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publicado em 01/11/2012 às 18h40:00
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SP faces difficulties in waste management in health services

Structural and operational problems that prevent disposal reach standards set by environmental legislation

 
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Foto: Marcos Santos/USP Imagens
Services must comply with legal requirements relating to waste management
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Services must comply with legal requirements relating to waste management

Waste Management of Health Services (RSS) is facing difficulties in Basic Units (BHU) Health of the city of São Paulo, as research shows, School of Public Health (FSP) USP. Dr Ana Maria Manieiro Moreira, author of the study, the amount of discarded material, including hazardous materials, and developed a plan for waste management (PGRSS) UBS for four in the center-west of the city. In entranto, structural problems, operational and management prevented the disposal to reach the standards set by environmental legislation.

The research analyzed 34 UBS initially existing in the central-west of São Paulo in 2010. No PGRSS had and the amount of waste generated was unknown, says Ana Maria. Then, four were selected for further analysis UBS and implementation of a waste management plan, between February 2011 and February 2012. The work was directed by Professor Wanda Risso Günther, Department of Environmental Health FSP.

According to the Municipal Law 13.478/2002, the UBS are classified as small generators of RSS, because they generate less than 20 pounds of hazardous waste per day and should, like the large generators (hospitals), adequately fulfill the legal requirements relating to the management of these waste, says the doctor, however, the evaluation revealed that there are structural flaws in these units, operational and behavioral addictions that need to be worked out, incomplete documentation, deficiencies regarding biosecurity and prevention of accidents and lack of managerial processes oriented to seek sustainability.

The research has developed an assessment tool that aggregates all the requirements of the legal-regulatory standards composed of National Health Surveillance Agency (ANVISA), National Council of Environment (CONAMA), Ministry of Labor and state and local laws that a health facility must comply. It allowed for an initial diagnosis of RSS management at UBS and also assisted in the preparation of PGRSS specific to each unit, says Ana Maria This same tool was used one year after the implementation of the plan for a second evaluation that revealed little progress in performance of these units.

"Until February 2012, were not acquired the necessary equipment for implementation of selective collection of recyclable materials, which would allow the minimization of waste and even common infective"

Difficulties <b> </ b>

During the first diagnosis were quantified residues in the four UBS and fed indicators such as mean daily waste generation (Kg per day), per group percent distribution of waste generation rate by service and generation rate by invasive procedure. However, by February 2012, it has not acquired the necessary equipment for implementation of selective collection of recyclable materials, which would allow the minimization of waste and even common infective, says the doctor. Consequently, the second measurement was made impossible, which would show the results of a numerically more effective segregation.

Despite sending reports to managers of units, showing the flaws identified and corrective measures proposed for short and medium term, beyond PGRSS designed specifically for each unit and the technical support of medical, no significant improvement in the management of the RSS period studied. Of the 142 legal requirements evaluated, one of UBS study of 38 advanced requirements, attended the first evaluation, for 54 (11%), one year later, says Ana Maria. The other three UBSs results achieved even lower, advancing only 4% and 5% in relation to the first diagnosis.

<b> Joint action </ b>

According to medical management shared between the department of health and social organization within the UBS faces problems regarding important decisions such as release of funds for acquisition of property and equipment and control the hiring and supervision of outsourced cleaning company . Moreover, there are also shortcomings in monitoring the health of civil servants, development of training programs and employee training and implementation of sustainability programs, highlights.

Ana Maria points out that for better performance management of RSS are needed greater concern with the issue of waste and faster decision making, availability of human and economic resources, information, training and integration of all actors involved in waste management. A tool developed and tested in the study was adequate and that can be replicated to similar situations and other healthcare facilities, as it is a tool for quick and easy application and adapted to the characteristics of the property, he said.

Source: USP
   Palavras-chave:   Waste Management    Basic Health Units    UBS    School of Public Health    FSP    USP    Universidade de São Paulo   
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