الفهرس 
Introduction to healthcare wasteOnly 14 pages are availabe for public view
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Abstract
Dental clinics generate several types of hazardous and infectious solid waste such as sharps, and waste with high heavy metal contents as amalgam, gypsum and lead foil packets.
The waste generated from dental clinics has the potential for spreading infections and diseases causing harm to the dentist, the people in immediate vicinity of the dentist, waste handlers, general public and the environment through production of toxins as by-products of the destruction process.
Safe management of dental solid waste could be achieved by ensuring proper management of waste in the processes of safe handling, segregation, collection, storage, transport and final disposal in order to mitigate and minimize health risks and prevent environmental contamination as required in various international waste management and environmental protection laws.
Aim of the study:
The present study aimed at improving the dental solid waste management system at specialized dental centers at Ministry of Health and Population in Alexandria.(ADRC and MBDC)
Specific objectives:
1. To assess the current dental waste management procedures in selected specialized dental centers.
2. To assess the knowledge, attitude and practices (KAP) of dentists and nurses regarding dental waste management.
3. To design and implement an environmental educational intervention program for dentists and nurses at the specialized dental centers.
4. To evaluate the impact of the intervention program on (KAP) of dentists and nurses participating in the program.
5. To develop an integrated dental waste management system in the selected dental centers.
The target population:
• The target population were administrators, dentists and nursing staff in the two selected dental centers.
Sampling size:
a- For cross sectional study:
All administrators, dentists and nurses (about 350) who were working in the two selected specialized dental centers (ADRC and MBDC) were included in the study to assess their KAP regarding dental solid waste management.
b- One group pre-test and post-test design:
A sample of 85 dentists and nurses were chosen at random for the implementation of the educational intervention program.
Data collection:
The required data were collected using the following tools:
I- Cross sectional study:
• A predesigned interviewing questionnaire and an observational checklist were used to assess dental solid waste management at the selected two dental centers.
a) Interviewing questionnaire included the administrative personnel with general qualification and the training received by them in both centers. It also included the availability of written plan, records, dental solid waste management team work, the waste generated per day and the frequency of waste disposal.
b) Observational checklist included the resources required for dental waste segregation, collection, transportation of dental solid waste and presence of waste storage room and its condition, as well as the availability and usage of protective measures by healthcare staff and waste workers.
II- Pre and post-test study: Assessment of knowledge, attitude and practice:
• The interviewing questionnaire which used for dentists included knowledge, attitude and practices of dentists regarding proper management of different types of dental waste, the importance of compliance with guidelines and regulations of dental waste management and identification of obstacles and barriers to develop proper dental solid waste disposal.
• The interviewing questionnaire used for nurses included knowledge, attitude and practices concerning proper management of dental waste, barriers to achieve proper dental waste management and preferred methods for learning about proper management of dental solid waste.
• An educational program was designed according to the results of initial assessment of the dentists’ and nurses’ knowledge, attitude, and practice regarding dental solid waste management at the selected centers.
• An educational program was done by using demonstrations, power point presentation, group discussion, booklet edited by the researcher, and videos concerning how to deal with accidental exposure to blood spills, as well as mercury.
• Assessment of knowledge, attitude and practice of the intervention participants was redone using the same questionnaire which was applied as base line data.
Study results:
The present study revealed the following results:
I- The interviewing questionnaire regarding the current dental waste management system through the administrative personnel in ADRC and MBDC:
• There was a lack of dental solid waste practices policy within the dental centers under study.
• There was no focal person or waste manager responsible for dental solid waste management, rather it was included in the infection control department in both dental centers.
• Absence of recording system concerning dental solid waste.
• There was no appropriate segregation for amalgam waste and lead foil waste.
• Storage room in both centers were not completely following the WHO guidelines.
• PPE were available in both centers. However, healthcare staff didn’t use them regularly.
II- Educational Intervention Program Results:
Pre-intervention results for dentists:
• It was reported that only 14.8% of the dentists in ADRC and 4.9% of the dentists in MBDC had good knowledge about dental solid waste management.
• The results further revealed that 9.7% of dentists in ADRC and only 2% of dentists in MBDC followed appropriate practices concerning management of dental solid waste.
Pre-intervention results for nurses:
• It was shown that 45% of the nurses in ADRC had good knowledge concerning proper handling of dental solid waste.
• Concerning their practice, it was documented that only 28.1% of the nurses in ADRC had good practice when dealing with dental solid waste.
Post-intervention results for dentists:
• A significant improvement in the dentists’ knowledge was shown in both centers as 77.8% of dentists in ADRC and 84% of the dentists in MBDC had good knowledge of proper management of dental solid waste. Statistical significant difference was shown in both center between pre and post-tests (p=0.0001).
• The results of the present study showed enhancement of the dentists’ behavior in both centers concerning dental solid waste practice. There was statistical significant difference between pre and post- test (p=0.0001).
Post-intervention results for nurses:
• It was shown that about 96% of the nurses had good awareness of dental solid waste management. Significant improvement of their knowledge was concluded giving statistical significant difference between pre and post-test (p=0.0001).
• Results of the study also revealed that all the nurses (100%) had a significant improvement in their practice regarding solid dental waste. Statistical significant difference was reported between pre and post-test (p= 0.0001).
Recommendations
• To develop a safe system of dental solid waste handling, segregation, collection, storage, transportation and disposal, with minimal risk to handlers, public health and the environment.
• A national collaborative effort should be applied between different ministries to minimize the effects of dental solid waste and to address these threats in comprehensive and effective ways.
• Designing and implementing training programs to dental center staff according to the needs based on interactive learning methods.
• Providing financial resources to ensure effective implementation of policy, plan, laws and regulations designed for dental solid waste management.
• Documentation of the activities related to the dental solid waste plan and record the data about the type and the amount of the generated dental solid waste.
• Integration of the guidelines for proper management of dental solid waste in the undergraduate curriculum at the Faculty of Dentistry.