Inadequacies in Hospital Waste and Sewerage Management in Chattogram, Bangladesh: Exploring Environmental and Occupational Health Hazards

Bangladesh has been grappling with the issues of improper hospital waste management. To reflect the inadequacies in existing management practices and the potential implications on the environment and health, this study evaluated the Knowledge, Attitude, and Practice (KAP) of doctors and nurses in a private and a public hospital in Chattogram city via a structured questionnaire survey. At the public hospital, 20.4% of the doctors and 6% of the nurses had occupational illnesses, compared to 36% of the doctors and 26.5% of the nurses at the private hospital. At the public hospital, 67.8% of the nurses wore PPE during waste collection, compared to 17.7% in the private hospital. Hospital wastes and occupational safety are not properly dealt with in both hospitals. An inadequacy was observed in the knowledge of hospital waste management among healthcare workers. The route of hospital wastes from the sources to the end destination was also traced via interviews and focus group discussions, which revealed that disposal practices of the hospital solid waste were environmentally unsustainable. In attempts to show opportunities for environmental and health risks from the hospital wastewater, this study also investigated the quality of the wastewater and tested it for the presence of resistant enteric pathogens. E. coli and S. aureus from both hospitals showed resistance against some common antibiotics used in Bangladesh. The physicochemical properties of the samples were nearly compliant with the Bangladesh Water Quality Standards for hospital wastewater. While more robust sampling and water quality analysis are required, this study provides basic water quality indicators and scope for future research to understand the apparent significant negative impact on the environment and health.