INTRODUCTION: Unregulated biomedical waste management is an emerging public health problem in the Philippines. This study aimed to differentiate the knowledge, attitudes, and practices of nurses and medical technologists toward biomedical waste management. METHODS: Using an analytic cross-sectional study design, an online survey of nurses and medical technologists from hospitals around the Philippines was conducted. A 27-item questionnaire covering knowledge, attitudes and practices was used. The percentages of correct answers and mean scores in each domain was compared between the nurses and medical technologists. RESULTS: A total of 196 respondents consisting of 77 registered nurses and 119 medical technologists were included in the study. Medical technologists had significantly better knowledge scores than nurses on disposal procedures for expired blood units and by-products waste (55% vs. 19%, p = 0.026). Both had low correct responses on adequate disposal of human tissue remains, throwing blood waste into domestic waste, and throwing of expired medications in domestic waste. There was no significant difference in the attitude of nurses and medical technologists. Nurses had significantly better practice scores on disposal of liquid waste in bags (84.4% vs. 68.9, p = 0.018), but medical technologists fared better at disposal of human tissue together with other waste (13.0% vs. 2.5%, p = 0.006). CONCLUSION Both nurses and medical technologists had adequate knowledge of some aspects but were lacking in others. There was no significant difference in the attitude of nurses and medical technologists towards biomedical waste management. Half of the respondents practiced proper biomedical waste management.
Medical Laboratory Personnel ; Waste Management ; Knowledge ; Attitude

Antimicrobial resistance (AMR) is increasingly becoming a threat to global public health, not least in low- and middle-income countries (LMICs) where it is contributing to longer treatment for illnesses, use of higher generation drugs, more expenditure on antimicrobials, and increased deaths attributed to what should be treatable diseases. Some of the known causes of AMR include misuse and overuse of antimicrobials in both humans and animals, unnecessary use of antimicrobials in animals as growth promoters, and lack of awareness among the public on how to protect antimicrobials. As a result, resistant organisms are circulating in the wider environment, and there is a need to consider the One Health approach to minimise the continuing development of AMR. Environmental Health, specifically water, sanitation and hygiene (WASH), waste management, and food hygiene and safety, are key components of One Health needed to prevent the spread of antimicrobial-resistant microorganisms particularly in LMICs and reduce the AMR threat to global public health. The key Environmental Health practices in the prevention of AMR include: (1) adequate WASH through access and consumption of safe water; suitable containment, treatment and disposal of human excreta and other wastewater including from health facilities; good personal hygiene practices such as washing hands with soap at critical times to prevent the spread of resistant microorganisms, and contraction of illnesses which may require antimicrobial treatment; (2) proper disposal of solid waste, including the disposal of unused and expired antimicrobials to prevent their unnecessary exposure to microorganisms in the environment; and (3) ensuring proper food hygiene and safety practices, such as sale and consumption of animal products in which adequate antimicrobial withdrawal periods have been observed, and growing vegetables on unpolluted soil. Environmental Health is therefore crucial in the prevention of infectious diseases that would require antimicrobials, reducing the spread of resistant organisms, and exposure to antimicrobial residues in LMICs. Working with other professionals in One Health, Environmental Health Practitioners have a key role in reducing the spread of AMR including health education and promotion, surveillance, enforcement of legislation, and research.
Developing Countries ; Disease Transmission, Infectious/prevention & control* ; Drug Resistance, Microbial ; Environmental Health/standards* ; Food Safety ; Health Personnel/standards* ; Humans ; Hygiene/standards* ; Role ; Sanitation/standards* ; Waste Management/standards*

Aims: Every year, an estimated 25 million tons of waste oil are produced worldwide, and the generation of waste oil is one of the biggest global environmental problems. The incorporation of oil as a substrate for lipase production has been studied and shown to have a positive impact on its production. Burkholderia sp. is one of the major lipase-producing bacteria with their ability in bioremediation of oil-contaminated soil. This study aims to compare the production of lipase by Burkholderia cenocepacia ST8 using waste cooking oil and unused cooking oil as feedstock. Methodology and results: The effect of different types of waste cooking oil (sunflower oil and palm oil) and concentration (1-3%) of waste cooking oil, agitation speed (100-400 rpm) and initial dissolved oxygen concentration (10-50%) on lipase production by B. cenocepacia ST8 under batch fermentation mode were investigated. The major fatty acids of which had been consumed were determined using gas chromatography. Results showed that 2% (v/v) of single used sunflower cooking oil produced the highest lipase activity of 138.86 U/mL with a productivity of 2.10 U/mL/h; agitation speed of 300 rpm produced the highest lipase activity of 183.56 U/mL with a productivity of 3.06 U/mL/h while 30% initial concentration of dissolved oxygen produced a lipase activity of 176.45 U/mL with a productivity of 2.94 U/mL/h. Oleic acid and linoleic acid were found to be the most consumed by B. cenocepacia ST8 among other fatty acids. Conclusion, significance and impact of study This study shows that 2% (v/v) single used sunflower cooking oil was the better type and optimum concentration of carbon source for the production of lipase by the fermentation of B. cenocepacia under 300 rpm and 30% initial concentration dissolved oxygen. The incorporation of 2% (v/v) single used sunflower cooking oil may be a great alternative to reduce the cost for the production of lipase as well as reducing the amount of waste oil generation.
Lipase ; Burkholderia cenocepacia ; Waste Management ; Biodegradation, Environmental

Aims: Researchers are focusing more on the isolation of new probiotic bacteria to increase varieties for the growing market demand. This study aimed to isolate lactic acid bacteria (LAB) strains from sugarcane waste materials and evaluate its characteristic. Methodology and results: In the present study, two strains of LAB (Isolates A and B) were isolated from sugarcane waste and investigated in vitro for their characteristics as potential probiotics. These isolates were evaluated on their characteristics based on four biochemical tests (acid tolerance, bile tolerance, microbial adhesion, and phenol resistance), with the commercial strain Lactobacillus isolated from Yakult ® served as a positive control. Both isolated strains (>8 log10 CFU/mL) displayed higher survivability than control (>6 log10 CFU/mL) in simulated gastrointestinal conditions at pH 2.0 and pH 6.9 after 24 h. Furthermore, both isolated LABs were resistant to inhibitory substances which are 0.05-0.3% bile and 0.4% phenol. For bile tolerance, isolate A (OD 6.83) had a higher absorbance at 0.3% bile concentration as compared to isolate B (OD 2.20). However, isolate B (7.49 log10 CFU/mL) showed higher resistance towards 0.4% phenol than isolate A (7.11 log10 CFU/mL) after 24 h. Both isolate A and isolate B displayed low cell surface hydrophobicity, strong electron donor, and basic characteristic. Conclusion, significance and impact of study Both isolates were able to survive under gastrointestinal stress conditions, implying their potential as probiotics. This study demonstrated that valuable products such as probiotic strain could be isolated from sugarcane wastes to use in food production or medical treatment.
Lactobacillales ; Waste Management

Numerous health issues can arise from improper domestic waste management. Uncollected wastes provide food and breeding sites for insect, bird and rodent which can expose the community to vector borne disease. Therefore, this study aims to investigate the community awareness towards domestic waste management. This study is a cross-sectional study conducted at Bandar Baru Sungai Buloh, Selangor, Malaysia. The questionnaire consists of five sections with a total of 57 questions. The questionnaire consists of four parts: Socio-demographic, knowledge, attitude and practice. The data were analysed using SPSS version 22.0. T-test, ANOVA test, Chi-squared test were used according to the type of variables and significance level will be taken at 95% or p-value of less than 0.05. A total of 355 respondents participated in this study. The mean age was 40.52 ±14.94. The majority of them were male (52.1%), Malay (71.0%), married (71.3%), with secondary educational (81%) and employed (41.1%). The majority of respondents mentioned that inappropriate waste management can cause dengue fever and leptospirosis (98.0%, 97.2%; respectively). Property type, education, occupation, ethnicity, religions and household income were significant influenced the knowledge of the participants towards domestic waste management. For attitude, gender, education, ethnicity, religion and income significantly influenced the attitude of the participants towards domestic waste management. For practice, ethnicity, religion and occupation were significantly influenced the practice of the participants towards domestic waste management. In conclusion, the community has moderate awareness of domestic waste management. Awareness of waste management should also be taught in school so that the next generation of people will have a better understanding and eventually have better practice in domestic waste management. It is also hoped that a carefully thought-out strategy can be developed to further improve the community awareness towards domestic waste management which will shed a new light on tackling this issue.
Waste Management ; Health ; Knowledge ; Attitude ; Practice ; general population

OBJECTIVES: The purposes of the study were to assess wastes generated in school foodservice and to identify factors influencing the generation of plate waste. METHODS: A survey was administered from November 18–30 in 2015 to dietitians and nutrition teachers that were employed in schools located in Gyeonggi province. A questionnaire file and on-line survey site link were sent to the dietitians and nutrition teachers by e-mail. A total of 622 dietitians and nutrition teachers responded and 594 responses were used for data analysis after excluding 28 responses with significant missing data. RESULTS: Plate waste was the major part of food waste generated in school foodservice. Vegetable menus and soup/stews were discarded the most as plate waste. The dietitians and nutrition teachers perceived students' unbalanced diet and lack of appreciation of food as causes of the plate waste. Regarding waste management, they were concerned about environmental contamination by food waste and felt uncomfortable about discarding food. No plate waste day was the most frequently used plate waste reduction activity, followed by newsletters on plate waste reduction. Difficulty in getting teachers' support for dietary education during meal time was rated the greatest barrier to implementing the activities. To reduce plate waste, they perceived that students should understand the importance of environment conservation, teachers should supervise students' eating during meal time, students should be educated about proper portion, and foodservice staff should improve food quality. CONCLUSIONS: To improve students' intake and reduce plate waste in school foodservice, foodservice staff need to involve students in school foodservice and improve the palatability of meals, especially vegetable dishes. School nutrition teachers and dietitians should educate students about healthy eating and environment conservation and the school community needs to understand and support plate waste reduction and healthy eating in schools.
Diet ; Eating ; Education ; Electronic Mail ; Food Quality ; Food Services ; Gyeonggi-do ; Humans ; Meals ; Nutritionists ; Periodicals as Topic ; Statistics as Topic ; Vegetables ; Waste Management

Sustainable practices of school foodservices are gaining more attentions. The study aimed to investigate dietitians' performance levels of sustainable practices in school foodservice settings in Gyeonggi Provinces. Using a survey method was used, and data were collected from 358 participants (response rate 59.7%) to be analyzed using the SPSS program. The evaluation tool for sustainable practices of school foodservices consisted of four sections and 34 criteria with 100 points. Employment status of the respondents was as follows: nutrition teachers 40.9%, dietitians (permanent) 45.1%, and temporary position dietitians 13.2%. Dietitians' performance for sustainable practices marked 65.67 points out of 100 (performance rate 66%) and were in the following order by section: sustainable foodservice management criteria (69%), support activities (69%), planning and evaluation (68%), and outcome management (52%). Regarding sub-sections, criteria that acquired higher performance rates were labelling of food origin (99%), use of seasonal vegetables and fruits (98%), food waste management by contract dealer (98%), and planning for reducing of food waste and solid waste (91%). Meanwhile, criteria that showed the lowest scores were installing water conservation devices on equipment (19%), operating food donation programs for communities (21%), use of sensor lights for electricity conservation (24%), planning for annual energy conservation (40%), and implementation of education programs for foodservice workers on sustainable activities (42%). Performance scores differed according to school levels and working experience of dietitians, indicating that dietitians at elementary school foodservices or with work experience of 15 to 20 years showed higher performance than those at high schools or with less than 5 years of work experience (P < 0.001, P < 0.05). Based on the results, action plans for improvement were suggested.
Attention ; Education ; Electricity ; Employment ; Fruit ; Gyeonggi-do ; Humans ; Nutritionists ; Seasons ; Solid Waste ; Surveys and Questionnaires ; Vegetables ; Waste Management ; Water

OBJECTIVES: This study aimed to evaluate the relationship between oral health professionals' knowledge, attitude, and practice with regard to infectious waste management and to identify related factors influencing it. METHODS: The study comprised of 219 oral health professionals from select dental clinics and public health centers recruited between August 25, 2016 and September 5, 2016, who agreed to participate in the study with full understanding of the study objectives. A self-reported questionnaire was administered, which consisted of 22 items on knowledge of infectious waste management, 9 items on attitude, and 16 items on practice. Data were analyzed using Pearson's correlation coefficient and stepwise multiple regression analyses. RESULTS: The age, knowledge, and clinical attitude of oral health professionals significantly correlated with waste management practice. Specifically, infectious waste management practice improved with increasing age, a greater level of knowledge, and a more positive clinical attitude. Additionally, the standardized regression coefficient demonstrated that, of these three factors, clinical attitude more strongly correlated with effective waste management practice, followed by age and level of knowledge. CONCLUSIONS: These results indicated that oral health professionals had a low level of knowledge regarding infectious waste management, and a more positive clinical attitude resulted in better practices. Therefore, the development of detailed and active education guidelines and strategies are needed to enhance the attitude, knowledge, and practice of oral health professionals with regard to infectious waste management.
Dental Clinics ; Education ; Oral Health ; Public Health ; Waste Management

One-third of all hospital-regulated medical waste (RMW) comes from the operating room (OR), and it considerably consists of disposable packaging and wrapping materials for the sterilization of surgical instruments. This study sought to identify the amount and type of waste produced by ORs in order to reduce the RMW so as to achieve environmentally-friendly waste management in the OR. We performed an initial waste segregation of 4 total knee replacement arthroplasties (TKRAs) and 1 total hip replacement arthroplasty, and later of 1 extra TKRA, 1 laparoscopic anterior resection of the colon, and 1 pelviscopy (with radical vaginal hysterectomy), performed at our OR. The total mass of non-regulated medical waste (non-RMW) and blue wrap amounted to 30.5 kg (24.9%), and that of RMW to 92.1 kg (75.1%). In the course of the study, we noted that the non-RMW included recyclables, such as papers, plastics, cardboards, and various wrapping materials. The study showed that a reduction in RMW generation can be achieved through the systematic segregation of OR waste.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Colon ; Medical Waste* ; Operating Rooms* ; Plastics ; Product Packaging ; Recycling ; Sterilization ; Surgical Instruments ; Waste Management

Health-care workers are at risk of exposure to occupational infections with subsequent risk of contracting diseases, disability, and even death. A systematic collection of occupational disease data is useful for monitoring current trends in work situations and disease exposures; however, these data are usually limited due to under-reporting. The objective of this study was to review literature related to knowledge, risk perceptions, and practices regarding occupational exposures to infectious diseases in Malaysian health-care settings, in particular regarding blood-borne infections, universal precautions, use of personal protective equipment, and clinical waste management. The data are useful for determining improvements in knowledge and risk perceptions among health-care workers with developments of health policies and essential interventions for prevention and control of occupational diseases.
Communicable Diseases ; Health Policy ; Malaysia* ; Occupational Diseases ; Occupational Exposure ; Personal Protective Equipment ; Universal Precautions ; Waste Management