Hazardous Home Medical Care Waste Collection: A Six Year Follow-up Study

Abstract

Background: Domestic medical waste from Home Medical Care (HMC) is a concern in Japan. In 2005, the Japanese government provided that HMC waste is collected by municipalities. HMC waste includes infectious or sharps, thus such waste should be collected by doctor or nurse. Nevertheless, no studies have examined the collection of separate HMC waste items, such as needles and infectious agents. Objective: To demonstrate the current HMC waste collection status for individual items and to assess whether HMC waste collection rate by nurses has been changed since the initial study. Methods: A questionnaire was mailed and delivered 1,022 offices, from which 677 office nurses replied for the follow-up study, 27 had closed down, and five had integrated with other offices. Thus, the final analysis was conducted in 645 offices. Offices were classified into three groups according to the size of the local population. Results: Most of the used syringes and needles, were collected by a nurse or doctor. More nurses in small-sized cities collected used syringes and needles from patients’ homes than nurses in medium- or large-sized cities. In contrast, more doctors in large-sized cities collected used syringes and needles from patients’ homes than doctors in small- or medium-sized cities. HMC waste collection rates by nurses for all city sizes had decreased since the baseline study. Both 2009 and 2015 study, the collection rate of HMC waste by nurse was as high as small-sized city and lower as large-sized city. The trend of this did not change over six years. Conclusion: The collection rate of HMC waste by nurses has declined in the last six years. This indirectly indicated that the HMC waste collection rate of municipalities improved in six years. Safe HMC waste collection program awareness should be promoted among nurses, doctors and patients. It is necessary for healthcare workers to work in cooperation with municipalities. The development of standardized guidelines for HMC waste handling protocols should be a priority for all municipalities.