Waste management in high-risk health care by health workers: study and practice

A cross-sectional study was conducted with a sample of 278 health professionals (GPs and specialists, dentists, physical therapists and nurses) in a private medical practice in Paris to study the medical waste management practices related to the production and disposal of potentially hazardous health care waste. With the exception of physical therapists, most professionals produced medical waste (72% to 96,2% according to occupation), with a monthly median of 3 liters (inter-quartile range 1-15 liters). All sharp objects and needles were separated and 91% of them eliminated via a specific process for that sector. These percentages were respectively 84% and 69% concerning contaminated waste that was neither needles or used for cutting. 48% of the professionals reported the existence of documents that could track the disposal of their medical waste. To improve practice, professionals cited collection on-site at the office (74%) and reliability of the contracted service provider to collect the waste (59%). The study showed that health professionals need information on the regulations regarding potentially infectious medical waste, in particular on the traceability of its elimination. They also noted the lack of clarity and precision with regard to the definition of risk of infection: 31,7% of professionals only declare the production of sharp or cutting waste without having specified criteria for risk of infection. // ABSTRACT IN FRENCH: Une enquête transversale auprès d'un échantillon de 278 professionnels de santé (médecins généralistes et spécialistes, dentistes, kinésithérapeutes et infirmiers) en cabinet libéral à Paris a étudié, en 2004, la production et le traitement des déchets d'activité de soins à risques infectieux (DASRI). À l'exception des kinésithérapeutes, la plupart des professionnels produisaient des DASRI (72 % à 96,2 % selon les professions), avec un volume mensuel médian de 3 litres (interquartile 1-15 litres). 100 % des déchets piquants et coupants étaient triés, puis 91 % éliminés via une filière spécifique. Ces pourcentages étaient, respectivement, de 84 % et 69 % concernant les déchets souillés non piquants ni coupants. 48 % rapportaient l'existence de documents de traçabilité de l'élimination des DASRI. Pour améliorer les pratiques, les professionnels ont cité en premier lieu la collecte au cabinet (74 %) et la fiabilité du prestataire (59 %). L'étude a montré un besoin d'information des professionnels de santé sur la réglementation r