BIOMEDICAL WASTE, HANDLING PRACTICES AND PREVALENCE OF SHARPS-INDUCED INJURY AMONG HEALTH WORKERS IN IBADAN, NIGERIA

Abstract

Biomedical Wastes (BMWs) generated in healthcare settings are hazardous. In Nigeria, knowledge of BMW handling practices and Healthcare Worker' (HCWs) vulnerability to sharps-induced injuries is inadequate. The study assessed knowledge, perceptions and BMWs handling practices among HCWs, determined the prevalence of sharps-induced Injuries among them and assessed the proportion of sharps waste generated in Healthcare facilities (HCFs) in Ibadan. The study involved a three-stage sampling technique in selecting five HCFs (two public and three private). A validated questionnaire with a 10-point knowledge scale was used to obtain information from 426 randomly selected major waste generators (doctors, nurses, laboratory scientists) and waste handlers (ward maids, cleaners, and waste disposal workers). An observational checklist and in-Depth Interview (IDI) guide were used to document BMWs handling practices. The wastes were weighed daily for a month after segregation into sharps and non-sharps. Descriptive, Chi-square statistics and logistic regression were used to analyze the data. Respondents had a mean age of 37.3±9.2 years and majority (73.9%) were females. 'On-the-job training' (47.9%) was respondents' main source of information about BMWs handling practices. The respondents' mean knowledge score on handling of BMWs was 4.7±1.8. The mean knowledge scores of HCWs in private and public HCFs were 4.4±2.0 and 4.8±1.9 respectively, with no significant difference. Most (90.6%) of the respondents opined that sharps and non-sharps wastes should be kept in different bins. About fifty-five percent of the respondents were of the opinion that segregation of waste should not be the responsibility of waste generators. Most (92.3%) used at least one Personal Protective Equipment (PPE). The PPE used by respondents were hand gloves (87.4), nose masks (26.8%), aprons (23.3%) and boots (13.5%). Sixty-five percent of the respondents handled BMWs inappropriately. Factors significantly associated with inappropriate handling of sharp wastes included being a male health worker (OR=1.98. CI=1.25-3.15, p<0.05 ), and lack of formal training on waste handling practices (OR-1.95, CI-1.24-3.06. p<0.05). The prevalence of sharps -induced injuries within six months preceding the study was 29.6%. Needles caused 79.1% of the injuries while 86.4% of injuries occurred on the fingers. The IDI showed that none of the HCFs had a policy on BMW management. Segregation of waste at the point of generation and use of colour-coded bins were observed only in one of the HCFs. The monthly weight of generated sharps ranged from 0.1- 8.0kg and 0.1- 4.5kg in public and private HCFs respectively. Tho ratio of sharps to non-sharps wastes in public and private HCFs were 1:90 and 1:32 respectively. There was low level of knowledge, inappropriate handling of Biomedical Wastes and high prevalence of sharps-induced injuries among the health workers. Training on use of Personal Protective Equipment and advocacy for the implementation of the national policy on biomedical waste management are needed to address these concerns.