ORIGINAL ARTICLE

Year : 2015  |  Volume : 6  |  Issue : 3  |  Page : 166-169

Knowledge, attitude, and practices about biomedical waste

management among dental healthcare personnel in dental colleges
in Himachal Pradesh: A cross-sectional study
Kavita Manchanda1, Shailee Fotedar1, Parveen Dahiya2, Ankur Vats3, Avishek De Sarkar4, Anjali Shrivastava
Vats3
1
 Department of Public Health Dentistry, Government Dental College and Hospital, Shimla, Himachal Pradesh, India
2
 Department of Periodontics, Himachal Institute of Dental Sciences, Ponta Sahib, Sirmour, Himachal Pradesh, India
3
 Department Conservative and Endodontic, Bhojia Dental College, Baddi, Himachal Pradesh, India
4
 Department of Oral and Maxillofacial Surgery, Gurunanak Institute of Dental Science Research, Sodepur, Kolkata,
India

Date of Web Publication 4-Aug-2015

       

Correspondence Address:
Kavita Manchanda
Manchanda Medical Store, 65 The Mall, Shimla - 171 001, Himachal Pradesh
India

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DOI: 10.4103/0976-433X.156215

  Abstract  

Introduction: The waste created by the healthcare services while providing services which may be either
curative, promotive, or preventive may be hazardous to health and environment if there is indiscriminate
disposal of hospital waste. Objective: The objective was to assess knowledge, attitude, and practices of
students (3 rd years, 4 th years), interns and teaching staff. Materials and Methods: A cross-sectional study
was conducted using a close-ended questionnaire among the students, interns and teaching staff of three
dental colleges in Himachal Pradesh. A total of 578 subjects were included in the study with their prior
consent. Statistical Analysis: The data were tabulated, and interpretation was done in percentages by using
SPSS version 13.0 (SPSS Inc., Chicago, IL, USA). Results: Many dentists have the knowledge about the
waste management, but they lack in the attitude and practice. Conclusion: There is a need for education
regarding hazards associated with improper waste disposal at all levels of dental personnel.

Keywords: Health care waste management, health hazards, hospital, medical professionals, survey
How to cite this article:
Manchanda K, Fotedar S, Dahiya P, Vats A, Sarkar AD, Vats AS. Knowledge, attitude, and practices about
biomedical waste management among dental healthcare personnel in dental colleges in Himachal Pradesh: A
cross-sectional study. SRM J Res Dent Sci 2015;6:166-9

How to cite this URL:

Manchanda K, Fotedar S, Dahiya P, Vats A, Sarkar AD, Vats AS. Knowledge, attitude, and practices about
biomedical waste management among dental healthcare personnel in dental colleges in Himachal Pradesh: A
cross-sectional study. SRM J Res Dent Sci [serial online] 2015 [cited 2021 Jan 19];6:166-9. Available
from: https://www.srmjrds.in/text.asp?2015/6/3/166/156215

  Introduction  

Let the wastes of "the sick" not contaminate the lives of "the healthy."

In spite of the remarkable innovations over the years in the health care system, it is strange that the health
care settings, which reinstates and maintain the health of the community, are also threatening their well-being.
A huge risk to the health of the public, patients, professionals, and environment arise due to poor waste
management practices. [1]

The hospital hygiene and safety of health care workers and communities are ensured by the process of health
care waste management (HCWM). One of the effective contributors of HCWM can be our health workers.
Although their efforts may seem to be small, but their each step builds a base of sound morals and rational that
are necessary for the success of the whole community. [2]

With the notification of the biomedical waste (BMW) rules, 1998, hospital waste management has been
brought into focus in India. According to the rules, it is mandatory for the health care establishments to
segregate, disinfect, and dispose their waste in an eco-friendly manner. [2]

Even though there is increased global awareness among health care professionals about threats and also
suitable management techniques, in India, the level of awareness has been found to be unsatisfactory. [3] As
there is no available information which describes the actual practice followed in handling these types of waste
products in Himachal Pradesh at present, so this study aims to assess the knowledge, attitude, and practices
among the dental health personnel's regarding BMW handling in the dental institutions.

  Materials and Methods  

For this cross-sectional closed-ended questionnaire study, ethical approval was obtained from the Institutional
Review Board of H.P. Government Dental College and Hospital, Shimla. The study was carried out for a period
of 3 months from May 2014 to July 2014. Of five dental colleges, three dental institutes were randomly
selected.

The survey had questions in four major categories. Section 1 consisted of demographic questions, including
the gender, college year, work experience, qualification. Section 2 had 10 close - ended questions concerning
the practitioner's knowledge about BMW management. The knowledge questions were answered using the
options "correct" and "incorrect." Each question answered correctly received 1 point, for a maximum score of
10. The scores were transformed into percentage of correct answers. Hence, a student's score could range
from 0 (no correct answer) to 100% (all 10 answers correct). Student with <25% was considered to have a
poor knowledge, between 25% and 50% to have moderate knowledge, between 50% and 75% to have good
knowledge and more than 75% to have excellent knowledge. The third section consisted of 10 questions were
included to assess the attitude regarding the management of waste generated in the health sector. The
answers to these questions were given on a five-point Likert scales (strongly agree, agree, don't know,
disagree, and strongly disagree). Further strongly agreed, agreed, strongly disagreed and disagreed were
combined. Then the correct attitude for each year was calculated in percentages. The fourth section consisted
of ten closed-ended questions on practice items with the answer options as "Yes" and "No."

A pilot study was undertaken on 10% of the study population to ensure that the subjects understood the
questions and were able to answer them without any help. Cronbach's alpha value of 0.75 showed acceptable
internal consistency of the questionnaire.

Statistical analysis

The data were tabulated, and interpretation was done in percentages using SPSS version 13.0 (SPSS Inc.,
Chicago, IL, USA).

  Results  

Of total 600 questionnaires that were distributed only 578 were received back, which means the response rate
of the study was 96.3%. There were 31.8% males and 68.2% females. The demographic details regarding the
distribution of gender, work experience, and qualification are given in [Table 1].
Table 1: Demographic details of the subjects

Click here to view

When the knowledge regarding the BMW management was considered, 246 (42.5%) respondents had
excellent knowledge regarding the proper management of BMW. [Table 2] represents the distribution according
to qualification of the respondents.
Table 2: Level of knowledge of respondents regarding biomedical waste
management

Click here to view

Totally, 513 (88.8%) of the subjects agreed that decontamination/disinfection reduces chances of infection and
189 (32.7%) disagreed that segregation of waste at the source increases the risk of injury to waste
holders. [Table 3] describes the profession wise distribution concerning the correct attitude toward hospital
waste management.
Table 3: Respondent's correct attitude towards hospital waste management

Click here to view

Regarding practices related to BMW management 53.8% subjects used segregate waste into different
categories at the point of origin. 41.7% of them collected waste sharps in heavy duty (puncture proof) plastic
container. Response toward practices of BMW management has been illustrated in [Table 4].
 Table 4: Practice of respondents regarding BMW and its management

Click here to view

  Discussion  

Proper handling, treatment, and disposal of BMWs are important steps in infection control program. Properly
designed and applied waste management can be a relatively efficient compliance-related practice. [4] The
inappropriate management of BMW can lead to various health hazards affecting the healthcare workers,
communities, and surroundings. [5]

Dentists have an ethical responsibility to the environment, so, it is the responsibility of the dental schools to
ensure the formation of an association with solid technical, scientific, and ethical knowledge, aimed at
promoting health, emphasizing the philosophy of prevention of health care risk due to improper disposal of
waste. Hence, the study was conducted to assess the knowledge, attitude, and practices about BMW
management among dental institutes of Himachal Pradesh.

The study population consisted of 31.8% males and 68.2% females, which is consistent with the fact that, in
India, the profession of dentistry is largely practiced by females.

42.5% of the total respondents had excellent knowledge which was higher than the results reported by
Sharma et al. where 30% had excellent knowledge. [3] On comparing the average, knowledge percentage was
th rd th
highest among teaching staff followed by 4   years, interns and 3   years. The reason that 4   years may be
having good knowledge compared to the other 2 years could be due to the fact that BMW management is
included in the theory circular apart from the practical.

In the present study, 90% of the participants agreed that use of color code for segregation is a must. This is in
lower than what was reported by Sanjeev et al. (96.6%), Chudasama et al. (96.5%) and but was more than
, ,
study conducted by Mathur et al. (81.3%) where different colored bags were used for disposing the waste. [6] [7]
[8]

One hundred and ninety-seven (34.1%) used to treat sharp waste prior to disposal while 241 (41.7%) collected
the waste sharps in heavy duty (puncture proof) plastic container. This was much less than the results
observed by Mathur et al., Bansal et al., and Chudasama et al. where around 65.3%, 58%, and 63.1% used to
, ,
dispose sharps in puncture proof containers. [7] [8] [9] But it was >19.5% and 26.4%, as reported by Osamong et
,
al. along with Charania and Ingle. [10] [11] Maximum care and precaution are required to handle sharps as
improper handling can lead to various health hazards. The needles, which comprised of the bulk of "sharps,"
should be destroyed by needle destroyers and should be placed in puncture-proof container containing 1%
NaOCl for disinfection. Once the container is three-fourth filled it should be sent for shredding, encapsulation,
and disposal in landfills. [4]

Thirty-three (5.7%) subjects used to follow the system of recording and reporting injuries/accidents. Low
reporting of injuries may be attributed to the fact that most of the doctors are not aware about a formal system
of injury reporting which should be established within all the health facilities. [12]

The limitation of the study is that it is based on self-administered questionnaire which may lead to over and
under reporting plus recall bias can also occur where the respondent's past experience influences his present
action. But according to Gilbert et al. and Charania and Ingle, this method is sufficiently valid for most
important research questions and is a good method of collecting data from a larger population in a quick and
 ,
inexpensive manner. [11] [13]

  Conclusion  

The findings of the study suggest that the BMW management program cannot successfully be implemented
without the willingness and cooperation of the health professionals. If we want to protect our environment and
health of the community, we must sense ourselves to this important issue not only in the interest of health
managers but also in the interest of the community. As it was seen that the attitude and practice of regarding
hospital waste management were less satisfactory there should be a continuing training program along with
the monitoring those of practices, so that it leads to a safe protected biohazard free environment.

 
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