Quantitative assessment of mortuary waste: occupational safety and environmental health

Abstract

Mismanagement of mortuary waste is a significant risk factor for disease transmission. Quantitative estimation of mortuary waste generation is needed to estimate the potential risk and as a basis for any waste treatment, disposal and management plan. Bangladesh, a developing country, is an example where there has been no rigorous estimation of mortuary waste generation and associated risk factors based on a thorough scientific study. The present study used a statistically designed sampling method of waste generation in a broad range to identify the factors associated with public health and environmental safety. The data gathering techniques included observation, formal structured interview, informal dialogue, and waste weighing. The proportion of mortuary waste classified as hazardous by the World Health Organisation (WHO) guidelines was found to be high. The waste generation rate per dead body was found to be 9.00 ± 2.52kg and average waste generation per day was 918 ± 11kg among the surveyed mortuaries. Operatives dealing with the infectious waste were frequently found to be untrained, without even a basic understanding of the hazards involved. Personal protective equipment was inadequate in most cases, which led to frequent accidental injuries. None of the mortuaries were found to have adequate storage facilities for dead bodies as well as hazardous waste in the context of environmental health and safety. Hazardous waste was dumped into city corporation bins, and disposed of on general landfill sites. As well as exposing the waste to the environment, this could potentially contaminate ground water, soil and sediments, especially as the dumps were located in areas subject to frequent flooding. The significant factor of health and environmental risk was identified as decomposition of dead bodies. The degree to which dead bodies are decomposed is related to the time taken to bring them to the mortuary and to the duration of the autopsies. The delay was due to poor communication, low level of interest, transportation cost, and trying to avoid social harassment. This is the first study to attempt this type of thorough estimation of mortuary waste and assessment of risk on environmental health occupational safety.