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In a study conducted by the World Health Organization (WHO), the distribution of hospital
wastes in developing countries are 80% general health care wastes, 15% pathological and
infectious waste, 1% sharp waste, and 3% chemical or pharmaceutical wastes. These bio-
medical wastes may be generated from any of the following facilities : hospitals, health
centers, clinics (medical, dental, veterinary), pharmaceutical laboratories, blood banks,
funeral parlors, medical schools, and research institutions.
Hospitals generate a vast amount of medical wastes each year. A Health Care Waste (HCW)
Generation study conducted by the Environmental Management Bureau of the Department
of Environment and Natural Resources (DENR) revealed that there are 3,760 health care
facilities in Metro Manila alone, which generate some 47,228 kilograms of bio-medical
wastes a day. Out of this, 56% are considered infectious.
In the past, many hospitals simply dumped all waste streams together, from reception-area
trash to operating room waste, and burned them in incinerators. However, incineration has
been found to be the leading source of highly toxic dioxin, furans, mercury, lead, and other
dangerous air pollutants. These emissions have serious adverse consequences on worker
safety, public health, and the environment. Dioxins, for example, have been linked to
cancer, immune system disorders, diabetes, birth defects, and other health effects. Medical
waste incinerators are a leading source of dioxins and mercury in the environment.
These recent developments have moved policy makers and sectors of society to push for
the banning of incineration. In other words, incinerator is NOT considered an option for
proper disposal and management of bio-medical wastes.
3. What are the legal backbones that support the ban on incineration?
There are three laws that tackle the proper management of hospital wastes. These are
Republic Act No. 6969 (Toxic and Hazardous Substances and Nuclear Wastes Control Act of
1990), RA No. 8749 (Philippine Clean Air Act of 1999) and RA No. 9003 (Ecological Solid
Waste Management Act of 2000).
A milestone development concerning hospital waste management was the phasing out of
incinerators on July 17, 2003, stated under Section 20 of the Clean Air Act. This
environmental law also exhorts for the use of best available technology in lieu of
incinerators, thus to promote the use of state-of-the-art, environmentally-sound and safe
non-burn technologies for the handling, treatment, thermal destruction, utilization and
disposal of sorted, unrecycled, uncomposted municipal, bio-medical and hazardous waste.
The Toxic and Hazardous Substances and Nuclear Wastes Control Act, on the other hand,
covers the management of all unregulated substances while the Ecological Solid Waste
Management Act institutes measures in the minimization, recovery and disposal of hospital
wastes.
4. How do you manage the disposal of regulated medical waste or infectious waste in
hospitals?
The Clean Air Act promotes the use of alternative non-burn technologies such as size
reduction and compaction, autoclave and microwave for thermal technologies, which are
among the most common technologies used in the country today.
Other alternatives include the use of chlorination and ozonation, as well as radioactive
methods such as electron beam and Cobalt-60, which are quite expensive and biological
processes like the enzymatic process or composting.
The DENR is in close coordination with Department of Health in enforcing concrete and
specific steps to tackle the wastes generated by health care establishments.
www.emb.gov.ph