中国医疗废物管理现状及制度完善研究

doi:10.19741/j.issn.1673-4831.2020.0828

Abstract

Abstract: Medical waste management is related to the overall situation of public health safety and epidemic prevention and control. Based on the statistical data on the current status of medical waste generation, treatment and disposal in China, in addition to the official management policies and practices, the following common issues related to current medical waste management have been revealed:various different statistical scales, insufficient information management, lacking of self-disposal supporting standards, and insufficient researches on harmless ways of its utilization, a mismatch between supply and disposal capacity, unbalanced distribution of disposal facilities, etc. Finally, considering the impact of the updated status of the epidemic on the treatment and disposal of medical waste, corresponding prospects are put forward in terms of system matching, process connection, implementation, supervision and management, as well as layout optimization. The national and local governments are recommended to take a multi-pronged approach to accelerate the timely update and improvement of the existing management system, to increase the investment in the missing supporting standards, to strengthen research on the recycling path of infusion bottles (bags). And in order to optimize the layout of medical waste disposal facilities, it is necessary to take measures of medical waste classification and distribution management, and combine centralized disposal with emergency disposal. The information statistics paths can be improved via the interconnection of medical waste information management with the establishment of efficient supply and demand docking platforms. Through the synchronous promotion of urban and rural management, to further promote the establishment of a modern system for urban and rural medical waste treatment, to improve the formation of multi-party linkage of information supervision and law enforcement, and to firmly guard the defense line of people's livelihood.

Key words: public health, medical waste, disposal capacity, environmental management

CLC Number:

X32
X799

MA Jie, ZHANG Cheng, ZHANG Ai-guo, ZHANG Hou-hu. Study on the Current Status of Medical Waste Management and Its Improvement in China[J]. Journal of Ecology and Rural Environment, 2021, 37(8): 953-961.

References

[1] 生态环境部.国家危险废物名录[EB/OL]. (2003-04-15)[2020-08-12]. http://www.mee.gov.cn/ywgz/gtfwyhxpgl/wxfw/201604/t20160424_336667.shtml.
[2] BLENKHARN J I.Clinical Waste Management[M]//Encyclopedia of Environmental Health.Amsterdam, Holland:Elsevier, 2011:716-731.
[3] 李慧平, 王小万.国际医疗废物分类及基本特点[J]. 中国医院管理, 2004, 24(3):18-21. [LI Hui-ping, WANG Xiao-wan.Characterization and Classification of Health Care Waste[J]. Chinese Hospital Management, 2004, 24(3):18-21.]
[4] 国家统计局.国家数据[EB/OL]. (2020-08-12)[2020-08-12]. http://data.stats.gov.cn/easyquery.htm?cn=C01.
[5] 生态环境部.大中城市固体废物污染环境防治年报[EB/OL]. (2019-12-31)[2020-08-12]. http://www.mee.gov.cn/hjzl/sthjzk/gtfwwrfz/.
[6] HOSSAIN M S, SANTHANAM A, NORULAIN N A N, et al.Clinical Solid Waste Management Practices and Its Impact on Human Health and Environment:A Review[J]. Waste Management, 2011, 31(4):754-766.
[7] KOMILIS D, FOUKI A, PAPADOPOULOS D.Hazardous Medical Waste Generation Rates of Different Categories of Health-care Facilities[J]. Waste Management, 2012, 32(7):1434-1441.
[8] 刘思娣, 任南, 李春辉, 等. 125家医疗机构医疗废物管理调查情况[J]. 中华医院感染学杂志, 2017, 27(18):4265-426[LIU Si-di, REN Nan, LI Chun-hui, et al.Status of Management of Medical Waste in 125 Medical Institutions[J]. Chinese Journal of Nosocomiology, 2017, 27(18):4265-4269.]
[9] 肖志伟.医疗废物典型组分物理化学特性认识及其热解焚烧特性的基础研究[D]. 杭州:浙江大学, 2010. [XIAO Zhi-wei.Basic Study on the Physical-Chemical and Pyrolysis-Incineration Characteristics of Typical Components in Medical Wastes[D]. Hangzhou:Zhejiang University, 2010.]
[10] 生态环境部.生态环境部通报全国医疗废物、医疗废水处置和环境监测情况[EB/OL]. (2020-06-08)[2020-08-12]. http://www.mee.gov.cn/xxgk2018/xxgk/xxgk15/202006/t20200609_783328.html.
[11] 前瞻产业研究院.2020年中国医废处理行业市场现状及发展前景分析未来五年市场规模将突破百亿元[EB/OL]. (2020-05-05)[2020-08-12]. https://bg.qianzhan.com/trends/detail/506/200430-68de7541.html.
[12] World Health Organization.Treatment and disposal technologies for health-care waste[EB/OL]. [2020-11-05]. https://www.who.int/docstore/water_sanitation_health/wastemanag/ch10.htm#TopOfPage.
[13] Environmental Protection Agency.Medical-waste[EB/OL]. [2020-11-05]. https://www.epa.gov/rcra/medical-waste.
[14] 生态环境部.《医疗废物污染防治技术政策(征求意见稿)》编制说明[EB/OL]. (2011-06-07)[2020-11-05]. http://www.mee.gov.cn/gkml/hbb/bgth/201106/t20110621_212806.htm.
[15] ILYAS S, SRIVASTAVA R R, KIM H.Disinfection Technology and Strategies for COVID-19 Hospital and Bio-Medical Waste Management[J]. Science of the Total Environment, 2020, 749:141652.
[16] 孙宁, 任志远, 孙添伟, 等. "十三五"医疗废物综合管理思路与对策研究[J]. 中国环境管理, 2017, 9(3):78-82. [SUN Ning, REN Zhi-yuan, SUN Tian-wei, et al. Idea and Countermeasures of Comprehensive Management on Medical Waste in the 13th Five Year Period[J]. Chinese Journal of Environmental Management, 2017, 9(3):78-82.]
[17] 许晓芳, 谭全银, 刘丽丽, 等. 基于层次分析法的医疗废物处置技术评价[J]. 环境科学, 2018, 39(12):5717-5722. [XU Xiao-fang, TAN Quan-yin, LIU Li-li, et al. Assessment of Medical Waste Disposal Technologies Based on the AHP[J]. Environmental Science, 2018, 39(12):5717-5722.]
[18] CAI X W, DU C M.Thermal Plasma Treatment of Medical Waste[J]. Plasma Chemistry and Plasma Processing, 2021, 41(1):1-46.
[19] BUJAK J.Thermal Treatment of Medical Waste in a Rotary Kiln[J]. Journal of Environmental Management, 2015, 162:139-147.
[20] WASHIO M, WAKABAYASHI M.Processing of Infectious Medical Waste Containing Various Bacterial Contaminants, from Hospitals and Infirmaries, Involves Sterilizing and Irradiating Medical Waste with High Energy Electron Beam:Japan, JP2002045418-A[P]. 2000-08-03.
[21] HOSSAIN M S, RAHMAN N N N A, BALAKRISHNAN V, et al. Mathematical Modeling of Enterococcus faecalis, Escherichia coli, and Bacillus sphaericus Inactivation in Infectious Clinical Solid Waste by Using Steam Autoclaving and Supercritical Fluid Carbon Dioxide Sterilization[J]. Chemical Engineering Journal, 2015, 267:221-234.
[22] 中央人民政府网.国务院关于全国危险废物和医疗废物处置设施建设规划的批复[EB/OL]. (2008-03-28)[2020-08-12]. http://www.gov.cn/zhengce/content/2008-03/28/content_5087.htm.
[23] 生态环境部.关于印发《全国危险废物和医疗废物处置设施建设规划》的通知[EB/OL]. (2004-01-09)[2020-08-12]. http://www.mee.gov.cn/gkml/zj/wj/200910/t20091022_172261.htm.
[24] 国家统计局.第一次全国污染源普查公报[EB/OL]. (2010-02-11)[2020-08-12]. http://www.stats.gov.cn/tjsj/tjgb/qttjgb/qgqttjgb/201002/t20100211_30641.html.
[25] 生态环境部.第二次全国污染源普查公报[EB/OL]. (2020-06-16)[2020-08-12]. http://www.mee.gov.cn/home/ztbd/rdzl/wrypc/zlxz/202006/t20200616_784745.html.
[26] 生态环境部.关于政协十三届全国委员会第二次会议第2673号(资源环境类159号)提案答复的函[EB/OL]. (2019-07-26)[2020-08-12]. http://www.mee.gov.cn/xxgk2018/xxgk/xxgk13/201911/t20191114_742326.html.
[27] 张筝, 程亮, 王夏晖, 等. 我国医疗废物应急处置体系构建思路[J]. 环境科学研究, 2020, 33(7):1683-1690. [ZHANG Zheng, CHENG Liang, WANG Xia-hui, et al. Construction of Medical Waste Emergency Disposal System in China[J]. Research of Environmental Sciences, 2020, 33(7):1683-1690.]
[28] 韦洪莲, 梁燕, 张喆, 等. 新型冠状病毒肺炎疫情医疗废物应急管理与处置[J]. 中国环境监测, 2020, 36(5):8-13. [WEI Hong-lian, LIANG Yan, ZHANG Zhe, et al. Emergency Management and Disposal of Medical Waste in the COVID-19 Epidemic[J]. Environmental Monitoring in China, 2020, 36(5):8-13.]
[29] CHANG H C, WANG M C, LIAO H C, et al. The Application of GSCM in Eliminating Healthcare Waste:Hospital EDC as an Example[J]. International Journal of Environmental Research and Public Health, 2019, 16(21):E4087.
[30] MANTZARAS G, VOUDRIAS E A.An Optimization Model for Collection, Haul, Transfer, Treatment and Disposal of Infectious Medical Waste:Application to a Greek Region[J]. Waste Management, 2017, 69:518-534.
[31] KARGAR S, POURMEHDI M, PAYDAR M M.Reverse Logistics Network Design for Medical Waste Management in the Epidemic Outbreak of the Novel Coronavirus (COVID-19)[J]. Science of the Total Environment, 2020, 746:141183.
[32] KOMILIS D, MAKROLEIVADITIS N, NIKOLAKOPOULOU E.Generation and Composition of Medical Wastes from Private Medical Microbiology Laboratories[J]. Waste Management, 2017, 61:539-546.
[33] NARAYANAMOORTHY S, ANNAPOORANI V, KANG D, et al. A Novel Assessment of Bio-Medical Waste Disposal Methods Using Integrating Weighting Approach and Hesitant Fuzzy MOOSRA[J]. Journal of Cleaner Production, 2020, 275:122587.
[34] YOON Y W, JEON T W, SON J I, et al. Characteristics of PCDDS/PCDFS in Stack Gas from Medical Waste Incinerators[J]. Chemosphere, 2017, 188:478-485.
[35] PATWARY M A, O'HARE W T, SARKER M H.Assessment of Occupational and Environmental Safety Associated with Medical Waste Disposal in Developing Countries:A Qualitative Approach[J]. Safety Science, 2011, 49(8/9):1200-1207.
[36] LE A B, HOBOY S, GERMAIN A, et al. A Pilot Survey of the US Medical Waste Industry to Determine Training Needs for Safely Handling Highly Infectious Waste[J]. American Journal of Infection Control, 2018, 46(2):133-138.
[37] 罗兰, 张俊丰, 王红梅, 等. 我国新冠肺炎疫情期间医疗废物收集管理现状分析及对策研究[J]. 环境科学研究, 2020, 33(7):1691-1697. [LUO Lan, ZHANG Jun-feng, WANG Hong-mei, et al. Analysis and Countermeasures of Medical Waste Collection and Management of COVID-19 in China[J]. Research of Environmental Sciences, 2020, 33(7):1691-1697.]
[38] MAKAJIC-NIKOLIC D, PETROVIC N, BELIC A, et al. The Fault Tree Analysis of Infectious Medical Waste Management[J]. Journal of Cleaner Production, 2016, 113:365-373.
[39] 左四琴, 吴永仁, 张志平.医院医疗废物信息化管理系统应用研究[J]. 江苏卫生事业管理, 2020, 31(9):1218-1220. [ZUO Si-qin, WU Yong-ren, ZHANG Zhi-ping.Research on Application of Hospital Medical Waste Information Management System[J]. Jiangsu Health System Management, 2020, 31(9):1218-1220.]
[40] 卫生部.关于明确医疗废物分类有关问题的通知[EB/OL]. (2006-01-06)[2020-09-30]. http://www.nhc.gov.cn/zwgkzt/pyzgl1/200804/18477.shtml.
[41] ANSARIM, EHRAMPOUSH M H, FARZADKIA M, et al. Dynamic Assessment of Economic and Environmental Performance Index and Generation, Composition, Environmental and Human Health Risks of Hospital Solid Waste in Developing Countries;A State of the Art of Review[J]. Environment International, 2019, 132:105073.
[42] 杨春悟.产生外带输液的风险与预防[J]. 医疗装备, 2015, 28(13):89-90. [YANG Chun-wu.Risks and Prevention of Taking-out Infusion[J]. Medical Equipment, 2015, 28(13):89-90.]
[43] LEE B K, ELLENBECKER M J, MOURE-ERASO R.Analyses of the Recycling Potential of Medical Plastic Wastes[J]. Waste Management, 2002, 22(5):461-470.
[44] 央广网.医疗废物处置难点与痛点何在?[EB/OL]. (2019-04-10)[2020-08-12]. http://china.cnr.cn/yaowen/20190410/t20190410_524572729.shtml.
[45] 林雪君, 常四铁, 蔡云东, 等. 新冠肺炎疫情下武汉市医废处置及应急管理的思考[J]. 环境工程, 2020, 38(8):213-216. [LIN Xue-jun, CHANG Si-tie, CAI Yun-dong, et al. Thinking of Disposal and Emergency Management of Medical Waste in Wuhan under the Outbreak of covid-19 Pandemic[J]. Environmental Engineering, 2020, 38(8):213-216.]
[46] 李悦, 陈扬, 吴安华, 等. 我国边远地区医疗废物处置技术和管理模式探讨[J]. 中国感染控制杂志, 2019, 18(1):83-88. [LI Yue, CHEN Yang, WU An-hua, et al. Exploring on Technique and Management Mode of Medical Waste Disposal in Remote Areas of China[J]. Chinese Journal of Infection Control, 2019, 18(1):83-88.]
[47] 刘秀凤.医疗废物处置需要补短板[N]. 中国环境报, 2020-02-17(3).
[48] 常杪, 唐艳冬, 杨亮, 等. 国际医疗废物管理与处理处置体系分析与借鉴[J]. 环境保护, 2020, 48(8):63-69. [CHANG Miao, TANG Yan-dong, YANG Liang, et al. Analysis and Reference of International Medical Waste Management, Treatment and Disposal System[J]. Environmental Protection, 2020, 48(8):63-69.]
[49] 生态环境部.关于印发医疗机构废弃物综合治理工作方案的通知[EB/OL]. (2020-02-26)[2020-09-30]. http://www.mee.gov.cn/xxgk2018/xxgk/xxgk10/202002/t20200227_766362.html.
[50] 陈亚男, 刘菁, 徐燕, 等. 医疗机构未被污染输液瓶(袋)管理模式现状调研与分析[J]. 环境保护科学, 2019, 45(06):25-28. [CHEN Ya-nan, LIU Jing, XU Yan, et al. Investigation and Analysis on the Management Modes of Uncontaminated Infusion Bottles(Bags) in Medical Institutions[J]. Environmental Protection Science, 2019, 45(06), 45:25-28.]
[51] 医政医管局.关于在医疗机构推进生活垃圾分类管理的通知[EB/OL]. (2017-09-27)[2020-09-30]. http://www.nhc.gov.cn/yzygj/s3585/201711/94826c0e542343ab8c1091310678bdf7.shtml.
[52] 许玉冰, 郭俊艳, 赵江河, 等. 环节质量控制对医疗废物处置的全过程管理[J]. 中华医院感染学杂志, 2015, 25(15):3592-3594. [XU Yu-bing, GUO Jun-yan, ZHAO Jiang-he, et al. Application of Link Quality Control in Whole Process Management of Disposal of Medical Waste[J]. Chinese Journal of Nosocomiology, 2015, 25(15):3592-3594.]
[53] 谢红艳, 赖晓全, 谭莉.湖北省121所医院医疗废物管理现状研究[J]. 现代预防医学, 2017, 44(19):3542-3545. [XIE Hong-yan, LAI Xiao-quan, TAN Li.Medical Waste Management in 121 Hospitals, Hubei Province[J]. Modern Preventive Medicine, 2017, 44(19):3542-3545.]
[54] HE Z G, LI Q, FANG J.The Solutions and Recommendations for Logistics Problems in the Collection of Medical Waste in China[J]. Procedia Environmental Sciences, 2016, 31:447-456.
[55] 周奇, 徐亚, 王菲, 等. 生活垃圾焚烧设施应急处置医疗废物现状与风险防控[J]. 环境卫生工程, 2020, 28(2):23-26, 29. [ZHOU Qi, XU Ya, WANG Fei, et al. Current Situation and Risk Prevention and Control of Emergency Process of Medical Waste by MSW Incineration Facility[J]. Environmental Sanitation Engineering, 2020, 28(2):23-26, 29.]
[56] 彭小龙.医疗废物高温蒸煮及其与生活垃圾焚烧协同处理[J]. 环境卫生工程, 2020, 28(2):51-54. [PENG Xiao-long.Thermophilic Digestion of Medical Waste and Its Co-Processing with Incineration of MSW[J]. Environmental Sanitation Engineering, 2020, 28(2):51-54.]

Study on the Current Status of Medical Waste Management and Its Improvement in China

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 7

Recommended Articles

Metrics

Comments

[1]	ZHANG Sheng-tian, LI Mei, LI Qun, FAN Ting-ting, LIU Jing-liang, DENG Shao-po. Analysis of the Disposal of Medical Waste Management at Home and Abroad and Suggestions on Countermeasures [J]. Journal of Ecology and Rural Environment, 2020, 36(12): 1505-1513.
[2]	QIN Wei-hua, GU Qi, LI Zhong-lin, XU Hui-min, CHU Ke-lin. Statistical Analysis on the Characteristics and Impacts of Construction Projects that Affecting Nature Reserves [J]. Journal of Ecology and Rural Environment, 2019, 35(3): 398-404.
[3]	JIANG Ming-Kang, HE Zhao-He, WANG Zhi, QIN Wei-Hua. Environmental Management of Construction Projects Involving Nature Reserve [J]. Journal of Ecology and Rural Environment, 2009, 25(1): 101-105.
[4]	YE Ya-Ping, SHAN Zheng-Jun. Status Quo and Countermeasures for Management of Pesticide in China [J]. Journal of Ecology and Rural Environment, 2002, 18(1): 62-64.
[5]	YE Ya-Ping, SHAN Zheng-Jun. Management of Pesticides in USA,Sweden and Japan [J]. Journal of Ecology and Rural Environment, 2000, 16(4): 51-53,57.
[6]	JIANG Xi-Liu, HUA Xiao-Mei. Strengthening Environmental Supervision and Management of Pesticides-an Imperative Task [J]. Journal of Ecology and Rural Environment, 2000, 16(2): 35-38,64.
[7]	ZHAO Yin-Wei, ZHENG Shi-Zhang, YE Yu-Wu. Study on controlling system for environniental pollution of a-griculture and animal husbandry in Songjiang,a source regiou of drinking water for Shangbai [J]. Journal of Ecology and Rural Environment, 1994, 10(3): 9-13.