Abstract
Abstract
A knowledge, attitude and practice cross-sectional survey was conducted among dental practitioners doing private practice in district central, Karachi after checking eligibility and taking their written informed consent. The practitioners were interviewed by the principal investigator with the help of a pre-tested structured questionnaire developed specifically for this study. The study results revealed that 175(88.8%) of the participants were aware that waste management guidelines are applicable to them, 184(93.4%) were aware that healthcare waste is a source of infection whereas 145(73.6%) were aware about the colour coding of healthcare waste bags/containers. Moreover, 165(84.1%) thought that health care waste disposal protocol lessens the chance of injuries and infections whereas 182(92.0%) were in favour of the need to continue medical education about health care waste management. It is recommended that healthcare waste should be segregated and disposed of in a safe manner to protect the people at risk and the environment.
Keywords: Knowledge, Attitude, Waste Management, Dentists.
DOI: https://doi.org/10.5455/JPMA.22368
Introduction
Healthcare waste is defined as the total waste produce from a healthcare activity; between 70-90% of the waste is nonhazardous, domestic or general waste, the remaining 10-25% health care waste is regarded as infectious/ hazardous/ healthcare risk waste; the nonhazardous waste or domestic waste contains paper, plastic packing and leftover food stuff, the hazardous waste or health care risk waste contains infectious agents, sharps, hazardous chemicals or pharmaceuticals, and is genotoxic and radioactive.1 The institutions involved in generation of health care waste are hospitals, clinics, laboratories, blood banks, mortuaries, physician's offices, dental clinics and pharmacies; the individuals exposed to healthcare waste and thereby at risk of becoming injured or infected include doctors, nurses, sanitary staff, hospital maintenance personnel, in and out-patients, their visitors, workers in support services linked to healthcare facilities such as laundries, waste handling and transportation services and general public particularly the children.1 In 2016, the average total, general and infectious hospital waste generation rates in Pakistan have been reported to be 0.667, 0.497 and 0.17kg / bed / day respectively; 73.85% of it consisted of general, 25.8% consisted of hazardous/infectious while 0.87% consisted of nonhazardous waste.2 Effective management of healthcare waste essentially depends upon proper identification and segregation of the waste.3 The latest guidelines for segregation of biomedical waste recommend the following colour coding: highly infectious waste, pathological, anatomical and other infectious waste is to be held in a yellow container, marked "HIGHLY INFECTIOUS", with biohazard symbol; Sharps waste is to be held in a strong, leak-proof and puncture-proof yellow plastic bag or a container marked "SHARP" with biohazard symbol and capable of being autoclaved; chemical and pharmaceutical waste to be held in a brown plastic bag or rigid container labeled with appropriate hazard symbol; radioactive waste to be held in a lead box, labeled with radiation symbol and general health-care waste to be held in a black plastic bag.1 Waste management and treatment options should first protect the healthcare workers and the population and then minimize the indirect impacts from environmental exposures to health care waste.1 For this purpose it is essential that healthcare professionals and waste handlers have necessary awareness and are properly trained to manage healthcare waste. Although literature reports that there is a lack of knowledge regarding healthcare waste management among dental practitioners of Karachi,4 to the best of authors' knowledge, the attitude and practice of dental practitioners in this regard have not been evaluated yet. In order to expand the relevant local data base, this study was therefore conducted to determine knowledge, attitude and practice regarding dental waste management among dental practitioners of Karachi.
Methods and Results
A knowledge, attitude and practice survey was conducted in private dental clinics of district central, Karachi, from May 2018 to October, 2018. The study population consisted of conveniently sampled dental private practitioners from district central, Karachi. Graduate or post graduate registered dental practitioners doing private practice in district central, Karachi whereas dental internees were excluded from the study. Using the percentage frequency of the study outcome as 50% for maximum sample size, with 95% confidence interval, 7% precision, and factoring in a population size of 100000, the calculated sample size was 196 practitioners. A pretested structured questionnaire specifically designed for the study was given by the principal investigator to the dental practitioners after taking their written informed consent and taken back once they had filled it. The questionnaire was developed after a thorough literature review and was then pre-tested on 5% of sample size to check for face validity and reliability and was modified accordingly to yield a Cronbach's alpha value of 0.701. Data were analyzed by SPSS version 21 while descriptive analysis was performed by calculating means and standard deviations for continuous and frequencies and percentages for categorical variables. A response rate of 100% was recorded for the study. The mean age of the study participants was 34.16±7.37 years, 50.8% of them were females, 39.1% were graduates, 41.1% had