# Common Environmental Health Hazards and Injuries in Health Care Waste Management Health care waste management (HCWM) is an essential component of safe health-care delivery because improper handling, storage, transportation, treatment and disposal of health-care waste can create serious risks to workers, patients, visitors, the community and the environment. Health-care facilities generate different types of waste, including general waste, infectious waste, sharps, pathological waste, pharmaceutical waste, chemical waste and radioactive waste. If these wastes are not properly segregated and managed, they can cause environmental pollution, occupational injuries, infections and other adverse health effects. Worker safety and patient safety are therefore closely linked with effective health-care waste management. One of the most common environmental health hazards is the contamination of air. Open burning or inappropriate incineration of health-care waste can release smoke, particulate matter, toxic gases and other harmful substances into the atmosphere. Burning plastics containing chlorine may produce hazardous compounds such as dioxins and furans. Exposure to polluted air can cause eye irritation, respiratory problems, headaches and other health effects among health-care workers, patients and nearby communities. Modern treatment technologies, proper incinerator operation, emission control and avoidance of open burning are important measures for reducing these risks. Water pollution is another major environmental health concern. Infectious waste, chemicals, pharmaceuticals and untreated liquid waste may enter surface water or groundwater when health-care waste is disposed of improperly. Pathogenic microorganisms can contaminate drinking-water sources and increase the risk of infectious diseases. Chemicals and pharmaceutical residues may also affect aquatic organisms and contribute to long-term environmental contamination. Proper wastewater treatment, secure disposal of hazardous waste and protection of water sources are necessary to safeguard both public health and the environment. Soil contamination may occur when hazardous health-care waste is dumped on open land or disposed of in poorly designed landfill sites. Heavy metals, pharmaceutical products, chemicals and other toxic substances can accumulate in soil and subsequently enter plants, animals and the human food chain. Improper disposal can also attract insects, rodents and stray animals, which may spread infectious agents. Secure landfilling, appropriate treatment before disposal and strict control of hazardous waste are required to prevent soil pollution. Sharps injuries are among the most important occupational injuries associated with HCWM. Needles, scalpels, blades, broken glass and other sharp objects can cause cuts and puncture wounds during collection, segregation, transportation and disposal. A needle-stick injury may expose a health-care worker or waste handler to blood-borne pathogens such as hepatitis B virus, hepatitis C virus and human immunodeficiency virus. Such injuries may also occur to patients if discarded sharps are left in inappropriate places or waste containers. Worker safety requires immediate disposal of sharps into puncture-resistant, leak-proof containers located close to the point of use. Inadequate segregation of waste increases the risk of injuries. When infectious or sharp waste is mixed with general waste, cleaners, waste handlers and other staff may unknowingly come into contact with hazardous materials. Incorrectly labelled or overfilled containers further increase the likelihood of spills and accidental exposure. Waste should therefore be segregated at the point of generation using appropriate colour-coded and clearly labelled