Avaliação do gerenciamento dos resíduos de serviços de saúde das Unidades Básicas de Saúde na rede municipal de Macapá

Abstract

Solid waste is the material that has been discarded after its useful life, which in itself is of no economic value and can be used or processed with adequate recycling. Waste generated as a result of health care activity also causes a significant social concern, which has been increasing, more significantly, since the 1980s. Such wastes are those that, due to their characteristics, composition and origin, require a to prevent the spread of infections. The management of hospital waste is governed by the basic principles of biosafety, integral management, minimization in generation, culture of non-production of garbage, precaution and prevention. The system of integral management for the management of hospital waste as the coordinated set of people, equipment, materials, supplies, specific regulations, plan, programs, activities and economic resources, which allow the proper management of waste by generators and providers of the garbage collection service. The objective of this research was to evaluate the management of the health services waste of the Basic Health Units at the Municipality of Macapá, knowing the dynamics of the management of Solid Health Wastes from each Basic Health Unit researched; in addition to identifying the level of knowledge and training received by the servers on the management of the RSS, verifying the perception of the residents of the UBS surrounding the RSS and evaluating the possible environmental and human health impacts generated by the UBS RSS. Research was done in 11 UBS located in the municipal headquarters of the city of Macapá and with the surrounding population, has a descriptive nature and quali-quantitative character. The questionnaire was adopted, with open and closed questions, and direct observation, as instruments of data collection. It was verified that only seven of them have RSS Management Plan. UBS have no control over the amount of waste generated. In all BHUs, continuous segregation of infectious, common and sharps-borne wastes is performed with internal storage as prescribed by relevant legislation. RSS managers have varied backgrounds. In the evaluation of the possible environmental impacts and human health generated by the UBS RSS, UBS did not produce radioactive type RSS, and only the infectious and piercing effects are segregated in the UBS. The negative points raised were: in only one UBS there is an external warehouse to store the containers of the time action, which are in poor condition; incorrectly stored residues were found in the internal collectors in most UBS; only one UBS respects the biosafety standards in the transportation of the conditioned waste to the waste room. The main positive points observed were: easy identification and visualization of the internal collection containers; the presence of sharps boxes (DESCARPACKS); the presence of carts consisting of washable material, rounded corners and fitted with lids in the internal transport of the RSS and in compliance with the biosafety standards in the operation of cleaning of the internal shelter of residues of the UBS. Taking into account the results obtained, it is suggested the seven UBS with deficiencies in waste management: Novo Horizonte, Marcelo Cândia, Hilda Iléia S. Ramos, São Pedro, Marabaixo, Rubim Aronovitch and Perpétuo Socorro, to establish an integrated management system for SSRs, with emphasis on staff training and establishment of adequate procedures for the entire process of managing these resources, from segregation, packaging, collection, storage, transportation, recycling, treatment and final disposal