
Two studies conducted by the Department
of Health indicated the need to introduce
modifications to the existing health care
waste management practices
› Waste Management Practices of DOH-Retained
Hospitals in 1995
› Waste Management Practices of Private and
Government Hospitals in Metro-Manila in 1997

Most common problems encountered:
› Inadequate waste management practices
› Lack of awareness about the health hazards
› Insufficient financial and human resources
› Poor control of waste disposal

Environmental and Occupational Health
Office (EOHO) initiated the revision of
the existing Hospital Waste Management
Manual (EHS-DOH, 1997)

The revision was meant to:
› assist facility administrators in evaluating their
operations in order to improve the health
care waste management practices
› promote the use of appropriate
technologies and to communicate with
heath care personnel as well as to the public
the risks associated with health care waste

Hospitals and other health care
establishments have the responsibility of
ensuring that there are no adverse health
and environmental consequences on their
handling, storage, treatment and disposal of
health care waste

Through this manual, health care
establishments will be able to install a more
appropriate waste management system

Through this manual, health care
establishments will be able to install a
more appropriate waste management
system

Healthcare waste (WHO)
› all waste generated by healthcare
establishments, research facilities, and health
laboratories
› classified as
1. non-risk/general healthcare waste/domestic
waste
2. hazardous waste
Prüss, A., Giroult, E., Rushbrook, P., 1999. Safe Management of Wastes
From Health Care Activities. World Health Organization, Geneva

Classification of Hazardous Waste (DENR)
based on these four characteristics
accordance with the Toxicity Characteristic
Learning Procedure (TCLP):
› Ignitable
› Corrosive
› Reactive
› Toxic
Department of Environment and Natural Resources. 2004. Hazardous
Waste Management. Procedural Manual Title III of DAO 92-29

All individuals exposed to hazardous
health-care waste are potentially at risk
Prüss, A., Giroult, E., Rushbrook, P., 1999. Safe Management of Wastes From
Health Care Activities. World Health Organization, Geneva

Certain infections, caused by more
resilient agents, pose a significant risk to
the general public and to hospital
patients
Mühlich, M. et. al. 2003. Comparison of infectious waste management in
European hospitals. Institute for Environmental Medicine and Hospital
Epidemiology, Freiburg University Hospital, Freiburg, Germany




health-care workers, particularly nurses, are at
greatest risk of infection
other hospital workers and waste-management
operators outside health-care establishments
individuals who scavenge on waste disposal sites
lower risk for patients and the public
Mühlich, M. et. al. 2003. Comparison of infectious waste management in
European hospitals. Institute for Environmental Medicine and Hospital
Epidemiology, Freiburg University Hospital, Freiburg, Germany
Metropolitan Manila Authority (MMA)
Ordinance No. 16
 Hospital Licensure Law (Republic Act No.
4226)
 Toxic Substances and Hazardous and
Nuclear Waste Control Act of 1990
(Republic Act No. 6969

Soncuya, Matias, Lapid. 1997. Hospital Waste Management in the
Philippines, two Case Studies in Manila. WASTE.
Urban Waste Expertise Programme

use four types of trash bags for easy
identification of waste:
1) black trash bag for non-infectious dry waste
2) green trash bags for non-infectious wet waste
3) yellow trash bags for dry and wet chemical and
other potentially infectious waste, pathological
waste, chemical waste and sharps contained in
puncture-proof containers covered with solution of
lime
4) orange trash bags with trefoil sign for radioactive
waste that will be stored in the hospital until
rendered as inactive and/or disposed in
accordance with the prescribed rules and
regulations of the Philippine Nuclear Research
Institute
hospitals are categorized as government or
private hospitals
 specifies the needed physical facilities of a
hospital for solid waste management such
as the physical plant, hospital equipment
and maintenance of these physical
facilities

covers the importation, manufacture,
processing, handling, storage,
transportation, sale, distribution, use and
disposal of all unregulated chemical
substances and mixtures in the Philippines
 defines the prohibited acts and provides for
administrative and criminal penalties


wastes, segregated or not, are collected by workers
employed by the health care establishment(usually cleaners
or janitors of the premises)
› aware of local opportunities for recycling of components of the
waste
› unaware of, or insensitive to, the hazards associated with
handling health care waste
› generally take no precautions in handling, transporting and
separating the waste
› not supplied with protective clothing or special equipment
Pescod, S. 1998. Hospital Waste Management in Four Major Cities.
WASTE. Urban Waste Expertise Programme

plastic bags, covered bins/trash cans, and glass
jars with covers

due to inadequate segregation of infectious from
non-infectious much of the generated hospital
waste is being disposed directly to municipal
landfills
Department of Environment and Natural Resources. 1993. Pasig River
Rehabilitation Program: Feasibility Report on Hospital Hazardous
Waste Management in Metro Manila. Volume I
collected by the municipal waste collection
service
 transported for disposal with municipal
waste
 all types of wastes are mixed and
transported, often along with municipal
solid waste, to municipal landfills

Pescod, S. 1998. Hospital Waste Management in Four Major Cities.
WASTE. Urban Waste Expertise Programme



existing treatment capacity is insufficient for
the proper disposal of the major part of
medical wastes generated in Metro Manila
area
the existing capacity for incinerating these
wastes totals to less than 3 tons/day
total daily quantity of dangerous medical
wastes generated was estimated to at least
12.4 tons
Department of Environment and Natural Resources. 1993. Pasig River
Rehabilitation Program: Feasibility Report on Hospital Hazardous
Waste Management in Metro Manila. Volume I



In developing countries, medical waste has not
received much attention and it is disposed of
together with domestic waste
Lack of a system of medical waste management,
a lack of necessary supplies and facilities, a lack of
knowledge among health workers and a lack of
coordination among different ministries.
A national program for medical waste
management is essential in Palestine
Massrouje, HTN., 2001. Medical waste and health workers in Gaza
governorates. Eastern Mediterranean Health Journal


In Lagos Metropolis, Nigeria, there is absence of full
compliance with the protocol stipulated in the
guidelines and standards of environmental
pollution control
There were problems in collection, segregation,
storage, treatment, and disposal among the
hospitals that were observed
Longe, E.O., Williams, A., 2006. A Preliminary Study of Medical Waste
Management in Lagos Metropolis, Nigeria. Iran Journal of Environ.
Health Sci. Eng., 3:2:133-139
In Dhaka, Bangladesh there is no proper,
systematic management of medical waste
except in a few private Health Care
Establishments that segregate their
infectious wastes
 Some cleaners were found to salvage used
sharps, saline bags, blood bags and test
tubes for resale or reuse

Hassan, M., Ahmed, S., Rahman, K., Biswas, T. 2008. Pattern of medical
waste management: existing scenario in Dhaka City, Bangladesh.
BMC Public Health. 8:36
Evidence showed that there are many flaws
in the compliance, implementation and
even in the construction of guidelines
concerning hospital management in the
Philippines and around the world
 Several studies have recommended several
steps that may be undertaken to address
these flaws


Recommendations:
› establishment of directorates responsible for
medical waste management
› coordination of different ministries
› provision of adequate supplies and health
education including encouragement of studies
on different aspects of medical waste (creation
of database information in different sectors, risk
analysis and disposal methods)
Massrouje, HTN., 2001. Medical waste and health workers in Gaza
governorates. Eastern Mediterranean Health Journal

Case studies in the Philippines have only
focused on two distinct hospitals in Metro
Manila

Should include the University of Santo
Tomas Hospital