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Risco biológico dos resíduos hospitalares : Contributos para a sustentabilidade via valorização material e energética
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Resumo(s)
Enquadramento: Os resíduos hospitalares não devem contaminar o ambiente ou causar doença no ser humano. Devem ser considerados o impacto que as deposições em aterro poderão ter no ambiente, bem como o que os resíduos de medicamentos possam ter no aumento da resistência aos antimicrobianos.
Objetivos: Conhecer o circuito, a quantidade e os custos dos resíduos; determinar o nível de contaminação microbiana e os microrganismos presentes; testar a resistência a antimicrobianos; demonstrar a possibilidade de valorização material ao invés da deposição em aterro.
Métodos: É um estudo primário, transversal, analítico e quase-experimental. População: resíduos de embalagens vazias de medicamentos. Amostra: embalagens vazias de soros e antimicrobianos. Local: ULS da região centro. Período analisado: 2020-2024. Solicitaram-se dados à instituição de saúde e ao operador de gestão de resíduos; colheram-se amostras; avaliou-se o nível de contaminação microbiana; e realizaram-se testes de sensibilidade a antimicrobianos.
Resultados: A separação dos resíduos é realizada por grupos. A produção, os custos, e o consumo de embalagens aumentaram no período de 2020-2024. Perante o nº de colónias desenvolvidas, verificou-se que o nível de contaminação foi baixo. Não foi possível identificar os microrganismos presentes. Verificou-se uma elevada resistência à ampicilina e ciprofloxacina, e alguma sensibilidade à gentamicina.
Conclusões: A produção de resíduos hospitalares revelou-se significativa pelo que, a gestão do impacto do consumo de embalagens de soros e antimicrobianos e do seu nível de contaminação, deverá ser criteriosa e sustentável. A impossibilidade de identificação taxonómica, e a não classificação do risco biológico inviabilizaram determinar a viabilidade da valorização material.
Palavras-chave: resíduos hospitalares, nível de contaminação, valorização, resistência microbiana
Abstract Context: Hospital waste should not contaminate the environment or cause disease in humans. The impact that landfill disposal may have on the environment should be considered, as well as the potential impact of pharmaceutical waste on increasing antimicrobial resistance. Objectives: To understand the circuit, quantity, and costs of waste; to determine the level of microbial contamination and the microorganisms present; to test for antimicrobial resistance; to demonstrate the possibility of material recovery instead of landfill disposal. Methods: This is a primary, cross-sectional, analytical, and quasi-experimental study. Population: waste from empty pharmaceutical packaging. Sample: empty serum and antimicrobial packaging. Location: Local Health Unit in the central region. Period analyzed: 2020-2024. Data were requested from the health institution and the waste management operator; samples were collected; the level of microbial contamination was assessed; and antimicrobial susceptibility tests were performed. Results: Waste separation is carried out by groups. The production, costs, and consumption of packaging increased in the period 2020-2024. Given the number of colonies developed, the level of contamination was found to be low. It was not possible to identify the microorganisms present. High resistance to ampicillin and ciprofloxacin was observed, and some sensitivity to gentamicin. Conclusions: The production of hospital waste proved to be significant, therefore, the management of the impact of the consumption of serum and antimicrobial packaging and its level of contamination should be careful and sustainable. The impossibility of taxonomic identification and the lack of classification of biological risk made it impossible to determine the viability of material recovery. Keywords: hospital waste, contamination level, recovery, microbial resistance
Abstract Context: Hospital waste should not contaminate the environment or cause disease in humans. The impact that landfill disposal may have on the environment should be considered, as well as the potential impact of pharmaceutical waste on increasing antimicrobial resistance. Objectives: To understand the circuit, quantity, and costs of waste; to determine the level of microbial contamination and the microorganisms present; to test for antimicrobial resistance; to demonstrate the possibility of material recovery instead of landfill disposal. Methods: This is a primary, cross-sectional, analytical, and quasi-experimental study. Population: waste from empty pharmaceutical packaging. Sample: empty serum and antimicrobial packaging. Location: Local Health Unit in the central region. Period analyzed: 2020-2024. Data were requested from the health institution and the waste management operator; samples were collected; the level of microbial contamination was assessed; and antimicrobial susceptibility tests were performed. Results: Waste separation is carried out by groups. The production, costs, and consumption of packaging increased in the period 2020-2024. Given the number of colonies developed, the level of contamination was found to be low. It was not possible to identify the microorganisms present. High resistance to ampicillin and ciprofloxacin was observed, and some sensitivity to gentamicin. Conclusions: The production of hospital waste proved to be significant, therefore, the management of the impact of the consumption of serum and antimicrobial packaging and its level of contamination should be careful and sustainable. The impossibility of taxonomic identification and the lack of classification of biological risk made it impossible to determine the viability of material recovery. Keywords: hospital waste, contamination level, recovery, microbial resistance
Descrição
Palavras-chave
Anti-infecciosos Eliminação de resíduos de serviços de saúde Fatores de risco Gestão de resíduos Poluição do ambiente Resíduos de serviços de saúde Resistência bacteriana a medicamentos Risco Saúde pública Anti-infective agents Drug resistance bacterial Environmental pollution Medical waste Medical waste disposal Public health Risk Risk factors Waste management