[Biomedical waste management in five hospitals in Dakar, Senegal]

Biomedical waste is currently a real health and environmental concern. In this regard, a study was conducted in 5 hospitals in Dakar to review their management of biomedical waste and to formulate recommendations. This is a descriptive cross-sectional study conducted from 1 April to 31 July 2010 in five major hospitals of Dakar. A questionnaire administered to hospital managers, heads of departments, residents and heads of hospital hygiene departments as well as interviews conducted with healthcare personnel and operators of waste incinerators made it possible to assess mechanisms and knowledge on biomedical waste management. Content analysis of interviews, observations and a data sheet allowed processing the data thus gathered. Of the 150 questionnaires distributed, 98 responses were obtained representing a response rate of 65.3%. An interview was conducted with 75 employees directly involved in the management of biomedical waste and observations were made on biomedical waste management in 86 hospital services. Sharps as well as blood and liquid waste were found in all services except in pharmacies, pharmaceutical waste in 66 services, infectious waste in 49 services and anatomical waste in 11 services. Sorting of biomedical waste was ill-adapted in 53.5% (N = 46) of services and the use of the colour-coding system effective in 31.4% (N = 27) of services. Containers for the safe disposal of sharps were available in 82.5% (N = 71) of services and were effectively utilized in 51.1% (N = 44) of these services. In most services, an illadapted packaging was observed with the use of plastic bottles and bins for waste collection and overfilled containers. With the exception of Hôpital Principal, the main storage area was in open air, unsecured, with biomedical waste littered on the floor and often mixed with waste similar to household refuse. The transfer of biomedical waste to the main storage area was done using trolleys or carts in 67.4% (N = 58) of services and wheelbarrows in 33.7% (N = 29). Biomedical waste was disposed of in old incinerators or in artisanal ovens with a great deal of smoke emanating from these. Working conditions were deemed poor by 81.3% (N = 61) of employees interviewed and personal protection equipment was available in 45.3% (N = 39) of services. Knowledge about biomedical waste management was deemed satisfactory by 62.6% (N = 47) of interviewees and 80% (N = 60) were aware of the health risks related to biomedical waste. The poor management of biomedical waste is a reality in hospital facilities in Dakar. This can be addressed by increasing the awareness of managers for an effective application of the legislation, implementing realistic management programmes and providing the appropriate on-the-job training to staff members.