A large number of users are serviced in primary health care units in Brazil, both in health facilities and in households. These services generate waste that must be managed safely, but there is no legislation that regulates this type of waste management in Brazil. The objective of this study was to analyse the production and management of waste in primary health care. A direct observation was performed of the stages in the handling and weighing of waste generated in primary health care units in the municipality of Goiânia (Brazil). The units generated infectious, chemical, and common waste, as well as sharp objects. The generation of waste ranged between 0.027 and 0.075 kg user-day. The generated waste was classified mostly as common and recyclable. Flaws were observed in the management of all types of waste. The critical point is segregation. Only 34.1% of the waste disposed of as infectious actually belonged to this group, the rest was ordinary waste. Flaws at this stage increase the volume of infectious waste, the occupational and environmental risks, and associated costs. Intervention to change this reality is needed and it requires the careful preparation of a waste management plan, corroborating structural changes to the implementation of this plan, and professional training and public policies to guide waste management in primary care, especially those generated in households.
Abd El-SalamMM (2010) Hospital waste management in El-Beheira Government, Egypt. Journal of Environmental Management91: 618–629.
2.
AborPABouwerA (2008) Medical waste management practices in a Southern African Hospital. International Journal of Health Care Quality Assurance21(4): 356–364.
3.
Agência Nacional de Vigilância Sanitária (2004) Resolução RDC n° 306, de 07 de dezembro de 2004: Regulamento técnico para o gerenciamento de serviços de saúde. Brasília (DF): MS, 2004.
4.
AlagozAZKocasoyG (2008) Determination of the best appropriate management methods for the health-care wastes in Istanbul. Waste Management28(7): 1227–1235.
5.
AlvesSBSouzaACSTippleAFV. (2012) Manejo de resíduos gerados na assistência domiciliar pela Estratégia de Saúde da Família. Revista Brasileira de Enfermagem65(1): 128–134.
6.
Alves-RezendeMCRRossiACAlves-ClaroAPR (2008) Amálgama dentário: controle dos fatores de risco à exposição mercurial. Revista Odontológica de Araçatuba29(2): 9–13.
7.
Assossiação Brasileira de Normas Técnicas (2013) NBR 12809 − Resíduos de serviços de saúde: gerenciamento de resíduos de serviços de saúde intraestabelecimento. ABNT NBR, 12809: 14pp.
8.
BarrosDXFrancoLCTippleAF. (2010) Exposição a material biológico no manejo externo dos resíduos de serviço de saúde. Cogitare Enferm15(1): 82–86.
9.
BendjoudiZTalebFAbdelmalekFAddouA (2009) Healthcare waste management in Algeria and Mostaganem department. Waste Management29: 1383–1387.
10.
Brazil (2005) Portaria nº 485, de 11 de novembro de 2005: aprova a norma regulamentadora nº 32 − Segurança e Saúde no Trabalho em Serviços de Saúde. Brasília (DF): MT, 2005.
11.
Brazil (2011) Ministério da Saúde (BR) Portaria nº 2488, de 21 de outubro de 2011. Aprova a Política Nacional de Atenção Básica, estabelecendo a revisão de diretrizes e normas para a organização da Atenção Básica, para a Estratégia Saúde da Família (ESF) e o Programa Agentes Comunitários de Saúde (PACS). Brasília (DF): MS, 2011.
ChengYWSungFCYangY. (2009) Medical waste production at hospitals and associated factors. Waste Management29: 440–444.
14.
Conselho Nacional do Meio Ambiente (2005) Resolução 358 de 29 de abril de 2005: tratamento e a disposição final dos resíduos dos serviços de saúde e dá outras providências. Brasília (DF): MMA, 2005.
15.
CorrãoCRNCimmutoADMarzuilloC. (2013) Association between waste management and HBV among solid municipal waste workers: A systematic review and meta-analysis of observational studies. The Scientific World Journal1: 1–6.
16.
CostaTFFelliVEATakayanaguiAMM. (2013) Caracterização dos produtos geradores de resíduos químicos perigosos: estudo em um hospital público universitário. Cogitare Enferm18(1): 109–116.
17.
DebereMKGelayeKAAlamdoAGTrifaZM (2013) Assessment of the health care waste generation rates and its management system in hospitals of Addis Ababa, Ethiopia, 2011. BMC Public Health13(28): 3–9.
18.
GaiRYXuLZLiHJ. (2010) Investigation of health care waste management in Binzhou District, China. Waste Management30(2): 246–250.
19.
GessnerRPiosiadloLCMFonsecaRMGSLaroccaLM (2013) O manejo dos resíduos dos serviços de saúde: um problema a ser enfrentado. Cogitare Enferm18(1): 117–123.
20.
GourniPPolikandriotiMVasilopoulosG. (2012) Occupational exposure to blood and body fluids of nurses at emergency department. Health Science Journal6(1): 60–68.
21.
GouveiaNPradoRR (2010) Health risks in areas close to urban solid waste landfill sites. Revista de Saúde Pública44(5): 859–866.
22.
HaylamichealIDDalvieMAYirsawBDZegeyeHA (2010) Assessing the management of healthcare waste in Hawassa city, Ethiopia. Waste Management & Research1: 1–10.
23.
HossainMSSanthanamANorulainiNANOmarAKM (2011) Clinical solid waste management practices and its impact on human health and environment – a review. Waste Management31: 754–766.
KevorkyanAKPetrovaNSAngelovaNG (2012) A survey of occupational risk exposures and behaviour of healthcare workers. Folia Med54(1): 44–50.
26.
KomilisDFoukiAPapadopoulosD (2012) Hazardous medical waste generation rates of different categories of health care facilities. Waste Management32: 1434–1441.
27.
KumakechEAchoraSBerggrenV (2011) Occupational exposure to HIV: a conflict situation for health workers. International Nursing Review International Council of Nurses. 58: 454–462.
28.
LemosKILSilvaMGCPintoFJM (2010) Produção de resíduos em hospitais públicos e filantrópicos no município de fortaleza (CE). Revista Baiana de Saúde Pública34(2): 231–332.
29.
MoreiraAMM (2012) Gerenciamento de resíduos de serviços de saúde: um desafio para unidades basícas de saúde. Dissertação (Mestrado em Saúde Ambiental) – Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo. Available at: http://www.teses.usp.br/teses/disponiveis/6/6134/tde-06092012-103002/ (accessed 09 Jul 2014).
30.
MoreiraAMMGuntherWMR (2013) Assessment of medical waste management at a primary health-care center in São Paulo. Waste Management33: 162–167.
31.
NagashimaLBarros JuniorCFontesC (2007) Análise da produção e taxa de geração de resíduos sólidos de serviços de saúde do Hospital Universitário Regional de Maringa. Acta Scientiarum29(2): 131–139.
32.
NascimentoTCJanuzziWALeonelM. (2009) Ocorrência de bactérias clinicamente relevantes nos resíduos de serviços de saúde em um aterro sanitário brasileiro e perfil de susceptibilidade a antimicrobianos. Revista da Sociedade Brasileira de Medicina Tropical.
33.
PatwaryMAO’HareETStreetG. (2009) Country report: quantitative assessment of medical waste generation in the capital city of Bangladesh. Waste Management29: 2392–2397.
34.
PenattiJTVeigaTBMendesAA. (2013) Riscos ambientais em um serviço de atenção secundária à saúde. Cogitare Enferm18(2): 331–335.
35.
PereiraMSAlvesSBSouzaACS. (2013) Waste management in non-hospital emergency units. Revista Latino-Americana de Enfermagem21: 259–266.
36.
PerryJJaggerJParkerG. (2012) Disposal of sharps medical waste in the United States: impact of recommendations and regulations: 1978–2007. American Journal of Infection Control40: 354–358.
37.
PhengxaySOkumuraJMiyoshiM. (2005) Health-care waste management in Lao PDR: a case study. Waste Management & Research23(6): 571–581.
38.
RamosYSPessoaYSRQRamosYS. (2011) Vulnerabilidade no manejo de resíduos de serviços de saúde de João Pessoa (PB, Brasil). Ciência e Saúde Coletiva16(8): 3553–3560.
39.
RuoyanGLingzhongXHuijuamL. (2010) Investigation of healthcare waste management in Binzhou District, China. Waste Management30: 246–250.
40.
SawalemMSelicEHerbellJD (2009) Hospital waste management in Libya: a case study. Waste Management29: 1370–1375.
41.
SharmaRRasaniaSKVermaASinghS (2010) Study of prevalence and response to needle stick injuries among health care workers in a tertiary care hospital in Delhi, India. India Journal of Community Medicine35(1): 74–77.
42.
ShineeEGombojavENishimuraA. (2008) Healthcare waste management in the capital city of Mongolia. Waste Management28(2): 435–441.
43.
SilvaCAMCCamposJCFerreiraJA. (2013) Caracterização microbiológica de lixiviados gerados por resíduos sólidos domiciliares e de serviços de saúde da cidade do Rio de Janeiro. Engenharia Sanitária e Ambiental16(2): 127–132.
44.
StallNMKagomaYMBondyJNNaudieD (2013) Surgical waste audit of 5 total knee arthroplasties. Canadian Journal of Surgery56(2): 97–102.
45.
TesfahunEKumieALegesseW. (2014) Assessment of composition and generation rate of healthcare wastes in selected public and private hospitals of Ethiopia. Waste Management and Research32(3): 215–220.
46.
TramontiniAPandolfoAGuimarãesJ. (2009) Resíduos de serviços de saúde: uma abordagem prática em hospitais gerais da cidade de Passo Fundo. Health and Environment Journal10(2): 45–53.
47.
WagenheimCDi PatrizioPRabaudC (2013) Assessment of liberal physician’s occupational risks management on the exposure to biological fluids. Presse Med42(11): 385–392.
48.
WHO (2005) World Health Organization. Management of Solid Health-care Waste at Primary Health-care Centers. Geneva, Switzerland: World Health Organization.
