste management to reduce the negative impact of waste on: (a) environment; (b) public health; and (c) safety at health care facilities.
There are different types of medical waste management systems in different countries [3
]. Although, medical waste disposal options are not completely risk-free, the risks can be minimized with care [27
]. Improper disposal of medical waste may include damage to humans by sharp instruments, diseases transmitted to humans by infectious agents, and contamination of the environment by toxic and hazardous chemicals [28
]. Therefore, proper management of medical waste is a subject of major concerns for a healthy environment. In Bangladesh, medical waste management systems to reduce the environmental and public health risk are grossly inadequate [31
Medical wastes account for a very small fraction, about one percent of the total solid wastes generated in Bangladesh [31
]. However, when this tiny amount is not handled properly, it gets mixed with domestic solid waste, and the whole waste stream becomes potentially hazardous. Until recently, there was no system for proper medical waste management in Bangladesh to protect environmental health hazards. It was generally disposed of in the same way as ordinary domestic waste. But, very recently, government is trying to develop a system to handle medical waste properly. This paper seeks to document an inventory of different HCE in Dhaka City and to quantify the amount of wastes generated by each HCE. In addition, the paper presents the current waste handling practices in terms of storage, collection, transportation and disposal within and outside hospital premises.