[Refuse disposal in the hospital. 2. Practical refuse disposal in clinical practice].
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From the point of view of hygiene and the prevention of infection, waste products from hospitals have to be divided into three groups: household type refuse, refuse specific to hospitals, refuse from infectious wards. Particular care has to be taken in hospitals with the collection and transport of specific hospital refuse and refuse from infectious wards, but after being delivered to the central collecting point the former--in contrast to refuse from infectious wards--can be removed together with household type refuse in the normal manner by the local waste disposal service. If it is not to be incinerated, refuse from infectious wards may only be disposed to together with household type refuse after undergoing a good disinfection practice.
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In two waste disposal sites in Cairo, drinking water samples from springs, drinking vessels and kitchens were investigated. Total germ count lay seldom below one thousand and ten million pro ml. Apart from various faecal germs, Aeromonas hydrophila was also found. The high occurrence of diarrhoeal diseases among the inhabitants of the waste disposal sites can be traced with certainty to the extremely bad drinking water quality.
In Cairo's waste disposal sites various germs could be isolated from cockroaches and flies; antibiotic resistance was determined.
For the classification of hospital-wastes in the categories infectious-contaminate or special waste are only significant views of the prevention by nosocomial infection in the hospital. Solely infectious waste become removed hospital-intern and -extern on conditions of hygienic prevention, namely through secure packing during the transport, combustion or desinfection. Special wastes to be defeated by special-conditions. The hygienist of the hospital is only competent for the classification of the wastes in the hospital as well as for their refuse.
Atmospheric germ measurements were carried out and the germ spectrum determined in medical ambulances, bedrooms and livingrooms.
In Cairo's waste disposal sites conjunctivitis is frequently found resulting from the burning process of plastic, paper, etc.. Recurrent secondary contamination of the conjunctiva by pathogenic and non-pathogenic microorganisms often takes place; however, in certain germ species, the differentiation between pathogenic or non-pathogenic organisms within a damaged mucous membrane cannot be made. Furthermore, in this study, we have attempted to investigate germ reproduction during the application of PVP-eyedrops. However, our results cannot be conclusive because of the high environmental contamination, very low personal hygiene resulting from contaminated water and the constant exposure of samples to environmental contamination. Studies will be continued.
Several laws and guidelines on the disposal of waste from hospitals and practice differentiate between diverse types of waste. The LAGA instruction sheet lists five types: type A = hospital waste, type B = medical waste, type C = infectious waste, type D = chemical waste, and type E = human pathological material. Especially the basis of differentiation between medical and infectious waste is the list of notifiable infectious diseases according to section 3 of the Federal Law on Epidemic diseases. Section 10a confines the list to contagious infectious diseases. However, some tropical epidemics and endemic infectious diseases are not taken into account. On the other hand, the list includes a few harmless childhood and other diseases. There is not scientific evidence that wastes of this kind have led to infections in the community. Therefore, the Federal Law on Epidemic Diseases does not seem to be a suitable basis for the differentiation between medical and regulated medical wastes.
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