Legal basis
Previously, waste classification was often carried out based on internal regulations, but with the Law on Environmental Protection 2020 (effective from January 1, 2022), this issue has been strongly legalized.
Specifically, Clause 1, Article 62 of the Law on Environmental Protection 2020 clearly stipulates the responsibility of medical facilities to classify waste at source. This means that if a medical facility mixes household waste with infectious waste or vice versa, it is not only a technical error but also a violation of environmental laws.
Accompanying the Law on Environmental Protection 2020 is Circular 20/2021/TT-BYT of the Ministry of Health replacing Joint Circular 58/2015. The advantage of Circular 20 is the simplification and scientific classification list, helping medical staff easily identify and operate quickly in high-pressure environments.
Accordingly, in Article 6 of Circular 20/2021/TT-BYT, the source classification process must strictly follow the color coding principle to prevent cross-contamination:
Infectious Waste Group (Yellow): Includes sharp waste (needle, scalpel), surgical waste, and waste contaminated with blood/body fluids. This is the focus group that needs the strictest control.
Non-infectious Hazardous Waste Group (Black): Includes discarded pharmaceuticals, toxic chemicals, medical equipment containing mercury/heavy metals.
Domestic Solid Waste Group (Green): Waste from daily activities of medical staff and patients without secretions.
Recyclable Waste Group (White): Paper, cardboard, plastic bottles that are not contaminated with chemicals/diseases.
Circular 20 emphasizes that infectious waste must be collected separately from the source to the temporary storage area within the medical facility premises at least once a day.
Practical application - advantages and difficulties
A survey at a number of provincial general hospitals and district medical centers shows the intertwined advantages and difficulties when applying these two documents.
Advantages: Clear legal framework: Hospitals have a solid foundation to build SOP (Standard Operating Procedure) and monitoring checklists. Standardization of equipment: Most large medical facilities have equipped a system of trash cans with lids, foot pedals and color codes according to regulations, minimizing the need to open the lid by hand (risk of infection).
Difficulties and Challenges: In practice, it is noted as well as the According to the report, the situation of 'mixed garbage' still exists, especially in departments such as the Examination Department or Emergency Department. The situation of patients' relatives throwing milk cartons and plastic bags (household waste) into the yellow bin (infectious waste) still occurs. This unintentional action increases the volume of artificial hazardous waste, causing a huge waste of the hospital budget. Along with that, many medical facilities, due to being built long ago and not being synchronized, have difficulty in renovating warehouses to meet standards.
Solutions and recommendations
In order for the Law on Environmental Protection 2020 and Circular 20/2021/TT-BYT to truly come into effect, medical facilities need to deploy synchronous solutions:
Strengthening surveillance via cameras and sanctions: Not only propaganda, it is necessary to attach the responsibility of waste classification to the competition of each department/office. Use a surveillance camera system at the waste collection area to trace the origin of waste that is not properly classified.
"Proactive Infection Control" Model: The Infection Control team needs to act as "environmental police" in the hospital, regularly conducting surprise audits of trash bins in patient rooms.
Optimize visual communication: Instead of lengthy texts, post visual sorting instruction posters right above the trash cans to make it easier for patients and their families to follow.
Investing in on-site treatment technology: For medical facilities in remote areas with difficulty accessing centralized collection units, it is necessary to invest in infectious waste treatment systems using integrated microwave or wet steam technology (more environmentally friendly than incinerators) according to the direction of the Law on Environmental Protection 2020.
Source: https://suckhoedoisong.vn/chuan-hoa-phan-loai-chat-thai-y-te-tai-nguon-tu-hanh-lang-phap-ly-den-thuc-te-169251129114228269.htm
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